1. Several weeks ago, Renee at the Providence Sacred Heart Kidney & Pancreas Transplant Clinic called me to schedule my next round of tests and appointments at the clinic. Now that I'm seventy years old, I meet with the transplant professionals every six months. Today's visit also included blood work, x-rays, an EKG, and an echocardiogram.
Here's what was not scheduled: on Tuesday, April 2nd, Patricia, a nurse at one of the transplant call centers, called me with the news that I was in line for an organ, a kidney that they hoped would become available on Wednesday, April 3rd.
The kidney would come from what's known as a DCD, or a Donor After Cardiac Death.
A DCD is a donor who has suffered devastating and irreversible brain injury, may be near death, but does not meet formal death criteria.
So, this donor's organs could not be removed until this person met formal death criteria.
Another important detail: I was a backup candidate for transplant with one other potential recipient ahead of me.
I began my day of testing by registering for lab work and an EKG and while registering, my phone rang.
When I answered, another call center nurse told me that I was to begin fasting, no food or water, at 10:00 a.m. This call came in at about 9:55!
This meant that it was possible that I'd be transplanted later tonight or just after midnight on Thursday morning.
2. At about 1:00, Debbie and I met with Tara Wolf, the transplant nurse assigned to my case.
She updated us on what was happening with the donor.
At 4:00 in the afternoon, the donor would be removed from life support and would die a natural death.
What Debbie and I didn't know was that in order for the donor's kidneys to be viable for transplant, that person's death had to occur within 60-90 minutes.
If the donor lived longer than that, any plans for transplant would be canceled.
Tara Wolf told Debbie and me that the transplant team agreed that when we were done with the afternoon appointments, that we should return to Kellogg and wait for a phone call telling us whether the transplant was going forward or canceled, whether the person ahead of me accepted the offer of the organ if things were moving forward, or, if I was to be the recipient, whether the surgeons, once they could closely examine the organ, agreed that this was a kidney suitable for transplant.
I'll jump forward: back in Kellogg, around 7:30, the nurse who had called me with the fasting instructions called again to tell me that the donor had lived past the 60-90 minute time frame and that the doctors canceled transplanting the donor's kidneys.
3. Every six months, when Debbie and I meet with members of the transplant team, we learn more than we knew before. Here are a few things we learned today:
* We had probably been told this before, but today it really sunk in that kidney transplant surgery is not replacement surgery. My kidneys will stay intact, untouched, and continue to function. In a spot below my kidneys, I'll have a third kidney placed in my circulatory system.
That my existing kidneys are stable, that they are doing good work filtering my blood, is great news. The new kidney might take a few days to wake up and get to work, but my existing kidneys will continue to do their work while the new one and my body adjust to each other.
I now understand better than I ever have why the doctors are eager to introduce a third kidney to my system while my diseased kidneys are still functioning pretty well. It will enhance the success of my recovery.
* It's becoming clearer and clearer to Debbie and me that the transplant surgery itself has evolved into a fairly routine procedure. The real challenges lie in what happens after the surgery, making Debbie's role as my primary support person vitally important in the days and even a few weeks after the surgery.
* We are getting a clearer picture all the time of what the post-surgery care involves -- all of it manageable -- but there will be a lot to keep track of -- when I take what pills, keeping a record of what goes in and comes out of my body, monitoring whether I'm showing symptoms of rejection or other potential problems, and more.
* I learned that as kidney donations have become available recently, my name as a potential recipient has popped up frequently. But, the program I'm enrolled in is very cautious about the kidneys they accept and at least some of these kidneys didn't meet the program's standards.
Both of these bits of news sat very well with me: I now know my case is very much in play and I was happy to have confirmed what I've observed over the last nearly six years that this is a careful and cautious transplant program.
* Last of all, our experience over the last two days of getting a call about a potentially available kidney on Tuesday and then waiting for most of the day on Wednesday to find out whether the donor's kidney would be viable and whether the person ahead of me accepted the offer or not also helped us understand more clearly than ever that when I receive the initial call about a potential transplant, I should stay as even tempered about the call as possible. In between that initial call and an actual surgery lie all kinds of hurdles that must be dealt with.
I helped us today when Tara Wolf told us about a patient from Great Falls, MT who experienced six "false alarms" before he finally was transplanted.
I also received a comment on Facebook today from Charlie Cameron (KHS, '71) whose wife recently had a liver transplant after two "false alarms".
Knowing of all the contingencies that lay between me and surgery, as Wednesday, April 3rd progressed, helped me stay calm.
All I could do was wait and find out.
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