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What I Learned When My Kidneys Failed, Part III

September 20, 2013

Prior Installment: Dialysis Days

The Big Show

By the spring of 2013, paired exchanges with other donor/recipient pairs, including me and a non-matching donor, began to appear.

A paired exchange is something simple in concept, but very difficult in real life. It requires a person who does not match their recipient but does match a complete stranger to donate their kidney to the complete stranger in order for their recipient to receive a matching kidney from another complete stranger. Some of these pairings (called “chains”) can be quite long and complicated and often involve pairs from all over the country.

Paired exchange chains are quite fragile. Any number of things can cause a chain to be broken, which means we have to start over. Final cross-tissue matches can fail, a donor or recipient can change their minds, and because the recipients are often quite ill, a recipient can die.

Between May and July, we had two exchange chains break for one reason or another-we were never told why, just that the chain was broken and the coordinators will keep working.

The third week in July, we were entered into a chain that had nine donor/recipient pairs. Obviously, the more pairs involved, the more likely things are to go wrong. The final tissue cross match takes a couple of weeks, which was probably the longest two weeks of my wife’s life.

Just as the final cross tissue match was completed—a glitch. Less than a week before the surgeries were to begin, my donor’s recipient received a cadaver kidney which meant that this donor no longer needed to donate. Good for him, very bad for the rest of us.

Three days before the surgeries, the chain was repaired. Instead of receiving a 52 year old kidney from Maryland, I was to receive a 41 year old kidney from Colorado. Younger kidney—and closer. This worked out just fine but it was a close call.

Further complicating the situation is that of the three living donors willing to give on my behalf, it was my wife who got the call. That meant that both of us would be in long post-op recovery at the same time. During the first three weeks of recovery, there would be very little we could do for ourselves.

My brother interrupted his Costa Rican sabbatical to come to California to serve as our primary caretaker during our recovery. Our neighbor organized and mobilized a vast network of friends to bring meals during our recovery. Almost everyone we know contributed what they could (our dog walker took care of Auggie and refused to take money, for example).

The day of our surgeries was undoubtedly the longest day of our lives. My wife’s surgery was scheduled for 7:30am, which means she had to be at the hospital at 5:30am. My surgery was tentatively scheduled for 4:30pm that same day.

I stayed with her and walked with her gurney to double doors that led to the operating suites. They wheeled her through the doors and the doors closed and she was gone. Now beyond any ability I had to protect or comfort her.

I never felt so alone in my life.

The next three hours seemed like 30 years. At 11:00am her surgeon reported that she was fine, a perfect patient and her kidney was on its way across town to save a life. The relief was something beyond my ability to describe. Knowing that she would be OK brought me peace of mind that, again, I cannot describe. Nothing else mattered now. I felt absolutely no apprehension about my upcoming surgery.

Unfortunately, by the time I would be allowed to see her, I would be in pre-op prep myself. We just got word that my kidney was on its way to the Denver airport. Show time was just around the corner.

By 2:00pm I was checked in and in my hospital room. We just got word that my kidney was in the air and on its way (every kidney in transit has a GPS tracker so the surgical team knows where it is at any time).

At 4:30pm the kidney landed at SFO. At 5:00pm the kidney was on its way by courier to UCSF. Time’s up. Now we go.

As I was being wheeled to the elevator that would take me to surgery, another gurney was coming my way. It was my wife who was coming from the ICU. We had a moment when we were allowed a moment to hold hands. It was a magical moment that I will never forget.

But it was a short moment. Time and tides wait for no man.

As I lay on the operating table, with everyone buzzing around me I could muster some last words of advice for the team: “Think clearly. Cut straight. Wake me when its over”. I could swear I could see one of the surgeons roll his eyes. The mask went on my face.

Then I was in the ICU/Recovery. I opened my eyes and the chief surgeon was there. He reported that the surgery was text book, the kidney was beautiful, and it was it was making urine even before he connected it to the bladder. I choose not to think to much about that.

As I drifted back into my drug-induced haze, I only had two thoughts: I wanted to see my wife. And the journey back starts now.

Next Installment: By the Numbers

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