Most of the prevalent anti-rejection meds have now gone generic. A lot of the best were approved in 1995-1997 so you can get generic tacrolimus instead of brand name Prograf. Some newer "induction therapy" meds are still under patent, but these are administered only for a short time.
Here I have to plead ignorance: Medicare laws change by the day. And with the current congress, I'd expect further cuts in the near future.
But long ago, when the best anti-rejection meds were under patent, and ridiculously expensive, the ESRD exemption of Medicare covered them for the life of the transplanted organ. This was later cut back to a three year coverage limit. I'm not sure where it stands now. But call and find out.
(political note: Mike DeWine of Ohio, and Dick Durbin of Illinois have for years been sponsoring a bill to make transplant drugs free or at least affordable Think before you vote.)
Cost is a huge issue, but with some planning and some investigation of alternatives, it isn't aleays insurmountable.View Thread
For the last 20 years or so, there has been an almost universal push in the medical community to prefer native tissue venous fitula over any other procedure. Supposedly this preference for one technique over all others was based on statistical studies of outcomes.
Unfortunately, the result has been that many surgeons feel pressured to do a fistula when their own judgement of a particular techniques for a particular patient might lead the surgeon to do a different procedure.
I can't even begin to suggest that this happened in your case, but the point is that no two patients are the same, and not every procedure works well on the first try. (Obviously my vote goes to leaving the choice to the surgeon without exerting any pressure to prefer one procedure over another. I got a synthetic graft, and it outperformed many native tissue accesses. That's not "supposed" to happen, but it did in my case.)
There are a lot of patients who have to have several attempts before finally creating a successful access point. (That's another reason that most docs encourage doing the access surgery long before it might be needed. It takes time for the thing to mature, and a lot of them have to be modified or done again.)
So I can't sat for sure why the second procedure was done, other than the first one probably didn't develop quite the way the docs had hoped.View Thread
Your friend is sort of comparing aples to oranges. It is akin to changing the variables because they don't match the answer of an equation. If 5 4 doesn't equal 7, then you change the question to match the answer 3 4 = 7. It's totally invalid to change the starting point to get the endpoint that you like.
Creatinine is a result of protein metabolism (or catabolism). If you remove ALL protein from the diet, then you will TEMPORARILY lower the serum creatinine level, simply because you are not digesting proteins. But eventually, the body will get wise to your trickery, and will start breaking down it's own lean muscle proteins to feed itself. Body mass will decline and the patient will end up in the hospital with severe malnutrition.
So sure, this sort of trickery might SEEM to work for a few months, but it is an illusion. Your friend is just fooling himself, and is probably making things worse in the ling run.View Thread
The radiologist used the word "cortical" just to indicate approximate location. (i.e., in the renal cortex, not in the medulla.) "Irregularity" is really too vague to mean anything specific.
If you currently have a nephrologist, you might ask for a more specific interpretation. If you don't currently see a neph, you might want to consult a urologist instead.
Urologists are basically surgeons who deal with the physical structures. Nephrologists are essentially biochemists who manage the function of the tissues. There is crossover between the two specialties, but don't be surprised if the neph want to get in touch with a surgeon before getting too detailed.View Thread
The only real info that I could find broke the cases down by causation (lupus, acquired cystic diseases, tuberous sclerosis, etc, etc)
Bilateral cysts from all causes are certainly not uncommon, but unilateral cysts from all causes are more common. One might infer that causation is a more important factor than is the unilateral v. bilateral status.
Ask your doc. You might get an answer that is more specific to your case. Sorry I can't help more.View Thread
I'm really familiar with only chronic kidney disease; these cases rarely show any physical symptoms until they are fairly advanced. So symptoms like pain, urine color, etc. don't really suggest anything specific to me.
As you said, it's likely just a pulled muscle. But it could be an obstruction of some degree, and that might lead to greater problems far down the road.
I'd suggest seeing your primary doc, reporting your symptoms, and getting a basic checkup with blood tests. Then follow up on the doc's suggestions, maybe an image or two. Just to rule out anything that might not be immediately visible.View Thread
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