Friday, October 19, 2018

Three Beautiful Things 10/18/18: Stitches Removed, Kidney Transplant Class, Post-op Support

1. I tore over the Fourth of July Pass and eased into the offices of Northwest Endodontics to visit Dr. Brittney Penberthy again. Today, she removed the stitches from the area where I had oral surgery a week ago and she reported that my biopsy was clear. It was a brief and comfortable visit and I'll return in three months. Dr. Penberthy will monitor this tooth and the surgery site every three months over the next year.

2. I hopped back in the Sube and made my way to Providence Sacred Heart Medical Center to continue the process of becoming listed for a kidney transplant in Spokane. For ninety minutes, I attended a very informative class about kidney transplants, the fourth I've attended since 2015, and the best. Some of it was redundant, but much of it deepened my knowledge and my understanding of the transplant process, especially what's involved in matching a donated kidney to a recipient. For starters, I learned once again that the demand for kidneys far, far outnumbers the kidneys available and that thousands of people in need of a kidney don't receive them every year.

The first criterion for a match between the donated kidney and recipient's is blood type. Then there must be an antigen match. Lastly, the blood of the donor is cross-matched in a tube with the blood of the kidney recipient to see if the recipient will react to the donor's kidney. If there's no reaction, the transplant can continue. So, when a kidney becomes available, it's not only time accrued on the waiting list that comes into play, but so does the question of whether there is a match between the donor and the recipient. These criteria are the same whether the kidney comes from a cadaver or from a living person -- and, of course, having a kidney donated by living donor (age 18-60 [with some exceptions]) is the ideal situation.

I also learned that several people can be contacted when a kidney becomes available. For example, the center could decide to contact, let's say, five recipients to be at the ready because a kidney that is blood match for five people high on the list has become available. Then the tissue testing and cross-matching happens and, importantly, all of those contacted have the right to decline the kidney -- without penalty. The donated kidney could be local, regional, or, in some cases, come from somewhere in the nation outside the Washington, Idaho, Montana, Alaska region.

There are other calculations that come into play when deciding to whom the donated kidney will be given and maybe I'll lay those out another day.

At Sacred Heart, the wait times tend to average about 4-5 years. I have been listed since about April of 2015, so soon I'll hit the four year mark in about five months. I came away from this class taking the instruction to always be ready for the call more seriously than I ever have.

But, in order to be listed in Spokane, it has to be determined through blood work, chest x-ray, cardiology testing, kidney ultrasound, and other tests that I am healthy enough to endure the surgery. My medical history will also be taken into account. I go back to Sacred Heart on Oct. 23rd for a day of testing. Then I'll return to Spokane on the 30th of October to talk individually with each member of the transplant team, except one, the social worker.

3. I won't talk to the social worker on October 30th because I talked with her today. I thought the most important thing we talked about was the support I'll need if I go through transplant surgery. I need to return a form to the transplant program, signed by the person or persons who will provide the support I'll need. Not only will I need to be transported to the hospital, but I will need a lot of help after the surgery. Let's say the primary support person is the Deke. Among other things, she will have to go through instruction to help me with my medication schedule and other post-op responsibilities. I would be in the hospital for 2-3 days and then I have to stay within an hour of Sacred Heart for 2-3 weeks and be transported to the clinic at least three times a week for blood work and visits with the doctor. I'll need help taking my medications at precise times. Whether I could stay in Kellogg or would stay in a hotel in Spokane during this period will be determined.

It's possible I'll be difficult to deal with because I'll be taking heavy doses of Prednisone, a steroid which can bring about irritability and mood changes. The social worker was adamant about the difficulties support persons often experience with a post-transplant patient and repeatedly told me that the transplant center provides counseling support for those in the support role.

By the time I left the medical center, my head was spinning and, because I hadn't eaten a bite all day, I was hungry. I decided to drive to CdA before eating and I thoroughly enjoyed a plate of yellow curry over rice at Thai Bamboo.

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