This is my second personal SWOT analysis of my current medical condition. I did my first analysis in May based on the results of my liver test results. This second one is based on the results of my kidney test done yesterday on 10 October.
Over the past few months, I have been closely monitoring my post-liver transplant recovery and my kidney function, which has shown signs of deterioration. My most recent blood test on 10 October indicated that my creatinine level had risen to 111 µmol/L and my CKD-EPI eGFR had fallen to 58, compared to 102 µmol/L and 64, respectively, from four weeks earlier. This decline suggests that my kidneys may be deteriorating faster than expected. I have since alerted my liver team, and they have scheduled a repeat test and a review of my FK (tacrolimus) level to determine whether my Advagraf dose can be reduced to lessen the impact on my kidneys.
To better understand my current condition and identify what I should do next, I have chosen to apply a SWOT analysis—a tool commonly used in business—to my medical situation. This helps me to see not only what is happening medically to me, but also how my personal strengths and circumstances can influence my recovery.
Strengths—One of my greatest strengths lies in my being resilient and my commitment to follow medical advice from my medical team. I have made it a point to take my medications punctually, maintain a liver- and kidney-friendly diet, and stay hydrated with around two liters of water daily. I also have strong family support, especially in managing meals and helping me to stick to my dietary restrictions. I monitor my condition carefully and promptly alert my liver transplant coordinators whenever I notice changes, as I did with the recent kidney test results. My being attentive has allowed my medical team to respond quickly. These strengths form the foundation of my recovery despite the challenges.
Weaknesses—At the same time, I face a number of ongoing weaknesses. Insomnia continues to disrupt my sleep, leaving me with about five hours of total sleep in short segments across the day. I often feel drowsy and fatigued and experience blurred vision and weakened legs, which may be linked to my medications or my declining kidney function. The anti-rejection drug (Advagraf), which is essential for protecting my transplanted liver, is now contributing to kidney damage, creating a difficult trade-off between two vital organs. My mobility has lately been affected too, and my physical stamina is lower than before. All these weaknesses have limited my independence and sense of normalcy.
Opportunities— Despite these setbacks, I see opportunities in my hope for a meaningful recovery. Because I am under the care of a highly competent and coordinated team of specialists in SGH who work closely together on liver and kidney functions. The upcoming retesting and FK level assessment on the coming Monday may allow for a dose adjustment that can spare my kidneys while keeping my liver safe. With advances in post-transplant care, it can offer hope for newer, more kidney-friendly immunosuppressants or supportive treatments. On my part, I can further make an effort to improve areas such as rest quality, strength, and energy management. Most importantly, I believe this is still an early stage of kidney decline, and timely medical intervention can make a real difference.
Threats—However, my current situation also carries significant threats. The most pressing is the potential for rapid kidney deterioration if my current medication levels remain unchanged. The side effects—tiredness, dizziness, weakness, and blurred vision—already impact my daily functioning and could worsen. Managing the delicate balance between liver protection and kidney preservation is medically complex, requiring precise adjustments. Beyond the physical issues, there is also the emotional strain of coping with chronic fatigue and uncertainty, which could affect my mental well-being. Finally, being immunocompromised means I remain vulnerable to infections and other complications that could further burden my health.
In practical terms, this would mean maintaining close communication with my liver transplant coordinators and doctors, continuing my disciplined routines, and staying open to adjustments in treatment or lifestyle that protect both my liver and kidneys. My journey after transplant remains challenging, but it is not without hope. With proper and timely management of my changes, close medical consultation with my medical team, and my resilience, I believe I can continue to navigate this recovery journey towards a more balanced and stable situation.
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