Notes from the Transplant

It's been over 2 months since the kidney transplant. I continue to do well in these last official recovery days before returning to work in mid-March. I see my nephrologist every two weeks and get blood tests weekly. I have just a little bit of tightness, but am walking a lot and the kidney continues to work well. Jason has gone back to work and feels great!

Here are my overdue recollections for the events around December 20, 2017.

December 19

The surgery was scheduled for the 20th, but Jason and I needed to check in to Stanford Hospital the day before to prep with blood draws and final tests. We also needed to meet with the teams of doctors (surgeons, nephrologists, nurses, dietitians) that would be taking care of us.

Our friend Sam is a photographer who graciously offered to document our hospital stay. We met up with him that afternoon as well. Please see his beautiful photos!

Jason and Melanie arrived shortly after I'd checked in. Everyone was wearing their Super Kidney shirt. We spoke to our transplant coordinators, walked to our separate but nearby rooms, and changed into hospital gowns.

Next item on the agenda: blood draws, urine samples, pre-surgery EKGs and chest x-rays. Nurses connected IVs to us. Our surgeon, Dr. Melcher, marked his initials on Jason's right side with a Sharpie to indicate the correct kidney to be removed.

Another nurse helped me hook into a PD cycler as I lay in my hospital bed. For dinner, we ate our clear liquid menu items of beef broth, jello, and fruit ices, which all tasted pretty good.

Our families and friends came to visit. Seeing them and Jason's daughters' posters with inspirational messages made us smile and tear up.

December 20

We woke up around 4:30am. Jason's surgery was scheduled for 6:30am. I walked over to his room, where we chatted and hugged before he was wheeled away to the operating room.

While Jason was in surgery, I found myself filled with a lot of giddiness, and used it as fuel to tell some of my most comedic personal stories to Linda and Melanie. The one about the time I called AT&T as my Aunt Kathy to make some cell phone account changes always gets a laugh.

I had told Linda that I was a little nervous about the surgery and the potential risks, but that it helped to try to see it from the surgeons' point of view and how for them, it was just "another day in the office." Sort of like how I would come into Symantec every day and help build web pages, they were going to remove a kidney from my friend, and install it inside me! No biggie, even if it actually is.

As well, my recent trial of a meditation app, Headspace, and one of the lessons in it, was helpful prep for me and all the thoughts that were popping up. Basically, Headspace talked about how meditation training can help us get more used to simply watching and accepting the constant traffic of our thoughts, without getting as invested in all the traffic. Here's their video explaining this idea:

Around noon, we heard that Jason was out of surgery and recovering well! What a relief. The kidney was in good shape, and I would now be heading into the OR soon. My parents and Linda accompanied me to the pre-operative area, where I met my anesthesiologist, a friendly Indian-American man. He gave me something to help relax me, but not completely lose consciousness.

Before I entered the OR, for some reason, "I Dare You," a song by the xx started to play in my mind. It's positive song with a beautifully calm but strong sound. I guess it fit my mindset at the time, and I'm grateful I can play it again now to relive that feeling of hope as I went into surgery. "I can hear it now, like I heard it then," as the bridge goes.

When I got inside the highly-illuminated OR, I no longer had my glasses on, so everything and all the nurses and doctors looked blurry, but incredibly bright.

The room was large and filled with lots of equipment, way more than I expected.

I asked my anesthesiologist, "Whoa, is all of this going to be used?"

"Ummm, yeah," he replied.

Then they lifted me from the hospital bed onto a skinny operating table. I closed my eyes and soon lost consciousness as the anesthesia did its thing.

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I woke up groggily around 6 or 7 pm. I was in a recovery room along with several other folks recovering from their surgeries. The nurse told me that the transplant went very well and my new kidney was working as expected. I also noticed my PD catheter had been removed. It was all a big relief to know Dr. Melcher and the team had successfully equipped me with one of Jason's kidneys!

As I was now in the post-surgery recovery phase, I noticed a lot of medical devices attached to me. These included wires, IVs, a foley catheter, and a JP drain for collecting blood and other fluids from around the surgical site.

Later, they moved me into the room I would stay in. I had a window overlooking ER parking, but didn't look out of it much. I felt very weak, but better than before. My parents and a few friends came to visit with balloons and flowers, and Linda lined them up nicely on the windowsill. Some of my volleyball friends are Stanford Hospital nurses, and they gave me a warm red blanket, slippers and a mug, all with the Stanford Health Care logo. I got a lot of use out of that blanket, and Linda made sure to later get one from the gift shop for Jason's own hospital stay.

Most patients that get new kidneys report a surge of energy right away. I didn't feel this, unfortunately. Mainly I felt tired in the days immediately following the surgery.

Even though I was exhausted, sleep could be a struggle. The nurses - all awesomely helpful and attentive - had to come visit during certain times throughout the days and nights to take my blood pressure, temperature, and give me medicine. Sometimes the IV lines would get twisted as I moved, causing the monitors to beep and forcing me to alert the nurse to fix it. One of my IV injections was done closer to my wrist, and when I needed to get phosphorous injections through it, those would sting, making it hard to sleep. Other times, a patient suffering from severe pain down the hall would moan or yell loudly and continuously.

