"I take a whole different view of birthdays now," said the kidney transplant recipient and mother of two. "Another year, and I'm still here."

For Christine, celebrating another birthday wasn't always a sure thing.

In spring 1995, Christine and her husband Phillip were adjusting to life with their new son, Thomas. But the fatigue, weakness, and low-grade fever Christine continued to experience were not the result of sleep deprivation. Repeated visits to the hospital emergency room led to a referral to a kidney specialist who diagnosed Christine with glomerulonephritis. Her kidneys were only working about 60% as well as they should have been.

Christine's doctor prescribed steroids, the progression of the disease slowed, and her energy returned. Steroids continued to help for a few years, but the damage to her kidneys continued. In April 2000, doctors discovered that Christine's kidney function had declined dramatically and she was placed on dialysis. Two months later, her doctors did a biopsy to determine how far her glomerulonephritis had progressed.

"When they did the biopsy, [my kidneys] were all scarred," Christine recounted. She had two options: remain on dialysis or undergo a kidney transplant.

A lifetime on dialysis wasn't a good option for Christine. Relying on a machine left her feeling out of control. She also felt the strain of being ill while trying to care for her young son. "You feel like you have the flu," Christine explained, saying that she tried to live a normal life while on dialysis. She would go to the clinic at 6 in the morning so she would be home from treatment when Thomas awoke. "I struggled with it, but when you have kids you don't want them to see that you're sick or hurting."

Both Christine's mother and sister offered to donate a kidney for transplant. When both were found to be a good match, doctors decided to take a kidney from Christine's mother as a donor organ.

Christine received her kidney transplant on September 19, 2000. The day after her surgery, she was moved out of the intensive care unit into a regular hospital room. Her new kidney worked immediately, and she could feel that she had already lost some of the water weight she had gained while on dialysis.

"I looked in the mirror and thought, 'I'm back,'" she said. Christine felt so much like her old self that she found it difficult to slow down and let her body recuperate. She knew that the immunosuppressive medicines she was taking to protect her kidney from rejection could also make her more likely to catch a cold, but she was eager to have an active lifestyle, including attending events at her son's school.

Christine took her pills every day because she knew how important they were to her new kidney. She also needed medication to lower her blood pressure and to help prevent infection. About six months after her transplant, she experienced side effects that made her feel very self-conscious. Her gums were growing over her teeth, and she had heavy hair growth on her face, back, and arms.

"My gums were growing at such a fast pace, they were growing up through my molars," she remembered. "It was very painful to eat. I looked gross. When you feel like that, you don't have much confidence."

The idea of gum surgery and repeated hair removal led Christine to raise the issue with her doctors, who offered another option—Prograf. Although Christine was a bit nervous about the effects of switching her anti-rejection medicine, she made the change under the supervision of her transplant center in May 2001.

Christine no longer needs steroids, as her doctors believe that her current immunosuppressants offer enough protection against rejection. She also no longer needs medicine to lower her blood pressure. Not all patients receiving Prograf will be able to come off these medications and may react differently than Christine. The side effects Christine has from Prograf are much easier for her to tolerate and consist mostly of tingling in her face and itchy skin.

Christine said she is pleased she raised the issue of her side effects with her doctors and that they were able to offer alternatives. She urged transplant recipients to be active in managing their own healthcare and to make sure all questions are answered to their satisfaction. Christine's close relationship with a physician's assistant at her transplant center has been a great resource for her.

All decisions regarding changes in your medication should be discussed with your transplant team. Individual patient results vary.

"Be aware of your body," Christine counseled transplant recipients. "Get in touch with your being, and communicate with your transplant center. Call with any concern, and find someone that will help you." A transplant coordinator might hear a question numerous times, but to the transplant recipient, it might be the first time they are hearing the information.

Two years after her transplant, Christine said she is still the same happy-go-lucky young woman who made a roast beef dinner the day she came home from the hospital. In March 2002, she and husband Phillip adopted a daughter, Mandy, from Guatemala. Her family is now complete, and Christine still feels as though even more good things are in store for her.

Prograf^® (tacrolimus capsules and injection) is approved for the prevention of rejection in patients who have received a liver or kidney transplant. Only physicians and facilities specializing in transplantation should manage patients taking Prograf. Anti-rejection medications may result in an increased possibility of developing an infection or lymphoma, a type of cancer.

In clinical studies, up to 20% of patients taking Prograf developed insulin dependent diabetes after transplant, but in some patients, after two years, insulin was no longer required. Black and Hispanic kidney transplant patients were at an increased risk.

Prograf has been associated with toxicity to the kidneys and nervous system. Common side effects are tremor, headache, high blood pressure, diarrhea, nausea and changes in kidney function.

Prograf should not be used in patients allergic to tacrolimus. Prograf injection should not be used in patients allergic to castor oil.

Only your healthcare professional can weigh the risks and benefits of a prescription medicine and decide if this medication is the right one for you.

Prograf Prescribing Information
Prograf Patient Information
Prograf Safety Information

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