Tuesday, October 19, 2010

4 Week Update & Question Request

Today marks the 4 week mark since the transplant! 4 weeks was the target point for me to return to work (yes, I returned at 2 weeks) and to be able to return to lifting objects greater than 15 pounds (I have tried to stick to this one).

I am happy to report that I feel wonderful! My energy has returned in full. I had to work full days this weekend so I am on 9 straight full days of work and yet still have fairly normal energy. Can’t beat that! I also rarely ever move in a way that causes discomfort now. The exceptions are if I try to sit up and twist at the same time or if I try to sit up while holding something heavy – both cause a sharp pain in my side.

The scabs and glue are almost completely off my incisions – replaced with nice new skin! I was thrilled today to be able to start carrying my laptop bag into work instead of having to wheel it in and take the elevator (my office is only on the second level – my pride took quite a hit wheeling my little bag into the elevator each day). I guess you could sum all that up by saying that my life has returned to normal.

Thanks again to everyone for your outpouring of love and support! Please do keep Candi in your prayers as she continues her recovery. Hopefully we’ll get an update up on the blog from her soon and I’ll continue to keep you updated on how I am doing.

Question and Answer Request: As you all know, I am writing this blog in part to create a resource for those who are considering donation (and their family and friends). I would like to add a question and answer post to answer all of those burning questions that everyone has about what the process was like (or for Candi – I am sure she will be willing to answer questions as well).

I already have quite a few questions but need more. This is where you come in – what questions do you have (you can post them as a comment to this post, on the Facebook page, or can email me at doxadigitalimaging@yahoo.com)? The more questions you ask – the better this resource will be for others. Once I have a good list, I will add the post. Thanks!

Friday, October 8, 2010

Post Op Visit & Day 17 Update

On Tuesday I had my post-op visit at the transplant center. They took another blood sample and did another urinalysis. The blood sample was to check my creatinine level (measures your kidney function) as well as other blood counts. The urine sample was to check the protein content in my urine. Both of these tests came back as normal so I’m all set until my 6 month check-up.

The doctor did have a lot of fun with my creatinine level. The lower the score, the better your kidney function. Candi started at 6.0 (complete kidney failure) and I started at .9 (well below the 1.5 that is considered normal). The goal was for Candi’s score to be at 3.0 immediately after the transplant but she made it all the way down to 2.0. I, on the other hand, was at 1.2 after the transplant (still a great level).

Well, the doctor was very pleased to tell me that they had just measured Candi’s level the day before and she was at .6 compared to my 1.2! He said that she clearly knows how to use my kidney much more efficiently than I did. Thanks doc. What that does mean is that Candi’s kidney function levels are absolutely phenomenal. How can that not make you smile?

The doctors also took a good look at my incisions and reported back that they looked great. I have graduated from lifting nothing over 10 pounds to lifting nothing over 15 pounds (and get to graduate to 20 pounds in a week)! This is especially good news for my cat, Pippin. He was sitting at about 12 pounds so he has been out of luck up until Tuesday. The doctor was also happy with my energy level, that I was off the pain meds, and that I was resuming some normal activities like work. He was comfortable with me driving and encouraged me to step up my cardio (I'm up to a mile at a fairly fast pace).

One piece of info that I didn’t know was that I was only supposed to be eating bland foods for the first 30 days. At that point I had already eaten out several times and the food was definitely not bland. Oops!  To show my discipline, I left the transplant center and had a Philly Cheese Steak at my favorite spot in Manassas (Philadelphia Tavern for you locals)!

This was my last visit with the transplant center so they also gave me some parting instructions. I was encouraged to buy a blood pressure monitor and to log my blood pressure once a month in a notebook. When I visit my primary care physician, I am supposed to bring in that log so he can see my blood pressure over time. If I notice my blood pressure rising above normal levels, I need to take action to make sure I keep it under control. High blood pressure is one of the largest drivers of kidney issues so this is an item I need to stay on top of the rest of my life.

I was also asked to have a physical performed after 6 months and then every year after that (including full lab work). I have the option of doing this at my primary care physician or returning to the transplant center to be checked. Since I am two hours from the transplant center, I will choose to use my PCP. I was given a nice certificate and pin as a parting gift from the transplant staff. Unless something goes wrong, this was my final visit to the transplant center.

After my delicious cheese steak, I had the opportunity to visit with my friends at the News & Messenger.  It was great catching up with them and having the opportunity to thank them in person for the wonderful gifts (I am totally addicted to the Kindle!).  They are a great group and I feel honored to call them friends.

