My Blood Test Results

It is all becoming very clear to me now.

I went to the Transplant Centre on the 5th of May for my blood test. The nurse took 4 tubes of my blood - 1 for Liver, 1 for Kidney, 1 for CMV Quantitative PCR, and 1 for FK506.

As I have been having a lot of pain in my joints and feeling very fatigued (including many other symptoms) these past few days, I decided to take a closer look into my blood test results. Hoping to find some clues as to why, all of a sudden, my conditions are deteriorating.

*For my Liver Panel, the crucial parameters of Bilirubin, ALT, AST, and GGT - they are all within the acceptable limit. 

*For my Kidney Panel, the crucial parameters of Urea Serum (9.3 mmol/L), Bicarbonate Serum (29.1 mmol/L), and the very important Creatinine Serum (105 μmol/L) are all outside the acceptable range. My Kidney Doctor (Prof Tan Han Kim) has a target for me, which is 95 umol/L. My previous Creatinine level was 101 μmol/L, which is already high. But the latest result is even worse. So, the severe fatigue I have been feeling in recent days is likely because of my high Creatinine level. 

*For my CMV Quantitative PCR, it reads <34.5 IU/mL. The report says that it is below the lower limit. I am still trying to understand what effects it has on me. 

*For the FK 506 (Tacrolimus)  Blood, it reads 3.9 µg/L at trough level. This is lower than my previous 4.1 ug/L, which the doctors have indicated to me as too low. Too low an FK level could mean my body is rejecting the transplanted liver.

So, it's quite clear from the blood test results that my kidney panel has problems, especially with my high  creatinine level. And I need to do something to lower it, or I will lose my kidneys and go for dialysis. The other problem is my low FK506 level. I have to do something to bring up my FK level without increasing my Advagraf dosage.  Even though it was expected that my transplanted liver could give me up to a maximum of 5 years of life, I want to do something that can allow me to have a good quality of life. But how?

Medically, my FK level can be raised by increasing my Advagraf dosage. Previously, I was given 2mg daily. But the high dosage is causing irreversible damage to my kidney. So the doctors from my liver team reduced my dosage to 1.5mg in February. At this reduced dosage, my FK level dropped, which is bad for my liver. Worst, my kidneys continue to be damaged, as indicated by my higher creatinine level. Simply put, I need the right amount of Advagraf for my liver to keep me alive. But Advagraf is damaging my kidney. If my kidney fails, I can go for dialysis. But if my transplanted liver is rejected by my body or fails, I will be dead. This is the reality that I have to deal with. For a maximum of 5 years of life without guarantee.

Is there another way that I can raise my FK level and protect my kidney from further deterioration and reduce the creatinine level? I did some research and found that there is a way - that is through my diet and food habits. To some extent, my dieticians had given me advice on my restrictions on sodium, sugar, and proteins and avoiding foods that have high potassium, etc. But nothing on food to increase my FK level and lowering my Creatinine level.

Foods that can help me to increase my FK level include oatmeal, olive oil, nuts, fish, chicken, egg whites, and beans. I need to avoid raw & uncooked food, high-potassium food (such as bananas, oranges, potatoes, spinach, etc.), as well as fruits that interfere with the absorption of Advagraf (such as grapefruit, pomelo, and soda).

On food that can help me to reduce my creatinine level, I should consume 2 to 3 cups of nettle leaf tea a day. It serves to nourish and maintain my kidney health. I should consume apple cider vinegar, green tea, cranberry juice, and soy milk. I should include turmeric and cinnamon (they are powerful anti-inflammatory drugs) in my cooking. Go for proteins like fish, chicken, tofu, and vegetarian protein sources. All these foods greatly help in reducing the creatinine  level. For fruits, go for apples, berries, watermelon, and pineapple. For vegetables, go for cabbage, cauliflower, carrots, bell peppers, chickpeas, and cucumber together with garlic & onion. All these foods should go a long way in helping to reduce the creatinine level. However, to prevent an increase in creatinine level, avoid NSAIDs, chemo drugs, and certain painkillers such as ibuprofen. Also avoid white bread, sugary food, pastries, and high-potassium food.