Post Transplant: Finishing My Hospital Stay and the Plethora of Meds I Need

(My sincerest apologies for taking so long to type this next chapter in my transplant saga. Since I have been feeling better, I was asked to continue editing a book that is about to be published for wide national release. Doing so has taken up nearly all of my time, and taxed me physically, and mentally. So, with the book nearly finished and my part complete, I now have the time to continue my blog...)
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With a normal transplant hospitalization, patients today are expected to be in hospitalization recovery for no more than 3-4 days--which to me is way too short. However, I also understand that hospitals aren't exactly germ-free, which is exactly why post-transplant stays are so brief. The longer you are in the hospital, the greater your risk of infection.

I bring this up because I learned just yesterday the reason why a transplant recipient is so incredibly immuno-compromised for the three months post-surgery. Every transplant recipient is given a round of "Thymoglobulin" at the time of transplant. This is to prevent the body from immediately attacking the transplanted organ, giving the body and the organ time to adapt to each other.

When I went into surgery, the key indicator of the strength of my immune system was at 19% (20% is normal for immuno-compromised patients, such as myself)). After the surgery, my immune system was nearly gone at 0.06%! Over the following three months of recovery, the strength of your immune system gradually rises. So now, after just six weeks post-surgery, my immune system has increased to 12%! (a HUGE rebound!). After three months, the doctors are hoping for a 19-20% immune response, which is about where it should stay. Any more than that and the body will start attacking the new organ--which we do NOT want!!!

Anyhow, as stated in the previous entry, I was moved out of ICU early on Saturday evening. The tenth floor at Intermountain Medical Center is only for transplant patients. This is because all staff on that floor are specifically trained for the care of said transplant patients and their specific medical needs, precautions and overall care. These rooms are only for a single patient for obvious reasons related to infection precautions. However, each room has a nice fold-out couch under the window for spouses or parents to sleep on if they choose to stay in the room. Additionally, this hospital has a terrific food service area on the main floor (for doctors, nurses, staff and patients and families) that serves fresh foods on numerous varieties. So, my wife did not have to suffer any patient-type foods while she was there.

That first evening was spent getting me setup in the new room, hooking me up to the numerous monitors (BP, HR, O2, Arterial Line pressures, Urinary Output, Cardiac Electrical Conduction, On-Demand Pain Meds--those are the things I remember...), going through nurses evals, seeing several doctors, and my just trying to get comfortable enough to get some sleep in the middle of all of this.  :o)
Each patient has a nurse who has just four patients on their round, and a nurses aide (again, with just four patients ea.), and vitals were initially conducted every two hours, which made it difficult to get that sleep I was wanting.
Any movement on my part was still extremely difficult, and my nurse had me walking the halls that first evening. Having been through several previous abdominal surgeries, I knew this walking was normal, and was able to push through the pain. Those first few walks on the tenth floor were with a lot of help from my nurses a/o aides. Most of that evening was still a bit of a blur due to the pain meds; but as the nighttime passed, I noticed the nurses had started coming in for vital less often, going four hours between. This was because my vitals were stable and the doctors agreed that two hour vitals were no longer necessary. Yay! More sleep!!!

On Sunday morning I was informed that because I was doing so well, I would be allowed to start a full liquid diet. Before anyone gets excited, the "food" I was given that day was, well, let's just use the term 'repugnant.' I mean, NASTY doesn't even begin to describe the "hot cereal, soup or other so-called foods" that were presented. About the only things I downed were juices, milk, hot chocolate and water. (I'm shuddering just thinking about what was called 'potato soup!')

For most of the day on Sunday I was again sitting up, getting off of my back because the titanium hardware on my spine just doesn't allow me to be comfortable laying down for more than five of six hours...even with heavy pain meds. And since I could not yet lay on my sides, sitting up was the only way to give my back any relief.

