Things to Ponder

Punctured, Poked and Probed

A Bit of Blood

I have been doing a bit more research into the surgery itself.  Here are a few images I found online of the surgery I will have.  It is called a laparoscopic nephrectomy.  Pretty fancy, right?!  To help you all better understand the operation here is how the procedure goes:

Laparoscopic nephrectomy is performed under a general anesthetic. The typical length of the operation is 3-4 hours. The surgery is performed through 3 small (1cm) incisions made in the abdomen. A telescope and small instruments are inserted into the abdomen through these keyhole incisions, which allow the surgeon to completely free and dissect the kidney without having to place his hands into the abdomen.The kidney is then placed within a plastic sack and removed intact through an extension of one of the existing incision sites.



A Kidney!!



Operation Diagram



Crazy!!!!  This looks intense.  And from the sound of it recovery is intense too.  Everything I have read/heard says that recovery is worse for the donor than the recipient.  That seems weird to me.  The way it has been explained is that the recipient is already feeling so awful that when they receive this new, healthy kidney it actually makes their body feel better than before the operation.  How amazing would that be to wake up feeling improved right after the operation?  I can handle the pain.  Just knowing it is temporary... a week or two at most, gives me the confidence to grit my teeth and bear it.



Slides Sheet to Study





Anatomy Lesson

The hospital had sent me via mail a packet of information that included a stapled sheaf of paper that had slides printed on it, as well as a DVD presentation to watch on my computer.  I viewed it a few days ago and got answers to a lot of the questions that I had, primarily regarding post op recovery.  That is my biggest concern.  It will be very, very hard for me to be away from work/my daughter/my responsibilities for much more than two weeks, so I am hoping that I will be a "Super Woman" case that recovers really quickly.  Fingers are crossed, per usual!



Surgery Info



Now that all of my labs are done, tests are completed and the video has been watched I am in a holding pattern.  I have contacted my donor contact in Colorado several times to get a status update (and results of my tests) only to discover today that she has been out of the office all week and will not return until Monday.  So no big news until next week.  I am also still waiting to do my psych evaluation so there is that step still left.  More news when I have it.  Until then.... have a great weekend y'all!









Drain My Vein

Pee jug.... round 2!

Stick it to me, nurse!

 










Today was lab day.  I did my second 24 hour urine collection from Sunday morning until this morning... yes the decorated cooler got a second 24 hours of use!  After doing the last collection in a 24 hour period I had to take it over to the lab and complete my blood draws.  If you remember from one of my previous posts I had to get a large quantity of vials filled for a couple of dozen different tests. 

I checked in with the lab receptionist and handed over my jug and then  took a seat in the waiting room.  Eventually the nurse called my name and directed me into the exam room where I have been getting all of my blood draws done.  She had a label sheet a mile long printed out for all of my vials, as well as lengthy instructions on what to do for the various bits of lab work.

Needle in.... vials filled.... and 16 tubes later I was done with the blood draw.  Easy breezy as always.  Next up she needed height and weight again, and then a "fresh" urine sample.  She sent me into the bathroom with a sani wipe kit and a sample cup as well as instructions on putting the sample cup into the door in the wall once I was done.  So in honor of chronicling every step of the way in this blog I included a picture of my sample in the wall.  Yes... I need to drink more water.  :(

16 vials of liquid Laura

Little box in the wall

So anyway today was a snap.  The next steps will happen this week.  I received a video in the mail that I need to watch and then I will have a psych evaluation done by one of the therapists that are on staff at the Colorado hospital.  I will take detailed notes on both so that all of you know what kind of information I am receiving.

For a little bit of fun.... I have been dog sitting for my parents this past week.  Here is my little buddy, Otis, who delights in dragging me down the block every time we go outside for a walk.  Don't let his size deceive you, this pupster is a strong one!

Otis the wonder dog

Radiate Me!

Early start to the day

Heading to the hospital

Today was the big testing day.  I was instructed to be at the hospital at 6:45 am to get all checked in at the Radiology department. 

Radiology department

Yet another waiting room!

First up for tests was a chest x-ray.  The nurses were nice enough to snap a couple of pictures of me getting the x-rays done.  For the x-ray I was posed in two different positions; a front view and a side view.  This was to check to make sure everything looked clear and good in my chest/lung area.  From gowning up to completion this took about two minutes.  Easy test!

