Tuesday, December 7, 2010

Flying Home

We flew home on November 30th, a mere 5 days after surgery and here's the important points:
1. Wheelchairs are good. Trying to walk, no matter the size of the airport is not worth the pain it will cause later.
2. Medicate beforehand. I didn't, and it sucked. I only had T3s for the pain, and wouldn't recommend taking 2 as it makes me woozy, but 1 would have taken the edge off.
3. Earl came in handy. The hospital recommended I have a pillow or blanket between myself and the seat belt as a cushion and most airlines charge for these now, but Earl worked quite nicely. Not only did he provide comfort but the cushioning was greatly appreciated.
4. Wheelchairs. They are on the list twice for a reason.
5. A ride or a taxi, don't park at the airport. Airport parking involves walking, walking is not good at this stage. Chances are it's already been a long day with a lot of activity (especially if a certain dog gets out of your friend's house just as the cab arrives to take you to the airport and you have to chase him down before you can leave), and friends and taxis meet you at the curb which is a very good thing. Plus, they don't really let the wheelchairs out of the terminal building.
6. Rest. When you get home, just go straight to your wonderful warm, welcoming and comfortable bed and sleep.  You need it.

All in all, its good to be home, and flying was way better than driving. Could not have survived every bump in the winter roads even on the way home from the airport, let alone from another city.

Wednesday, December 1, 2010

Freedom! Discharge Day

I loved Day 3. First, I had oatmeal with brown sugar for breakfast, which was the closest thing to real food I'd had in days, and second I got out.
Here was my conversation with the surgeon who checked in with me first thing in the morning:
Him: "how are you doing?"
Me: "I would like a shower and I would like to go home, please"
Him: "alight then, we should be able to do that."
He took a look at my chart, saw that I was eating and moving well and got started on the paperwork.

My husband showed up shortly, when and filled the prescription for T3 with codeine for pain management, a nurse  took out my IV, and gave me a shower (I HATED not being able to wash myself - one of the reasons I wanted to go home), I got dressed in some loose fitting yoga pants and a sweater, and away we went.

Home at this point was my friend's house, he had very generously opened his home to us for the duration of our visit, and although there is no place like home, this was so much better than the hospital. 1, I didn't have someone bugging me every 4hrs to take my vitals. 2, I could pee without assistance. 3, I wasn't in a hospital with a room full of other patients, who I understand had their own issues, but at times were very noisy, and those times felt like they were always when I was trying to sleep. 4, I could wash myself (which granted I didn't do until the next day, but even knowing that I could made me so much happier).

Once at home I took 2 T3s and took a much needed nap. The simple activity of showering, walking from my room to the cab and then into the house was a bit much for me. I was exhausted.

This first day of freedom involved a few naps and not much more, even food-wise. I was/am still on mostly soups with some soft solids in them, nothing much more than that. So although the food did get better, we are still limited on what I can/should be eating. Lucky for me my husband is a pretty awesome cook, so when I am able to eat more, I know I'll be in good hands.

I P Freely

Day 2 brought about the removal of my catheter. Yay! I was super stoked about that. It happened shortly after waking up on Day 2, after a breakfast of OJ again. The nurse simple came and said that she was taking it out, I was laying on my back, she reached inside the waistband of my PJ pants, grabbed the tubing and it was out. Simple as that. No pain or discomfort (other than having someone reach into my pants). I was now at a stage where I pee freely.

Which wasn't actualy true. I still had an IV, and my IV was plugged in behind my bed. So everytime I had to pee, someone (my husband during the day, a nurse at night) had to some and unplug the machine for me. But, it was great to be up and moving around even just that tiny bit.

Speaking of being up and moving around, I was also able to start taking short walks down the hallway (assisted of course by my husband), holding on to my IV stand which I rolled somewhat awkwardly alongside of me. Being able to take these short walks meant my days were not spent exclusively in bed, and that was a joy in itself.

Earl was always waiting for me when I got back, and I say always like I had more than 2 walks, which I didn't. Those simple walks of 50 and 75ft were exhausting. As the doctors, nurses, and transplant coordinators had been telling me, this was major surgery and I was not to underestimate the stress it would place on my body. Which I totally had, and that was my own fault.

My midsection was still quite distended, apparently it can take some time for the CO2 to be fully absorbed by the body, but I was more used to it at this point in time.

Day 2 wasn't very interesting. Day 1 my hubby, Earl and myself watched Toy Story 3, and today we watched Toy Story 2. Of which I slept through most of it.
It was almost easier to sleep during the day than at night, not sure why, but it was.

The other highlight of Day 2 was ice cream. I was almost on full fluids, which they tried at first with some vanilla ice cream in the afternoon. It was tasty! And I handled it well so I was able to have more than just juice and broth for dinner, and even had chocolate ice cream for dessert. Food got a lot better on Day 2.

Post-Op Day 1

Hospitals are not great for sleeping, at all. Every 4hrs there was a nurse to take my vitals, and if that so happened to be during a few precious moments of sleep - oh well.