Plus, because of the intubation I had during surgery, my TMD (Temporo Mandibular Dysfunction) was triggered in a massive way--which always happened when I'm intubated because of the stress my jaw has to endure. The TMD causes migraine-type headaches that, on a scale of 1-10, can cause headaches that hit a 15 on that scale! No kidding! So, in addition top all the abdominal pain, back pain and overall post-surgery discomfort, I had a TMD headache that was a solid 11, and would not go away or be knocked down to a reasonable level, even with the meds I was on. Add to that the fact that, in my haste to suddenly prepare to get to the hospital pre-transplant, I forgot to grab my NTI devices--an oral device that goes over the front of the teeth to prevent clenching, which helps to relax the jaw and prevent further "bruxism" of the Temporomandibular muscles; the band of muscles that start at one ball joint of the jaw and extend over the scalp to the other ball joint.
So, the only relief I could find for my headache was for my wife to fill surgical gloves with hot water and place them on the back of my neck. She did this about every 15 minutes for about three hours straight on Sunday night/Monday morning. This was able to allow my neck to relax, which helped decrease the headache to a tolerable 8, or so. We continued to use the hot water gloves throughout the remainder of my stay at IMC.

Also on Sunday I had several visitors show up. They were almost all family friends who we essentially consider to be a part of our family. In addition, two of my wife's coworkers brought a gift basket of treats for me to enjoy once I arrived home.
For any transplant patient, anyone who arrives to visit must sanitize their hands any time they leave the room, use the restroom or touch their hair or faces excessively. Plus, whenever I have visitors, I must wear a surgical mask. Anyone who visits must be cold or sickness free, or run the risk of infecting not only myself, but other patients as well. So remember, if you go to visit a transplant patient in the hospital (or at home during the first three month especially), they, their kids and any spouses or coworkers etc. must all be free from any type of sickness. 
IF a transplant patient becomes sick with a cold, the flu or any other type of illness, that patient runs a huge risk of losing the transplanted organ, and if serious enough, they could even die! This is NOT an exaggeration!! It is a very real danger! After the first three months the risk is reduced, but it will forever remain a concern for the patient.

Anyhow, it was nice to visit with everyone, despite the fact I was drifting in and out of sleep.

Later on Sunday, because I was doing better with each passing day, I was taken off of IV pain meds and put on oral meds only. At this point I was being given 15 mg of immediate release Morphine--the ONLY pain med my body can tolerate. I cannot use any synthetic pain meds due to severe anaphylactic reactions.
Also on Sunday evening, because my urinary output was so good--and consistent (at around two liters per day, with good color and no blood or cloudiness) the urinary catheter was removed--NOT fun! (Thank goodness I was asleep on the OR table when it was put in!)  :o(  As a result of this, and the fact that, after not being used for three and a half years, my bladder was, as the surgeon put it, "incredibly small," I was having to walk to my restroom every 45 minutes, like clockwork. Having to keep track of my output by using a urinal, I knew that each time I went, I was peeing out anywhere from 75cc to 150cc. Over the course of a day, that small amount really adds up!
Despite my drinking nearly two liters of water, I was still getting a bit dehydrated as my body was continuing to rid itself of the excessive fluid buildup that occurs in any long-term dialysis patient.
I believe I already told you in my last blog that I lost nearly three liters of fluid (about a gallon of water!) while I was in ICU. Now that I was off the catheter, I was ridding more than the two liters I was taking in. Over the course of my hospital stay, I lost a total of about four and a half liters of fluid, despite my increasing intake.

Because of the fluid loss, my feet, which had for so long looked like Hobbit feet, now appeared normal in every way! I could see veins and ligaments for the first time in years, and my toes were looking normal again! So weird!

When my Sunday 'dinner' was brought, I was informed that on Monday, I would be upgraded to a full, normal diet. This was fantastic news! I eagerly filled out the meal card for the following day!

The remainder of Sunday evening was uneventful...aside from the TMD headache, or course. I eventually got some sleep, which was nice.

Monday found me walking several times--one loop around the floor equaled 1/10 of a mile--doing some physical therapy, continuing my use of the breathing exercises, getting LOTS of doctor visits, eating some far better food (!!), and getting some decent sleep throughout the day. Other than that, Monday was rather uneventful, aside from being informed that Tuesday was my day to go home.
Throughout the day my urinary frequency and output both remained consistent. Like I said...every forty five minutes, like clockwork.

