Pancreas transplant: Cyclosporine BP issues and kidney impact
I'm 43 and had pancreas transplant 22 months ago. Started on tacro, but it was causing my blood sugar to stay high. Now w cyclosporine and januvia I'm basically a type 2 diabetic and A1c in low 6's. Cyclosporine ended up pushing my gfr down to 64, but now back to 84 with lesser dosage and creatinine back within normal range. my BPs had been getting worse and worse too, but now improving with 30mg lisinopril and 12.5 carvedilol 2x a day. My cholesterol was a bit high last check too and now back on atorvastatin 10, but has caused muslce weakness in past. For past year I've had bad knee pain and bottoms of my feet really started hurting for past 6 months now w ankle swelling at times too. I'm a pretty skinny individual considering weight. Basically none of these issues existed before my xplant (BP, joint pain, swelling, cholesterol, temperature sensitivity/neuropathy). I'm now down to 150mg cyclosporine 2x per day, mycophenalic 360 1x & 180 1x day, prednisone 5mg. I think the cyclosporine and my kidneys not operating as well as previously are causing most of these issues (issues didnt exist before surgery)? can I go to a lower dosage if I'm sensitive to cyclosporine and might help some of these things? Is there another alternative to tacro and cyclosporine to consider? I think prednisone could be what's part of still causing me to need Januvia for my bgs as sensitive to it in past with bgs... do I need prednisone with other immunosuppressants? or is there a prednisone alternative as well? Part of reason for my surgery after 15+ yrs of being type 1 was to avoid kidney issues, neuropathy, foot pain issues, and now the irony is I think the surgery and meds have caused these things to occur. Any help or experience would be great. thank you all.