Saturday, October 24, 2009
Unexpectedly in ICU
Mark spent three days in ICU at Harlan ARH this week. Last week, the Nephrologist who is following Mark at the dialysis clinic in Harlan noticed a very slight increase in his kidney function. Mark's creatinine had dropped to 3.8. He was making plenty of urine. His overall kidney function was estimated to be approximately 25%. Anything below 15% requires dialysis. Because Mark's kidney function was higher than 20%, his Nephrologist wanted to experiment with taking him off of dialysis to see if his kidneys could work independently. When we heard this news last week, we decided to be cautiously happy. We understood that taking Mark off of dialysis could only be temporary. The doctor was planning on monitoring Mark closely and deciding week to week whether or not he would need dialysis. We also understood that a creatinine level of 3.8 is not a significant enough of a drop to think that the transplanted kidney was working. Kidney function of 25% is still considered to be stage four renal disease. Well....on Wednesday morning, Mark went for the blood work the Nephrologist had ordered. He had been feeling fine all week. He had not experienced any symptoms of uremia or elevated potassium. Around noon, the results from the blood work came back. The Nephrologist called Mark and told him to report to the ER as soon as possible. His potassium level and creatinine levels had jumped back up. In fact, his potassium was in a dangerous level-high enough to cause a heart attack. So, off we went to Harlan's ER. The physician at ARH gave Mark several medications to control his potassium. Mark was dialyzed as an inpatient also. His potassium began to drop. However, Mark's Neprhologist decided to keep him overnight for continued monitoring. They decided to place him in ICU... I think partly because of the heart monitoring and partly because of the fact that Mark is immunosuppressed and there is a high incidence of H1N1 in Harlan. On Thursday, Mark's potassium had dropped to a normal level at the 6:00am blood work, but increased by noon. So, they decided to keep him another night. From that point, each blood sample indicated that his potassium was controlled. So, we were discharged yesterday afternoon. We are very happy to be home. However, our spirits are a little low. We are beyond disappointed that Mark's body could not tolerate the absence of dialysis. In addition, several weeks ago, we had booked a weekend trip with some of our friends. We had really been looking forward to this "retreat". However, the doctor recommended that we stay at home. We are also really concerned that we didn't realize that Mark's levels were so high. As I mentioned above, he was feeling fine and did not have any symptoms of elevated potassium. This is really scary and causes us both a great deal of anxiety. As always, I'm asking for continued prayer for our family.