On Tuesday, the doctors finalized the plan to send me home. But before that could happen, I had to see several Transplant Team members including my post-transplant Coordinator, the Cardiologist, the Nephrologist, the Surgeon, and most importantly, the Team Pharmacist.

Now, I bring up the Pharmacist last because it is now time to talk about the plethora of meds I had been taking since the transplant. I'm not referring to the pain meds; I'm talking about the Immunosuppressants and associated meds. During my stay I did not ask about these meds I was given twice every day because I already knew their general purpose. Add in the fact my brain was too foggy to remember much of anything, and it is easy to understand why I hadn't asked too many questions up to this point.

Anyhow, the Transplant Team Pharmacist came to see me to go over the meds I would shortly be given to take home. (I use the term 'given' loosely because patients must purchase their first month of meds before going home. In my case, they cost (after insurance) $193.00 and some change.) Now, before any future transplant patients get upset at that cost, it was far, far LESS that we thought it would be! We were actually expecting to pay anywhere from $600 to$2,000! So $193 was nothing compared to that!

Once I had the meds, the pharmacist returned to go over the meds again, and the schedule I needed to follow. Plus, I had to demonstrate my ability to follow the schedule by using the provided pill box, which was easy for me as I had been using a pillbox for the entire time I was on dialysis. So, there was no learning curve except for the new meds I would be using. And what exactly are the new meds? Read on....

I will be listing the Trade and Generic names for each med, the dosage, times and purpose for them. It is a lot of information, so if you are truly interested, please read carefully!    **Remember...this list contains only the meds and dosages that I am on. Each individual patient will be different, so if you are looking at transplant, only your physicians will determine the meds and dosing schedule best suited to you!

1) Trade Name: Prograf (Generic: Tacrolimus) 1 Mg Capsules 
Dosage: 2 Caps q (every) 12 Hours.
*Prevents organ rejection. If taking on a lab draw day, the Morning dosage should ONLY be taken after the blood draw has occurred! Be sure to check with your Transplant Team before taking any new medications as there might be contraindications in regards to the Prograf for the new meds. In other words, the new meds might produce side effects with the Prograf that could be serious and endanger the organ a/o your health.

2) Prograf (Tacrolimus) 0.50 Mg Caps  
Dosage: 1 Cap q12 Hrs.
Prevents organ rejection.

3) Cellcept (Mycophenolate mofetil) 500 Mg Tabs  
Dosage: 1000 Mg q12 Hrs.
Prevents rejection. Take or delay antacids, iron, magnesium or aluminum at least 1 Hr before or 2 Hrs after this med.

4) Prednisone (No Generic) 5 Mg Tabs
Dosage: 3 Tabs in the A.M. only
Prevents rejection. *Follow the Prednisone Taper Schedule.
*Dosage gradually decreases to 1 Tab 1x/day where it will stay permanently.

5) Bactrim (Sulfamethoxazole; Trimethoprim SS) 400 Mg Tab
Dosage: 1 Tab 1x/day in the A.M. only.
Treats/Prevents Bacterial infections. Specifically, transplant induced pneumonia.

6) Acyclovir (Generic only) 400 Mg Tabs
Dosage: 1 Tab q12 Hrs
Treats/Prevents Viral infections.

7) Coreg (Carvedilol) 25 Mg Tabs
Dosage: 1 Tab q12 Hrs
Heart Med. Controls  Blood Pressure.

8) Imdur (Isosorbide Mononitrate) 25 Mg Tabs
Dosage: 1 Tab q12 Hrs
Treats Angina

9) Prilosec (Omeprazole) 40 Mg Capsules
Dosage: 1 Cap in the A.M. only.
Treats/Prevents Stomach Ulcers a/o Heartburn.

10) Aspirin Generic or non-generic) 81 Mg Tabs
Dosage: 1 Tab in the A.M. only.
Prevents Blood Clots.

11) Calcium w/Vitamin D (Generic or non-Generic) 600 Mg Tab
Dosage: 1 Tab q12 Hrs
Treats Low Levels of Calcium.

12) Phospha 250 Neutral (Phosphorous) 250 Mg Tab
Dosage: 1 Tab q12 Hrs only if labs indicate it is needed!
Treat Phosphorous Deficiency.

