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Archive for July, 2010

Evaluation process to be a Living Kidney Donor – finding a recipient – laparascopic surgery to remove kidney – my recovery

Even though the process was not without its frustrations and last minute blips – I would not hesitate to donate a kidney all over again if I could.
For anyone considering donating a kidney, whether to a relative or friend or to a stranger, the majority of this blog would apply. I have been as honest as I can and not just put a glossy cover on it all.  The events are as they happened and my feelings and thoughts at the time. I hope this blog will enlighten some people as to the process of donating a kidney. It has been a great learning experience for myself as well. Spending so much time with people who have kidney problems and speaking to patients on dialysis or just having had a transplant, and speaking with their families ….. it has opened my eyes even more to the fact more organ donors are needed.  There was nothing in my evaluation or the operation or recovery process that put me off having donated.

Through this journey I have met people on dialysis and they are not living a life, they are surviving a life. Dialysis is life support. Without it they will die – with it they are alive but the quality of life for them and their families is not the sort of life anyone should have to live. They do for years.  Once I knew it was possible to give someone and their family back their life it was just something that, God willing,  I was determined to do.

I also want to thank everyone working at the transplant unit. Everyone was great and made this whole experience good. There was always a smile and more than that, everyone had time for me. I was never made to feel rushed. When it came time for the operation itself I was made to feel very relaxed and the after care was brilliant.

Please scroll down to read my account of being a kidney donor. The first posts are at the bottom of the blog, the latest just below this posting.

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My Recovery at Home

I was allowed home 2 days after the operation. The journey home was okay. Couldn’t really avoid all the bumps and potholes in the road so had to support my abdomen during the journey. It was good to be home. Own bed, own bathroom etc. Couldn’t keep my eyes open so had not been home for long before went up to bed. Now of course, my bed does not raise up like the hospital one. So with great effort I got onto the bed at a sort of an angle and then couldn’t move, lol. The pain in my abdomen was intense. Oh well – I just stayed there on the bed sort of laying across it – and went to sleep. Woke about 5am feeling refreshed and wanting the bathroom, but quite a battle to get out of bed. took around 10 minutes trying to work out the least painful way.

Decided that the next night I would sleep with lots of pillows behind me so my upper half is already raised, just like the hospital bed was. It would then be much easier getting in and out of bed as would not have to use my abdominal muscles as much.

In myself I felt very well. Still bloated which was uncomfortable rather than anything else so hopefully the extra 4 kilos would go soon. I got tired very very quickly. In fact I had only been up for around 3 hours and was walking back from the kitchen with a cup of tea and almost dropped it as I found my eyes closing as I walked. The tiredness just came out the blue!! I know I was told I would feel tired, but I was not sure if that meant bodily tired i.e. no energy, or tired in wanting to go to sleep. Now I know. I had to go back upstairs and get some sleep. I arranged the pillows so they were like a backrest. I have a memory foam mattress which is bliss. I could get into bed a lot easier now with little pain. I got a good hours sleep and woke refreshed. Around 3pm the same thing happened and I found my eyes just would not stay open, so got another hours sleep. I must say the first four or five days was like this. Suddenly feeling sleepy when I had only been up a few hours. I didn’t fight it as I knew my body needed the rest. I was also going up to bed around 7pm or 8pm in the evenings. I actually felt more comfortable laying propped up in bed than sitting in the chair downstairs, which squashed my abdomen up a bit and was uncomfortable. I had very good night sleep for the first week, most nights not waking at all until the morning. Pre operation I would wake about 3 or 4 times needing the bathroom. I also found that sleeping with my upper half propped up I could breathe a lot easier as well which I am sure aided a good night sleep. In fact I have continued to sleep propped up and find it much better than laying flat in bed. When I have saved the money I may just invest in a bed where I can raise the back up. I am surprised at the difference in quality of sleep I get this way.

