Wednesday, October 31, 2018

Three Beautiful Things 10/30/18: Meetings with the Transplant Team, Relaxing at Slate Creek, Back Home

1. At 6:30 this morning I hopped into the Sube and, before I knew it, I'd arrived in Spokane at the Sacred Heart Transplant Center, checked in, and took a seat in examination room #5. One by one, members of the transplant team came in (not in this order): the nurse coordinator assigned to me, the financial coordinator, a pharmacist, the surgeon, a dietitian, a nephrology nurse practitioner, and the nephrologist himself. I enjoyed talking with each of these professionals. They were personable, relaxed, articulate, eager to help me understand things, and full of helpful information that further broadened and deepened my understanding of the transplant process.

I left these meetings with a pretty good understanding of the following:

* I might not be done with the testing required to be listed at Sacred Heart. After today's meetings and after reviewing the testing I had done last week, the doctors might request further testing. I should find out in about two weeks if I need more testing or I could find out that I've been accepted on the Sacred Heart transplant list.

*I have a much better understanding of the medications I would be taking after the transplant, how long I'd be taking each medication, and about what the expense might be. This picture looked better than I had expected.

* I have a much better understanding of the surgery itself and how the new kidney is, well, hooked up inside me. Thanks to Dr. Okechukwu Ojogho, I understand better how blood flows in and out of the kidney and and how urine flows out and how the new kidney has to be hooked up to an artery, a vein, and to a ureter. I've always known the old kidneys would stay in my body and that the new kidney would be placed in my abdomen. I now know that it's placed on whichever side has the healthiest artery and vein.

*I have a much better understanding of the risks of a kidney transplant. I'd always known rejection was a risk, but, until coming to Sacred Heart, it hadn't sunk in that transplant patients have a higher risk of contracting certain cancers, especially skin cancer, that the very medications that help a recipient recover can also bring about diabetes, and that in the weeks immediately following the surgery (which takes about three hours), the recipient is vulnerable to infections because the recipient's immune system is suppressed in order to transplant the kidney.

* In consultation with my other nephrologists, it's never been precisely determined what caused my kidneys to go into failure. Dr. Zachem, back in January 2005, surmised that my kidneys might have been damaged by my episode with bacterial meningitis in 1999, possibly by the bacteria, possibly by the large doses of antibiotics, or both. Today, Dr. Saed Nemr expressed hope that with some research of medical records he might put that explanation to the test. He then explained to me why it is so important to understand the cause of the disease. There could be something inherent in my system that goes after the kidneys (he said this better than I can) and would go after the new kidney. I hadn't thought of this before. He added that if we never figure out the cause, it would not keep a transplant from going forward and that if problems arise post-transplant, the doctors would address them at that time.

* I got the impression during the day that my chances of being listed at Sacred Heart look good. It's possible that I might be asked to do a cardio stress test (my last one was in 2017 and the results looked good) and the doctors might want to look more closely at the condition of my lungs which were compromised, but not severely as it turns out, by the sulfur dioxide gas I inhaled when I had that accident at the Zinc Plant in 1973.

2. I talked with the dietitian about drinking alcohol. She had come to talk with me more about diet and alcohol consumption post-transplant, but I turned our conversation to the present. She liked what I had to say about how much I drink and thought it was a good idea, especially for my weight, that I am drinking less alcohol. I think she was especially happy when I told her that, during this time that I am living alone, I am not drinking alcohol at home at all. I told her that when the Deke is here, I drink a bit more at home because we enjoy different beers together.

Satisfied after this discussion that drinking beer from time to time is all right, I decided on my way home that I'd stop at Slate Creek Brewing in CdA for a pint and a half. I got off the freeway at State Line and texted Byrdman that I'd be stopping at Slate Creek and hoped he could join me.

He did. We got in some good yakkin' and I enjoyed drinking some Diablo Rojo, a splendid red ale from Boneyard Brewing in Bend. The beer had an underlying bitterness, but its sweeter maltiness prevailed. I enjoy the slightly sweeter ales as the weather cools down, and while no one would mistake Diablo Rojo for a winter ale, it was refreshing and warming.

3. Back home, I was tired after all my meetings. Christy has spent some time bonding with Maggie and Charly treated them to a snack. I was happy to see that they were not lonely, but, as always (!), they were hungry. I fed them, listened to some progressive rock on Pandora, took a brief nap, and then I published on my blog three of the four Sibling Assignments I've written recently. If you'd like to read these posts, I'll list them:

#197 Homecoming Tear Gas  here
# 198 Ghosts (remembering Mom) here
# 199 An Ecstatic Experience in Eugene's Whiteaker Neighborhood  here 

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