13) Mag Ox 400 (Magnesium Oxide) 400 Mg Tabs
Dosage: 1 Tab at 1200p and 1 at 600p only if labs indicate!
Nutritional Supplement. *Separate from Cellcept by at least 2 Hrs.

14)  Sennosides/Docusate Sodium (No Generics) 8.6-50 Mg Tabs
Dosage: 1-2 Tabs q2x/day
Laxative plus Stool Softener.

15)  MSIR (Morphine Sulfate Immediate Release) 15 Mg Tabs
Dosage: 1/2 to 1 Tab q4 Hrs prn (as needed for pain).
Treats Acute and Chronic Pain. Taper off as symptomology allow.

Each of these med descriptions had a picture next to the names so identification was easy for putting your pill box in order.
After our thorough discussion [with the Pharmacist], it was easy to put a 1 week dosing schedule in the pill box. The Pharmacist then checked each day's dosing, counting each pill and checking it against my personal schedule. After getting everything perfect, he signed off on my ability to set up my meds; especially with my paramedic background!

*Now, these meds will be gradually reduced/eliminated until I only have a few to take every day. As time goes on I will keep you up to date on those eliminations until I get to my maintenance-level meds. Even those might be altered from time to time, depending on how I do.

Once the Pharmacist was finished, the nurse came in to remove my art and neck lines, and the drainage line. All monitors were turned off, all monitor connections removed, and all I was left to do was get dressed, relax and await discharge.

For final instructions my nurse went over several things including not bending over, no straining for two weeks, no lifting more than 5 pounds for at least two weeks, leave the abdominal binder on for a full three weeks post-discharge at which time I could leave it off at home, and another three weeks of wearing the binder whenever I was in a car or walking outside. I was also briefed on attending the twice weekly Transplant Team Kidney Clinic (Monday and Thursday mornings), and doing labs at IMC between 600a and 800a on those days with also bringing a Urine Sample on Mondays.
And with all of those instructions--and probably more that I don't recall now--I awaited my discharge. As with my double radical nephrectomy in Nov 2013, the nurse have me a swag bag filled with supplies I would need over the next few days including a new abdominal binder, trauma pads (for under the binder to reduce discomfort over the incision), stretch gauze tape, gloves, compression socks (if needed), surgical masks, urinals (New, clean ones, of course!), and other such supplies.
I was also taking home a big Kidney Pillow that Nurses, Doctors, PS and other staff can sign as a reminder of your new lease on life. My pillow is pretty much covered in signatures and well-wishes.
As far as my "Go Bag" is concerned, I did not use most of its contents, but was grateful for the items that I did have at my disposal such as Toothpaste, Lip Balm, Q-Tips, Hair Brush, Deodorant, Slippers, PJ's, Baseball Cap, Socks and Teva's. I had put the Go Bag together anticipating any needs that might arise. Everything that wasn't used simply gets absorbed into my everyday supplies and clothing.

And with everything now completed for discharge, I was taken by wheelchair to our car where I very gingerly eased my way in, while my wife and daughter helped me get settled and comfortable. After that was a 44 mile drive home, and my wife made sure the ride was as smooth as possible. Once at home, she helped me out of the car, and very slowly up the twenty steps from our garage to our living area. She then eased me gently down onto the couch and got me comfortable; even lifting my legs up so they could rest on the ottoman.

Aahhhh...it was great to be home!

(Next Up: Home routine and Kidney Clinic)

Good Health to All!

ScottW

Renal Transplant and the ICU

*I have some photos of both pre and post transplant. I will post these in a separate blog after I discuss the hospitalization post-transplant.)


Once in the OR and on the surgical table I told the anesthesiologist where to place any IV lines on my L arm, or to hit a vein in my neck. Apparently he didn't believe me about the placements because, after putting me out completely, he spent an hour and a half trying various locations on the arm, finally placing the line in my very deep  AC (antecubital) artery. As a result of his "fishing around" for a vein, I had some nasty bruising on the arm.
In total, I had the Arterial line, which was used to monitor blood pressure, and two lines in my neck in the R side, one into the Internal jugular, and one into the External Jugular. These two lines were always planned, so they were no surprise.
Also in this time frame, a Foley catheter was put in place so that any urine would automatically drain, and my bladder would not have to work much, giving it time to expand at a natural pace. 

