Transplant Two

Previously on The Diagnosis

By early evening on Sunday of the fateful phone call a group had assembled at Brackenridge Hospital to await my transplant. Ryan and I had arrived around noon and quickly got down to the business of getting me checked in. Heather had been notified and Heather being Heather showed up at the hospital to wait with us. Mom, using her magical American Airlines Platinum Member Powers managed to join the party by six o'clock.

First matter of business as always when dealing with transplants was to draw a massive amount of blood. This was to be sent to San Antonio, which was a transplant hub for out-of-state organ donations. The kidney was coming from Utah, so, not close by. They would need to do a final match with our blood so no time would be wasted shipping a kidney cross country if it was not compatible. 

Second order of business while we were waiting for lab results was a dialysis treatment for me. As I mentioned in Transplant One, the healthier you are going into surgery the better. This time around I had not been walking two miles a day before the operation so getting one last cleaning of my system would have to do. I was a bit put out as I had hoped to be done with dialysis, but this would only be a three hour treatment. Too wound up to sleep, I watched episodes of the Simpsons and silently flipped the mental bird at the dialysis machine.

After that it was a waiting game. The four of us chatted in my room that looked out onto I-35 as nurses occasionally popped in with updates of "still waiting." I tried desperately to ignore my hunger as I was not allowed any food or drink until surgery and we didn't know when that would be. My last meal had been a Sunday morning bagel.

At midnight we sent Heather home. Ryan took pity on me and snuck me a Jolly Rancher. 

Finally at 2:00 in the morning I was given the green light. The results of the final match were positive and the kidney was on its way to Texas. A nurse brought me some weird smelling surgical soap and I was instructed to go shower and use it liberally. Afterwards I put on a fresh gown and settled down for more waiting.

At 5am they came to transport me to pre-op. Mom and Ryan were allowed to come along, partially because the surgery waiting room was right next door and they would be spending their morning there. The transplant nurses were chatty and entertaining. One of them came up to us and asked, "would you like to see it?" 

"It" being the kidney, which was in a small cooler I had not previously noticed. 

It was six in the morning and I had not slept or eaten in almost a day. NO I did not want to see the kidney. Ryan also took a hard pass. My mother, on the other hand, lit up like a Christmas tree and hurried over to take a peek.

Luckily just as I was seriously veering into Nausea Land my best friend the anesthesiologist showed up to give me a Happy Hour cocktail in my IV. As the sleepies set in, the transplant surgeon arrived, punchy on coffee and adrenaline and loudly sharing that he had been awake doing surgeries for the last 24 hours. My last thought before drifting into unconsciousness was, "Wait, what......?"

Despite this last minute uncertainty, the surgery went very quickly and very well. I am pretty slender and like last time it was a laparoscopic procedure, so just a slice in my abdomen was needed to rewire everything. Ryan says he was so tired he laid face first on the Berber carpet of the waiting room and felt like he had barely drifted off before my mom was shaking him awake. He had carpet marks on his face for the next hour.

Just like my last transplant, this kidney started working immediately. There was of course the usual surgical site pain, but in general I felt better right away. It's still amazing to me how quickly kidneys can resume operation and also how much I had gotten used to a lower energy level on dialysis. My appetite returned with a vengeance, in part due to once again returning to steroids. I was doing so well that by Friday I got the all-clear to go home.

Ryan was a busy bee while I was at the hospital. Though he was there a good portion of the time, he was also preparing the house for my return. Cleaners came in to give it a good scrubbing and Ryan's parents met him halfway from Houston to collect Melbotis the golden retriever. We didn't want to kick Mel out, but he was a bit like Pigpen in that house, spending much of his time in the dirt under the front shrubbery and getting covered in burrs. Because of my high dose immunosuppression that first month, we would need to be extremely careful about germs.

My dad, who had been at an orthodontic course in Dallas that week, was in town the day I came home (my mom had departed a few days earlier). He brought us dinner Friday night and breakfast Saturday morning before returning to Oklahoma. During the Melbotis hand-off, Ryan's mom had loaded us up with enough frozen meals to last a week. 

Things were going amazingly well, so of course that couldn't last. 

A side effect not often discussed that commonly occurs with major abdominal surgery is severe constipation resulting in horribly painful stomach cramps.

During laparoscopic abdominal surgery carbon dioxide gas is used to inflate the area and make it easier to move things around. This gas can get trapped in your abdomen. In addition, many strong pain relievers like morphine used for post-op discomfort cause your bowels to go on strike. The weekend after my surgery my intestines began feeling like they were being stabbed by knives.

It was a miserable few days. Just unrelenting abdominal pain that couldn't be relieved. Adding to the awfulness was the fact that I was back on high dose steroids and couldn't sleep. Poor Ryan had to hear me moan for three days straight. 

Things eventually started *ahem* moving again and the pain gradually lessened. Ryan had taken a few weeks off of work to keep our environment sterile and I myself got an entire month break from my job. I was keeping busy with a multitude of transplant related appointments, blood work, doctor visits, and some IV drips of various medications.

After that first month things started getting back to normal. I went back to work, we got Mel back, and I was easing off of the steroids, though a tiny dose would always be part of my transplant regimen. I felt better than I had in a few years. Dialysis could, for now, be an unpleasant experience in the rearview mirror and I was so grateful for my freedom.

I can't wrap this up without acknowledging the painful truth that someone died for me to receive this kidney. All the information I was given was that the donor was 20 years old and had perished in a motorcycle accident in Utah. It's not an easy decision to have to make when a loved one passes unexpectedly, and it's especially hard with someone who is so young. I always advise people if they would like to be organ donors to have that discussion with your family now, when they're not in crisis mode. Hopefully they will never need to make that decision at all, but that little indicator on your driver's license means nothing without a family member's approval, so make it easier on them.

When you become an organ donor, you can donate up to seven different organs. That's a lot of people's lives you could save! And as someone who received one of those organs I guarantee you your generosity will never be forgotten. I will never forget that family in Utah who suffered a terrible loss and made a difficult decision in the face of sorrow. Thank you so much for your gift.

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