The first week was obviously the hardest as I was not allowed to do much and I felt tired so quickly throughout the day and there was a bit of pain when I walked or used my lower abdomen. For some reason the first couple of days I forgot about the pain medication. Duh! After that I took it and made sure I took enough. Although I still had some pain, it was not troublesome. In fact I was quite pleased I had a little bit of pain as it reminded me to take things easy. I enjoyed being spoilt and looked after the first week!

Some people get no pain at all. I believe the only reason I got pain was because I am overweight and the pressure of a tummy “overhang” on the incision area coupled with gravity pulling down on it when I walked, just aggravated everything! If you picture walking with a bowl of jelly ….?? Yup I think you have the picture!  If I held in my abdomen muscles which then supported the incision area, then I had no pain at all when I walked. Of course remembering to take the pain medication would have helped!

Once 10 days had passed then I noticed a quicker improvement. I was not sleepy during the day any more, although I did physically get tired. It was quite some time before energy levels restored themselves. Incisions were healing nicely and everything was just great.

I also heard that the recipient was doing excellently well! That is the best news of all. Wonderful!

Recovery continued and things are great.  It has been a while since the evaluation finished in October 2009  and some time since kidney donation, so I hope I have remembered everything, I did make notes at the time but not always. Anyway I hope this blog gives a good insight into the process of becoming an Living  kidney donor and the actual donation process itself. I know if I had another spare kidney I would do it all again without hesitation.

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After Kidney Removal – Recovery in Hospital

Same day as operation:
My bed in the transplant ward was going to be ready at 5pm so my family had been told to give it until 6pm to allow me to be settled etc. It was actually 6.15pm that we heard my bed was ready and as I was wheeled into the ward I saw my family at the nurses’ desk and called out a “Yoo Hoo” and gave them a big wave. They expected me to be half asleep and out of it I think, and they almost fell on the floor so see me so awake, happy and smiling … hahaha ….I was taken to my room. Very nice room. Just two beds, I was by the window overlooking the little garden area which had a bird table in it. Shared the room with another lady (who had a kidney/pancreas transplant) and we had our own bathroom. My family were told that I needed to be settled in and it would be a little while so to go for a coffee and come back in say an hour.

I was helped off the trolley into my bed. I couldn’t quite manage this on my own as for some reason my right leg would not bend properly and had not much muscle power. This did by the next day correct itself. The first night I was going to be regularly monitored. Blood pressure sleeve was put on and automatically every two hours it would inflate and do its stuff! Gone are the days when the nurse had to come and do it. I was constantly impressed by all the advancements over the years since I had last visited someone or been in hospital myself. I had boot wraps on my calves over the thromboses stockings. They were wired up to some sort of pump and alternatively each one would inflate and deflate so massaging my calves and thus helping to prevent any blood clots (blood clots are rare, but can happen). A “clip” was put on my index finger which was wired up to a heart monitor. I had a drip in my left arm giving me fluids . In my right arm was another drip which was for the pain meds…

The nurse showed me how to use the pain med control. Each press of the button gave me one dose of painkiller. There was a little machine next to the bed that showed how many doses I had. Once I had the maximum amount then I could not use it again for 5 minutes. The machine gave me all the information regarding this. So even though I could self medicate the pain meds, I could not overdose on them. I had a buzzer if I needed to call a nurse and another control for the bed (to raise and lower the head or foot end etc).  The hospital bed was beautifully comfortable, wow .. plenty of support yet you sunk into it and you felt like it wrapped around you, rather like a memory foam mattress. It really was very good.  Pillows too … and no crinkly waterproof covers!! Shows how long ago it was that I was last an in patient! You also had the control that raised or lowered the different parts of the bed. Had fun playing with that later until I dropped the control on the floor and had to embarassingly buz for the nurse to come and retrieve it for me – one look from him as to the position I had got the bed in caused us both to laugh. Believe me, it hurts when you laugh! The table next to me had a jug of water. I had to drink quite a bit of water each day and the amount was monitored and then compared to the urine output in the bag attached to the catheter. Next to the bed was a swivel arm on which was a TV and telephone.