From what I have been told, the surgery went better than expected. The R slanted incision was made on my L side from just above the pelvic girdle down to the middle of my bladder's location. Usually, a renal transplant is placed on the R side of the patient. Why this change was made is unclear to me. It is possible that the scarring (from previous surgeries) on my R abdomen was too much for a clean incision; or, that the kidney, which was larger than average, was too big for the R side.
In any event, the surgeons made an approximately 12-14 incision--larger than I was expecting, by the way. This kidney has two Renal Arteries, which is a bit uncommon, but not unheard of. The arteries were attached to my blood system, with one artery being so small that the surgeon used the smallest surgical silk they had. IF that artery had failed, I would have lost about 10% perfusion to the organ. However, the very skilled surgeon was able to successfully attach both arteries, so I have 100% renal perfusion.
Also, the surgeon used surgical glue to adhese the incision closed, and added surgical tape over the surface skin along the length of the incision. Between the two, the scar should end up being clean and minimal in appearance.

Also, the decedent's ureter--the tube from the kidney to the bladder--which comes with the kidney was also successfully attached to my bladder. A stent is used at the connection with the bladder to allow the ureter and stitching to heal properly without distending the ureter and causing any tears at the connection. The stent will be removed on 12 June.

Now, because my bladder had not been used for three and a half years, and being like a muscle, had shrunk to the size of a kidney bean...very, very tiny. Once everything was hooked up, the new kidney began producing urine immediately, which is an excellent outcome so soon after transplantation. Some kidney's take time to "wake up," to use the proper vernacular. In that case, transplant patients must continue doing dialysis until the organ kicks in, if ever...which sometimes happens.

From what I was told the surgeons found nothing unexpected, and the entire surgery went quite well. Total surgery time was about four hours, with 1.5 hours used to place all the IV line access (as described above), then 2.5 hours on the surgical table, followed by about one more hour in recovery during which I was NOT awake or lucid at all. The surgical team notified my wife every hour on the progress and how I was doing. About thirty minutes after the surgery was completed the surgeon came out and talked to her, telling her how the surgery went, and asked for any questions.

After being in Recovery, I was taken to a room in the ICU (Intensive Care Unit) because of my new cardiac issues. This was a purely precautionary move by the doctors so I could be closely monitored in the event any serious cardiac events arose. Luckily, none did.

I was completely asleep in the ICU for about forty minutes before I began to be aware of the pain I was in; which was far worse that I was expecting. That's because I was under the assumption that the surgeons would be using the same site through which my older, cyst engorged kidney's had been removed, which is about three inches in length. The realization that the pain was far more intense than I thought it would be was hard to endure. Add to that was the fact that the ICU had not yet received the necessary pain meds, and I was in terrible pain. Once the meds had arrived--about an hour after my arrival--it took around two hours for the pain to be under some sort of semi control.  In the meantime, I was having muscle spasms along the incision, causing horribly intense pain; so much so that apparently, I was crying and shaking badly, crying out every minute or so.
My wife and our friend Kelly took turns holding my hand, stroking my hair gently, and verbally trying to keep me calm. Both had to leave occasionally to get a break from my seeming constant cries of pain.
During this time I also became very aware of how dry my mouth was. I'm talking your tongue sticking to the bottom and roof of your mouth dry. This added to my incredible discomfort. The nurses offered ice chips in moderation, or regular swabbing of my mouth with water. I actually used both, which helped immensely.
The night following surgery was very long! Finally, at around 300a, I was able to sleep again following numerous injections of pain meds via the on-demand pump at my disposal. Even sleeping fitfully was better than not sleeping at all.

