The blood work is what I like to call the “go / no go test.” This is the last step in the testing process. The lab drew blood from both Candi and me and will ship the vials off to Johns Hopkins University for testing. The testing will mix Candi’s blood with mine to “make sure they play well together,” as Candi likes to put it. They need to make sure that Candi doesn’t have any antibodies in her blood that will attack my kidney when it is placed in her body. The transplant center has already tested Candi’s blood many times and are confident that she has no such antibodies so they are confident that this test will not present any issues. We are both hoping they are correct! We will have to wait 10 to 14 days for the results so we will have to patiently wait until then! We go back to the lab exactly 7 days before the transplant for the same test to be performed one last time.
The second part of my visit was with the surgeon. The surgeon showed me a picture of an x-ray of my kidneys (see below). He explained that they are going to take out my left kidney (along with the attached ureter and blood vessels). They plan to use laproscopic surgery. This means they will put in a 2 inch incision below my belt line and some small holes in my stomach in which to insert tools and a camera. They will then be able to watch the surgery on a tv monitor. They will pull the two muscles there aside and pull the kidney out through this opening. This saves them from having to cut through any muscles.
If they run into any problems, they could have to switch to an open procedure which would mean a larger incision in my stomach and having to cut through the muscle. This is a very safe type of surgery but requires a longer recovery period, is more painful, and results in more scarring but this is only required in 1-2% of the surgeries they perform. I’m hoping for laproscopic!
The surgery itself will last two to three hours if we are able to go the laproscopic route. The open procedure is actually quicker since they don’t have to work around the muscle. I should be awake before they finish Candi’s surgery. There is some overlap but they won’t start on her until about the 2/3 mark in my surgery. The tough part for me is going to be waiting to hear how the surgery goes for Candi!
The surgeon echoed what I had heard earlier in terms of recovery times. I should be in the hospital for 2 to 3 days and then will need to recover from home for another 2 weeks. I should be able to work from home after the first week. If I can get completely off the pain killers and the pain isn’t too bad, I may be able to start driving and head back to work before the two week mark. This will certainly be my goal.
My final question for the surgeon was regarding how close of a match Candi and I are. From earlier conversations I had with other personnel from the Transplant Center, I was under the impression that we were a close match but I had never heard for sure. The surgeon wasn’t sure how close a match we were but stated that it really wasn’t that important any more. With recent advances in anti-rejection drugs, donors and recipients no longer need to be a close match (but they do still need to have the same blood type). It is amazing how far we have come medically the past few years!
With all of my questions answered, we moved on to signing some important legal forms. I had to state that I was aware of the risks associated with surgery, that I understood what type of surgery was going to be performed, and that I had ample time to have my questions answered. With that, I was on my way. Just 28 days until transplant!!!
3 comments:
Hi all -- Candi here. According to my countdown clock, there are now 25 days left. It's becoming very real for me now. While I am so thankful that Josh is doing this for me, I have to admit that I am scared to death! Any encouraging words out there?
Candi...I'm concerned I might oversimplify the situation with what I say, but I have to comment anyway. Of course I have never had to face anything like what you are facing, or what Josh is facing for that matter. But I must tell you I'm really optimistic about what the outcome will be for you (and for Josh). The medical techniques have become so advanced now, and the potential benefits to your health, along with the excellent chance of success, seem like an unbeatable mix! I have to believe that once it's over, and you've gone through the healing process and learned to adapt to the changes it will bring, you will be very happy you have done it. That's my sincere wish for you. Good luck to you (and to Josh)!
Gary Graff
Hi Josh. I found your blog through the NKF Facebook page where I posted about my transplant experience with my mom in December 2009.
I had three incisions when they removed my kidney: two small (1.5in) incisions on the side of my stomach for the camera and tools, and one larger (3-4in) incision below my navel where they physically removed my kidney. All of the scars on my stomach have faded considerably, with the most noticeable being the largest scar. It's really not too much of an issue for me right now, but I was told that there are some creams that are available over-the-counter or from a dermetologist that can actually fade the scar. Moisturizing the area and taking vitamins, specifically vitamin E, or vitamin E oil rubbed on the healed site, can also aid in reducing scarring.
Hospital stay is only 2-3 days, just like your doctor told you, and I personally was driving after about a week and a half. The pain is bad at first, but I did myself a favor in the hospital and tried to ween myself off of the heavy painkillers as soon as I could. They gave me morphine post-op, which didn't do a hell of a lot, and switched me to dilaudid, which is stronger and did a little bit more for easing discomfort. I didn't like taking the dilauded because even though I wasn't allergic to it, it still gave me a weird, sick feeling with labored breathing that was scary. My mom is actually allergic and can't have it because she went into respiratory arrest one time that they unknowingly gave it to her, so hence my concern when they told me they were switching me over to it. By the second day, I didn't even want to use it, so I cut myself back to using it when I absolutely needed it - a few times during the afternoon and less often during the evening - and on the third day, my discharge day, I was completely off of the pump and on to pain pills.
If you are feeling a little better by the second afternoon in the hospital, you should get up and walk around a little bit - even if it is only to the bathroom or around the room and back with assistance. They will probably work this into your regime, anyway, but it is still something to keep in mind just in case you have bad nurses, like the ones I had who basically ignored me half of the time (no exaggeration). Even if it hurts, take it easy and slow, but push yourself to move around little by little. They pump air into your body during the surgery to inflate the abdomen so they can see better and all of that air is trapped inside post-op. Moving around helps dispel some of it so those air bubbles don't cause discomfort; I think I had one that ended up migrating up to my shoulder somehow and it was very annoying.
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