Hiking with One Kidney

by Rudy Dankwort

My wife Kathy's kidneys failed last September (1997), and we immediately started thinking in terms of my becoming her kidney donor as we knew our blood types were compatible. The crossmatch was negative, and so in January '98 we went to Fairview-University Hospital in Minneapolis for our workup.

I actually flunked the EKG but the echo was OK, so the cardiologist gave me the green light after I persuaded him with my hiking prowess. They also tried to persuade me to stop smoking cigars; this ended in a compromise where I promised to stop two weeks before the surgery. All other tests went OK, so the operation was scheduled for March 10.

After final EKG, x-rays, etc. on the 9th, they performed the angiogram which was completely painless even without analgaesic. The bad part for me was lying still for six hours afterwards; my back absolutely killed me! I consequently dreaded the subsequent multi-day layup in hospital, but this fear turned out to be unfounded. Must have been an unfriendly mattress.

I assume you have read others' reports on the details of the operation. Fairview does not use laparoscopy and so my incision was the classical 8-10 inch slice (I never have measured it). They also don't use epidural pain control; I had the PCA pump, which I did use the first twodays. Yes, there was a Foley catheter which I never even was aware of until it was removed. Any objection to this device is grounded in machismo idiocy. And there were pneumoboots which I actually found quite comfortable, so I persuaded them to leave them on me for two days and nights. (These are boots they wrap around your legs to keep the muscles working and circulation going. The idea is to minimize the possibility of a blood clot forming in your leg and moving to the lungs, which is frequently fatal. They are actuated via electrically operated air pumps. I felt good about them since I kind of worried about this eventuality. I also expected to be outfitted with "teds," which are stockings worn for the same reason, but I just got the boots.)

Surgery was Tuesday a.m. and I awoke to the good news that the transplanted kidney hit the deck running and worked immediately.

As for pain:

The first two days were definitely uncomfortable. If they had asked me to sit up or stand up on the day of surgery, I would have cursed them. Fortunately I was left alone until the next day when the mandatory walking began. It really wasn't too bad; I admit I was in high spirits that things were going so well. Day 2 post-op (Thursday), I was told I could probably leave the next day, which I did - I walked out of the hospital on my own power three days after being admitted. I have to admit I haven't heard of anyone beating that record, though I'm sure it's been done, especially with laparoscopy.

We left for home (Phoenix) on March 18 (Kathy was released March 15, 2 days after me). We did splurge on first-class tickets; I would have dreaded the three-hour trip in sardine class.

Advice to potential donors:

For the first couple of days post-op, don't let yourself slide down the bed; I found that the pain was very strongly dependent on my bed position. I always tried to get help to slide me up towards the pillow.
Before the operation, get your hair cut short; it's not nice to have gooey hair in the hospital and you don't want to be sitting in a barber's chair too soon after the operation. For the first 2-3 weeks post-op I was most comfortable lying flat in bed! Also, get your nails cut short; cutting toenails would be total agony or impossible for several weeks.
Wear VERY loose pants! They filled me so full of fluids to get the kidney working overtime just before removal and to make sure my remaining kidney continued to work hard. My weight went up from my normal 175 to 194 for a couple of days post-op and then you're naturally swollen around the incision site which intersects your belt! I advise AT LEAST two sizes above your normal size. And be prepared to live with a distended gut for some time. I still have significant swelling & numbness at the incision site as of this writing, May 25, though it has healed perfectly.
Obviously, use common sense as to where to have the surgery done. I was impressed with the plethora of information Fairview sent us, ranging from the simple to the extremely technical. Convince yourself that the hospital has a good record of successful transplants. Also, for diabetics, it behooves one to seek out an establishment where a significant (preferably 50%) of kidney transplant patients are diabetics (the national average is about 25%). I also liked the idea of separate donor and recipient surgical teams.

Recovery:

Finally: recovery was fast at first and I hoped to be back on the job (as an electronics engineer) four weeks post-op. But when April 6 came around I begged off for another week. The first week I put in six-hour days instead of my usual eight+.

Kathy and I were quite worried how we would fare without outside assistance the first couple of weeks at home. We have no kids and we anticipated the cat would not be of any great help. This however turned out to be no issue. We went grocery shopping together almost immediately. We had prepared for a "siege" before the operation, with food, etc. in place, but this proved to be not essential. We never needed any help except initially to put our suitcases, etc. away (no lifting in excess of fifteen pounds for six weeks, I think the prescription read). Kathy had no problem appearing at her lab for the mandatory thrice-weekly blood draws, including driving.

In general, I would say the reports I've read of others' similar experiences might be somewhat exaggerated. It's no picnic but it's over before you know it and the blessings of a dialysis-free spouse are infinitely compensating.

Which brings me to my last topic...

Should you do it?

I was lucky in that for me, nothing is as important as my wife's health. I can imagine a more difficult decision if a more distant relationship obtains between the potential donor and recipient. I maintain that it's the right thing to do even then - but now we're into ethics. Let your conscience be your guide!

Note: I am 57 yrs old, have never had any athletic ability, suffer from asthma now and then, but hike up a 600 ft hill (about three miles total) once or twice a week.

I would be happy to respond to any questions.

Rudy Dankwort