Cuts force transplant patient to take chances.

Jean had her blood tested monthly, and monitored the level of creatinine - a waste product in the blood removed by kidneys. A rise in creatinine would reflect a decline in kidney function.

Jean's creatinine level was .9 - just fine - before cutting back.

In the spring, Jean was referred to the Schuylkill Alliance for Health Care Access, a nonprofit that helps the uninsured in Schuylkill County. The Alliance cobbled together a plan for her.

She went to see a primary-care physician for $13.50 a visit. He accepted the Medicaid rate; the alliance paid half and Jean paid half.

Same deal for bloodwork - it cost her only $12.

Alliance staffers applied on her behalf to pharmaceutical programs that provide free drugs to the poor.

Jean waited.

April. May. June. July.

Jean's creatinine level climbed from .9 to 1.6.

"She was very much gambling," said Spry, the kidney expert.

But what could she do?

Finally, in late July, "great, great news," she said. Novartis, a drug company, had sent a three-month supply of Myfortic.

"They will carry me for one year, free of charge," she said. "That is the best news I could have."

A few weeks later, another call. She got Rapamune through a program from CVS-Caremark.

Jean resumed her normal dosage. By September, her creatinine count fell back to .9.

"I feel great," she said this week, at home enjoying the grandchild of her late daughter, Tammy.

"At 1.6, rejection was starting to occur," Spry said. "But she caught it by getting back on her medicines.

"I've seen it when they up the dose back to normal and it doesn't respond," he added. "The person goes on to lose the kidney. Sounds like she might have been lucky."

What Went Wrong