Getting my chest x-ray

Side shot

Next on the agenda was my CT abdominal angiogram. I had an angiogram done about 10 years ago for my pancreas, so I kind of remembered what to expect, but I did have a feeling of anticipation about experiencing the icky feelings again.  If you have never had an angiogram I will explain.  You first get put through the CT scan machine several times to take pictures of your insides.  A recorded voice tells you when to take a breath and hold it, and when to release it.  The images are taken by a whirring, quickly revolving scanner that rotates around you as you go through the tube. 

Once that was done the nurse came back into the room and inserted an IV into my right arm.  Then my arms are put over my head and some chilly saline is shot into my body to test that the IV is working correctly.  Then the nurse leaves the room and a dye is injected through the IV.  The dye had to be shot very quickly through since this is a test that relies on speed for accurate results, so the impact of the dye is intense and immediate.  It is iodine based and causes your body to feel very warm from the inside out and makes you tingly.  For me it also made me very dizzy... the same way I feel right before I am about to pass out.  The warm (or rather HOT!) feeling started at my shoulder, shot through my throat and then immediately went to my groin.  It literally felt like I had wet my pants... which the nurse warned me about... but not to worry, it just feels that way, it does not actually  happen.  While this is happening the CT machine has started again and more pictures are taken.  The entire process - from the dye being injected to the completion is less than three minutes.  And the icky feeling is pretty short too.  By the time the nurse came back in the room to remove the IV I already felt better.

CT Scan Machine

In I go!

View from the top

Coming through!

Then the nurse was nice enough to let me come back into the room she was in and to view my kidneys on the computer screen.  Yup, I have two of them!  And all looks well!  Next off to get my EKG done.

My kidneys!



EKG...wired up!

I checked into the Cardio Eval department and then followed the nurse back into an exam room to get my EKG.  I have never had an EKG done before, and my only experience with them has been seeing the test done in movies.  To my surprise they no longer use the suction cups that I was used to seeing, instead they were small sticky tabs that they attached the alligator clips and wires to.  I had 10 wires attached to my chest and stomach, and then thirty seconds later the test was done.  The nurse handed me my EKG reading and snapped a picture.  She said everything looked great!

So the next step was to head down to the lab to get my next round of blood draws done.  This was going to be the biggie where they collected about a billion vials of blood.  When I checked into the lab I was told that unfortunately I had to come back Monday, as the 24 hour shipping requirement for my HLA tests could not be done on a Friday.  So they handed over my pee jug (for round two of collecting) and said "See ya Monday!"

So I'm almost there... the finish line is in sight...

The Short Walk

Papers and vials for the lab

Walking across the street to the clinic

 












It's testing day!  Today I had an appointment set to get my physical, EKG and chest x-ray.  My papers and blood vials had arrived in the mail earlier this week, so I packed everything up and headed across the street to my doctor's office.

Waiting room

Temp Taking

 











Once I got there my doctor's office informed me that there might be an issue with my getting the tests taken at their clinic.  The issue seemed to be with the billing and the fact that my doctor's office would not participate in third party billing.  Hmmmm.... their solution was to instead bill me and have me try to get reimbursed by the Colorado Hospital.  Clearly this was not going to work, especially since the billing instructions ask the testing clinic to cover 30% as a goodwill discount since this is a donation process.  I was asked to go sit in the waiting room while they tried to sort everything out.

Finally the nurse came to get me and told me they would go ahead with the physical since that was being billed to my own insurance, and they would keep me posted about the rest of the testing.


Blood Pressure



Reagan keeping me company



 

My physical consisted of getting my medical history and the following: allergies, height, weight, temp, blood pressure, heart and lungs check, ears, nose, throat check, and a check on my abdomen to make sure there were not any lumps or bumps.  I had already had my pap done two months prior, so it was not necessary to get that done again.

Once we were through with that we got a call from the billing department letting us know that I would need to go to the hospital for the rest of the testing, as my doctor's office would not do the necessary third party billing.  Frustrating?  A little.  But the good news was that once I sat down with the appointments gal, she was able to get me in tomorrow morning for the remainder of my tests. 

Getting my physical

Papers for the lab

 

So the line up for tomorrow:

- EKG

- Chest X-ray

- Abdominal Angiogram

- Dozens of blood tests

Bright and early.... 6:45 am appointment to get it all taken care of.  Then I will also be collecting another pee jug for my second 24 hour collection.  Good times!

More tomorrow....

And the Verdict Is.....