Because the room often felt a little chilly at night, I kept covered with a few blanket layers. I also wore special electronic stockings that periodically massaged my calves and ankles to help prevent blood clots. These leg warmers/massagers would invariably make me too hot. I'd wake up to peel off a blanket and un-velcro the stockings to offer my sweaty legs some air. This routine would continue over the next couple nights, until I decided that I didn't need to use the stockings any longer.

December 21

I remember having more energy that day. With the help of an excellent physical therapist, I rolled myself up into a sitting position, stood up out of bed and slowly walked a bit. I was on pain meds, but still felt sore and weak, so I had to concentrate on each step. The PT walked with me and held onto my IV pole as I took a lap around the hallways, glancing at the posters of Van Gogh irises and photographed landscapes. Suitably fatigued from the pacing, I returned to bed.

A lot of friends came by to visit that afternoon and evening. It was great to see everyone, receive their gifts, and prove that I was doing well with a smile and thumbs-up for our photos. I'm grateful people took the time to wish me well in person, along with all the texts and social media support.

December 22

I got my diet upgraded to include puréed foods, so for lunch I tried the carrots that were just a little firmer than baby food. They were ok, but didn't seem to mix well with my pain meds. When my family came to visit, we took some photos in which I can tell I look a little nauseated, like I have a kind of worried smile. Sure enough, my mouth started to salivate and taste funny. I motioned for Linda to grab any kind of barf container, and I quickly vomited in the ziplock she gave me. After that I just needed to rest and so everyone except Linda went outside.

I felt a little better later, and a few service dogs happened to pass by the room, to the adoration of my family. One small dog did some tricks like "praying" by putting both its paws together. Its trainer asked to see a box of kleenex, so we handed her one from my room, and the pup pulled out tissues from the box with its mouth, one after the another. Cute as this was, Linda and I thought it was a little unhygienic, especially in a hospital ward full of immuno-compromised patients!

Later, Melanie wheeled Jason in to visit me in my room. This was the first time I'd seen him since he went to the OR. I hugged them both from my bed, and Jason and I held hands as we discussed how the experience was going for each other. He sounded like he'd been having a rough time of it the day before, when he wasn't able to walk and mostly stayed in bed. But he felt much better now.

As we talked, I recalled something Sam had mentioned to me a couple of days ago. "Jason must really love you to do this. He has three daughters, and now he'll be with one less kidney. That's just incredible."

The reality of Jason's gift and generosity really began sinking in as we chatted. He had been all smiles throughout this process, and continued to be so positive. I privately recalled my desperation from a couple years ago, when I wasn't sure how to go about asking my family and friends to consider donating one of their kidneys. Then there was the subsequent, rising hopefulness as Jason initially stepped forward and kept passing tests until he was somehow, miraculously, a match. Some sadness washed over me as well, understanding that he'd now have the pre-existing health condition of having one kidney. But mainly I felt so much happiness, appreciation, and love for Jason, my wonderful friend.

At some point, I just broke down and cried as I thanked him. After a few sobs, I told Jason, "I really can't thank you enough. Giving me a kidney -- You can't fake this sort of thing!" I told him. We laughed and as I wiped my tears away, someone in the room started to hand me a tissue box. Suddenly, Linda intercepted it.

"No, those are dog tissues!" she exclaimed, pulling out the upper layers of possibly contaminated tissues to drop in the trash. Hey, if you've just had a kidney transplant, you can't be too careful! We laughed some more and got together for a big family portrait.

December 23 & 24

One of the last things the doctors wanted me to do before I could be discharged was to make a bowel movement. It turns out a major surgery traumatizes the intestines, making it really difficult and painful to poop for quite some time. I had taken many frustrating visits to the toilet, some laxatives and even a suppository, but still nothing. On Christmas Eve, however, I made some progress finally, plus my blood pressure had improved enough, and I was allowed to go home.

Before we left, we gave the nursing staff some chocolates and placed the last of the Super Kidney magnets we'd made on my patient whiteboard. All of the nurses and doctors had taken such good care of me during my five-night stay, and I was and remain grateful for their patience and expertise.

Post-script

For my hospital stay, I realized I had brought way too many books and clothes. I had never really changed out of my hospital gown, and hardly touched my sketchbook or journal. I hadn't watched much TV or my iPad. We had brought a lot of snacks that I never ate. Mostly I wanted to sleep, and that's what I did. So, if you ever have a scheduled kidney transplant, my advice is don't overpack! Unless you get that boost of energy that most transplant patients say they get and aren't as sleepy and tired as me.

Here's a list of what I did read and listen to while at the hospital:

Short story: "Victory Lap" by George Saunders from Tenth of December, a gift from Frank - one of the nurses mentioned he had this book, along with about 20 others he still had to read.
Audiobook short story: "The Americans" by Viet Thanh Nguyen from The Refugees short story collection.
Podcast: WexCast: Chris Ware at Cartoon Crossroads Columbus
Listened to Radiohead Daydreaming (first music post-transplant) and the xx.