 Once settled my family came and stayed for about an hour. They got me a couple of magazines. They also got me a TV card. £7 for 3 days – quite expensive but well worth it but thank goodness I was not in for a fortnight, unless there was a discount for longer periods. My son set it all up and activated the card. I must say it was great having this TV (with headphones if required), which also had internet and telephone. I Did not make any phone calls during my stay as it was quite expensive to make a call and even for a person to ring you on it – but once the card was activated apparently it automatically sent the number of the phone to my contacts (presumably the numbers I had entered on the form I completed when I was admitted?). The phone rang me later with an automated message to say it had informed my contacts of this phone number. Wow!! I was constantly being surprised. (I later found out that it was very expensive for people to phone in on that number, so advice from me is do not use the bedside TV/phone to phone anyone or for them to phone you. Use a cell phone or ask the nurse for the general ward phone).

A lady from the kitchen came to see what I would like to eat and I chose chicken and leak pie. When it came to be honest I was not really that hungry. The nurse said she could get me a “snack box” if I preferred. I didn’t actually know what that was but it sounded good, so yes! …. I had a choice of sandwich and had ham, then also in the box was an apple, bag of crisps, a snack bar, small drink of juice – can’t remember what else. I ate the sandwich and had the juice and the rest I saved and snacked on them during the night as I got rather peckish then.

Later in the evening the lady in the bed next to me had a bit of a setback and had to be taken to ICU. It was rather upsetting to witness . I believe she was okay though. Next day another lady came to share the room. They both had been given kidney/pancreas transplants. The first night I did not sleep much at all. What with the blood pressure going off every couple hours, which to be honest I found quite uncomfortable when it was doing it. When it reached maximum pressure my chubby arms really felt pinched. Then the bleeps from the heart rate monitor going off periodically and the foot compression pump thing. If I bent my left arm another monitor would start bleeping and a nurse would have to come and reset it. All sorts of little noises and things which I was just not used to. As I would doze off one of them would fire up and make me jump. I was tired but ended up deciding I would put on the headphones, watch TV and maybe would fall asleep in front of that. It didn’t matter really that I was kept awake, I was very comfy and the transplant ward was very quiet. I was quite content just laying there resting. I didn’t have any pain unless I moved then it was where the bikini line incision was to remove the kidney. I tried the pain med and it worked like a dream. Within a very short time (30 seconds or so) the pain was dulled and had I clicked again it would have totally gone. As I rarely moved though, I didn’t bother with the pain med. Also it did make me feel a little light headed which I was not keen on.

I had some discomfort at the back of my right shoulder that I felt each time I breathed in. Again this was normal. To enable the surgeons to rummage around inside me they puff me up with Carbon Dioxide, sometimes a little of the gas gets trapped up around the shoulders and can take a couple days or so to go. Bit of a nuisance more than anything else. Towards the end of the night I was actually getting used to the boots inflating and at times was not aware they had so would actually focus my attention on them to make sure they were still working! I am just so very thankful that there are all these machines and pieces of equipment available to monitor me and help keep me safe. It was very reassuring in fact. The only time a nurse came was to take my temperature (or turn off the buzzer if I bent my left arm – lol!). I had my TV to watch (with headphones so no one else was disturbed). I think I also found it a bit hard to sleep as I was still on a high knowing that by now someone else had a working kidney. How wonderful is that. Doctors, nurses, surgeons, medical, non medical personnel – everyone on the two teams are just absolutely amazing to enable this to happen. I am in awe of them all. I did get to sleep periodically which was fine.

