Yes, more waiting for us as we wait to here from the other nephrologist about my biopsy report. My doc just rips out a piece of my kidney and leaves for vacation! Haha.
I felt a little in limbo about hearing from him. Since my doc said no news is good news, did I really want to hear something before my appointment that following week? At the same time, I wanted to know what was going on with my kidneys that was making me feel so terrible!
After coming home from the hospital, I had a couple days off before I had to return to work. I was to work Monday, Tuesday afternoons, and Wednesday midnights. I remember my guy asking me, "what are you thinking? You feel terrible. Call off!" I knew I was feeling terrible but didn't want to give up just yet. My stubbornness was getting ahead of me. I went to work that Monday and worked with one of my awesome fellow nurses, Sammie. From the beginning of the shift I knew I was in for a long night! I was so tired but knew I had a job to do and was determined to do it! I wanted to care for my patients just as I always had. Unfortunately, my body was getting in the way. Luckily, we had been having a pretty low census and there were only a handful of patients that evening which made the workload light.
I remember coming back from my supper break and was beginning to feel aweful. Sammie expressed that I was looking not myself and pretty bad. I agreed! Once again, I love my blunt co-workers. Nothing like co-workers who are real with you and vice-versa! We had done most of our evening duty's, such as; VS, getting all the patients into bed, med passes, snacks for patients, etc. Honestly, Sammie did most of it! She insisted I just sit at the nurses station, but I wasn't listening! ;)
I was helping get a patient ready for bed. My patient was in the bathroom and I was getting her bed ready for her. I felt like I could collapse. I was so dizzy, the room spinning, my back pulsating with pain, I was having cold chills but sweating profusely at the same time. I was stubborn. I didn't want to let this get me down. Sammie, who had just got done assisting another patient, came into the room where I was. She took one look at me and
pretty much demanded that I go sit down the rest of the night! I listened this time, considering it really would not be a good thing if I had passed out in front of my patient! I knew if I didn't sit down that is exactly what was going to happen. My colleagues would be calling a Rapid Response on me!! (a RR is not quite a code blue. Called when a patient (usually), visitor or colleague takes a turn for the worse, falls, passes out, etc.)
After all of the patients had been medicated and were in bed, Sammie and I finished up our charting at the nurses station. We talked a bit about my biopsy. I had her take a look at my biopsy site to see how it was (us nurses like stuff like that). As she was looking at my back I explained how my lower back felt swollen. She agreed and said it was pretty swollen. I was really filling up with fluid by this time. The back dimples I had always had were filled in! Lol. Since the water had no where further down to go, it was beginning to creep up!
While at work I ended up talking to the nursing supervisor (I'm pretty sure Sammie made me call her too! What would I have done without her!?) She explained to me how she would possibly need to EO (Excused Off) an RN the next couple of nights. Knowing my situation, she said she would put my name down on those nights to be one of the first called. I was so grateful for her and knew it was God working. Finally the end of sift came. I never thought that night was going to end! I remember walking through the door at home that night, barely able to say 'hi' to my guy. I literally crawled, hands and knees, up the stairs to my room. Barely able to take off my scrubs and crawl into bed. My wonderful husband just loved on me the best he could, praying for me and just letting my cry myself to sleep.
I got called off work the next two days! Thank you Jesus! I think my family was
even more glad I was called off than I was. They knew it was wearing on
me and that I was too stubborn to call off.
Those nights that I was called off work were the beginnings of some of the worse days I have ever seen. All I could do most of the evening was lie on the couch and watch my girl and guy play. Mommy was pretty much useless. I was having those terrible cold chills and night sweats in the evening and well into the night. Nausea and pain were taking over my body. 'Though there is pain in the night, JOY comes in the
morning!' Psalm 30:5. That verse was such a help to me during those
nights! I remember crying that verse out to God MANY nights. The afternoons
and evenings were my worst moments of the day. In the morning, I felt my
best and knew if I could just make it through the night, the morning
would come and bring me a little energy and less pain.
