337) In Which Jack Gets a Kidney Call!

March 9, 2009
Monday

Morning: I just got my first kidney call! James the Transplant Caller Guy called at about 8:20 to say that they might have a kidney for me! It is a "high risk" kidney and yet it has passed the cirology tests (?). The kidney came from a guy (?) who had a past history of IV drug use with heroin. He was in treatment and died in a car wreck. Dr. Lewis, my transplant doc thinks the kidney is good and James says I have about an hour to make a decision on it. Okay.

So now what? Liz and I talk it over and decide we need to ask Moritz what he thinks. I call his office at 8:30 and no one is there! I call the Dr's Exchange to have them page him and they can't find him but pretty soon Judith Betts calls and we discuss the kidney and she gives me the questions to ask:

1. What was the creatinine level when the guy died? We want to know how the kidney was functioning then... if 1 or 2 that is good... not 4.
   
2. Are there other reasons he was "high risk" other than the social history of heroin use?
3. How did he die?
4. What does Dr. Lewis think? She reminded me that Lewis is on the cautious side and wouldn't risk as much as other docs might.

So, I thank her and call James back and right in the middle of my conversation, my phone dies... must need charging. So I call him back on Liz's cell phone and ask the Betts' questions and get good answers, as follows:

1. Creatinine was 1
2. No other reasons he was high risk
3. "vehicle related"
4. Don't think I need to talk to Lewis after all, since James' answers are so clean.

Then James informs me that there is another person ahead of me on the list and he is also waiting for that person's decision. I should hang tight, don't drink or eat anything... and btw, he wants to know my height, weight, if I have any ulcers or open sores, any flu or cold, or anything currently "wrong" with me. NOPE! Then I remember my referral for my "murmur" and tell him Venkatesh or someone has the results but I haven't heard anything yet.

So, he says hang tight and he'll call me back just as soon as he gets an answer from the other person higher on the list.

WOW is all we can say right now. The I-Ching I throw throughout these conversations, based on the question, "What will be the result of taking this kidney" gives me hexagram # 54, Marrying Maiden changing in three positions (2nd, 4th, and 5th) to # 48, The Well. For those of you who know, this might be a prospicious reading... it warns that I am subordinate to the situation and it could change in several ways; being disappointing (2), refraining from action to await a more prospicious time, and finally, overlooking my social position to place myself in the service of others... these changes leading to "The Source". So, the way I read this is that it might be a disappointment this time... that I shouldn't just jump at it without forethought, and that the ultimate choice is not mine, but I should put myself in the service of others (the other candidate or the family of the deceased in some way) and that those moves will lead to the source... ultimate success. WOW again.

So, here I am awaiting James call. He just called at 10:40 while I was blogging this, asking more detail about my recent sonogram of my murmur... is that good news?

11:30 am: Call from James the Transplant Caller Guy... I am on my way... need to come up to N. Austin Med Center North Entrance to check in NOW! They'll do tests etc and we're on on the way to Part Two of the ADVENTURE. All goes well? I get the operation tonight! WOW.

12:30 pm: Arrive at North Austin Med. Center (NAMC) and meet with Elizabeth the Admissions person who has lots of forms to sign and "an important question to ask me to think about while she goes off to make some copies of my forms...What do I want from my stay here?"

"Well... how about computer access to keep in touch with the world?" I say. No promise, but Elizabeth writes it on the folder. Elizabeth had asked the important question with a comment about it being a new procedure, which said to me that she wasn't completely going with it herself (my hallucination). It is also new for her to escort us up to ICU to start this part of my adventure... used to be she took people up to fourth floor... which, of course, means nothing to us.

Rachel the Nurse remarks on the newness too. She is used to getting patients right before they go to the OR, not at the beginning of the process... and she likes the new way of doing this cause it shows her more of the patient than she used to see before surgery. They used to bring patients from surgery into ICU and the nurses didn't get a chance to know them as they are... only groggy and spaced out after their surgeries... she seems to like it this way better for more complete patient contact.

Later: Rachel has been here most of the 3 hours I have been here... doing all the hookups, checkups, pokings, and proddings... and she has been GREAT! Very gentle, personable and explaining all she can... which answers about 90% of our questions....

Liz and I are here and still kind of in shock. Johnny has shown up from College Station and is ready to help in any way he can. We meet Mark the EKG guy who puts me in a wheelchair and rolls me down to the EKG machine and talks about his motorcycling up to Wyoming and also informs us that James the "nerdy-looking" Transplant coordinator also has several motorcycles. He also who remarks about my hairless body while attaching leads to my chest for theEKG... sticking about 10 stickies that attach to the wires and remote control unit. He reports back that the EKG is "perfect "! Then we meet Jessie the Transporter who takes me in a wheelchair to get a chest x-ray from Maureen the x-ray Tech. Jessie bring us back to ICU and all the while we were gone Liz is on the phone with friends and relation about this surprising turn of events; it's like we're having a baby! She tells one caller that when I got the call from James the Transplant Coordinator, I said, "I haven't heard from you guys in years!" in response to his salutation from the Transplant Center. As I remember that now I smile atthe remark and think, "Liz is part of this blogging thing now". At the point I talk about my blog, I find that too is Rachel is interested in blogging... telling the story of her sister's baby blog, and how interesting it is to catch up on a daily basis... and how when the new parents don't blog, she get antsy to know what's going on over there with the baby.

