Yesterday’s Appointment With Dr. Fan

If I can’t find Nick’s prednisolone again, call him and he’ll prescribe a different strength liquid (same med) that will have to be drawn up differently. The other option would be to switch from prednisolone to regular prednisone. I had looked up the difference in side effects years ago and I’m pretty sure there were a lot more listed with the latter. I could be wrong though.

Bones: he’s sending a note to Dr. Szabo (Nick’s new endocrinologist) and Dr. Verma to say that he feels we should prioritize Nick’s bones over the fact that he’s passing kidney stones. In other words, make sure he gets enough calcium and Vitamin D even if he’s still getting stones. Increase his liquid to 2-3 liters a day, which will help. He’ll also address the question of giving him calcitriol and Vitamin D level. Dr. Verma had decreased his vitamin D intake from 2,000IU to 1,000IU per day because of the kidney stones. If Nick continues to pass stones, we’ll do a 24 hour urine collection on him to see if there’s a medication that can help with the kidney stones.

Dr. Fan mentioned a rheumatologist, Johnathan Cheah, who specializes in bone mineral disorders. He asked if I wanted Nick to see him. I said I just want the best for Nick. Dr. Fan recommended that Nick continues to see Dr. Szabo for now, and see Dr. Cheah in the future if needed. One less doctor to have to visit.

I let Dr. Fan know that I increased his potassium a bit. He’s due for labs next week.