Posts Tagged ‘psychiatrist assessment’
The purpose of this interview was to make sure that I understood what I was offering to do and that I was not doing this under any sort of coersion. Was not being offered money or any incentive to donate. They also needed to know there was not any underlying mental conditions that could adversely affect my decision making . That I was donating for the right reasons and my life was stable etc etc.
The interview lasted around an hour and basically we just chatted. The doctor asked me about my childhood and schooldays … also about my time while growing up and then questions about my family life past and present. I was also, of course, asked why I wanted to donate. She probed further and asked me how I would feel if say the operation presented problems … if something went wrong – how would I cope. How did I feel about never knowing who the recipient is? Would that bother me. I explained to her that just knowing they were living a better life and enjoying doing things again was plenty to make me smile. I think at the end of our chat she could see that I was a strong person mentally, knew my own mind and had made my decision freely with no coersion from anyone or payment and with full understanding of the whole procedure and risks etc etc.
It is a bit nerve-wracking knowing you are going to be quizzed by a psychiatrist. All one can do is say things as they are.
The doctor had no more questions and asked if I had any. I said I just had one … “Had I passed!” …. lol …. she said there was nothing untoward in our discussions – nothing that would make her query my decision. She would write up her report and send it to those concerned and a copy to me.
Couple of days ago I wrote to the Transplant Nurse Specialist and asked her to remind me of what happens next. We are so near now. I did chat with her a few weeks ago about what happens once the evaluation tests are done – but I never wrote anything down, so I am in a muddle as to what order things happen next. So look forward to her response.
I thought it might help to just go over what has happened so far, and the evaluation stages left.
I had an initial consultation with the surgeon and a Transplant Specialist Nurse. Various questions regarding my health, past and present and my families health as far as any illnesses they may have had. My weight and height were checked.
This gets taken as high blood pressure can cause damage to the kidneys. Blood pressure is taken more than once during the evaluation period.
Urine sample is taken and checked for underlying problems such as glucose, protein, bacteria, etc.
I have had blood taken three times and checked for a variety of things. Blood group, tissue type …. infections, all sorts of things are checked for to make sure you are quite healthy.
Blood samples will be taken which is checked for blood group, tissue type, can show if there is anaemia, various infections etc etc . Various checks on the blood are done to make sure you are quite healthy and the kidney and liver are functioning okay ….
A chest x-ray was taken.
I had an ECG (Electrocardiogram) where you have electrodes placed on you and your heart is monitored and the electrical impulses of the heart are recorded onto a graph and from that they can tell if there are any weaknesses in the heart.
This is a non-invasive scan. It checks that there are two kidneys. Some people are born with only one kidney but are totally unaware of the fact. The ultrasound can show the size of the kidneys, if there is any scarring or obstructions. I had a small scar on the top of the right kidney which was probably due to an infection as a child. It did not affect my ability to donate. For those who have never had an ultrasound (most pregnant mums have) – then for a kidney ultrasound they wanted it done on a full bladder (that was the hardest part ..lol…). A gel is put onto your abdomen/side and then the technician moves a probe over your abdomen and sides and the probe can “see” your kidneys. Once she had done the part that required the full bladder I was allowed to go and pee ! Then came back for the rest of the ultrasound. It is totally painless, not at all uncomfortable. The gel was a bit cold but that was all. None of the tests I have had have been at all uncomfortable.
A doctor was assigned to me to make sure that everything was being done that should to ensure I was healthy and fit enough to donate. He checked my weight and height. Asked me a few questions. Listened to my heart which sounded okay. Blood pressure was 138/81. Peripheral pulses were present. His opinion was that I was fit to proceed for further evaluation. Ideally though I should lose some weight (being 89kb with a height of 1.6m). I also take HRT and was recomended I come off that for the donation.
(Note: I do not take any form of HRT which is derived from pregnant mares – such as Premarin etc. I take kliovance which is plant based. Speak to your doctor about switching if you are concerned about how the medication is produced).
I am working on the weight loss …. !
I saw the psychologist (see previous blog entry) and that is all fine.
Still to come ….
I am waiting to hear my appointment date for this. They need to make sure I am fully aware of what I am committing myself to; that I am mentally okay and freely consenting to this procedure.
This I have yet to have. It This is where they have to check the anatomy of each kidney. Arteries and veins have to be identified. It is not unusual for a kidney to have more than one artery. These results go towards making a decision as to which kidney will be removed.
GFR Test (Isotope Glomerular Filtration Rate).
I also have this to come. I believe I will be having this same day as the DMSA. The GFR is a test to assess the capability of the kidney to ’clear’ the blood of a substance. A small amount of dye is injected into a vein and blood samples are taken at hourly intervals for three/four hours, to measure the renal clearance of the dye.
Finally I have to see the Consultant Nephrologist again as he gives the final decision as to whether I am medically fit enough etc to donate a kidney.
All the information is given to an independant Assessor and I have a meeting with him. He needs to make sure I understand everything etc etc. He then makes a report and presents to the Human Tissue Board and seeks their permission for the donation to go ahead. The producing of the report and seeking permission can take up to a month in total.
It was explained to me that there was no guarantee that it would be keyhole surgery. The surgeon would make that decision once both kidneys had been evaluted etc. It is not unusual for a kidney to have more than one artery and vein and if it turns out that there are two or three arteries and/or veins etc, it maybe that the operation would easier with open surgery. So that does affect recovery time. Keyhole surgery – the stay in hospital is shorter by a couple days I believe and the recovery time is much quicker.
I have some personal committments late Autumn that are a must to keep and may involve physical activity. So allowing enough time for the donation and full recovery, it may be difficult to make the actual donation any earlier than late November/December. That is fine and allows plenty of time for the rest of the tests and assessments to take place. Approval for the donation will be sought once my committments are over. I certainly don’t want to be under any pressure during my recovery especially as I don’t know if keyhole or not – so need to be sure there is plenty of time afterward to get back to normal.
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