So Day1 started with a surgeon waking me up around 7am. He was a part of the team, but not my actual surgeon and thus I had never met him before. It amused me as people don't seem to understand why I did what I did. I have no connection with kidney disease, no connection with organ donation/transplant, I just decided to do it. He seemed baffled. He did take a quick look at the port sites and the incision (my 4 dots and a dash) and said that I was doing great and away he went.

I'm not overly sure what time things were going on during the morning, I was still pretty close with my morphine drip and that added a bit of a haze to everything. Breakfast for me was tea, orange juice, apple juice. Or that was what was served. I was only able to have the OJ, wasn't feeling very hungry.
One of the nurses washed me, which was an experience in itself. I am not a big fan of not being able to take care of myself, and not being able to wash myself was not fun. Plus, I am not a big fan of other people touching me, especially in all those places - even if its just to make sure I am clean. So I got a wash and was able to brush my teeth, which was super awesome. And I was able to put on PJ pants, which I cannot tell you how happy they made me. Finally my bum wasn't hanging out every time I rolled over! And I added some super soft socks as my feet have a tendency to be cold. I still had the compression stockings on as I was very sedentary and they help prevent clots, but they also helped keep me nice and warm. I couldn't put on a PJ top as I had my IV in and it didn't work with the sleeves. Which kinda sucked, but at least I was able to have pants despite the fact I still had my catheter in.

My husband arrived around 10am, visiting hours were from 12noon to 8pm, but the nurses did say he could come early if he wanted, but not before 10 as they had stuff to do. Which was true, I had 'eaten' breakfast and washed up after already meeting with a surgeon before he arrived. But it was so nice to see him. He always makes me smile.

In the early afternoon or late morning (again, not totally sure) one of the transplant coordinators came to see me. She brought flowers and a card from the recipient and their family. Apparently the recipient was doing great, creatine levels were down from the 600s to the 100s, which is huge, and it was like night and day for them. She said that quite often recipients have almost a grey pallor before surgery, and after they really get their colour back, which was a good sign, and this recipient was no exception.

To protect both myself and the recipient's anonymity, I won't share the contents of the card the wrote me, but I can tell you it made me cry. The recipient was a mother, father, son or daughter. They had a family. This person was now able to do things that mere days before they were unable to do. They had a future to spend with their loved ones that didn't involve 20hrs of dialysis a week. They thanked me for what I had done, for what it meant for their family and wished me a speedy recovery. Rereading the card now, it still has the power to bring tears to my eyes and lessen my pain. It was all worth it, plain and simple.

The rest of this first day was pretty uneventful, the only other thing to note was the physiotherapist came and had me stand up and take a few steps in place. I wasn't yet recovered enough to be walking, but standing was do-able. My meals were still clear fluids, so nothing really of note, and I didn't really 'eat' much as I had (and still have) very little appetite.

I kept the flowers my my bedside, the card in the drawer of my hospital table, and my Bunny Earl by my side at all times.
If this bunny had a green ribbon, it would be identical to Earl
A while back while waiting for an appointment I was texting my best friend and we decided to name my kidneys Earl and Pearl. Pearl being on the right, Earl on the left.  When my husband came to see me when I was first out of surgery, he came bearing a white bunny stuffed animal, and when we were thinking of names for him, my husband suggested Earl. Thus the recipient got Earl the kidney, and I have Earl the bunny.

This night, however, was not as uneventful. One of the side effects of morphine is nausea. Sometime during the middle of the night the nausea hit me like a freight train. It woke me from my sleep, I started pressing my call button for a nurse, and before they could even get there I was throwing up. It sucked. They wiped me up, gave me some gravol and a small dish for if it happened again. It did. Twice more. Each time worse than the last both in quantity of 'output' and in the retching which incidentally engages you abs which hurt my incisions. It was not a pleasant night. But, thankfully, it was the worst of my nights and really the only unpleasant part of my stay.

Donation Day - 4 Dots and a Dash

For whatever reason my husband's post(s) seem to have gotten lost in the abyss of the Internet and thus its taken a few days to get you all the insider information on what it was really like to have the surgery to give a kidney away.

At Home
Thursday morning we wake up pretty early, and by wake up I mean get out of bed, neither of us really slept much, and off I go to take my second anti-bacterial shower. This one leaves my skin feeling a touch itchy as its now a bit on the dry side, but I don't have much time to ponder this.


At the Hospital
We grab my 'overnight' bag, which in hindsight was completely over packed, and head off to the hospital. Upon arrival we do not go through admitting, rather we go straight to the floors as previously directed and they were waiting and ready for us. The nurses direct us into a room where I am told to change. My clothes, jacket and boots all go into clear plastic bags that get labeled with my information, and I put on the garb.

Dressing for Surgery
This was rather interesting as I had only expected a hospital gown and housecoat over top, which I did get, but also got white, thigh-high compression stockings with a hole at the ball of each foot (I'm assuming so they can check circulation). On top of those were hospital slippers, the thin paper ones that are more for sanitary reasons than anything.
Once I was all dressed and ready the surgeon came in to have me sign a few final forms authorizing the procedure, any other necessary life-saving procedures, as well as a possible blood transfusion should the need arise (which they didn't think it would, but just wanted to cover the bases).  Once the forms were all signed we left the stuff that was to go to my room (a nurse would deliver it at some point in the day) and walked to the surgical unit.

