kidney update

Today I learned a lot about my body. I also had to take my clothes off four times!!!!

Yesterday I collected my urine all day. I had to be away from home for part of the day, so I had to carry my pee in a cooler. Very odd. Anyway, as part of my tests, they needed a 24-hour collection of my urine. This is to test my creatinine levels. My father has had to do it many times.

My day started with one last urine collection before leaving my house bright and early and heading to UIHC with my mom to support me. Last spring when we traveled to UIHC we went through a bunch of construction in the building -- it's been through several aesthetic changes -- and now, a few months later, it seems to be complete. Very beautiful. Art everywhere. When we arrived we checked in and headed to the Surgical Specialty Clinic -- which was our home base for many of my dad's appointments, so we know it well. They took several vials of blood out of me, and asked for ANOTHER urine sample!! I met with Shelley, our transplant coordinator. She had a side-kick with her today -- another woman that is learning how to do Shelley's job.

After the blood was out, a little food went in. I had to fast for my lab work and only had a small window of time before I had to fast for a test later in the day (CT Scan). So I had a Zone Bar, a banana and a Diet Dr. Pepper (of course).

They took my vitals, I signed a bunch of paperwork, and I met with the social worker. Her job is basically to make sure I am aware of any potential risks, and that I will have a good support system to help me out when I get home from the hospital. Then I met with Dr. Heather Muster about a study that I have an opportunity to participate in. It's called Assessing Long Term Outcome of Living Donation (ALTOLD). I will probably participate in this study....more on that at a later time.

The first time I had to undress was to be examined by the nephrologist, Dr. Bertolotus. This is the same doctor that saw dad on his first visit to UIHC for the beginning of his evaluation. Dr. Bertolotus examined me and took a look on the computer to see if any of my tests were back. Even though it had only been about 3 hours, there were many complete and already entered in the system. Apparently I'm very healthy. My kidneys are functioning "normal" (whatever that means). My cholesterol is 203, which to me seemed high. But Dr. Bertolotus said that the reason it is so high is because my GOOD cholesterol is about as high as it can be (apparently that's good). My BUN (blood urea nitorgen) and creatinine levels are all good -- low even. Here's some information on that. I have low BUNs....lol.

The second time I had to undress was for an EKG. And then the third time was for a chest x-ray. Both of these were very quick, and painless.

The fourth and final time I had to undress was for my CT Scan. This was not my favorite part of the day. It didn't hurt much (IV went in well), but I was uncomfortable....more mentally than physically I suppose. They had to inject "contrast media" into me and take a bunch of pictures. It wasn't bad...just not my favorite. They took pictures of my kidneys. They are checking to make sure I have two, for starters. :-) Then they will be looking at them both to decide which one to take for the transplant.

I learned:

• When the donor kidney is put into the recipient, the recipient's existing kidneys stop working completely in a short time. So, even though they will not take out any of dad's kidneys -- they just hook up the donor kidney-- he will only have one functioning kidney...mine. This is why it is important to wait until just the right time to do the transplant. For example, I was very upset that things were put on hold last spring....and although he went downhill quicker than anticipated...by doing a transplant too soon, we are essentially wasting the good kidney a bit. What I mean is, the donated kidney doesn't last forever...only 15-20 years or so. Had Dad's kidney function remained at a manageable level for several years, we could have been giving him a few extra years with my good kidney down the road. However, he's nearly 73, so.....I think that probably cancels all of that out (in my opinion). As he ages, his health naturally declines, so, in my non-doctor opinion, it would seem to make more sense to do the transplant while he is younger and feeling better. But....he's not younger or feeling better now, so none of that last part really matters....And, although I am wicked smart, I suppose I don't know EVERYTHING...moving on.....
  
• The veins connected to the left kidney are longer, so they prefer to take that one....and as long as everything else is equal, that will be the one they take. However, if there are more veins on the left one, or detaching it would be more difficult, they will take the right one. Also, if one kidney is better than the other one -- I get to keep the good one!! So, I wonder....if they take my left kidney, will that make me lean even more to the left, politically? :-)
  
• They only do kidney transplants on Thursdays at UIHC.
• Two healthy kidneys do not work to their full capacity. So, if you donate a kidney, you aren't actually losing 50% of your kidney function. The remaining kidney beefs up and begins to work better (notice I did NOT say harder -- harder implies that there could be undue stress on the remaining kidney). In fact, there are people that live with one kidney their whole life and don't even know it.
• All of my tests (that were complete when I left today) were good....better than good actually. The nephrologist told me that as long as I continue to exercise and I don't gain a bunch of weight or something....even if I just stay like I am right now....there is no reason to think I will get diabetes. Of course, there are no guarantees. But I've learned that there are no guarantees about ANYTHING in life, no matter how perfect it might seem, it can all come tumbling down at any moment (how's that for positive thinking). Anyway....
  
• (I already knew this next part before today, but I'm putting it in here for any of you that think I'm putting myself at too big of a risk in the future). Studies show that a kidney donor is no more at risk for kidney disease than a person with two kidneys. That, along with the VERY thorough exam that I received today, is more than enough to convince me that this is the right thing to do.
  
• They will not do the tissue typing until the PRE-OP appointment. That is how certain they are that I will match Dad at LEAST enough for the transplant. It has something to do with me being his daughter. :-) More importantly, Dad has not had a previous transplant, has not had a blood transfusion, and has not given birth to a baby....so he should not have developed any antigens against me. I keep telling them that I'M A LIBERAL and dad is a REPUBLICAN, there is a chance we won't match....but apparently politics has nothing to do with it.
• Surgery lasts 3-5 hours, and I would go home Saturday or Sunday. Dad would be hospitalized a bit longer, closer to a week.
  

So what does that all mean???

I will know next week for sure...the rest of the tests will be in by this Friday....and then Shelley will "present" my case to the panel of doctors.....but it looks like Shelley will schedule the transplant for November 29, or December 6, 2007!!!

Here is a bunch more info on organ donation for those interested.