Sprinkled Blessings

...Paired Kidney Donation
by Angela Robinson

In July 2007, my husband’s grandfather passed away. We came home to Michigan for his service and it was while we were home that my Aunt Mary Ann told me that she was in the beginning stages of renal failure. I remember being in shock, when she explained that the doctor told her that it was the result of her years with diabetes. In 2004, my aunt underwent bariatric surgery, resulting in a 150 pound weight loss. Remarkably, her diabetes no longer required treatment. However, the damage to her kidneys all ready had been done. Immediately, I said, “well, you can have one of mine”. She giggled and said, “OK, thank you”. While on our way home back to Wyoming, I asked my husband if it was all right with him for me to donate my kidney. He simply said, “If that is what you want to do, I think it would be great”.

February 2008, Aunt Mary Ann began dialysis treatments, three times a week, four hours a day to keep her alive. She did not tell me right away, but when she did, I promptly reminded her of my offer to donate one of mine to her, if we matched. She thanked me again, and went on to explain that my Uncle Dan had not been feeling well and was undergoing testing, and she was not going to pursue the issue. In May 2008, my uncle was diagnosed with cancer. In September 2008, testing revealed that his prognosis was bleak, with only 3-6 months to live. Sadly, in November 2008, my Uncle Dan passed away. We traveled to Michigan for his service. I again approached her with the idea of donating one of my kidneys to her; that it was time for her to worry about her health. She was receptive to the idea, but said we needed to wait, it was not time. I returned to Wyoming, but talked to her daily on the phone. In February 2009 she finally got the ball rolling and we were tested.

I got the phone call from the Transplant Coordinator, Chad, and remember feeling defeated when I heard the news that we were not a match. However, that feeling was quickly replaced with hope, when he explained that there was a program that we could be placed in, the paired kidney program. I would give a kidney and my aunt would receive one. I said that I would ask my aunt. I called her and explained that we were not a match, but she still could get a kidney through the paired exchange program. I suggested that she call and get information and she told me No, she did not think so. Huh, she did not think so?? It was her decision, so I just let it go. I continued talking to her on a daily basis. In May 2009, I came home from work, listened to the answering machine to hear my aunt’s voice filled with excitement, explaining that she had heard of a program from her sister to please give her a call as soon as I could. When I phoned her, her excitement was barely contained as she explained the paired kidney program. What??? This is the same program that she had said no to in February. She explained the details and then asked if I was interested. Yes, this is the program that I had mentioned in February and you said no. She said I do not know what I was thinking, but let’s do it! So after extensive testing, I was cleared to donate in July 2009 and not a moment too soon because there was a potential match for the two of us, but that quickly fell through. In October 2009, we learned of another match and a surgery date of November 6, 2009 was set. I was a week away from leaving Wyoming for Michigan, when we were notified that this too had fallen through. I have to admit I was quite upset, but not for myself. I was so excited for my aunt, thinking that it would have been an incredible early Christmas present to get her kidney. In talking with my aunt, she told me that we should wait until spring because the severe Michigan winters were unpredictable and she did not want to make the three and a half hour drive on dangerous roads. I could not blame her. Late April, we received the news that there might be another match, but that this would be a triple exchange, involving three families. My aunt kept her faith that it would all work out this time. We underwent the crossmatch testing and were elated to hear that it was a go. By the end of May 2010 we were given our surgery date of July 21, 2010. This was almost three years to the date of when I had first told my aunt that she could have one of my kidneys. This was our third pairing, our third year of the process and it would involve three families. I knew that my aunt was right; this was going to work. I had to be in Michigan for my pre-op appointment on July 14, 2010. I was so excited and a little nervous with my excitement far outweighing my nervousness. I knew that this was the right decision because I was not scared; the Lord was there to take that away. I talked with my aunt, who also said that she felt excitement, but no fear. She told me what I all ready knew, that it was all in the hands of the Lord.

