*WARNING: TODAY'S POST IS LONG!*
All in all, Donor Day was a rousing success. Nevermind that I was deliriously tired, having worked last night and having gotten up at 6 this morning, and let's forget the fact that a good part of my day was spent going between two different buildings for the various appointments I had to keep. Let's go ahead and visit this lengthy process for a bit:
7:45 am: Check in with the Transplant clinic, meet with the Donor Coordinator's Assistant and review the upcoming appointments for the day.
8:00 am: Meet with the Donor Coordinator and have a "presentation" about the donation process. This included a Power Point presentation (we went through the printout, as I was the only donor there today.). We discussed what the surgical procedure was like, what to expect from my hospital stay, what my restrictions would be post-operatively (no lifting anything over 10 pounds for two weeks, which is easier said than done with a 19 month old, pain management, etc.), how often I would have to follow up with the team after donation (I will be followed by the transplant team for 2 years, this is standard protocol for the hospital I am donating at), and the various risks of donation. As a whole, the risks are fairly standard as surgeries go; blood clots, pneumonia, wound infection, hospital-acquired infection, and that ever-present risk- death. Those are all pretty minimal, but they have to be discussed with the team. There is also a risk for depression and/or anxiety. This mainly ties into the fact that they will be removing an organ and that there will always be an uncertain possibility of rejection. These risks are discussed almost to the point of beating a dead horse; it is important to always keep these risks in the back of your mind though; being caught unaware would be undesirable. We also discussed the long-term implications of having only one kidney. My remaining kidney will grow a bit to make up for the fact that it has to take up the slack for its counterpart being taken away. I'm sure that if organs had thoughts, up until this point, my pee makers were pretty oblivious to what was going on. Then they got flooded with radioactive contrast, at which point they were probably screaming "What the bloody hell is going on out there?!?!" More on that in a minute. With only one kidney, I will not be able to take Ibuprofen or other medications that are broken down by the kidneys. My kidney will have a slightly tougher time handling their job on a day-to-day basis; throwing anything extra its way would not be very nice. We also discussed that while this is a necessary surgery for the recipient, this is 100% elective for the donor, and that I should in no way feel obligated or pressured to do this (I know this, I don't feel obligated. The choice to donate is deeply personal and while the team would help me should I change my mind, I don't think this will be an issue) This wraps up the Donor Presentation, so then we move on to Radiology.
9:10 am: I am waiting in Radiology to have a chest x-ray and CT Angiogram done. The angiogram is to check the structure of the kidneys, adrenal glands, and surrounding blood vessels. This is important, because this test will show the surgeon what he can expect before surgery from an anatomy standpoint. It will also alert the surgeon if there are any stones, cysts, or abnormalities that are otherwise undiagnosed. The chest x-ray is fairly standard. It will show any abnormalities in your lungs and ribs, make sure you have no fluid in your lungs (pneumonia), masses, or other abnormalities. Go in, hug the metal plate, inhale, hold and wait, exhale. Turn to the left, raise my arms above my head and inhale, hold and wait, exhale, done. The angiogram was a little more intense. If you've never had a CT scan with the contrast, hold on to your undies, you're in for a ride (literally)! I went in to the freezing cold CT room (wearing 2 hospital gowns, my socks, and sneakers. I was one sexy woman!) and was warmly greeted by the technologist. She explained the procedure and then we started. She placed an IV into my arm, tested it with some saline, and hooked me up to the pump that administers the contrast. We did 3 scans: a "scouting" scan, where they just quickly scan to get a sense of my anatomy, the second scan during which they fill the blood vessels with a little saline and contrast, and the third during which they pump the rest of the contrast as the scan is happening. The last is to see how the kidneys filter the contrast out and into the bladder. Now, one important thing to note is that the contrast had a weird side effect: it gave me a brief metallic taste in the back of my throat, which was quickly replaced by an intense feeling of heat from the back of my throat to my nether regions, almost like I had peed my pants. Not at all pleasant. After the scan, the IV was removed and I was on my way!
12:15-12:50 pm: Lunch. Panera Bread, nothing too exciting. Lots of water to rid myself of the taste from the IV.
12:50 pm: Meeting with the donor nephrologist. I had to pee in a cup again (I probably could have filled that damn bucket!) and had an EKG. My ticker is fine. Kind of a bland guy, went over my medical history for the billionth time. Reviewed my lab work for the millionth time. Had my second physical exam of the week. Discussed the risks of the surgery again, discussed again that the team would help me should I change my mind about donating, and he wished me well.
1:20 pm: I had to meet with the Social Worker. We discussed the whole process again, but in more detail. We talked about my support system (I am fortunate enough to have tons of amazing family and friends who will help me through this process), who will be home with me after the surgery, trying to uncover any underlying risk factors that could potentially halt the process (mental health issues or prior drug abuse are two of those things), making sure my mental faculties are intact, making sure that finances weren't going to be an issue (I am not paying for any of the testing, surgery, hospital stay, or after care. The finances in question are any lost wages while I'm out. There are grants available to help with basic bills. All I have to do is call. We also discussed whether or not my job is supportive of my being out; they are super supportive! We finished up with a "See You Soon" and I was on my way.
2:15 pm: The final meeting of the day, and it's with the surgeon and Donor Coordinator. Of course, me being me, the first question I ask is what happens to the adrenal gland. He kind of chuckled and pulled up my CT scan from this morning. He showed me that because the way my anatomy is, the adrenal gland will likely be unaffected. He also said that my kidneys are in great shape, the blood vessels look awesome, and he sees no real problems with proceeding with surgery. He also did a quick physical exam (again). The surgeon and Donor Coordinator let me know that they will review my results this coming Monday and assured me that I should hear back from them by Wednesday next week as to an approximate timeline for surgery. From there, we schedule surgery, do our pre-operative testing, and do this thing!
So, the moral of today's post: I have had more physical testing and labwork in the last month than most people have in 3 years, I should get paid for my urine and blood, and I got no super powers from a radioactive injection. Good Night!
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