Yesterday while I was celebrating my really great lab results, I kinda failed to notice that the doctor's office had faxed the wrong ones to me. DOH! They'd re-faxed the labs from about a month ago, instead of the ones from earlier this week.
Of course I didn't even realize this until the office called me today to tell me the doctor wants to up my Prograf dose. I was like, HUH? Because the labs I'd gotten yesterday had an acceptable (but on the low-end) tacrolimus level.
I had the office fax me the correct set of labs. Again I held my breath until I had a chance to look them over. All the values are still awesome (creatinine .7?!) but my TAC level was down to 4.2 (supposed to be in the range of 5.0-10 for a post-transplant patient).
I guess I'd like to know (and you'll be certain I'll be asking my transplant doctor when I see him week after next) what the purpose of upping the Prograf dose is if all the other clinical signs of kidney function and graft health are excellent. Prograf can actually be nephrotoxic (bad for the kidneys) if the level isn't monitored carefully... AND since my creatinine is .7 - exceptional in the kidney-function department - does it really need to be increased?
I'm a little concerned about increasing my Prograf for a couple of reasons: First of all, I already have the more common, but still weird, side-effects from the dose I'm on (nerve tingling, intolerance to sudden changes in temperature, insomnia); Secondly, Prograf can 'cause' or 'contribute to' a transplant patient having a higher likelihood of post-transplant diabetes. Since my family history of diabetes is obvious (my dad, grandmother and several aunts/uncles and at least one great-grandparent) I'm not really keen on increasing my odds. Plus (and here's the part that worries me most) my fasting blood sugars for the last few months of labs have all been either in the very high-normal range, or in the bottom of the abnormal range. (on these labs, it was 92, on the last few labs its been 90-102, with the 'normal' range being 65-99).
Of course I'll do what my regular nephrologist directs and increase my Prograf from 3/2, to 3/3, but I'm anxious to see what my transplant doctor thinks when I see him.
In the meantime, here's to being thankful I've got a prescription for Ambien to use as I need :)