So how am I doing? Great! I have now made it through my first full week at work. My energy level is continuing to rise and my pain level is continuing to fall. Most people who see me now would never know that I just had surgery 17 days ago. I’m definitely not at 100% but I feel like I am on my way!  Thank you yet again to those who have been praying and also a special thanks to those who have donated to our efforts to raise money for the National Kidney Foundation through the 2010 Kidney Walk.  You all are great!

Monday, October 4, 2010

Recovery Days 11 & 12

I am psyched to be able to report today that I am finally out and about!  Yesterday I drove to and from church and made it through an hour and a half Sunday School class.  It was great just to get out and see people...although the less than comfortable chairs were a little annoying.  Overall pain level was minimal.

Today was my big day - the return to work!  I planned to work until my body told me it was time to leave and set an internal goal in my mind of making it through lunch.  I ended up not leaving until 5:30...and I still feel great!  The pain was very minimal and it was so great to see my colleagues and not be sitting at home! 

I thought maybe I would pay for it this evening (usually that is when the pain catches up to me) but I still feel quite good.  I even finished the day off with a good walk around the neighborhood.  I know I still have a long way to go before I hit 100% but today definitely felt like a great day.

As a reminder for those thinking I am nuts, I have a sit down job (insert lame bean counter jokes).  Working from the office is really not very different from working from home.  The only factor that adds some pain is having to drop the gym shorts for dress pants.  The weight of the pants (and belt, and wallet, and keys...) is uncomfortable on one of my incisions but once I am able to get myself situated in my desk chair, I am good to go.  So while I still have permission to miss work days or work short days as needed, I think I am probably back to work for good!

Tomorrow is my return visit to the transplant center for a check-in with the surgeon and for some blood work to make sure my kidney function is still where it should be.  After that I hope to pay a visit to my great friends at the News & Messenger and then head for home.  Should be a good day!

Sunday, October 3, 2010

Candi's Recovery - Another Guest Blog!

I can't begin to tell you how much Josh's gift means to me. Although I'm still very weak, I am no longer on dialysis and that is a WONDERFUL feeling! No more going to bed at 9:00 pm every night and no more waking up before dialysis is over and having to lay there until the machine signals me that I can get up. After only 12 days, the freedom is amazing - I hadn't realized how much I missed it! If I can't sleep, I can now get up, go downstairs and read (from my amazing Kindle that the folks at News & Messenger and Culpeper Star-Exponent bought me) or I can watch TV. I can also travel without taking my machine and all the supplies with me. We'll be heading to Saluda next weekend for a long weekend - I can't wait!

I can also have Diet Coke again. Colas are very high in phosphorous, as is chocolate. Phosphorous is one thing that dialysis can't handle. But now that I am no longer on dialysis, I can have my diet cokes and I can have chocolate (although those that know me know that I sneaked chocolate every now and then even while on dialysis). Now I don't have to sneak. Also, when I eat anything, I no longer have to take two very large pills called Renvela. That was tough to get used to at first - not that I enjoyed taking the Renvela - it was just hard to get out of the habit. But it's a very good habit to be able to break!

Josh is one of the most extraordinary people that I will ever know. He gave me a kidney, which is giving me my life back. What better gift could one ask for? His mom is pretty extraordinary too - she's an amazing woman who has raised an amazing son.

I haven't been able to walk very far yet - between the rain, the pain, and my lack of strength - but I'll be starting my walking regimen tomorrow after my next clinic appointment. At my last clinic appointment, I found out that my kidney levels are at 0.6! This is fantastic - even for someone without a transplant! I just pray that both Josh and I will stay this healthy the rest of our lives! My goal is to celebrate my 77th birthday with Josh's kidney still working. I know that may sound young to some of you, but that's 24 years from now! That's a lifetime to me - one that I didn't expect to have with dialysis. Thank you Josh for my life!

By the way - has anyone noticed that I still call it Josh's kidney? I guess it will always be that to me!

Thank you to all who prayed for us. Please continue to keep us both in your prayers.

Saturday, October 2, 2010

Recovery Day 10 - Driving

I just hopped in my truck (well, maybe "hopped" is a stretch - more like "I slowly climbed into my truck") to see how it felt to press the brake (this was my surgeon's suggestion). It felt fine so I drove around the block a few times (also the surgeon's suggestion).

I am now 100% confident that I can drive safely but I must admit, I was hurting a little by the time I arrived back home.  It really isn't much different than the pain that I experience after riding in a car for a while.  I don't think I would want to do anything more than a short trip at this point...but it will get me to church and back tomorrow!  This is good news for Monday as well as I should be able to drive to work and then come home if I can't make it a full day.
Last night I ventured out for my first outdoor walk.  My 11 year old niece, Tessa, "babysat" me (thanks Tessa!) on the walk to make sure I didn't end up in a ditch somewhere.  I only made it to the end of our street and back (a little over a half mile) before feeling like it was time to stop.  It hurt but still felt great to get outside!
So tomorrow I have church, Monday I have at least a half day at work, and then Tuesday I have my return to Fairfax to see the surgeon and have some bloodwork taken to make sure all is still well.  Hopefully life will be mostly back to normal by Wednesday!