The next morning the nurses had me up and walking...however briefly. Plus, having had abdominal surgery, I was expected to do the breathing exercises to ward off potential pneumonia. I started in on these exercises after my first walk.  Once I was done with that first walk I asked to be seated in the reclining chair that was in my room--I just had to get off of my back after being in the prone position for over twelve hours. Plus, the beds in this hospital are anything but comfortable--a purposeful tactic to get patients to go home, I believe.
Anyhow, I spent most of that day in the chair, doing the breathing exercises regularly and even falling asleep a number of times. Helping me to be comfortable in this position was the abdominal binder that was placed around me once the transplant surgery was completed. This binder is a huge support to any abdominal surgery patient as it constricts the overall movement of the abdomen. This also aids in the overall heal process as the body has lessened pain to deal with. Don't get me wrong...I was in plenty of pain. However, the binder simply aids in the patient being a bit more comfortable; until they move or walk, that is! :o)  I would wear the binder constantly while in the hospital, then during the first two weeks at home. Now I only wear it when traveling anywhere. At six weeks post-surgery I can go without the binder entirely--which is next week, by the way!

As I stated earlier, I began producing urine immediately once the kidney was hooked up. Post surgery I was producing urine in volume. In fact, I lost nearly 3 Kg in water weight during my time in ICU!


Another vital aspect of healing from abdominal surgery is the ability of the body to produce and pass gas. This actually indicates that the digestive tract was not impacted during the transplant--or that it is healing properly following any surgery that involves the intestines. My first day post-transplant I was passing gas, though painfully as the body really doesn't like anything cutting into it. The pain receptors were firing constantly, and even the simple passing of flatulence caused lots of pain.

I spent two days in the ICU, and the precautions observed because of my heart were for naught as my vitals were excellent, stable and showed zero signs of cardiac compromise.
In fact, I did far better post-transplant than anyone expected! Having had numerous abdominal surgeries before, I knew what to expect, how to recover best and how to push through the pain to get up and walking as often as I could tolerate.

So, on Saturday evening--two and a half days after surgery, I did so well that the doctors ordered that I be moved to a regular transplant patient room on the 10th floor.

(Up next: Finishing My Hospital Stay and the Plethora of Meds I Need)

Good Health to All!

ScottW

Pre-Transplant: The Unexpected Odyssey

We arrived at the nurses station on the tenth floor of the patient tower about five minutes after checking in at the ER. The tenth floor is where all transplant patients are taken both pre and post surgical. All the staff from the doctors to the nurses to the cleaning crew are specifically trained to care for transplant patients; and at the Intermountain Medical Center that patient care is beyond exceptional!

Anyhow, we were taken to my room and told that I would be doing my regular dialysis there as soon as the dialysis tech was available, which would not happen for another three hours. In the mean time I was to get changed into the ever stylish hospital gown, relax, and maybe get some sleep. Meanwhile my wife called our daughter who would be there several hours later, and texted numerous friends and coworkers with the news of my impending transplant.

When my daughter arrived she was all excited because I would have my transplant on Star Wars Day, May the 4th. She said, "The Fourth would be with me...Always." A good joke!

Anyhow, the dialysis tech and cart arrived at about 0630a, and was told the transplant surgeons wanted her to take 5 Kg of fluid, which I immediately objected to because at the most I had only been taking just over 3 Kg. I also stated my current dry weight (96.3 Kg), and told the tech that if 5 Kg were taken my body would be wracked with terrible cramps. As it was, at only 3 Kg taken I was having severe leg cramps following dialysis. So, the tech contacted the doc on call and repeated my concern. He asked if I could go for 4 Kg, but would have the Tx stop if the cramping became too much. I reluctantly agreed to the compromise, and the four hour Tx was started.

At the three hour mark the cramping began, but I was able to remain relaxed enough that they never became terrible. Once completed, the tech gave me a .50 Kg bolus of NS IV fluid to counter the lactic acid now coursing through my muscles. This was enough to hold the cramps at bay.

Right after the dialysis tech had wrapped up her cart, the procession of surgeons and other doctors began. They were greatly concerned because I has some fluid in the atria of my heart, which had apparently been there since my previous Echo cardiogram last Fall; which I was never told about, and also which I could have been working on the whole time between then and now with a cardiologist. The fluid causes a form of cardiomyopathy, and was likely caused by the fluid that would accumulated under my diaphragm between dialysis treatments (Tx's). This caused the lungs to push against my heart, which could not then sufficiently afterload blood from the atria. Over time this causes fluid to build up in either the lungs, or the heart. As one doctor stated, "Instead of your lungs filling with fluid, your heart took the hit."

