Last week was my biopsy #7. Pressure were great. The doc says my heart is ahead of schedule with regards to the pressures. Yay!
The bloodwork showed that my tacrolimus level is very high. They prefer it to be below 15, whatever that means, but mine was 23.5. And I did wait to take my tac until after the bloodwork. This would be the cause of my tremors. So the docs decided to lower my tac from 4mg in the morning and 4mg at night to 4mg in the morning and 3mg at night. It's a start.
The bloodwork also showed that my white blood cell count is low. I'm told this could be for two reasons: I could have an infection or I could be over-medicated. They don't see any signs of infection so that is unlikely. Since they expect I am over medicated they decided to have me hold one of meds. The options of meds to hold are a) anti-rejection meds, b) valcyte c) septra. Now let me explain as best I can a little about these meds. The anti-rejection meds are fairly self explanatory in this case and are not an option to be held right now since rejection is a concern. I have been prescribed Valcyte as a preventative to CMV, a viral infection. The reason I am taking this is because I am in a donor/recipient mismatch situation. I am CMV Negative, meaning I have never come in to contact with the CMV virus but my donor is CMV Positive. Back in the day, I would not have been given this heart because of the history of CMV in the donor, however with the use of Valcyte CMV is controlled. Long story short, since my transplant is quite recent, docs don't want to hold the Valcyte. Lastly, septra is another med to prevent infection, which is PCP, a lung infection. This is the med they chose to hold until further notice. Of course, I am always watching for any signs of infection and I do my best to keep a distance from anyone I know is sick or could pass something on. I have to make difficult and frustrating decisions quite often and where I can and cannot go but hopefully by the 6month or 1year mark after transplant I will have a cautious routine and understanding of my individual limitations.
The biopsy results showed 1A rejection. A part of me is disappointed because this means a stand-still again for another couple weeks but the other part of me is happy that is not higher rejection. I do understand that I am a case of concern for rejection and I will just roll with the punches.