Surgical Unit
Here we were taken into a curtained-off area (similar to a ward with lots of beds and only curtains for privacy) where we sat and a few nurses came to introduce themselves and ask a few final questions (most of which they had asked when we first got there, but the duplication was a safety thing, so didn't bother me) - when was the last time I had anything to eat, do I have any allergies etc. The anestelogist introduced himself, as well as a few others on the team. It was about 8am when I said goodbye to my husband and went into the room.
The room had a table in the center that almost looked like a cross- the main part for my body, the cross part for my arms. When I got up on the table I needed to make sure not to lay down on the hospital gown as clearly they would need access to what was underneath it. I'm laid down and they start with the needles. I'm not a fan at all, but apparently the first set of drugs was to relax me, and the second set was to put me to sleep. I was totally okay with both sets. My view from the table was whomever was in the immediate vicinity and two of those large, round OR lights. Not scary, but a little unnerving.I didn't spend a lot of conscious time in this room, so I don't have much more to say about it.

The Surgery
Here's what I do know about what happened in that room and in surgery. Laproscopic surgeries typically tend to be a bit longer than open surgeries as they are working in a confined space, by mine was only 2hrs in and out. I could tell that my surgeon had done this many times before. While I was out, they did put in a catheter, IV, and of course took out my left Kidney (named Earl). During this time my husband was waiting in one of the surgical waiting rooms on the same floor as the one we went to upon arrival that morning; after the surgery was done the surgeon came out and gave him an update as to how it went, which was perfectly.

4 Dots
I have 4 laproscopic sites on my left abs, 1 beside my bellybutton, 1 a bit higher and to the left of my naval, right below my ribs, 1 in line with my bellybutton but almost on the side of my body, and one down from the one below my ribs. They vary from 5mm to 12mm in size (I'm not sure which ones are which to be honest). If I take the heel of my right hand, place it on my stomach near the bellybutton incision, at the tip of my fingers is the one on the far side of my body, at my thumb is the one below my ribs, and at the midpoint on my pinky finger is the lowest dot.  Not a large area, but hopefully that gives you an idea of how they are spread out.

The Dash
The incision, is almost where my left leg joins up with my torso. Almost right on the crease of my leg/body. They do the incision here for cosmetic purposes, its easier to hide the scar. The incision is about the length of my pointer finger, 4inches or so.

Recovery Room
Apparently I was in recovery for about 2 hours, mostly still under anesthetic. I remember the nurse (male) waking me up with a warm washcloth on my face, and being very cold. They grabbed me lots of warm blankets and after what seemed like a few brief minutes of checking my vitals, took me to my room.

My Room
I didn't know most of this when I first got there, but my room was a 4 patient room in the surgical ward (the recipient was in a different ward to help protect anonymity). I was on a morphine drip to help manage the pain, and I had this handy little button, much like what I assume the ones they use on Jeopardy are like, to administer some when I felt the need. It would of course lock me out if I tried to get too much in too short a period of time, but I didn't really notice much of that the first day.

I was feeling pretty happy, I knew it had gone well which is what I wanted, and a little loopy from all the drugs running through my system. All of this I had expected. What I hadn't expected was how distended my abdomen was going to be from the CO2 they pumped into me during surgery. I looked like I was 5 months pregnant. Or at least it felt that way. My entire midsection was pretty tender.

I was on clear fluids as a diet, and still had both the catheter and IV. The catheter served 2 purposes. 1, to monitor my 'output' to make sure there wasn't blood in the urine or anything like that, and 2, there was no way I would be able to get up and pee as often as I would have needed to give how much fluid they were pumping through me via the IV.
Hospital food, not that great. Mind you, I wasn't exactly getting the best selection at this time, and even then could only manage a bit of orange juice and a few sips of vegetable broth.

I spent most of the day on my back, and had to get the nurses to assist me to roll onto my right side the first time as I was that tender. Of course I was still wearing that ever so lovely hospital gown, and thus when I was on my sides during the night, I constantly felt like my butt was hanging out, even when I knew it was covered.

I was so drugged up that day, and stayed pretty consistent with the use of the morphine, that although they woke me up every 4hrs to take my vitals (temperature, blood pressure, pulse, O2 saturation), I was out of it. Not saying that I was sleeping, that didn't happen much at all, but I was pretty out of it.

During the night my blood pressure did drop pretty low, 93/45 or something like that. It happened at the midnight vitals check but they didn't do anything that I could tell, other than to keep a pretty close eye on me. Apparently morphine can lower blood pressure, which combined with my typical blood pressure which was on the lower side of normal, resulted in the drop. Thankfully the next time they roused me to check my vitals it was a bit higher.

My dear husband was by my side all afternoon, having made call to the small group of people who know during my time in the recovery room. From his side, apparently those 'guest' chairs in the hospital rooms are not that comfortable, and the entertainment that we brought was mostly for him as I was too out of it for any of it.

Thus ends DDay.