Day after operation:
Various people popped in to see me the next morning. I lost track of names I am afraid as most people I had not seen before and they said who they were before I could take it in. Everyone was just so lovely. Always smiling and a cheery hello. Thought I would use the internet and pop a few emails off. Nearly got as far as sending then got the black screen! lol. The whole screen froze and could not access internet or TV. Shortly after, the co-ordinator came in to see how I was. We had a good chat and I just mentioned the TV was not working now and why. She was brilliant! Got straight onto patientline and they rebooted there and then and I was back in business though have to admit I didn’t try to use the internet again – just in case.

A lady came and asked me what I would like for breakfast. I chose weetabix followed by toast and marmalade. I really enjoyed it. Long time since I have had toast and marmalade, in fact I am having it at home each day now I so enjoyed it.

A nurse came and said it was time for me to get out of bed. Not as easy as it sounded! Just laying in bed I felt fine. I did not feel ill (after anaesthetic etc), or feel any pain in fact I felt totally relaxed and comfortable. I hardly used any of the pain meds as I didn’t need them. When I did (mainly just testing how well it worked really), it worked but I also felt a bit light headed if I moved my head. So I didn’t use it much. Once I wanted to get higher up the bed and it did hurt in my lower abdomen area to do this, so a click or two on the pain med control and with slight discomfort I could then move up the bed. More clicks and there would have been no discomfort I am sure. Trying to get out of bed though was painful. You don’t realise how often you use your lower abdomen until it hurts! I was a wimp and laid back on the bed grinning sheepishly at the nurse as I had given up so quickly!

It hurt a lot around the lower abdomen where the incision to remove the kidney was made. So the nurse said to use more pain meds and get rid of the pain and we would try again shortly. I clicked the pain med button until I got to maximum dose and very quickly the pain went. Let’s have another go. The nurse stood next to me with his arm out in case I needed support. I held on to it and in one courageous effort hiked myself out of the bed …. oh boy! As soon as I was upright I felt so dizzy and light headed, it was horrible, I thought I would pass out. I steadied myself, and said I felt yuk and could he help me to the chair. Luckily it was only next to the bed so a couple of steps and I sat down in the chair. I felt not very nice at all (polite way of putting it). No pain though! lol. My nurse looked most concerned and asked if I was okay. I told him I just wanted to sit there and do nothing, but I was fine. He said he would come back shortly. Another nurse came in to change my urine bag which was nearly full. I turned to say hello to her and my head nearly span off my neck, lol. Oh I don’t make a good patient, that’s for sure. The dizzy feeling made me feel sick and I said that I thought I would be. She quickly got me a sick pan and I retched twice but that was all. I felt sure it was the fact I did the pain meds too quickly on top of the fact I had been laying down for over 24 hours. I just sat in the chair and closed my eyes and waiting for it all to pass.

Couple hours later lunch came, but I said I did not feel like anything. I was feeling not so bad now, but still felt “delicate”. The nurse said I had to eat as I had to keep my body going, it had to heal and get better and it needed food to do that. Very sensible advice, so I did have some food. I have to say, I did feel a lot better after that and very quickly got back to normal. So maybe lack of food also contributed. I still didn’t like the effect on the head of the pain meds though, it made me feel very dizzy when I moved my head, not very nice. The nurse said she would give me tablets instead. The drip was removed and the canula was closed off but not removed, just in case it was needed again. I was given pain tablets periodically. I was also given a dose of laxative! I was offered some the night before and I refused (mistake!) as I did not want to be suddenly caught out. No worries on that account, you certainly do get constipated which can be quite uncomfortable and the laxative is very welcome!

My weight when I came into the hospital was 89 KG … having an operation – then the fluid drip and all the water I had to drink does bloat you. Most people there got bloated. In 24 hours I went from 89KG to 93KG!! quite an increase. My hands were noticeably puffy I also felt bloated in the body. Fluids have to be got into body and they need to give them to me via the drip until they are totally sure I am drinking enough myself and that my body is processing it okay etc. I had to drink quite a bit of water which was fine as I normally would drink 1.5-2litres of water each day anyway. A doctor came to check me over and I mentioned the bloating. He suggested one more drip bag after the one I was finishing then to discontinue.

