March 15th

I just got back from Dad’s appointment with his kidney doctor.  Good news - his kidney function based on creatinine level improved slightly.  The doctor didn’t have the ultrasound results.  We chatted a bit as the doctor explained there was still some concern about protein in his urine.  The doctor had done some tests to try and determine why but had not come up with anything definitive.

Dad’s BP was 158/79 with a pulse of 60.  The creatinine went from 2.9 to 2.4 (1.6 is high normal).  Of the proteins found in Dad’s urine he said none of them were “abnormal” but that they were 3 times higher than they should be.  I asked if it could be from muscle breakdown and Dad asked if diet played a role.  Both answers came back “no”.  The kidney has a barrier where it can filter the blood to clean it, but should leave the protein behind (to stay in the blood).  Dad’s barrier isn’t doing its job and the doctor is looking to see if he can do anything to improve that situation.

As we were wrapping up, the doctor asked about how Dad was feeling in general.  Dad came by the store for a visit yesterday and he spoke about his lack of energy interest in doing things (although he went to the community concert by himself last night and Kyle’s baseball game the night before).  Anyway, I brought this up to the doctor and mentioned his anemia.  The doctor then talked about treatment with a drug called EPO, a hormone secreted by the kidneys to stimulate red blood cell production.  Red blood cells carry oxygen.  I have asked Dad’s regular doctor (Nichols), his PA (Trevor), and cancer specialist (Mokabadi) about using this drug and they all said Dad was not “there” yet.  While not encouraging the direction, I’ve wanted Dad to try this simply for the improved quality of life I thought it might provide.  This doctor explained that there were risks such as stroke, if his body makes too many red blood cells, and tumor growth, which is why Dr. Mokabadi wanted to do more tests.  Dad would have to get a shot every two weeks and have his blood checked every interval.  I tried to stay neutral in advising Dad as we asked about the side effects and negatives to this approach.  There really didn’t seem to be many, besides the inconvenience of the shot frequency and blood tests.  If there is some underlying condition they have not discovered the EPO may aggravate that condition.

Even if that is the case, I still believe this is the correct course of action.  Dad is slowing down both mentally and physically and I believe it is due in part to the lack of oxygen.  I’ve seen him climb the hill to tennis and have to stop halfway.  He mentioned that he parked in front of our store to walk to the concert and the walk back exhausted him.  This is a non-invasive treatment that may offer some benefit.

They were not able to start the shots today.  They have to get approval from Dad’s insurance carrier.  We will keep you posted on the progress.