So, of course, since Rachel is so easy to talk to, we ask her tons of questions, and some of the answers are: the surgery is about 6 hours long, the stay in ICU afterwards is about a day or so with a catheter measuring every drop of liquid coming out and us recording every drop going in to partly track how the kidney is doing.

Bernadette the Post Transplant Coordinator comes in to give us some education, leave a notebook and a WRITTEN TEST that we have to pass after the kidney comes on board, or we cannot leave the hospital. But it is an open book test so Liz thinks we can't possibly fail... after all, we have Master's in Science (ala the Duck's Breath Theater). Bernadette spends about an hour or so with us and informs us of more than the following:

• The kidney is coming in to San Antonio from somewhere else and will be tested for anti-bodies, HLA, and antigens (tissue testing) before being sent up here
• They will cross match it on the way up to Austin... while the kidney is driven by car
• And it should be ready for me by 7:15, so I am on the OR schedule for about 7:15!
• I will have a catheter and sometimes the kidney is "asleep" for hours or days before it kicks in
• Sometimes people have spasms or cramps after the kidney is put in
• Dr. Lewis will be in to talk to us about an hour before the surgery.

Bernadette brings out a plastic device called a Inspirato and shows me how to use it to get a baseline on my breathing... you blow all your air out and then put the mouth piece in and draw air in while watching a measure on the left that you try to keep in a range, while measuring the amount of air in on the right... doing this about 10 times until you hyperventilate or get tired of this operation... so we establish my Insprato Baseline as 2500.

Bernadette, who happens to be from Switzerland originally and has this really cool Swiss/British kind of accent, short white hair (about my age) and wears clogs and those hiking kind of socks... goes on to explain the complications that can make a transplant complicating:

• Pneumonia ~ stand up lots to breath & walk to stave this off... take deep breaths and cough when I can
• Clotting in bed ~ get out of bed as much as possible... there can also be clotting in the catheter. (right beside this I have noted, "no herbal meds")
• Watch out for SOIL... has lots of microbes and bacteria ~ If I work in the yard I have to double-glove, wear a heavy duty mask and get double clean afterwards ~ best not to garden, but if I have to, take above precautions and wear sun block, and shower afterwards.
• The Campeth totally wipes out my T-cells so I have to be VERY Careful about infections for the 3 to 6 months it takes to re-build them ~ WASH HANDS many times a day with antibacterial soap (they have neat dispensers outside the rooms here that dispense a mouse-like foam that you rub into your hands and it dries right there with no use of a germy towel. COOL!

I'll be in the hospital about 5ays, recouping at home at least 6 weeks, and probably not back to my office for a couple more weeks and then possibly no trainings and contact with the general public for up to 6 months... good time to be developing Webinars and computer driven training exercises! So, we'll know much more as we involve ourselves in this new "adventure" and I expect to continue blogging as long as it seems helpful to someone out there.

Dr. Lewis comes in to visit, give some info, and answer any of our questions... of course we are totally up to our gills in new data from Rachel, Bernadette and actually every person we have talked to so far. Dr. Lewis explains that if the final tests on the kidney are okay it is a

good kidney. He examines me and explained the basic procedure of the surgery... I asked about taking my cystic kidneys out and he said "not unless I need to...there is probably enough room in there for the new kidney and if not he will take the right one out. I ask about getting my former svelt figure back and he gives more information: "we don't want to get more complicated than we have to because each new complication can add to later difficulties and he likes to keep it as simple as possible."

After Dr. Lewis leaves, Rachel says he wants a CAT scan to ensure there is enough room down there for slipping in a kidney under the right one (see picture on sidebar). She runs into another nurse down at the CAT room who is also from Louisiana and on the way back we talk LA food and she likes it spicy... and I tell her about Cypress Grill but she not so sure cuz she hasn't found a good place yet. When we get back to ICU John and Liz are gone but Liz comes back with John and Katie, and gives me one last kiss and promises to be in the waiting room for updates from surgery.

At around 8 Kim the Other Transplant Coordinator comes to take me down to the operating room where Dr. Shawn the Anesthesiologist gets ready to set me up for the surgery, asking how I am, and I honestly say I'm a bit anxious and he replies he'll give me something for that. He plugs into my access and says something that I never quite respond to... cause I'm gone to the ozone......