It was late afternoon now and I was drinking plenty of water and my urine output was fine and the nurse agreed to remove the fluid drip at the end of that bag rather than give me another one. She left the canula in though in case it was needed again. She wanted to remove the catheter but agreed to leave it until the morning. I was just worried that with the incision pain I would find it hard to get out of bed to go to the loo in the night and would have an accident.

Evening meal was really enjoyable. I had mushroom soup followed by chicken and mushroom casserole. Some orange juice and then a small tub of ice cream.

My family came and because I was no longer on the drips I was more mobile so Matthew went and got a wheelchair and they took me out into the little garden. Even at 6.15pm it was hot out there. We had a lovely hour in the fresh air. It really was a glorious day. The garden was just outside the window to my room and the nurse was in there and saw me through the slatted blinds and peered out and gave a wave ….

Just a few minutes earlier I had been telling my family how the nurse from recovery did say she was going to pop in to say hello at the end of her shift, but I think she had forgotten as it was now gone 7pm. Of course she hadn’t forgotten! She turned up and I was so chuffed she had not forgotten. We had a good hug and chat. I will miss her. After a long and no doubt tiring day, she still came to see me. How wonderful was that.

My son wheeled me back and my family left and I got settled in the chair for the evening. It was lovely not having a drip in each arm as I could move around without getting tied in knots or setting buzzers off. No more blood pressure sleeve or the inflatable boots! I watched Britain’s Got Talent then got into bed. I slept very well even though woke a couple of times when had temp checked by a nurse.

2nd day after operation and going home!:
Getting out of bed painful again but I did manage it on my own. Had the catheter removed but a “dish” was left in the bathroom for me to pee into so they could measure how much I was getting rid of. I also had a bowel movement. That was good as believe me, one of the main drawbacks is not having one! Had my weetabix and toast and marmalade for breakfast. I used to have that as a child sometimes which perhaps is why I am now so fond of it again. Someone came and checked my wounds. The top three keyholes had a lot of bruising around them. The guy said when they put the drain in there was a bit of a discharge. I imagine the drain went in immediately after the op and was removed before I came around as I don’t remember any drain being in me. But he was happy with the wounds. Just said to keep an eye on the bruising and to regularly check on them. I had large waterproof breathable plasters on them, so as long as no extra discharge that was fine. The nurse took some more bloods and said they will be sent straight away for testing and if all okay I can be discharged later that day. Probably early afternoon. The pharmacist came and went over with me the medication I would be sent home with. There would be panadol and tramadol for pain relief and lactulose and senna to help with constipation. She would prepare them so they were ready and waiting for me on discharge.

I was then advised by a nurse that they would move me to the Renal unit just up the corridor. Someone had just had a transplant and they were male, so the nurses had to shuffle people around a bit. I would go to Renal. The lady with me who would be in for around 10 days plus would go to another room in the transplant unit and then our room would become a male only room …. I collected all my belongings and then the nurse said to stay until after lunch. Have lunch in my room, then if I didn’t mind not having a bed I could spend the rest of the time in either the Transplant Day Room or the Renal Day room or in the garden. If the blood tests came back okay I could then go home. If for any reason they didn’t then I would have to be officially transferred to renal and stay there. Well that suited me great. I have to be honest and there was a huge difference between the Transplant Ward and the Renal Ward.

Lunch was lovely, again. Couldn’t fault them on the food. The transplant day room was full so I went into the garden for a while. While I was there two patients came, pushed by their relatives and spent some time in the garden chatting with me. They were both resident at the hospital and with failed transplants behind them were back on dialysis.

