Transplant Day 5

My new kidney is in OVERDRIVE! The nurse emptied my catheter bag at 4am, and it had put out 500 cc of urine in just 2 hours. Considering that the average person probably puts out 2000-3000 cc/day, that's a huge amount! Of course, I have 20 lbs of extra fluid on board, so that's good. 

I just went for a walk down the hall, and my kidney site is sore, so I just took some Percocet. But, it's worth the discomfort!

I get my Foley catheter out in 2 more hours, and labs drawn at 7:30. Can't wait! 

Transplant Day 4

 Good day today. My creatinine went from 5.9 yesterday to 4.8 today, and I'm putting out up to 200 cc of urine an hour!

I'm starting my Prograf today, my IV fluids will probably be d/c'd today, and they'll take the catheter out tomorrow. I do have a 20 lb weight gain since dialysis on Saturday, but once the kidney acclimates, that should come off.

I'm out of bed walking and in the chair. I've had to take some Percocet, because it does get painful where the kidney is when I'm sitting or laying, but that's to be expected.

I'll try to update more later. 

Cross posted at WordPress

Hospital Pics

Just a quick post of some pics from tonight. The one of my arm is showing the various spots they tried to insert an arterial line for surgery.  They ended up putting it in my armpit, and glued it down to the hair; it hurt more when they took that out than my incision site. The wrist pic is also of where they tried to put in the a-line.  The last pic is of the Happy Transplantee showing off 2 hours of pee!  Cross posted at WordPress.

 

Transplant Day 3

 What a whirlwind 2 days. The new kidney is "peeing like a racehorse", but according to the surgeons, is still "waking up. I'm putting out 30-120 cc of urine per hour, but my creatinine is 5.9. The reason is that it is a "pediatric" kidney, and they usually are hypersensitive (for lack of a better term) when first "installed". Dr.M (transplant surgeon) said that I'm having some ATN, and that the blood vessels in the kidney are in vasospasm. But at this point, I'm putting out urine, and that's what's important. 

I'm off of my IV pain meds (Dilaudid), and have minimal pain. I was out of bed to eat lunch, and my legs are a bit shaky, but otherwise, no problems. I started solid food last night, and am eating well. I feel unbelievably fantastic, and can only now fully appreciate how cruddy I felt for so long.

I appreciate all of the replys, messages, phone calls, and visits. I'm inundated with email, so I apologize if I don't respond. It's awkward typing on the laptop, since I can't keep it on my lap, and it's on my bedside table at the level of my face. 

As it looks, I'll probably be discharged on Wednesday.

Cross Posted at WordPress.

TRANSPLANT!

 Not sure where to start, as everything has been such a blur; I'm wide awake in my hospital bed, I feel FANTASTIC, and I'm ready to eat. I'm not sure if it's from having improved kidney function, the steroids, or both. I got my new kidney last night, call number 7 was the charm!

The surgeon was just in, and is very pleased.  I'm putting out 40-60cc per hour of urine. He explained that since the donor was young, it may take a few days for the kidney to settle in, and that there is probably some spasms of the blood vessels which will resolve.

I went to the pre-op area at 5:30 last night and met with the anesthesiologist. Then, I saw the box with the kidney show up.  It was sort of surreal; a guy in a delivery uniform had an orange box marked "Human Organ" over his shoulder, like he was delivering auto parts or a pizza. The thought that went through my head was "he better not drop that".

They put an IV line in my neck without sedation. It was uncomfortable, but not terrible.  The next thing I remember is waking up after the surgery.  In addition to the central line in my neck, they put in an arterial line. I assume that didn't go well, because there are several bruised areas on my arm, and they ended up putting it in my armpit. They removed it in the recovery room, and it wasn't too comfortable, as they didn't shave my armpit before putting it in, and the hair stuck to the dressing.

Im got back to my room from the OR at around 1:30 this morning and was still a little sedated. Jackie went home right after and I took cat naps. The nurse was in frequently, so I didn't get more than 45 minutes of sleep at one time.

I'll be on Plavix for a couple of months because of something with the anatomy of this specific kidney. I started CellCept during the night, which is an immunosuppressant. And when my creatinine lowers, I'll start ProGraf. The creatinine at midnight was 5 (2 weeks ago mine was 8), and it increased to 5.6 at 8am, but again, the surgeon said it was due to the hyperreactivity of the adolescent kidney, and is not at all worried about it, since I'm putting out adequate urine.

My pain is well controlled. I'm on a PCA (patient controlled anesthesia) pump with Dilaudid. It's just enough to take the edge off, but I'm not at all "snowed".

I'm sure there will be other things that happened that I don't remember, so I'll add them to future posts. 

Cross posted at WordPress

Dialysis Day 106

 

I'm on dialysis now, waiting to talk to the surgeon. They are now retrieving the kidney, and I assume will bring it back to Geisinger via LifeFlight (helicopter).

