The Last Round of Tests Are Done
Wow, that was a long couple of days. I'm on my train back home after my two day marathon of tests and meetings. I’m glad I’m headed home, not because it was a bad couple of days, but because it was just a lot to do in two days. I am definitely going to sleep well tonight.
Yesterday, November 6, started early because I had to arrive at the medical center at 7:45AM. The medical center was a very impressive, and very large, seemingly brand new building; it was almost three buildings combined into one. After I checked in at the transplant department, they had me transfer my 24 hour urine collection into one of their own special containers, and I gave them a new, fresh urine sample. They then drew some more blood, for what seemed like the hundredth time in the past month.
After a bit of waiting, I was taken to a conference room with a few other donor candidates for a presentation. In the presentation, the donor coordinator talked about the donation process as a whole; the process we're going through now as well as what surgery and what recovery will be like (If you'd like a copy of the PowerPoint slides, feel free to email me at ryan@kidneydonationdiary.com. I then met with the donor coordinator, who did the presentation, privately and she answered my questions as well as made sure I had absorbed the information in the presentation, giving me a little quiz.
From there, I was sent to a different part of the building to have a chest X-ray. The X-ray was easy and painless and took all of 3 minutes. After the X-ray, I was sent to a different part of the building to have an EKG. For that, the tech put stickers all over my chest, hooked wires up to those stickers, and 10 seconds later the reading was done. So, both of those were easy, quick, and painless.
I then went back to the donation department and had a meeting with a social worker. Just like the meeting with the donor coordinator, I was quizzed about some of the information I learned in the presentation to make sure I knew what was “getting myself into”, as she put it. She also asked me a lot of the same questions I was asked by another social worker before over the phone, which I mentioned in my previous post. She asked me things like if my work was being supportive of my decision to donate, if I would be able to get the time off I need without getting fired, who would be my primary caregiver during recovery, and who would be my backup caregiver in case something happened to the primary. She also asked me more questions about my health background, sexual history (to make sure I wasn't at risk for transferring STIs through my kidney), and about my mental health. Some of the mental health questions were interesting, like whether I could see or hear anything others didn't, whether I believe I'm being sent secret messages through the TV, or whether I believed I could read others' minds or if they could read mine.
My appointment with the social worker was finished at around 11AM, and my next appointment with the transplant psychiatrist wasn’t until 2:30PM. So I got some lunch, got some steps in on my FitBit, and came back when it was time for the appointment.
The session with psychiatrist started off similarly to the other meetings I had earlier, quizzing me on what I had learned and making sure I knew the risks of donating a kidney. But then she probed deeper, looking for the reason I wanted to donate because I didn't know the donor, and more about my personality and past. She also stressed me to think about the worst case scenario, like what would happen if my recovery didn't go well? Would my wife be able to take time off from work to take care of me? Would my work allow me to take more time off if I needed it? Then she asked me some questions I hadn't thought about before: how would I feel if my kidney was rejected by the recipient’s body? How would I feel if, in the future, my wife or my future children needed a kidney, but I couldn't give them one because I had already given mine to a stranger? She also wanted to make sure my wife was 100% supportive of me through this process, because she has seen instances where a spouse got jealous after the donation to a stranger, or recovery doesn't go according to plan and the spouse left the donor. In the end, she said there weren't any red flags that would prevent me from donating, which is always good to hear from a psychiatrist. All in all, a very interesting meeting, leaving me with lots of things to think about.
After the psychiatrist, I was free to go home. So I went back to my in-laws' house, where I was staying, for some much needed R&R after a long day. I was so tired, I went to bed early and ended up getting more sleep than I've gotten in a while.
This morning, I arrived at the medical center at 8:30AM after not having breakfast or drinking anything after 8, in preparation for the CT scan which wouldn’t be for a few more hours. First, I met with a nephrologist (kidney doctor). Again, we went over what I had learned the previous day, she asked me a bunch of questions about medical history that I had been asked 1,000 times previously by others the day before, and then she did a brief physical exam. We then went over any questions or concerns I had about the donation process and recovery. She also mentioned that for a while after donation, kidney function can drop 30%-40%, but that kidneys function normally at 60% or greater. Thankfully, she said that my kidneys were functioning at 160% (which is possible, apparently), so my kidney function should be fine after surgery.
A possible complication the nephrologist mentioned is my family history of high blood pressure. Having only one kidney can increase the risk of high blood pressure, and with only one kidney, high blood pressure can lead to an increased risk of kidney disease. If that happens, I might need to receive a new kidney. However, past donors are moved to the top of the kidney recipient list. She did mention that a healthy diet and lifestyle can decrease the risk of high blood pressure, so as long as I commit to that everything should be fine, but it was still something to think about.
After the nephrologist, I met with an independent donor advocate. That's someone who is independent of the hospital and is assigned to my case by law. She is there to act as my voice if I have any concerns or need to raise anything with the transplant team. She asked a lot of the same questions I had been asked before, again making sure I knew what I was getting myself into. She also wanted to make sure that I didn't feel pressured to donate or I wasn't being compensated in any way for donating, which is illegal. She also reminded me that I can back out of the process of I want to, at any time and for any reason, up until general anesthesia is administered. If I decide to do that, they’ll give the recipient's family a medical excuse to protect me instead of telling them that I got cold feet.
Next, I went to the infectious disease department after talking to the donor advocate. I had spent more than 2 weeks at a time outside of the US in the past, so they want to make sure I don't have any infectious diseases which could be passed on to the recipient. That's especially important because for the transplant surgery, the recipient will be taking immune system suppressing drugs, so she would have a much greater risk of getting sick if any diseases caught a ride on my kidney. The doctor asked me about my travel history, if I had ever been sick abroad, stuff like that. She gave me another brief physical, then concluded I was a low risk of having any diseases and didn't need any additional blood work done other than what was already scheduled. So, I went back to the transplant department and had my final round of blood work done.
My final appointment was for my CT scan. Relieved to get that over with so I could finally eat, drink, and go home, I headed to the radiology department. There, they gave me an IV to administer the dye that would make my blood vessels easier to see in the scan. I was expecting it to be like an MRI, where you're inside a machine making very loud clanging and banging noises for a half hour, but it was a lot better than that. My head never went all the way into the machine, it wasn't any louder than being on an airplane, and it took only 15 minutes. The weirdest part of it was the dye they injected after I was in the machine. They prepared me for all of this beforehand, but it was still weird: after the dye was injected, I started to feel a warm sensation that went down my throat, which felt like I was drinking soup. Then the sensation moved to my bladder and genitals, and the warm feeling made it feel like I had peed myself (I didn't, by the way). Then it went to my toes and finally to my fingers and subsided. I was told it feels this way because the dye is thick, but whatever it was, it was odd. That was injected twice over the course of the 15 minute scan.
After the CT scan was over, I was free to go. The first thing I did, of course, was to get something to eat. Belly full and thirst quenched, I walked to the train station to wait for my train. All in all, a very long two days, but I learned a lot and even have a few new things to think about that I didn't have before. I heard a couple of the doctors say my results look good before I left, but I won't know for sure if I'm approved for another couple of weeks. I'll update here as soon as I find out, please keep your fingers crossed for me.