Impaired Kidney Function Leads to Hemorrhaging

 Impaired Kidney Function Leads to Dangerously Low Hemoglobin and 7 Units of Blood

 

    My creatinine had been on the rise due to the damage sustained from Polymyxin B, other antibiotics, and my antirejection medicine. One of the complications I faced was issues with uncontrollably high blood pressure. I could feel pressure in my throat, and I got headaches because of it. I needed to be on a cocktail of blood pressure medicine to try to keep my pressures a bit lower. One of the medicines I took was Clonodine. This medicine had a very sedating quality. I had to take it three times a day. I remember a half hour after taking it I would fall asleep for two hours. I would try to visit my sister, who had just had her first daughter, but I always ended up taking my two-hour nap in the beginning of our visit. I was on several other blood pressure medicines at this time as well.

    My impaired kidney function took a toll on my blood counts. I would go into the hospital on at least two occasions for infections, and my hemoglobin would dip into the 7’s. I was not actively bleeding in any way. I would end up needing blood transfusions both times. My impaired kidney function also made my periods heavier as well. During one hospital stay, I had my period and I passed very large clots with an unusually heavy period. I tried telling the doctor on call what was happening and that I was afraid I was losing more blood than usual. This was not a doctor I had ever seen before. He just told me it probably wasn’t as bad as I thought and that people often think they are losing a lot of blood but they aren’t. However, I was no stranger to a heavy period with clots. This was not that. Just a few days later my hemoglobin would dip into the 7’s and I would need a transfusion. This would not be the first time I would run into trouble with my period. 

    One day, I got my period and it wasn’t too heavy at first, but it was lasting a lot longer than it should have. Soon enough, my flow became extremely heavy to the point I became very concerned. The amount of blood and clots I was passing was even more severe than the previous time. I made a call to my lung transplant coordinator. She told me she would discuss it with the doctor. When she called back, she told me they decided to order Aranesp shots. I had used these in the past when I wasn’t bleeding, but had a low hemoglobin. I would administer one dose a week and my hemoglobin would soon come up. I wasn’t convinced this was a good answer. The blood wasn’t letting up and I decided to have my sister drive me to a local ER. They did some blood work and it showed my hemoglobin was in the 7’s and I would need a blood transfusion. They also decided to admit me to do some further testing to find out what was really going on. One of the nurses told me I did the right thing coming in and advocating for myself. I felt I was in good hands. I continued to bleed an extreme amount. I had many tests done including and internal ultrasound but no one had any answers. I kept needing more blood transfusions every few days. I was very weak and always out of breath as I did not have enough blood volume to oxygenate my body. I had to have a commode put next to my bed as I could not make the walk to the bathroom. One morning, I woke up feeling especially weak and more winded than usual. I asked the nurse, whom I considered an ally at this point, if she could ask the doctor to order a blood test, STAT, as I suspected my hemoglobin was quite low. She simply told me I had to wait until it was time for my regularly scheduled blood work. I didn’t have the energy to fight for what I needed. My father did visit me every day but he was not there when this occurred. When I finally received my blood work, it came back showing my hemoglobin was now at a 5. I was quite angry that I had to wait as long as I did when it was quite obvious that I was in a dire condition. I received two more units of blood. After two weeks the doctors came to me and said they could not handle my care anymore. My bone marrow was suppressed and I was not making any new red blood cells. I was a complex case and beyond what they could care for. I needed to be transferred to my transplant hospital via ambulance. There, many of the same tests were repeated. They first came up with a plan to give me a hysterectomy. At this point I was so scared and desperate I was willing to entertain any idea that might keep me from bleeding to death. However, my parents vehemently refused. They came back with another idea. I was treated with IV Estrogen. This worked exceptionally well. I also particularly liked how soft it made my skin. After a few treatments they told me I would need to go on a birth control pill. This prevented my periods from coming and thus I avoided a repeat of what had just happened. In total, I ended up needing 7 units of blood, making my total count of transfused blood since transplant around 20 units. I would stay on the birth control pill until a few months after my kidney transplant. When I eventually came off the pill, my periods were lighter and shorter than they had been before any of this ever happened.