Perceptions

High-visibility version

My experience of receiving a kidney from my sister

by Douglas Ross

Let me first of all say that I am well on the way to returning to a full and active life.

Since my transplant at the beginning of November 2007 I have and continue to feel stronger and more able each day to do many of the everyday necessities and challenges I perhaps used to take for granted before the onset of the later stages of my renal failure.

I will be eternally grateful to my sister for the kidney she donated to me.

I would like to share with you a number of the experiences I have had on my road to recovery.

• I have little recollection of the operation itself apart from being wheeled along the corridor and into an anteroom next to the operating theatre. There a line was placed in the back of my hand through which I was administered by the anaesthetist a little anaesthetic which made me feel a bit woozy. The next thing I knew I was back on the ward waking up (four hours later).
• You will be admitted to hospital the day before the operation. You should phone the ward the morning of your admission in order to find when you have to be there.
• It cannot be overstated the importance of having someone close to be with you before and after the operation. You will need their love, support and assistance to help you through a traumatic experience. It is vital and you will welcome having a friendly face around you as their presence will certainly aid your recovery.
• It is also nice to have someone to scratch that place you cannot quite reach or indeed wash that part you cannot get to.
• Soon after you come around you will become aware of the different tubes that are coming out of various places around your body. These will include from the top down
  1. A neck line
  2. A line going into the back of your hand
  3. A drain at either end of your wound
  4. A catheter

All of the above will hinder your movement and sometimes will have to be gathered up quickly if you need to dash to the toilet. You will have plenty of time to disentangle the tubes when you have completed your lavatorial duties.

You will lose each of the attachments in turn during your stay in hospital. For most the removal of the catheter tube is a most unusual sensation – it was like being tickled or even being stroked internally. It is also quite surprising how long the tube is.

• It is important to take control of your own pain relief as you will feel sore and uncomfortable for a number of days. This can be achieved by making use of the morphine pump and by asking for appropriate strength painkilling drugs.
• All the staff on the ward will try to the best of their ability to ensure you will recover in as short a time as possible. Contrary to some beliefs they are not trying to keep you in longer than is necessary nor are they going to discharge you before you are fully recovered.

They will politely and efficiently attend to all your recuperation needs and at times demands. Sometimes you may have to remind a member of staff to deal a request you have made but this should be expected as the ward is busy and a more pressing matter may have had to been dealt with first.

Even though your care is monitored at all times you may have to bring something to their attention they might have not been aware of. Remember you are part of the team working on your recovery.

You will witness the nursing staff and doctors discussing your own individual case during the ward rounds. They are effectively working together to plan the best course of action for your speedy recovery. At times there may appear to be a debate about the next steps in your treatment but this be expected as each of the members of ward staff are bringing their particular expertise to the forum and wish to voice their opinion. The senior member of the team will always make the final decision based on all the available information.

Some more post-transplant information

After the op I spent about 10 days in hospital. It was vital that all my test results had stabilised before being allowed to return home.

Before the op it had been mentioned by the nurse specialist who went through everything with me and my sister that the average time spent in hospital for recipients is 7-10 days but of course patients are not discharged if for example their new creatinine measure has not levelled off.

Furthermore at some time prior to being admitted you will have to speak to independent non-renal doctor to demonstrate your knowledge of what you think the op will entail. You will have to go into a little detail about all the various aspects of the procedure including all the risks involved and issues that could lead to the op being unsuccessful.

Returning to post-op. A number of hours will pass before you become fully aware of your surroundings and what has happened to you. During that time and the days that follow there will be frequent blood tests and blood pressure monitoring together with weight readings to ensure that things are going in the right direction. Indeed throughout your stay your progress will be regularly monitored. Any necessary steps will be taken if needs be to put matters back on track. For example a few patients will require a number of dialysis sessions as their new kidney is “sleeping” but more often than not it soon wakes up and starts functioning.

After a day or two you be encouraged to get out of bed and sit in a chair in order to relieve the possibility of fluid building up in the chest. At first this manoeuvre can cause a little discomfort but it will soon become easier.

The passing of urine is taken care of as you will have been catheterised but as the days pass you will need to move your bowels as you feel bloated and uncomfortable. To be a little indelicate for a moment the first post-op fart provides a welcome relief for most patients. Nevertheless to obtain a greater relief some assistance may be required as the combination of the anaesthetic and pain relief measures will have left many constipated. Once you have decided upon the appropriate aid to help improve your digestive function, it will be administered at your earliest convenience after which you will be, for up to the next 24 hours, a frequent visitor to the rest room.

As the days have gone by, mobility for most will have hopefully improved sufficiently to make it possible for them to make the speedy trips to the facilities with all the different tubes that are coming out of various places around your body wrapped around the drip stand.

It is important throughout your stay to become progressively more active and of course not to overdo it. Most patients will gradually become stronger. At some time you will be advised not to lift heavy objects for three months post-op as this sort of activity could cause a hernia.

Your liquid intake and output will be recorded in order that a recommendation about following day’s fluid intake can be made as it is important that the new kidney does not become dehydrated.

The daily Doctors’ round provides the opportunity to discuss your progress with a consultant and so eventually during one of the visits you will be told you can be discharged the following day. You should by this stage feel strong enough to go home and perhaps may have become a little restless or even a little bored. Many patients say that one of the things they have been most looking forward to in the short term is a good night’s sleep – hospital wards can be noisy places. It is worth being made aware that it will take a few days post-op to be able to sleep on your side once again.

Throughout your stay you will have been given your appropriate medication to take so before you can leave hospital time will be taken to ensure you have the correct tablets and also you know when to take each pill. It has to be said that one the main reasons for post-operative rejection of a kidney is a patient neglecting to take the necessary medication at the designated time.

You will also be given the time for your first appointment at the renal clinic. At first you will have to attend clinic three times a week but the frequency of visits will decrease if a stable pattern of test results emerge and for the vast majority this is the case.

Being one of the fortunate 3% of kidney recipients who have had a pre-emptive transplant from a living donor, I have never been on dialysis. Nonetheless my transplant procedure experiences will be the same as many other recipients. Perhaps the major difference being I have greater chance of a longer term of success thanks to my sister who donated one of her kidneys and to the skill and care of the dedicated Renal Staff at Manchester Royal Infirmary.

I continue to feel better and stronger. Recently I have started to lift some weights and now I can jog slowly for about 3 minutes. I am trying to build myself up slowly but surely. However I think my rugby playing days are over and so I may take up elephant polo instead.

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