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.

Timelines

I called the Transplant Center this morning and spoke with the woman who has been coordinating everything for me thus far. I was looking for information on timelines and a bit more about what to expect.

I am still waiting for my psyc appointment, but that should be in May (apparently the Dr is bringing in another Dr to help with his course load as he is overwhelmed with all the refferals he is getting). The appointments with the nephrologist and the surgeon will follow within about 2 weeks, but right now they dont have an Operating Rooms open until July, so the wait time for surgery is about 3 months. I'm kinda hoping I can get scheduled for July as that still allows me to have the time off work that I need without infringing on our busy time. I know I will have to take as much time as I need to heal, and that with laparoscopic surgery I could be back within 3 weeks, but I need to be back at work, and be back 100%, before September.

My other question was about staying local vs going national. I am not opposed to going where I am most needed, but I think I would prefer to stay at home. Here I have my husband to take care of me, as well as a friend or two. I will have my own bed, and not be racking up a hotel bill. Apparently there is a very high demand for Kidneys, almost 1000, so as long as I am a match I should be able to stay here.

Part of me is still coming to terms with some of the reactions I have been getting, and although they do not have me doubting my decision or anything like that, they have made me wonder why I think so differently than other people that I know? The reactions I'm speaking about are not just ones that I have gotten personally when talking to people about my specific choice, rather from when talking about living organ donation in general. Things to ponder as I get back to my day...

One of the reasons why...

http://www.time.com/time/audioslide/0,32187,1983982,00.html
Right now I am hyper-tuned to anything involving organ donation and especially kidneys. I have been reading all about wait times and how Ontario has the lowest rate in the country for registered donors, how in 2008, there were 4,330 people on the waiting list for an organ transplant, 215 people died while waiting for an organ transplant, and various other stories which go to confirm that not many people do what I'm about to do.
There are so many stories out there about our health care system, scary statistics, and tales of woe. Heart warming stories are few and far between, so when I found this story, I wanted to post it as a reminder of why I am doing this.

I know that if it was my husband, I would be pulling people off the streets and begging them to get tested for donation. I would do anything in the world to keep him alive and by my side. We dont have children yet, but if we did it would make it all that more important to keep him alive. Dying due to a lack of organ donation is so horrible because its preventable, and its not really that hard to donate. Yes it takes time, a multitude of tests, and a bit of recovery post-op, but really, 6-10 weeks out of my life to give someone another 15years with their husband/wife/child/mother/father... thats hardly anything in the grand scheme of things.  So seeing this story online this morning just reminded me of why I am doing what I'm doing, and strengthened my resolve to see it through.

Hospital Gown, House Coat, and my Red High Heels

Last night was my MRI to look at the veins and arteries of my kidneys to help the surgeons determine which kidney to remove (which one will be easiest to remove) and to make sure both kidneys were functioning at a level which will enable my body to function with only 1.
So here's how it went. The test was scheduled for 630pm, I was to arrive at the hospital by 6, and was to fast for 6hrs prior.
Upon arrival I am given a questionnaire to fill out mostly pertaining to prior surgeries and any instance where I would have metal in my body. Thankfully I don't have a pacemaker or screws in any bones, and the tattoo that I have is over 3 weeks old (its 8 years old actually). I fill out the form, and get to change into the hospital gown, and robe. Everything had to come off except underwear and shoes. Of course I managed to still look fashionable in my red high heels. Or at least as fashionable as one can look in such a situation.
I do admit it was a joy having to wait in a general waiting room with friends and family of other patients while in such a fashionable outfit, instead of a waiting room normally reserved for patients who have had to change.
Needless to say the wait felt rather long, due in part to the fact they didnt call me for my test until 7pm.
At this point a technician went over the form I had just filled out ensuring I fully understood everything and walking me through the MRI.
I laid down on the "bed" and the tech went vein hunting. My veins are not easy to find on the best of days, and they like to hide when I am not well hydrated. Being as I had been fasting for over 6hrs, it took 2 techs 2 arms to get a vein that worked. Did I mention I hate needles? Super fun.
On the "bed" I have a needle in my arm, some cage-esque device over my abdomen, and am strapped in. The vein on my left side had a tube which would carry the contrast into my body, and it was hooked around my left fingers to keep it in place. In my right hand I had a panic balloon in case it was too much and I needed to stop the test and get out immediately.
They put me into the machine and that was certainly an experience. I've never had an MRI before so this was all new to me.  The top of the machine was hardly 4inches from the tip of my nose, there was a bright light and a fan. I fully understand how the fan would help keep air moving and help people with claustrophobia, but for me, it just made me cold, and I am frozen at the best of times.
I had these headphones on to get breathing instructions as it was important for when they were taking the pictures. And also to muffle the incredibly loud noise of the machine.
The instructions were "breath in, breath out, breath in, breath out, stop breathing" and I was to hold my breath until they told me to resume. This was about as hard as it sounded. Thankfully when they were walking me through the procedure before we started the told me about how long each time was going to take, and it was easier when I counted as compared to me just holding my breath and having no idea when it would be okay for me to breath again. Each time it was about 23 seconds, and there was 1 longer one of just over 30seconds.  They took several pictures in this way, and each time the machine made a new and different, yet equally loud and annoying noise.
Then the contrast was inserted. This felt akin to slowly dipping my arm in very cold water as the contrast worked its way through my veins. I didnt really feel it through the rest of my body, mostly just the arm. Once the contrast was in they took another series of pictures, same breathing instructions, waited 2mins, and took the final series. The entire test took about 20minutes.
The pulled me out, unstrapped me, took the needle out, and I was free to put my red high heels on, change and leave.
How did I feel during all this? It felt like the world only existed in that small space, and I lost all concept of time. I didnt feel claustrophobic or anything like that, but I did feel nausuated and disorientated when it was finished.
It wasnt a hard test, and other than the multiple needles looking for a vein it was relatively painless. If they hadnt been running late I would have been at the hospital for about an hour.

The last things I have are a meeting with the psychiatrist (the appointment still hasnt been booked and likely wont be until May), then with a Doctor to go over all the test results and to determine which kidney they are taking, and finally on to the surgeons. How many surgeons and transplant specialists depends on if I am staying local, or if I am going to be going somewhere else in the country for the surgery.
I hope to be able to donate in this city as I dont think  I would be comfortable trying to recover in a hotel.
And as we get closer to being confirmed for surgery I am getting to a point where I am going to need to tell my boss. I havent said anything at this point, although I did tell her I was going for an MRI, and was 1 step away from telling her the full story. I told her about the MRI so she would know that some of this has been going on for a while, and wont be caught fully off guard when I do tell her. My husband thinks I should tell her the full story when I get confirmed, but I am leaning towards just telling her that I need surgery to remove a kidney and leaving it at that. I dont want any accolades or special treatment, and I know if I tell her it will be very hard for her to keep this between us. I know I need to figure all of this out, but I also know that it will be a while before I tell her as there is really no point until I am confirmed as a donor and the surgery is booked.
For now, I'm just happy to be back in regular clothes and out of the hospital gowns.