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
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