Tuesday, my guy called my doc's assistant Tammy, to ask her if she had heard anything from the pathologist yet. She said no, but would check and give us a call if she had, regardless of the results.
Wednesday came as I anxiously waited a call. Then that afternoon my phone rang. It was Tammy calling. Tammy explained that the pathologist report had come back and that the doctor filling in for my doc was going to be calling me shortly. About 10 minuets later the nephrologist calls. He had quite an accent so it was a bit difficult for me to understand him. I sat at the table with paper and pen in hand. I didn't want to miss anything he was telling me.
He stated that my kidneys were showing on the pathology report extreme damage and he wanted me admitted to another hospital first thing in the morning (one where they could monitor me a bit closely). At first I thought, oh man, this must be bad if I have to go there first thing tomorrow and be admitted for 3 days! He then explained to me the reason for the hospital admittance was to complete 3 rounds of intense I.V. therapy. He said he would like to do chemotherapy treatments to reverse the damage. Then he asked if I wanted to have more children. "Yes, I would!" I exclaimed. He then changes his mind and says, "well since you do want to have more children, we will go with high doses of steroids instead." (chemotherapy can cause infertility issues) I asked him if there would be any other treatments or monitoring other than the IV steroids and lab draws. I didn't understand why this couldn't be done at MY hospital. He confirmed that it would just be IV treatments and I could have it done at my hospital if I preferred. I then told him we had outpatient special procedure treatments where you can go in on a scheduled time, have your treatment, and go home. He said it would be fine to do that too! (it really paid off being a nurse and knowing these options existed!) I REALLY did not want to be that far from my girl for 3 days if I didn't have to! He agreed that it would be fine and set it up where I would go in for my steroid IV treatments, Thursday, Friday, and Saturday. I would then follow up with my regular nephrologist that following week for my scheduled appointment.
He then explains to me a little more about my diagnosis. He says I have been given the diagnosis of lupus nephritis. Honestly, I can say I was a bit relieved by the news that it was lupus and nothing worse. (even though right now I can honestly say LUPUS SUCKS! ;) He explained that because of my high ANA lab level and my joint pain back in December it all came together and was lupus. He said he was unsure what exactly caused my lupus to all of the sudden "come out" of hiding. At that point, I was unsure as well.
Just to give you a little idea of what the kidneys do and how mine were damaged, here is a description of normal kidney function followed by my pathology report for those medical people out there who are interested! :)
The kidneys' function are to filter the blood. All the blood in our bodies
passes through the kidneys several times a day. The kidneys remove wastes,
control the body's fluid balance, and regulate the balance of electrolytes. As
the kidneys filter blood, they create urine, which collects in the kidneys'
pelvis -- funnel-shaped structures that drain down tubes called ureters to the
bladder.
Glomerulonephritis: An overactive immune system may attack the kidney,
causing inflammation and some damage. Blood in the urine and kidney failure are
common symptoms of glomerulonephritis.
Stage IV Lupus Nephritis (Diffuse Proliferative) is both the most
severe, and the most common subtype. In it, >50% of glomeruli are
involved which can be segmental or global, and active or chronic, with
endocapillary or extracapillary proliferative lesions. In Electron
Microscopy, subendothelial deposits are noted, and some mesangial
changes may be present. Immunofluorescence reveals the so called "Full
House" stain, staining positively for IgG, IgA, IgM, C3, and C1q."
Clinically, Hematuria and Proteinuria is present, frequently with
Nephrotic Syndrome, Hypertension, Hypocomplementemia, elevated
anti-dsDNA titers and elevate Serum Creatinine.Source
So that gives you a bit of an idea what the kidneys do and what mine were not doing! Filtering. In a nut shell, as you see in my diagnosis at the top of the pathology report; Active (happening now), diffuse (affecting a large area), global (entire kidney involved), proliferative (multiplying) glomerulonephritis. Whew!
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