It was late afternoon now and I wondered when my blood results would come back. I went into Transplant and asked at the nurses desk. They checked and not ready yet, but should be soon. The nurse came and found me in the day room and yes, blood results all okay I could go home. My discharge papers would be done and wouldn’t be long now. I telephoned my family to come and collect me. I was given my bag of medication and discharge form. I thanked everyone for taking such great care of me. I didn’t bother getting changed into day clothes. Apart from the fact I was still very bloated, I knew getting dressed would not be that easy a task. Also what was the point, I would only change back into nightclothes as soon as I got home. I quite happily left the hospital and walked through the car park in nightdress and dressing gown and slippers.

Was good to be home!

 

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Recovery Room after operation to remove kidney

Next thing I could hear a voice saying my name and asking me to wake up. It is strange but you can hear the voice perfectly but for a short while you can’t move or speak. It was not that I was even trying to. I was just listening to this voice but not reacting to it yet. I didn’t even try to open my eyes, I was sort of getting my bearings and remembering where I was. For a second I was confused and wondered why I had to wake up, why had I been asleep? I thought it sounded like the operation was over, yet I had only just gone down to theatre! Of course I soon twigged that it was indeed all over. For some reason I was totally surprised by the lack of “lost time”. How wonderful though. One minute feeling woozy, then next minute it is all over and I am back awake.  Sounds a bit crazy, but I sort of felt I had missed out on the best bit! I would have loved to have watched the operation and having lost a few hours seemed so strange as literally I felt like I had one minute said how woozy I felt and the very next second was being asked to wake up … with no awareness at all of the time lapse between, it was as though the wakening immediately followed the woozyness.

I felt fine in the recovery room where you are expected to stay about a couple of hours and they keep an eye on your stats etc to make sure everything is okay before taking you to the ward. I was told the operation had started at 9.30am and was finished at 12.45pm, so just over three hours. I forget actually what the time was when I came around, but I was in no pain at all.  I was offered an oxygen mask but preferred the nose tube, which only just sits inside the nostrils. It doesn’t go right up your nose and into your lungs which I had previously thought. Duh! Oxygen is pumped through which aids recovery and certainly I felt I was breathing a lot better than I normally did. I felt slightly light headed, but not unpleasantly so and a very dry mouth. I anticipated this as had been under anaesthetic before and had both those feelings before – water seemed to be the cure back then and so I asked for a drink of water which I was given. Head cleared immediately and I felt fine and dry mouth went. Even though you are given fluids intraveneously you do get dehydrated, at least I do and taking a drink of water works wonders.

Recovery unit were waiting for a bed to be prepared for me in the Transplant unit but there was a delay with the discharge of the previous patient I believe, so I was actually in recovery for around 5 hours.   The nurse who stayed with me for best part of that time was great. We had a good laugh together and chat about all sorts of things. She said they had been discussing why someone would do what I did and she couldn’t get her head around why I had donated to a stranger and even explaining it as best I could, she was still a bit “confused” by it all. I can understand that perfectly. Another nurse asked me to explain exactly what altruistic was so I explained. She said that her husband donates bone marrow and had done so 4 times! Wow.  She said it was very painful for him to do but each time of course a life was saved.  What a courageous man. There are some truly remarkable people in this world.  I was offered a cup of tea and while thinking “did I or didn’t I feel like one” – the offer of some biscuits was made. Well – only one answer to that – Yes Please! I suddenly felt really hungry and did I enjoy those biscuits and that cup of tea.  I know the British are sometimes mocked for our love of a cup of tea but I have to say they can mock away all they like – I love my cup of tea, and that day it was the best cup of tea I have ever had! I was beginning to feel rather spoiled. A companion to keep me company for all those hours – cups of tea and biscuits – I have nothing but the highest praise for the NHS and the many many people I have had contact with over the months.

From what I could see there was only one other person in Recovery, next to me. He was still a bit “out of it”. 

My main recovery nurse said when she finished her shift the next day she would come and find me to see how I was. I would look forward to that. She had made my time in recovery go quickly and was very friendly and kind – it takes a very special caring person to become a nurse  and my brief stay in hospital brought me into contact with many very special people who enriched my life more than they will know. 