So, even though I have zero cardiac history, and my family has zero cardiac history, I now have some permanent damage to my heart. It isn't severe by any stretch, but there is now damage that really shouldn't bother me.

After the line of doctors was done, I was sent to do another Echo to see if the dialysis had removed any of the fluid in my heart--which it hadn't. This development further concerned the doctors who conferred over whether or not to go ahead with the transplant. The Transplant Cardiologist was sure a new kidney would solved the problem. The Medical Director for the Transplant Team agreed. They in turn conferenced with the rest of the Team doctors (right in front of me, by the way), who all assented to going ahead with the transplant.

The hope was that with a new kidney--and a few cardiac meds--my heart would, what they called, "Remodel itself" over time. This would eliminate the fluid, strengthen the heart and, aside from the damage that had already occurred, leave my heart as healthy as possible.

By the time that decision was reached, it was after 300p. I was told the surgery would happen at about 830p. We also learned--quite inadvertently, I must emphasize--that the kidney was exactly what I had been hoping and praying for...a young healthy organ from a 32 Y/O male who had apparently been in a nasty MVA (Motor Vehicle Accident). Considering the Transplant Team knew about the organ yesterday (03 May), I can assume that the decedent donor had been kept on life support; possibly to keep the vital organs perfused until harvesting.

So it was another waiting game until I would be taken to the Operating Room. However, at 0600p, we were told that a transplant that was scheduled ahead of me had been canceled for some reason and that I would be taken to the surgical suite at 0630.

The anesthesiologist arrived just past 0630p to administer a pre-med dosage to help me relax. A surgical nurse also arrived to finish prepping me for the surgery. By now I was drifting a lot, and apparently my daughter convinced the nurse to give me a surgical hat with some cartoon characters on it...gee, thanks, daughter of mine!  :o)

When I was prepped the journey to the OR began; wife, daughter and family friend in tow. They, of course, had to stay in the waiting room. I was then taken into surgery...

(Up next, surgical highlights and the ICU.)

Good Health to All!

ScottW

Renal Transplant: Getting 'The Call'

Just like I had been told by numerous people, getting "the call" turns into a whirlwind.

My initial call came on Wednesday, 03 May at about 1130a. The Transplant Coordinator stated that I was #2 on the list for my blood type, but because the top recipient was not feeling well, I became the "Primary" [recipient].

My labs were being cross-matched as we spoke, and he--the coordinator--was highly confident that I would be receiving the kidney. He told me to stay by my phone.

After speaking with him, I immediately contacted my wife to tell her the news; which she was both excited and nervous about.

About two hours later I received yet another call from the Transplant Coordinator stating that I needed to get to Intermountain Medical Center (in Murray) for an Echocardiogram by three o'clock. Also, I asked when the kidney would be available, and was told 'tomorrow afternoon.' I was told to go to my regular Thursday dialysis after which I was to head up to the hospital and get checked in. After that call I called my wife and told her about the needed test, and the plan for the following day.

So, she rushed home, picked me up and on we went. We arrived at the Cardiac test area at just after 3pm, and I was immediately taken back for the test, which proceeded smoothly and was uneventful.

After this we headed back home to get ready for the next day.

Once home, we both went about readying our 'Go Bags', getting a good dinner then relaxing. However, at 0130a, the Transplant Coordinator called yet again and stated that I needed to be at IMC as soon as possible. Seeing that my wife was asleep, I told him that it would be at least 3am before we would arrive. I then received instructions for checking in via the Emergency Room, repeated them to the Coordinator, then hung up and woke up my wife very gently, telling her the new plan. She woke up instantly and we both began readying ourselves.

By 0215a we were on the road, arriving at the ER 40 minutes later. As instructed I went up to the ER reception desk, interrupted the nurses on duty (as instructed) stating that I was here for a renal transplant. The nurses immediately verified my info--while interrupting their conversation with a regular ER patient--and gave us instructions on where to go and who to check in with. I thanked then for their time and we headed to the patient tower elevators to begin the process of my transplant.

(Next up in this report...the unexpected pre-transplant odyssey.)

Good Health to All!

ScottW