Post-Transplant Medications {Update#2} (移植之后疗程)

Post-Transplant Medications {Update#2} (移植之后疗程)

Finally August is gone! End of August denotes the end of Valganciclovir for me. May be not a standard protocol but it is common to take three months of Valcyte for newly transplanted patient. Besides being one of the priciest medicine I ever came across, one of its side effects is reducing White Blood Cell counts.

Rejection Prophylaxis

1.        Cyclosporine (Neoral^®)

- You may refer to my latest post on “Blood Test Report & Creatinine” for my current dosage on Cyclosporine

2.        Mycophenolate  mofetil (Cellcept^®)

- Both Neoral^® & Cellcept^® must be taken every 12 hours and taken on time

- Cyclosporine may cause potassium retention & increased blood pressure

3.        Prednisolone

- A steroid being used to prevent rejection in organ transplantation

- To be taken AFTER foods

The above three drugs are to be taken for life.

Pantoprazole

- For the treatment of GERD

Insulin Aspart

- For the treatment of Type 2 Diabetes

- Taking 12u (breakfast), 12u (lunch) and 9u (dinner)

Two methods to monitor (监测) the "Concentration” (浓度) of Cyclosporine:

(A)     Cyclosporine  Trough, also known as C0 (谷值), which is the lowest concentration – To draw blood within one hour to half an hour before the next dosage

(B)     Cyclosporine  Peak, also known as C2 (峰值), which is the highest concentration – To draw blood, two hours exactly, after taking (服用) taking the dosage

It is important to monitor the concentration:

(A)     Insufficient dosage will cause rejection from the new kidney

(B)     Taking too much of Cyclosporine may lead to higher creatinine

Matters to Note (应注义事项):

1.        High dosage of Cellcept & Methylprednisolone will reduce the immunization (免疫力).  Doctor should reduce dosage from as early as third week to forth week, the latest, subsequent to the surgery.  I am taking the minimum dosage of Prednisolone at the moment.

2.        Taking both Cyclosporine & Cellcept with fresh milk will tend to give better absorption within the system (用新鲜的牛奶进食将会更好的将Cyclosporine & Cellcept吸收在系统内)

3.        Wear face mask for at least three - six months whenever going out.  Avoid going to crowded places for at least one year due to low or no immunization (每当出去, 戴着面罩至少三 - 六个月. 由于低或没有免疫, 不要去拥挤的地方至少一年)

Is Peanut Butter Good for High Creatinine Level {花生酱有益于高的肌氨酸酐水平}

Is Peanut Butter Good for High Creatinine Level

{花生酱有益于高的肌氨酸酐水平}

Peanut butter with no added ingredients is the best and has more healthy benefits:

·                The protein and fiber in peanut butter are both beneficial for blood sugar control.

·                Peanut butter is a great source of iron. 

·                Peanut butter also has a benefit of lowering high blood pressure and high blood fat. 

However, peanut butter contains many other nutritions such as vitamin A, B, E and K, potassium and rich protein - intake too much protein can increase the burden on the kidney and elevate patients’ creatinine level.

Here is the Original Article, courtesy of Kidney Cared Community.

CANCER – Causes & Prevention (癌症 -原因&预防)

CANCER – Causes & Prevention (癌症 -原因&预防)

This 8-minute video explains how cancer is caused, and how it grows.

Also, how it can be prevented quite easily.

Please do listen to it carefully, and share with as many people as possible.

http://www.redefineyourreality.com/what-is-cancer.htm

Personally, I have ceased taking both red and white meats since my transplant, if you notice from my post on “My Diets”.  However, I am still taking low-fat with anti-rejection drugs for better absorption.

Blood Test Report & Creatinine {Update#7} (验血报告&肌氨酸酐)

Blood Test Report & Creatinine {Update#7} (验血报告&肌氨酸酐)

I have mentioned in my “Update#6” that Nephrologist (肾脏病学家) has reduced both the morning and evening dosages of my Cyclosporine (Neoral^®) after a laboratory test on 30 August.

A laboratory test was carried out on 4 August to verify the appropriateness of the dosage and the result is within the expectation of Nephrologist.  Most important – Creatinine is stable (肌氨酸酐是稳定的).

In my “Update#6” I mentioned that dosage of Mycophenolate mofetil (Cellcept^®) is due for a review during this visit.  Nephrologist (肾脏病学家) has decided to reduce the dosage from 1000mg to 750mg, to be taken twice daily.