I was taken up to the Transplant ward around 6.15pm.

 

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Laparascopic Nephrectomy  (Keyhole surgery)

Laparoscopic surgery is performed by inflating the abdomen with gas, usually carbon dioxide, which creates a space between the wall of the abdomen and the organs inside.
Using short incisions instruments can be inserted to perform the manoeuvers necessary for the operation. All this is viewed directly on a video monitor which receives its picture from a video camera attached to the laparoscope which is inserted through one of the incisions.

Our journey to the hospital was a hoot. For the first time ever  we missed the turning off the dual carriageway.  Drove on to the next turn off … missed it!! I was not driving. I was sitting in the back keeping my lips very firmly glued together, taking slow deep breaths and Praying!  You see, men go on about how much women talk, but today, it was because two men were talking non stop that between them they allowed two turnings to be missed!! That would not have happened had I been driving and even if I had been talking as well, because we women all know, we are experts at multi-tasking! hee …. Had to laugh though at the reason why we missed not one, but two turnings! Today was not the day to get lost, be late or end up stressed.  A few minutes later and iphone to the rescue with its built in sat nav and my son got the directions –  and we got back on track! We did eventually get to the hospital about 10 minutes late instead of 15 minutes early as planned. I had to laugh. No way could I see anything but the funny side of this. Right up until the last minute these little things were being sent to “try” me. At long last though, I had learned patience and had a bit more Faith!

We went to Day Surgery and I filled in a basic form with personal details, next of kin, telephone numbers etc. A nurse took me through to another room and into a cubicle – my family was allowed to come and wait with me which was nice as I was now into  unknown territory a bit. I could have been quite nervous at this point, but I was not. Here I knew everything was out of my hands and my total Faith in the transplant team and God was all I needed now.

I was weighed. had name bands put on both wrists having confirmed my name, date of birth and address.

At this stage my family went back to the Day Surgery room to wait. They could have stayed with me, but at this stage I preferred to have them wait outside. I felt it was not really fair on them to put them through watching me being injected and that sort of stuff. I would see them again before the op. I was given some tablets and a heparin injection. My blood when originally tested for clotting, clotted very well, so the heparin will help to thin it slightly so as to help stop blood clots from forming. The nurse measured around my calf as I was to wear anti thrombosis socks. She asked me to get changed into the hospital robe. Why is it that the ties that do up around the buttock area are always the ones that are broken, so you walk down the passage with with your bum sticking out! lol  The anaesthetist came and said hello. Checked the forms and got my weight. We had a little chat and off he went.

I then tried to put the stockings on the nurse gave me. They are special ones that help stop blood clots forming. Oh my!!! They were so tight I could hardly stretch them to get them over my toes let alone up my calf and over my knee!  Took all my effort to stretch it partly open. I managed to get the first one on, but not without grunting, groaning and generally going red in the face and feeling exhausted and throwing a mini tantrum – lol!!
…. to read more about my operation – click here

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Sorting out last minute hitches i.e. Heart ultrasound

I had to wait a few days before an appointment was given to me. Before I heard, I emailed my co-ordinator a couple of times, flapping around a bit with meaningless questions! lol … Finally the ultrasound department rang me with an appointment for 2 days before the operation. I emailed my co-ordinator to tell her, although I am sure she would have already been told. I also asked when we would get the results? Could I come straight over to her department and sit and wait for them? She responded saying she was not sure if they would give me the results straight away but she had given the anaesthetist my phone number so he could ring me asap once he heard.

The anaesthetist actually telephoned me that evening to put my mind at rest. He reassured me that there was nothing major wrong with my heart at all, that he was just a very very thorough person and wanted absolutely everything covered. I was not to worry. I very much appreciated not only his phone call which did put my mind totally at rest over this, but I very much appreciated him as well. I had 120%+ faith in the whole transplant team. If I was not, I would not be doing this. I was really more concerned for the recipient and how they would feel should the operation have to be postponed until this “wiggle” was sorted. It was the time scale I think that got me anxious. Had all this happened with plenty of time to spare, then it would have been just one more test I had to have. But only 2 days from the operation was not leaving much time to spare should any further tests be required.
click here to read more about the last minute hitch!

