12 September 2012

The Transplant Evaluation is done.

I was incorrect about the tests--aside from a prodigious amount of blood drawn--but spot on in my anticipation of the remainder of the day. Here's how it went...

0850a--Arrival at InterMountain Medical Center [campus] in Murray, UT. Check in with Transplant Team Office front desk. Verify Insurance, Emergency Contacts, Basic Info, etc. I was invited to set up their "My Health at Home" online site so I can access my labs, keep track of things, etc. This is similar to the Davita and Central Utah Clinic sites that I actively use.

0900a--I am weighed (106.00 Kg's this morning) then escorted to the exam room I will be in for most of the next six and a half hours. Then, vitals were taken, I provided a list of my meds, and the attending nurse went over the schedule for the day.

0915a--Meet my Transplant Coordinator (Mayra, pr my-ruh). Mayra went into depth about the process I would go through during the Transplant Eval, as well as the process for the transplant itself. I had to sign a number of agreements, understandings, policies, etc. She also conducted a question and answer with us to clarify anything not understood.

1000a--Financial Adviser discussed exactly what my insurance will cover, the deductibles, meds, etc. She had a lot of paperwork for me to sign, and tons of info to help us understand as much as we could about the costs, our financial obligations, etc. It was incredibly informative.

1100a--Social Worker came in to talk about the support and care mechanisms that need to be in place for any transplant patient. I had to list family, friends and close associates who might be available to help care for me once I am home from the hospital [and the transplant]. She also had questions for me pertaining to how I am doing with everything I am going through, how home life is, if I feel I am depressed, how I cope with things, etc. It was in in-depth interview. No hiding or deceiving here!

1200p--Labs. I had to do a urine sample, and a LOT of blood for tests such as CBC, Renal Panel, HIV, Hepatitis, etc. In all I had 10 vials of blood drawn for this series of tests.

After that, I was given the rest of the hour for a lunch break. Luckily, on the IHC campus there are a number of choices for food offerings.

0100p--Dietitian comes in to discuss my current dietary guidelines/restrictions and emphasize that as I go through this process what I eat, when I eat and how much I eat will change and be adjusted according to what my body is doing at any given time. This is determined by my labs and by the dialysis dietitian.

0200p--A Transplant Surgeon came in to talk with me about my overall health, past surgeries, and explained the basics of the transplant itself. If I get the transplant, he decided that my kidneys will be removed (about 4-6 weeks prior to the transplant) because of the pain I am having over both flanks. He also did a Q & A with us. A fairly specific exam was done, as well.

0300p--A Transplant Team Nephrologist came in to go over my [PCKD] disease history, meds, dialysis and another physical exam. He also conducted a Q & A and got a general feel for me as a patient and potential transplant recipient.

0330p--End of the Transplant Evaluation. I then had to go to the lab to give another 5 vials of blood for cross-matching, measuring antigens and antibodies, etc.

Now, I get to wait. Within a week the Transplant Committee will meet to discuss my case. They will pore over the information gathered today, as well as my Pt Hx, and decide whether or not I am a good candidate for transplant. I should know by this time next week what the decision is. The Transplant Committee is made up of about twenty Specialists, Clinicians and assorted others.
As the day progressed, I got the impression--based on questions, info given, and other comments--that I am likely to be approved.
However...that is ONLY a guess on my part! I won't know anything one way or the other until next week. So...as we used to say in Search and Rescue training, "Hurry up and wait."

I was given far too much information today to put it all down here. Among the highlights:

-All testing associated with the transplant must be done at the IHC Murray Campus. This has to do with being a Medicare Optimum Provider...or something like that.

-The transplant workup should take 3-6 months, or so. Anything much longer than that and the Transplant Team will begin to question the patients' commitment to the lifetime of schedules, meds, doctor appointments, etc. After all, if a transplant patient neglects the organ donation--the gift they have been given--and has preventable complications a/o rejection, then they have prevented another patient, committed to caring for the donation, from obtaining the organ and an opportunity is wasted. Hence the very in-depth scrutiny of this whole process.

-In Utah, a living donor transplant will be done within 6-12 months. A cadaver donation could take as long as two+ years.

-The Transplant Team is available to the patient twenty four hours a day. Any changes, any new meds, and hospitalizations, etc are to be reported immediately day or night. The Team is there to help the patient from now on. It's a pretty awesome setup.

And that's what I've got for today. My brain is fried, I've been up since 0600a this morning and have to be up in six and a half hours from right now for my Thursday dialysis. So, if you have questions, please type them up under the comment section and I will get to them ASAP.

Good Health to All!

ScottW