Good news today. My creatinine, which was 1.39 yesterday, was down to 1.31 today. Yeah! It suggests that the steroids worked and Brutus is happy. My red blood count is up to 24. Normal is in the high 30’s, low 40’s so I still have a way to go but my bone marrow is cranking out the red blood cells. This also means I get tomorrow off – my first day without having to get stuck for blood and having to go to the hospital.
I thought I would go back and explain some of the dynamics of the transplant itself. I have attached a few pics for demonstration purposes. The first shows the donor scars, which Sarah has described. The donor operation in the past was pretty major – not that it is not major now but it is much less invasive than it used to be. They used to make about a 12-inch incision from the back down the side and take out the kidney from the retroperitoneal space.
Now they do what is called a “laparoscopic assisted” technique. They make 2 small incisions and inflate the abdomen with gas so they can see what they are doing. They insert instruments to cut the renal artery, renal vein and the ureter, which drains the urine from the kidney to the bladder. There is then a small incision -? about 3 inches would you say Sarah? Around the belly button where they actually draw the kidney out.
For the recipient, they do not remove the native kidneys unless there is a problem, such as people with polycystic kidney disease where the kidneys have lots of infections and cause pain. So I have three kidneys now. The new one is in my right pelvis. They attach the donor artery and vein to my vessels and attach the ureter to my bladder using a stent to make sure the tube stays open. I actually feel the stent when I pee and it is pretty strange. The stent will come out about 3-4 weeks after surgery. The kidney sort of floats in the pelvis – I can feel it, it feels like a ball under my right hip.
If, for any reason, god forbid, Brutus should fail and I need another, they would put it in my left pelvis and I would have 4 kidneys.
I talked to the doctor yesterday about our goal creatinine. Basically they are very happy with a creatinine under 1.5 at 6 months. That suggests a good long-lived kidney. If it is 30% higher than that it starts to shave years off the life of the kidney.
Next up will be another round of eculizumab and lab tests on Thursday. Hopefully then I will get the deep sutures out of my incision, which are really tender. The staples will stay in for another 2-3 weeks.
I actually went to a movie today! We saw Secretariat, which was great. Sitting for 2 hours was not the most comfortable but it was really great to get out.
Sarah take it easy! You are overdoing it!