Anatomy of our innards

Success!  I received word from Colorado that according to my first round of labs that my kidneys are functioning normally.  Whew!  What a relief.  I guess I had never considered up until this point that there was a possibility that my kidneys might not be functioning normally.  What a kick in the pants that would have been, huh?  But thankfully it appears that all is well.

So anyway, I digress....  My secure message from the University of Colorado Hospital (sent via email), told me that I would have several more labs to do, an informational CD to watch and a social worker consult.  The next series of labs would be a bit more involved than what I had just participated in.  Here is what is on the agenda:

§  Laboratory Tests

        Albumin                         Creatinine                      CBC w/differential

            Alk Phos                       Glucose                         PT/PTT

            ALT(SGPT)                    LDH                              HIV

            AST(SGOT)                   Magnesium                   Hep B Surface Ag

            BUN                             Phosphorus                  Hep C Antibody

            Bilirubin-total                 Potassium                    EBV

            Calcium                        Protein-total                  Urinalysis

            Cholesterol                   Sodium                         Urine C&S

            CO2                              Uric Acid                       CMV IgG/IgM

            Hgb A1c

           

24 Hr urine for creatinine clearance and protein (2nd collection)

HLA/Crossmatch 

§  Health Maintenance Testing

           

1.  Pap smear for all females (within past year or repeat)

§  Consults

1.     History and Physical by Primary Care Physician

2.     Evaluation by Transplant Social Worker 

§  Other

1. Chest x-ray

2. EKG

        3. CT abdominal Angiogram -Clinical Question: Anatomy for Laparoscopic Kidney Donation.  Please include size of kidneys and dictate on bilateral vessels of kidneys.

Sounds like fun, right?!  So my physical is scheduled for Thursday of next week.  That will include the chest x-ray and the EKG.  The rest of my labs will be done at the hospital once I receive my many, many vials in the mail!  I am looking forward to watching the informational DVD that is being sent to me.  I have a feeling there are things that I have not even thought to wonder about. 

So until then, it is life as usual.  For a bit of fun, I attended a Brewer's game tonight with my friend Julie.  How cute are we?

Girls in a glove

Down the Hatch

Glucose beverage... um, yum?

Hanging in the waiting room.

Glucose test day.  Dum da dum!  I have been dreading this part of the testing.  I am a big fat baby about eating or drinking things that are disagreeable to me.  I am a VERY healthy eater, and I never ever drink sugary drinks, so I was very worried that I would end up gagging and not be able to choke the drink down.

After fasting since 8 pm last night, I arrived at the hospital at 9 am to get a fasting blood draw.  One little needle stick, a vial of blood and I was sent back out to the waiting room.  I hung out there for about fifteen minutes while my vial of blood was tested and then they brought me the dreaded bottle.  I was instructed to drink it quickly, in five minutes or less.  I unscrewed the cap, smelled it, took a tentative sip... and realized that I had psyched myself out for nothing.  Flat orange soda is what it tasted like.  No big deal at all.  Would I drink it on a daily basis?  Absolutely not.  But I can handle it for this test. 

So I slugged the drink down and then was instructed to come back in two hours for the next blood draw.  Within about ten minutes I started to feel pretty sick to my stomach.  The glucose drink certainly did not agree with me.  I went home and laid down for an hour and a half and tried to ignore the growing nausea.  After two hours I headed back to the lab and had my next blood draw done.  And that was it!  All in all a pretty darn easy set of labs.  Now I just have to wait for the results to come back from Colorado to determine what the next step is.  Will I pass?  I sure hope so!

Vial of my blood.

A Jug Full of Fun



Getting ready for the big collection!

Putting it on ice...







So Sunday morning began my 24 hour collection.  Basically I had to stay close to my pee jug and cooler for 24 hours so that every time I needed to, um, go.... I would be near my supplies to collect it.  So a cooler full of ice and my jug sat ready and waiting in my bathroom at home.  I did take my jug on a brief tour of town and a visit to my parent's house...

At the hospital to drop off my jug!

Getting weighed

24 hours later it was time to take my jug to the hospital and turn it in.  While there I had to get weighed, measured and my blood drawn.  The nurse was awesome - best blood draw EVER!  I did not even feel the needle go in!  Then I was sent down to the ER to get my blood pressure taken.

Collecting a lil bit o' blood

Heading to the ER

At the ER the nurse was nice enough to take an interactive picture of me getting my blood pressure taken.  So this part of the testing is over.  On Wednesday I get to head back to the lab for my glucose tests.  Today's visit was short, sweet and totally pain free! 

Getting my BP