I'm BELOW my "dry weight" by a half kilo due to not eating much.  One of the dialysis nurses said that IV dye can cause diarrhea; maybe that's what happened.

Jackie is more nervous than me; I'm pretty calm...

No heparin today due to surgery; instead, I get boluses of saline every half hour so that the machine doesn't clot off.  I'll post again when I know more.

Beginning wt: 93.0 kg

Cross posted at WordPress.

Pre-transplant update 1

I got a call from my TC several hours after the first call with the kidney offer, to tell me not to go to the Emergency Department at 7am, but to instead go to dialysis at my regular 10:30 time. They had a change in plans with the donor's liver, and had to push back harvesting his organs. However, the transplant is still on at this point. Still cautiously optimistic.

My diarrhea has gotten a bit better this morning, probably because there's not much else inside my intestines. Still no fever, so it should be OK.

Cross posted at WordPress.

Rollercoaster Ride; Number 7 The Charm?

The transplant rollercoaster made another stop. I just got a call with a PRIMARY offer for a kidney. The potential donor is a 16 year old in the Lehigh Valley area who was in a group home, and found unconscious with agonal respirations. He was apparently resuscitated, and is going to be an organ donor. This is my 7th transplant offer, but only my 3rd as the "primary".

I just said to Jackie tonight "with my luck, I'll get a call for a kidney tonight and won't be able to get it since I have diarrhea". Well, I was up front with the fact that I have had nausea and diarrhea since my Fistulaplasty on Wednesday, but since I have no other symptoms and no fever, the doctor was OK with this (could be a viral illness, but also could be a response to the dye?). The only other concern is that this boy was on Methadone for a history of IV drug use, but his "serologies" were negative (HIV, Hepatitis). Of course, there is always the possibility that he could be infected with one of these viruses and it wouldn't be picked up, but that's a chance that I have to take.

I have to go to the Emergency Department at 7am in the morning, and they'll draw blood, and decide on how much dialysis I'll need.

I'll post when I hear anything else. 

Cross posted at WordPress.

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I don't think the vomiting the other night was from meds; I have a stomach virus which just happened to occur at the time of my fistulaplasty. I'd much rather have a cold than this, but sometimes, you just have no choice...

They took my suture out prior to when I stuck the needles in, and since I had the infiltrate on Tuesday, I put both needles in the bottom end of the fistula. I only gained 0.9 kg between treatments, since I'm hardly eating, and only sipping fluids.

I asked the Nephrologist about the stents and what would happen were I to develop Steal Syndrome. He told me that they would then be able to surgically revise my fistula.  I don't want to take a chance of one of the aneurysms rupturing, so I'll go ahead with the plan; I think that's the best way to go.

Beginning wt: 94.4 kg. End wt: 92.8 kg.

Last night I was run down, and in be by 8:30, but I think a lot of that has to do with the virus. I ate a bowl of soup for dinner, and today I only had an orange,  but don't really feel much like eating.

At work, we have a lot of patients calling in for notes from their doctor to either get out of work, get out of school (more so for the parents so that they don't get fined for illegal absences), etc. Some are legit, others are chronic.  Dr. White Coat has a humorous story of a guy who was looking to get out of work because he can't sleep at night. I like Dr. W-C's style....

Cross posted at WordPress.

Fistulaplasty, "Snow Storm"

As we used to say when I worked in a Psych Hospital about the acutely psychotic patients receiving heavy doses of meds, "there was a snowstorm in the room today" when I had my fistulaplasty. in other words, I received ample doses of meds today. Yes, I left there a walking polypharmacy. I had 4mg of Versed, 225 mcg of Fentanyl, 4 mg of Zofran (for vomiting, 5000 units of Heparin (not sure why I got that; doctor's preference maybe?), Oxygen, and an unknown dose of Reglan, all IV of course (except for the oxygen).

This time, I wasn't "with it" during the procedure. There were times when I was aware of what was going on (like when I had the dry heaves several times),and the doctor did have a challenge today (it's the first he's worked on my fistula). After multiple attempts at ballooning my fistula, he finally decided to end it after almost 2 hours, and is having me come back in 2 weeks.

He explained that my fistula is tortuous, with an area of stenosis followed by a large aneurysm.  He didn't have the correct sized stent today, so they will order it in, and then place it in 2 weeks. He said that the only problem may be that by stenting it, it could reduce blood flow to my hand, and cause Steal Syndrome (a lack of adequate blood flow below the fistula; in my case, my hand and forearm). But that's a chance I'll have to take.

Afterwards, I was very nauseous, despite Zofran and Reglan. I did tolerate sips of ginger ale, and came home and
slept it off.  I'm still not very hungry, but I'm not nauseous, nor am I sedated.

Cross posted on WordPress.