My 3-Month Evaluation, Part II

Sometimes, the best movies are those that keep you guessing what is going to happen in the end until the very last moment. Everyone once in a while, you'll watch something that gets you ready for one of two possible conclusions... then at the last minute the movie shifts and produces a completely different ending altogether. "Wow", you say as you leave the theater. "I never saw that one coming".

Unfortunately, these plot twists aren't as enjoyable when you apply them to real matters of life and death.

It was good to talk to my new 'official' nephrologist, who was amazed at my annotated graphs. There were no surprises on how I should proceed with my diuretics. I was told that total removal of fluids was not possible, and that I should 'stay the course' with my current regimen of Lasix, unless adjustment is needed.

And then I got to speak with Dr. Rosenzweig, one of the doctors on the amyloid team. Dr. Rosenzweig is sort of like the press secretary of the team, who takes your results and tells you the good or bad news, spinning it accordingly. I didn't want spin... all I wanted to know was (a) how my kidneys are doing, and (b) how were my light chain ratios. I got some answers, but not exactly what I expected.

First, he gave me the bad news:

• There has been no reduction of protein loss from my kidneys. I am leaking the same amount (actually, a tiny bit more) than when I was evaluated in May. As a result, my body is producing abnormal amounts of cholesterol and triglyercides. They are very, very high -- much higher than they were in May. Who heard of someone having a cholesterol rating of 571?
• The triglyercide levels in my body are so high, they threw off the light chain tests. The data that was returned from them are worthless. I will be unable to get any idea on how I am doing through these tests until these levels are reduced.

Very depressing. But let's look at the bright side:

• My vitals and blood cell counts have all normalized since I was discharged. The white blood cell problem I had in August has disappeared.
• My potassium levels are fine.
• Albumin and protein levels are low, but not abnormally so.
• Creatinine levels in the kidney are normalizing.
• If the amyloid is still being produced in my body, it hasn't affected my heart and/or liver yet. Tests for both of these organs came up normal.
• While not optimal, is it not unusual to see no change in protein loss after 3 months. Usually improvement trends can be marked after 6 months, and noticeable deduction is observed within a year.
  

Wow... I never saw that one coming. I left the hospital today with no conclusive evidence either for or against the success of the treatment. All I wanted was a sign, but instead I got mixed numbers and a stronger Vytorin prescription.

Where do I go from here? Well, I need to get rid of the triglyercides. I will be evaluated very closely now for changes. The goal is to reduce them by January so that at my six-month evaluation they'll be able to do the tests properly. My prognosis? I guess we won't know until January.