Friday, October 1, 2010

Recovery Days 3 – 8

Over a week has now passed since the surgery but it honestly feels like a lot longer. I have been home now for 6 days and am definitely getting cabin fever! As crazy as it sounds, I will be thrilled when I can get back to a normal routine and return to work.

The ride home from the hospital was a bit brutal. What should have been an hour and 45 minute trip ended up being a 3 hour and 30 minute trip due to accidents. Every bump in the road was quite painful. I was definitely happy to pull into my driveway!

My first task at home was trying to figure out where to stake my tent. I tried my bed and a couch before settling on a recliner in my living room. This would become my home for the next 3 days. Lying flat felt like it was stretching the incisions which wasn’t comfortable and sitting up straight was definitely not comfortable but the recliner actually felt pretty good. After three days, I did a test run on the couch to see how I would do lying flat all night. I woke up a little more sore than when on the recliner but considered it good enough to graduate to my bed the last two nights! That has been a welcome change!

I stayed on the heavy duty pain meds for the first two days and then dropped them for just a couple of Tylenol in the morning and at night. One of the key obstacles I had to pass before I am released to drive is being off of the prescription pain meds for at least 3 days so I wanted to kick them as quickly as possible. I have really found the incision pain to be quite bearable with just Tylenol.

Sleeping has been a small challenge. The pain meds or Tylenol PM have been enough to get me to sleep pretty quickly but not enough to keep me asleep all night. I have found that I wake up often and it isn’t always easy to get back to sleep. I have been trying to stay in bed for 10+ hours to ensure I am getting enough down time. That combined with a nap or two throughout the day has really helped me keep my energy level up.

Eating has been one of the hardest things for me. I simply have not had any appetite for food. In just 9 days since surgery, I have lost another 5 pounds! I knew I needed to start forcing myself to eat and slowly but surely I have returned to my normal eating habits. I still don’t have much of an appetite but at least I can force down enough calories!

On Monday I started to work some from home. I was hoping to be able to go into the office some this week but ruled that out. Each day I have been trying to spend a little more time working and a little less time resting to build up to return to work next week. One unusual hurdle I have faced is a lack of concentration. The pain meds are no longer in my system so I can’t blame it on them. I feel a little better knowing that it is not just me - Candi is having the same issue.  Fortunately this lack of concentration has dissipated each day.

So where does this leave me? I am feeling pretty good right now. I can now sit at my desk for a pretty good chunk of the day while taking only minimal breaks. My brain is starting to function better and I am becoming more productive. The incision pain has decreased substantially. Coughing and getting up from a low position are still quite painful but most of the day the pain is minimal. The pain does increase as the day goes on and I am still worn out by the end of the day. But when I look back at the progress that I have made over the past 9 days, I can’t help but feel good about my recovery and expect that I will be 100% before long! Thanks again for all of your prayers, well wishes, flowers, and endless baskets of fruit (newly learned fact - many people assume that guys won't appreciate flowers so they send fruit baskets instead - I have a lot of fruit)!

Saturday, September 25, 2010

Hospital Recovery

The first afternoon in the hospital was fairly uneventful. I was still feeling the extreme effects of anesthesia and felt very little pain. I was put on a liquids only diet but was able to eat very little of it. I felt quite nauseous and really couldn’t get out of bed. The good news (if this can be considered good news) is that I was catheterized so I didn’t really have to get out of bed. I know I napped a good chunk of Monday evening and had my vitals regularly checked to make sure all was still well.
Wednesday was the hardest day of all. I started the day with some difficulty breathing. I basically just had some nasal drainage, but the medical team wanted to make sure I didn’t have any lung issues resulting from the surgery. They ordered a chest x-ray to take a closer look. One of the hospital workers brought in a stretcher to take me down. I hadn’t been out of bed at this point so the nurses said they would just carry me to the stretcher. I figured that was overkill, so I forced myself up and walked over to the stretcher – ouch! Adjustments to the height of the stretcher, the transport technician throwing a huge blanket right on my incision, and every crack we hit in the floor paled in comparison to the shooting pains that then came from having to sit up straight with no support while they took the x-rays. By the time I made it back to my bed, I was in pure agony.

