John Baker Update 12/22/2011 11:50 AM

John had a good nights rest last night. For his arm pain they are giving him pregabalin which is a cousin to gabapentin only the side effects are less invasive. I seems to be working. He is on very little pain meds other than that. He also seems to have gained motion and strength in that arm in the last 24 hours or so.

His creatinine us up to 1.8 from 1.6 yesterday.  This is not good however the anti-rejection drug tacrolimus could raise the creatinine if the tacrolimus level is over the prescribed target in the bloodstream as it Is an accumulative drug. They will be checking the tacrolimus (hereinafter refered to as tacro) levels today.  His B.U.N. is 40 as was yesterday.

His hemoglobin is 7.2 which is down from 9.1 on Tuesday. They draw about 15cc of blood daily for blood work. The kidney produces a hormone called erythropoietin that controls red blood cells. It is appropriately assumed that the new kidney is not producing adequate amounts of this hormone. They will begin giving him Epoetin alfa commonly called Epo, which is a manmade version of the natural hormone, until the kidney takes over.

The H.L.A.  (Human Leukocyte Antigen) levels in his body are still on a plateau. It is good that they have not risen but they need decreased. We will still continue plasmaphresis and doses of eculizumab on a scedual of every other day at this point in hopes to reduce the HLA’s in his body until the liver begins to absorb them.

John is feeling good and getting around well. We haven’t any definite info on a discharge date.

Thank you for your prayers.

John Baker Update 12/21/2011 12:45 PM

John is still progressing in the right direction. His creatinine is down to 1.6 from 1.7, a small an=mount but still progress. His B.U.N is down to 40 from 46 yesterday.He is mostly on oral fluids and a goal of 2 liters a day minimum. His urine output is keeping up nicely. His arm is going to be a very slow battle. We are still waiting for an MRI to access the nerve damage however the information  obtained will more than likely not change the direction treatment, but will hopefully be very informative. John is getting around much better, doing some walking and such. We don’t know about discharge in Thursday  yet but It appears to me that Friday or Saturday has more potential.

Thank you again for your love and prayers.

John Baker Update 12/20/2011 1:35 PM

Well Lori didn't get an opportunity update yesterdays events so we will bring you up to speed.

John is feeling better all the time except for his arm. With his arm we have a long road of therapy with hopes of full recovery but no guaranties. They are going to do an M.R.I. today or tomorrow to locate and evaluate the nerve damage. Gabe, Lizzy, and the kids were here to visit yesterday afternoon / evening. It is the first time John got to see Aydrien and Aneisha  since the surgery. They had a great visit.
His creatinine was 1.9 on Monday and 1.7 today. His B.U.N. 57 on Monday and 46 Today so things are moving in the right direction. He is eating better so they will take him off of IV nutrition (TPN) this afternoon. They will not do plasmapheresis today but will tomorrow and then every other day for the next 14 days

More good news is that they will able to do this as an outpatient so we may get discharged on Thursday.
Thank You for your prayers.

John Baker Update 12/18/2011 12:36 PM

Sunday morning. Sorry about no update  yesterday. I guess we got lazy.

On the emotional side of things John is happy,  not happy,  happy,  not happy,  happy,  not happy, happy,  not happy.  Prednisone tends to give you mood swings, however things are improving. From a liver standpoint things are looking excellent. From a kidney stand point things are improving. His creatinine went from 3.4 on the 16^th to 3.2 on the 17^th and is 2.5 this morning. His BUN went from 110 on the 16^th to 93 on the 17^th and is 76 this morning. His urine output is increasing. He will continue Plasmapheresis treatments and eculizumab for anti rejection therapy for the next five days. His left arm still gives him a lot of pain but motor movement is slowly improving. His two hurdles for today and tonight is eat good and sleep good. In the study of genetic trends in our family at least on the Baker side eating should not be a problem. As far as sleeping they will plan a medication strategy.  We want to thank everyone for your continued prayers. They are much cherished.

John Baker Update 12/16/2011 1:14 PM

Good Morning

John had an ok night. This morning his creatinine and B.U.N. was the same as yesterday, which is good they are not up. His antibody levels were down 15% which is good. They will continue plasmapheresis for the next seven days with a dose of eculizumab following. We are hoping for a reduction in antibodies through this process. His liver lab numbers are doing good. The liver is continuing to progress towards full function. In theory it should help protect the kidney from rejection damage. His blood counts are in the ok range, they should improve with time. He is back on solid foods with talk of IV TPN to supplement nutrition. His liquids are taken in orally and IV. Neurology looked at his left arm this morning. their thought is that his arm will recover over time with much therapy. They may do an MRI to see if there is pressure on the nerves still but I will hear from them later on that. I have persuaded them to do therapy every day instead of two or three days a week.

Thank you.

John Baker Update 12/15/2011 9:45 AM

As for the upset stomach the iv meds  for nausea seem to help tremendously. He got a fair nights sleep. He is doing plasmepheresis again this morning and will be getting another dose of eculizumab following. They will give him the nausea meds prior to the eculizumab  since we believe the eculizumab is responsible for the upset stomach. His antibody levels are stable but not low enough. We are still fighting rejection. His creatinine is up to 3.3 from 2.6 yesterday which is not good. Most of his fluids are IV and he is off solid foods for this morning. His left arm is very slowly getting better as far as movement but is in a lot of pain. Thank You for your prayers.

John Baker Update 12/14/2011 7:50 PM

John had plasmapheresis this afternoon and then they replaced the Medication eculizumab as the plasmapheresis removes it from your system. As mentioned in the last update his stomach was upset and we think it is from the eculizumab. He is not able to hold down food or drink so they gave him an iv Nausea medication. If that does not do enough they will give all his meds iv as well as fluids and nutrition. Say a prayer for him. He is quite miserable.

Thank you.