Happy Halloween

It's Joaquin's second Halloween and although he's still too young to really understand what's in it for him as far as trick-or-treating and candy, he does love all of the decorations that are around the RMH. He likes the jack-o-lanterns and bats - he likes to point out all the decorations that are hanging around the house too. We have to stop to touch and look at them. It gets pretty festive around here and there is trick-or-treating at the hospital. Some of the mothers at the house have decorated the play room to make it look like a haunted house. I think next year Joaquin will really understand and appreciate this fun holiday, but this year it still isn't too important to him.

We had blood labs and a clinic visit yesterday. Chris is down in Palo Alto for the week, so came with us. One thing that we were discussing with them was his biopsy that is scheduled for November 28th. A biopsy is where they put him under (again) and put a small needle through his belly and take a small sample of the kidney tissue to look at and test to make sure that rejection is not taking place. I am part of a group on yahoo for people who have had kidney transplants. Most of them are adults and a while ago there was a brief discussion about biopsies and many of them had never had one. At LPCH they have them scheduled for 3 months, 6 months, 1 year and 2 years post-transplant. Many of the people on the yahoo group feel like there is no reason to do a biopsy unless rejection is suspected because no biopsy is without its risks. They feel like why mess with a good functioning kidney. And with Joaquin, we all know what happened the last time he had to go under anesthesia.

Dr Wong assured me that all of the doctors would be there to make sure that didn't happen again and I asked, why did you let that happen in the first place when doctors know that anesthesia makes the blood pressure drop and that is not good for a kidney patient. She had no answer and I knew that it was worthless to ask at this point because it's said and done. But they feel like biopsies are important because with a baby and small children they have less muscle tone so rejection could be taking place and they would not see it from their blood work. For an adult, the reason that they generally don't do biopsies is because it usually is detected in blood work. We're still not sure whether or not we are going to go through with the biopsy because of the risks involved, but you do want what's best for your child - still, it's scary. Sometimes I don't understand why they are so willing to just put these children under anesthesia time and time again because with any kind of surgery, be it large or small, what also goes along with that is morphine and other drugs to "make the patient comfortable."

When Amy called yesterday with the lab results from the blood work she told us that his white cell count was a little low - which could make him more prone to infections. It's because they raised his Cell Cept dose - they lowered it yesterday, but now we have to be careful of crowded places and uncooked food for a few days. Also, his creatinine was a little higher than they would like it to be. But along with the creatinine being a little higher, his BUN was too. BUN stands for Blood Urea Nitrogen, a waste product normally excreted by the kidney. The BUN level is determined by your kidney function and your protein intake. It's a little less worrisome that his BUN and his creatinine were a little higher together because it means that he just needs a little more water. If it had just been his creatinine going up, that would be more cause for concern. So we just gave him some extra fluids yesterday and took him in for labs again today. Hopefully his creatinine will look better. I feel like it will.

Happy Halloween everyone!