As a pick-me-up, my Uncle John visited for much of the afternoon. Unfortunately, I wasn’t very good company. Shortly into the afternoon, the gas pains began. I had been warned that this was the worst part of abdominal surgeries. They need to pump your stomach full of gas so they have more room to move around during the surgery. They attempt to expel most of this gas but if some remains, you are in for some pain. For some reason, my gas pains didn’t hit until Wednesday afternoon but when they did hit, it was in full force. I can honestly say that I have never been in more constant pain in my life. I simply could not get comfortable or get any relief. The gas pains just moved around in my stomach, chest cavity, and even in one shoulder.

The medical team gave me various medications that “could” help with the pain but they warned me that the chances were slim. The only real way to get rid of the pain was to make it expel from the body. The only good way to make this happen is to endure the pain and get up and walk around. It doesn’t feel productive, but I had heard this from enough former transplant patients to know that it was true. The difficulty was in knowing when was the right time to get up. I didn’t want to start too early and risk falling, but I didn’t want to endure the gas pains any longer than needed either!

My first attempt was at about 11 PM Wednesday. The night nurse came in and told me I was getting up for a walk. I politely declined but she wouldn’t take no for an answer. She could tell I was hurting and knew a walk was the only way I was going to see improvement. So I stumbled out of bed. The act of getting out of bed was the most painful for me. It shot pains through my stomach and made me feel like I was going to pass out. Once I was on my feet, I instantly felt like I needed to lie back down before I fell down. The nurse had me hold my IV pole and just stand there for a minute or so. Again, I was ready to lie back down but she insisted I keep going. I made it all the way to the door in the room before she let me turn around and go back. I must say, while that walk was quite painful, it was wonderful. I was able to pass some of the gas which led to a short relief from the gas pains. This meant I was able to sleep for several hours which gave me more strength for Thursday.

I woke up ready to walk a ton on Thursday but then couldn’t find a nurse to help me walk! When my mom arrived, I set out immediately. I made it all the way around the hospital wing and was even able to stop in and say hi to Candi (although it was a very brief hello!). It was exhausting and painful but felt wonderful at the same time. I tried again a few hours later but the act of getting up left me clammy and light headed. I barely made it out of the hospital room before having to turn around and head straight back to bed. Frustrating! But I was determined and did make it around the wing two additional times on Thursday. These walks definitely helped me turn the corner. When I was no longer so focused on the gas pain, the incision pain just wasn’t that bad. It was much easier to get up and move around and even to eat. These were the signs that the doctors were looking for and which ultimately led to my being released on Friday.

The highlights of my hospital visit were the meetings with my surgeon and Candi. The surgeon explained that the surgery was an awesome success. He said my kidney was one of the best he had ever transplanted and this was a great sign for the kidney’s future in Candi. He also said that her energy level and ability to move around were a fantastic indicator of how big a success the transplant was. Seeing Candi confirmed what he said. She looked simply wonderful (a whole lot better than me!). She was upbeat, energetic, and chipper (as my mom described it). I’ll let Candi explain the numbers but that was all great news as well. These discussions were just the pick-me-ups I needed!

Prior to being released, I was told that I would need to come back 10 to 14 days after surgery to have them take another look at my incisions and help break up some of the glue holding it together. I can’t lift anything over 10 pounds for 4 weeks. Once I get off of the pain meds, I can start driving again as long as the pain of pushing the brake isn’t too great. I asked about going back to work and they are recommending I take it a little eaiser than planned next week. I had anticipated getting a ride into the office and working full days.

The surgeon loves the idea of me trying to do some work, but he is afraid I will only be able to do it in 2 – 3 hour increments. He feels there is no way I can make it a full day, which is what I would be locked into with riding with others. So I still have to figure out my work plans. I can shower (great news!) but am to avoid baths and swimming for a couple of weeks. I need to drink massive amounts of liquids and try to get back to my normal eating habits. Bowel movements are the biggest challenge donors face upon going home. The pain meds naturally constipate you and it often takes the stool softeners several days to begin working. That brings us up to date. I am taking it easy for the weekend, hoping my body will be ready to return to a somewhat more normal routine on Monday.

Many people have asked me if I would be honest about the pain levels in this post. Obviously, I have to be in order for this to be a valuable resource for future donors. But, at the same time, I don’t want to scare people away from considering donation just because of some pain. So perhaps the best way to end is simply to share my thoughts at this stage of the game.

The surgery itself was extremely painful and certainly not a fun experience. But hearing the doctors talk about how great my kidney was doing in Candi’s body and then seeing the energy that Candi gained have continued to make my decision to donate a no-brainer. The pain and inconvenience I suffered are a tiny price to pay for the freedom and future this rewards the recipient. If I had to do it all over again, I would dread the gas pains, but I would definitely make the same decision! I believe even more strongly today that kidney donation is an amazing gift that almost anyone should consider. Thank you so much for coming along for the ride! I will continue to keep you updated on our progress!!!