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 Living Donor Pre Assessment Clinic including final meeting with surgeon, anaesthetist, pharmacist and Transplant co-ordinator.

By law you have to have some medical checks done within 2 weeks prior to the operation. This is to ensure that you are fit and healthy just prior to the operation. Some of the evaluation tests were done a few months ago, so up to date ones would be required. 

I arrived early in the morning at the hospital, knowing I would be there most of the day. Here is a list (as presented to me at the hospital) as to what the day would hold. I was at the hospital for around 5 hours and the following took place but not necessarily in this order:

Tests I had done:
1. Blood and urine samples (they took 20 tubes of blood! yes .. 20!)
2. MRSA swab (gave me a loooong q-tip I had to wipe the inside of my nose with)
3. Chest X-ray
4. ECG

I was seen by:
1. Consultant Surgeon
2. Anaesthetist
3. Pharmacist
4. Transplant Co-ordinator

1. Consultant Surgeon:
My Consultant Surgeon explained that he would not be available to do the operation.  There would be two other surgeons. He told me a bit about them. I was a little unsettled about this, as familiarity of people/faces goes towards a relaxing atmosphere and I felt I knew my current  Surgeon and felt very relaxed in his company. But then I thought I am going to be out of it anyway under anaesthetic, so won’t really matter, so I was okay with that.

The surgeon went through the procedure from admission to after the operation. He drew a picture showing where the incisions would be and why. There would be a small incision just above the belly button, through this the camera would go.  Two more would placed to the right of the camera incision – one just under the rib cage and the other same distance below the camera one. Through those two the surgical instruments would go. My surgeon comically called them “chopsticks”. Another small incision would go to the right of the one just under the rib cage. Through this incision an instrument would go that would move the liver out of the way which is very close to the right kidney. Those four small incisions would be around 1-2cms (the one above the belly button actually ended up around 4cms the others were very small though). The final incision is along the bikini line and would be around 6 inches. It is through that the kidney is extracted.  He also explained that it would be hard to move around in my abdomen as not much room, so they inflate me like a large balloon with carbon dioxide. An after effect of this could be that some gas could escape up into the shoulder blade area and afterwards cause some discomfort for a few days (it did! lol).
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HTA approval given to donate a kidney – Finding a recipient

My transplant coordinator asked if there were any dates I may not be available for the operation and when was best for me. Once I was registered at UK Transplant things could happen quite quickly so it was important I was not registered at until we were ready. I had a couple of dates that I wanted to avoid otherwise a clear calendar. My family were fine for things to proceed also. My details were then registered at UK Transplant.

The recipient is selected for blood type matching, tissue match, age, length of time on waiting list and various other medical / non medical factors, all of which are there to make the system as fair as possible and also to select the best match to reduce any chance of rejection.

Do not think that once you get to the stage of HTA approval that everything will be straightforward.  It may not be. It was not for me. I made the mistake of assuming it would all now be plain sailing but we still had a few hurdles to get over and it was quite an emotional time for me.
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It has been  some time since I posted re my final evaluation test, the CT Scan (October 2009). Following that I got HTA approval and I donated my kidney.  Here is an account of that and the operation and my recovery.  There is quite a lot to comment on so I will do it in separate posts. It may take a couple of days to fully post.

Independent Assessor Report and HTA (Human Tissue Authority) approval to donate my kidney.

My last and final evaluation test was the CT Scan in October 2009. That all went well and an appointment was made for me to see the Independent Assessor (IA). The IA is totally separate from the medical teams that have dealt with me, he acts as the HTA (Human Tissue Authority) representative and sends a report to the HTA for approval.
read more about the Independent Assessor Interview

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