Date	Peak (UG/L)	Creatinine	Cyclosporine Taking
4 August 2014	896	109	125 mg - OM 110 mg – ON (No actions are required)
30 July 2014	1381	107	125 mg - OM 110 mg – ON (reduction in OM & ON)
14 July 2014	1360	110	150 mg - OM 125 mg – ON (reduction in ON)
30 June 2014	1695	103	150 mg - OM 150 mg – ON (reduction in OM)
17 June 2014	1704	108	175 mg - OM 150 mg – ON (reduction in ON)
13 June 2014	667	112	175 mg - OM 175 mg – ON (No actions taken)
9 June 2014	1274	113	175 mg - OM 175 mg – ON (reduction in ON)
3 June 2014	Not Tested	108	Existing Dosage: 200 mg - OM 175 mg – ON

I did not do anything unusual in the manner of taking my drugs as compare to my earlier post “Post-Transplant Medications” (我没有做什么异常以服我的药方式):

1.     I always take my drugs on time (我总是准时服我的药)

2.     I take my drugs with HL milk for better absorption and for my daily calcium intake (我使用HL牛奶服药达到更好的吸收和完成部分每日钙的需求)

Do take note that renal doctor DID NOT adjust the dosage on the basis of test results alone.  There are other indicators that he will review before making the final and crucial decision. (注意à 肾脏医生没有根据单独测试结果调整剂量。他在做出最后和关键的决定前将回顾的其他显示。)

FDA Approves Jardiance to Treat Diabetes (粮食与药物管理局批准Jardiance治疗糖尿病)

FDA Approves Jardiance to Treat Diabetes (粮食与药物管理局批准Jardiance治疗糖尿病)

The U.S. Food and Drug Administration today approved Jardiance (empagliflozin) tablets as an addition to diet and exercise to improve glycemic control in adults with type 2 diabetes.

Jardiance – Block the reabsorption of glucose (blood sugar) by the kidney, increasing glucose excretion, and lowering blood glucose levels in diabetics who have elevated blood glucose levels

Jardiance – NOT suitable to treat people with type 1 diabetes; those who have increased ketones in their blood or urine (diabetic ketoacidosis); and in those with severe renal impairment, end stage renal disease, or in patients on dialysis.

Jardiance – Can cause dehydration, leading to a drop in blood pressure (hypotension) that can result in dizziness and/or fainting and a decline in renal function.

Side effects - Urinary tract infections and female genital infections.

Here is the Original Article, courtesy of FDA.

Blood Test Report & Creatinine {Update#6} (验血报告&肌氨酸酐)

Blood Test Report & Creatinine {Update#6} (验血报告&肌氨酸酐)

Three months after my transplant, a lab test was taken on 30^th July 2014.  After reviewing the results as well as other conditions, my Renal Doctor decided to reduce both the morning and evening dosages of my Cyclosporine (Neoral^®).

Date	Peak (UG/L)	Creatinine	Cyclosporine Taking
30 July 2014	1381	107	125 mg - OM 110 mg – ON (reduction in OM & ON)
14 July 2014	1360	110	150 mg - OM 125 mg – ON (reduction in ON)
30 June 2014	1695	103	150 mg - OM 150 mg – ON (reduction in OM)
17 June 2014	1704	108	175 mg - OM 150 mg – ON (reduction in ON)
13 June 2014	667	112	175 mg - OM 175 mg – ON (No actions taken)
9 June 2014	1274	113	175 mg - OM 175 mg – ON (reduction in ON)
3 June 2014	Not Tested	108	Existing Dosage: 200 mg - OM 175 mg – ON

I did not do anything unusual in the manner of taking my drugs as compare to my earlier post “Post-Transplant Medications” (我没有做什么异常以服我的药方式):

1.     I always take my drugs on time (我总是准时服我的药)

2.     I take my drugs with HL milk for better absorption and for my daily calcium intake (我使用HL牛奶服药达到更好的吸收和完成部分每日钙的需求)

Do take note that renal doctor DID NOT adjust the dosage on the basis of test results alone.  There are other indicators that he will review before making the final and crucial decision. (注意à 肾脏医生没有根据单独测试结果调整剂量。他在做出最后和关键的决定前将回顾的其他显示。)

Next item that is up for review will be my dosage of Mycophenolate mofetil (Cellcept^®), another drug that I am taking to help preventing or treating rejection.