So, I went down to the U for testing Tuesday afternoon and was back again this morning at 7.
One of the things I learned was that between the 18th and 22nd day post-transplant people have their highest risk of rejection. Apparently this is when the body has recovered enough from surgery to realize there's something new in the neighborhood.
For me, Monday was the 18th day.
So, after a nearly-sleepless night, there I was signing consent forms for a kidney biopsy. We still didn't have any lab results from my Tuesday visit -- "I think they broke the tube, is what happened," the coordinator said. While we waited for the morning labs to come back, they explained kidney biopsy, the only way to determine whether a kidney's being rejected.
Biopsy is a simple-enough procedure; they inject lidocaine in the skin above the kidneys' location and use ultrasound to make sure it's where it's supposed to be. They make a small incision -- so small it doesn't need stitches later. Then a contraption like a small gun shoots a hollow needle into the kidney, something like taking a core sample from a tree. They may need to make several passes to get enough tissue. And there's always a risk -- of launching bleeding, causing a hematoma, introducing infection. Worst, a cascade of events that doom the kidney.
The nephrology fellow who met me at T-1, followed me through the hospital and switched to "outpatient" the same time I did was shocked to see me back, as was the research coordinator who'd just met me 20 days ago.
So, after a nearly-sleepless night, there I was signing consent forms for a kidney biopsy. We still didn't have any lab results from my Tuesday visit -- "I think they broke the tube, is what happened," the coordinator said. While we waited for the morning labs to come back, they explained kidney biopsy, the only way to determine whether a kidney's being rejected.
Biopsy is a simple-enough procedure; they inject lidocaine in the skin above the kidneys' location and use ultrasound to make sure it's where it's supposed to be. They make a small incision -- so small it doesn't need stitches later. Then a contraption like a small gun shoots a hollow needle into the kidney, something like taking a core sample from a tree. They may need to make several passes to get enough tissue. And there's always a risk -- of launching bleeding, causing a hematoma, introducing infection. Worst, a cascade of events that doom the kidney.
The nephrology fellow who met me at T-1, followed me through the hospital and switched to "outpatient" the same time I did was shocked to see me back, as was the research coordinator who'd just met me 20 days ago.
The waiting wasn't helped by hearing the nephrology fellow talking to the woman in the bed next to me about the infusion she'd be getting after what sounded like days of interventions. "We're gonna give your kidney one last chance," she said.
Finally, the results came back -- thank God, 1.3. "You're off the hook," the nephrologist told me.
We may never know what spiked the creatinine -- damage to the kidney? an infection that was headed off? Everyone apologized for scaring me, but I wouldn't want them any less cautious.
After 3 months, your risk of rejection is lessened. After 6 months it goes down further, and after a year, everyone breathes a sigh of relief. By the time you get to where my dad is, you're probably going to take that kidney with you when you go.
At least my answers are nearby. My father has had to drive himself 6 hours to a kidney biopsy. That's way too long to spend thinking about what could happen.
On Tuesday afternoon, I fell apart quite a bit, but Randy was there to dry my tears. The U's pamphlet on transplantation says simply "You will have complications." I have kept telling myself that to be prepared, but knowing it and having it happen are two different things.
After the last day and a half -- and a lot of sleep to catch up -- it feels good to be off the hook.
Finally, the results came back -- thank God, 1.3. "You're off the hook," the nephrologist told me.
We may never know what spiked the creatinine -- damage to the kidney? an infection that was headed off? Everyone apologized for scaring me, but I wouldn't want them any less cautious.
After 3 months, your risk of rejection is lessened. After 6 months it goes down further, and after a year, everyone breathes a sigh of relief. By the time you get to where my dad is, you're probably going to take that kidney with you when you go.
At least my answers are nearby. My father has had to drive himself 6 hours to a kidney biopsy. That's way too long to spend thinking about what could happen.
On Tuesday afternoon, I fell apart quite a bit, but Randy was there to dry my tears. The U's pamphlet on transplantation says simply "You will have complications." I have kept telling myself that to be prepared, but knowing it and having it happen are two different things.
After the last day and a half -- and a lot of sleep to catch up -- it feels good to be off the hook.
