THE HARD PART COMES NOW

I have to tell you that the easy part was the kidney transplant. Now comes the really hard part. There are so many things that have to be adhered to now. Sergio, my husband, has to take over 15 pills daily, 4 times a day, check his blood pressure, check for fever and weigh himself daily after his kidney transplant (November 2008.) It's not really difficult but just the discipline of it all will be a big adjustment. It's like I told him, if you think I nagged before, you have no idea what you are in store for! 

Actually, it's going to be very difficult for me because I have to leave him. We came here just for the surgery, and I miss my kids soooooo much, who stayed back home. I worry what will happen when I leave. Not that he won't do just fine without me but if you've been reading my blog long enough, you'll know I'm a control freak. I just want to make sure that he is doing what he is supposed to and doesn't overdo it. 

Personally, I have to be really, really careful when I get home with the kids and my incisions. I still have lots of pain and am very sensitive around the four incisions. I have four, with one of them being about 5 inches long by the bikini line, where the actual kidney came out of. It's pretty amazing how advanced science is. Although I still have pain, it is incredible that I was able to get up and walk around the next day after surgery and take pictures and talk to the other couple. I am so excited about seeing my children again. 

After being in the hospital and being surrounded by so many people less fortunate than me, it only makes me appreciate my family and friends that much more. I was thinking the other night that I always KNEW that it would be ME to help him. When we first started discussing the transplant options for a few years back and I was tested to see if I was a donor. I used to joke around with him that I really wanted him to have a Cuban kidney. I thought that was pretty amusing. I was pretty disappointed that I was not a direct match. When the two other donors fell through years later (actually, two years ago,) his sister and his first cousin, I just knew that somehow, I was going to be the one to help him. As Thanksgiving approaches, I can honestly say I am sooooo thrilled that I had that power to do something. When my mother was diagnosed with cancer, I felt so helpless. Not that this case is similar but just the feeling of being able to do something good and do something to help is empowering. 

I am very grateful that my children will have their father around for much longer. He knows if he doesn't take care of himself from this point on, I will kick his ass! As I get my strength back, I will slowly begin to reconstruct all the pieces that brought us to this point, of the kidney swap and I will share numerous pictures with you as well, as I documented almost every step of the way, from the moment I took off on a plane to New York to the moment I awoke in my hospital bed. 

 Until then...live, love, laugh and take lots of pictures!

TECHNICAL STUFF - KIDNEY DONATION

Now that I am getting closer to the actual day of the operation (5 more days!) I figured I'd share a little technical information with you, so you know what's going on or better said, what's going to happen. "surgical approach to living kidney donation is called laparoscopic donor nephrectomy and involves the use of small cameras and instruments inserted through the abdominal wall. During this procedure, the kidney is separated from its surrounding structures. The operation is performed using TV imaging. Once entirely separated from its surrounding structures, the kidney is removed through a small incision usually in the mid portion of the lower abdomen. The operation can take from one and one-half to four hours or more depending on the complexity of the surgery. After a kidney donation, as with most major operations, the patient is monitored in a post anesthesia care unit or recovery room. Blood pressure, heart rate and temperature are observed as are oxygen levels and wakefulness. The level of pain is also monitored. Most donors will come from the operating room with a Foley catheter draining the urinary bladder and with at least one intravenous line allowing fluid administration in the early post operative period. Patients are not permitted to eat or drink anything until they are fully awake, and until they have no nausea and vomiting. After the immediate recovery period, the donor is transferred to either an intensive care/monitored bed, or to a medical-surgical ward. In either case, post operative pain control is ordered and may take the form of patient-controlled analgesia (PCA), or epidural pain management. Usually, the PCA technique, which the patient can control by pressing a button, is used for the laparoscopic donor surgery and epidural pain management is considered for the patients having an open donor nephrectomy. All patients are encouraged to begin walking within 12 to 24 hours following surgery, and self-care including routine hygiene such as showering, shaving and brushing teeth can begin very soon. As a rule, the intravenous fluids are discontinued when the patient can drink or eat food by mouth. The Foley catheter is discontinued when the patient is walking and beginning self-care. Some treatment plans related to prevention of post operative complications are part of the post donation protocols, just as they are part of patient care for any major surgical procedure. Compression stockings or elastic hose are applied to the feet and legs to prevent blood clots from forming, and small injections of heparin or a similar drug may be given at eight- or 12-hour intervals to also address prevention of abnormal blood clots. This is important because one of the major complications that can occur following kidney donation is a blood clot traveling to the lung (pulmonary embolus). This infrequent, but well known, complication can be life threatening and measures to prevent blood clots traveling through the body are standard in all hospitals. As activity and walking increase, these preventive measures are stopped. As the first day or two passes, most kidney donors begin to return rather quickly to the usual activities of daily living. 

Food and fluid intake resume, less pain medication is needed, and patients begin to anticipate discharge from the hospital to their home. Usually, the only discharge medication required is a standard pain medicine taken by mouth; it may contain some amount of narcotic. Pain control, therefore, may be accompanied by advice not to operate a vehicle, power tool or other machine. 

Further, most surgeons recommend patients do not drive until they are entirely comfortable with operating a vehicle. Patients are also instructed not to lift any object heavier than approximately 10 pounds for a three-to-six-week period following donation. This activity restriction is to prevent the occurrence of hernia in the incision. 

Usually, discharge planning is completed, and the patient is ready to go home on the second, third or the fourth post operative day. "

Whew!!! I am ready!