The day before the surgery we picked my husband, Brett, up from the Detroit airport and headed to lunch at Chili’s. As a donor, I was only able to have clear liquids the day before surgery. I have to admit that was torture!! I had chicken soup that was strained; while tasty it did nothing to satisfy. To make matters worse, my husband had ordered Cajun shrimp pasta and was teasingly waving it under my nose. Now that was just plain mean of him, but I took it all in good stride. We headed back to the Med Inn to relax for the evening. My husband and I had a room at Med Inn, while my aunt and her brother, Harry, had a room across the hall. In addition to not being able to eat, I had to take magnesium citrate to cleanse my colon for surgery. I learned during my pre-op appointment that this was necessary because the colon is displaced during surgery to access the kidney. The cleansing was a success and a bit embarrassing as I had to endure a few wisecracks from my husband. Before going to bed, my Aunt Mary Ann came to my room to thank me and to tell me she was nervous and excited, but still not scared. We tearfully hugged and exchanged goodnights. Alarm set for 4:00 a.m., I went to sleep.

At 5:00 a.m., I checked in at the hospital and was seated briefly before being called to go back to be prepped. I felt a little more nervous than I had, but still not scared. While it may not seem like there is too much difference between the two, but really there is. I got into the hospital gown and went through the process of stating and restating my information to the nurse, talked with the anesthesiologist, who asked me about nausea problems following surgery. He assured me that it would fine. Dr. Sung, my surgeon paid me a visit and asked how I was doing. Fine, I said. He told us my surgery would take 2 ½ to 3 ½ hours and my aunt’s would take just about as long. A team of anesthesiologists visited me again; one asked me if Dr. Sung had drawn on my side yet. Nope, he was here, but did not do any artwork. He paged Dr. Sung, who promptly returned and marked my left side with an x. Within minutes of his departure, I told my husband that I was very thankful that he was by my side and that I would not have been able to do it without his support. I told him that I loved him and that I would see him later. Once in the operating room, I remember looking at the big white enameled light fixtures, thinking that they looked antique, but adequate. Believe it or not, that is the only memory I have of the OR.

When I woke up, I was a bit disoriented at first, feeling as if I had been sleeping forever. A nurse quickly assured me that everything was fine, the surgery was over and they did not hurt Brett. Hurt Brett, Huh? I said what? She quickly smiled and said your tattoo on your side, we did not hurt it. I laughed and said oh, remembering my heart tattoo with my husband’s name in it on my right side. Before I knew it, I was sleeping again. It was tough to keep my eyes open. What seemed like forever later, I was taken to my own room. My first memory of feeling pain was when they transferred me from the gurney to my bed. It was not sharp, but present. I still was very groggy, but asked how my aunt was. She had long since gotten out of surgery, was doing well and in recovery. I asked my husband how long my surgery was and he said that it about 4 hours after they had taken me before he was paged to the Surgical Waiting center to speak with Dr. Sung. When I had registered, they had given Brett a round pager, much like those you receive when you are at a busy restaurant, waiting for a table. Apologies were given that there were no gourmet meals offered.

After waking up for what seemed like the millionth time, I began to be aware of my increasing pain and the nurse reminded me of my button, which I pushed without hesitation. I looked at my husband, who was quietly sitting in the chair watching television and apologized for sleeping a lot. He was not worried and then I was off to sleep again. I am not sure how much time had passed, but when I came to, I was feeling very nauseated. I told the nurse that I was going to be sick and she gave me the emesis basin, but I only had dry heaves. They had been given me anti-nausea meds, so I was surprised to feel ill. Once the dry heaves passed, I felt ok. I had some ice chips, which were remarkably satisfying. Later, the nurse came back in, told me to give myself a shot of medication, because she was going to help me to my chair. She came back in, unhooked the compression stockings, corralled the IV tubing and helped me up. Without too much difficulty, I sat in the chair. Almost instantly, I was nauseated and had the dry heaves again. I looked at my husband and said that is it, no more IV pump for me! This was about 7:30 p.m. the day of surgery. They will have to figure something else out. I told the nurse the same thing, who said that I would be given a pain medication through my IV. I did not have the dry heaves again and my pain never was unbearable. Before going to bed, I learned that my aunt was doing all right and was resting in her own room. The next morning, I was told I had to get up six times. I thought that was a lot. By noon I had only been up once and, Susan, the transplant nurse practitioner told my husband to get on the nurses and that I had to get up. Well, my nurse was busy helping other patients, and I decided to get up on my own. I unhooked the compression hoses from the stockings, got up and sat in my chair. The catheter had since been removed; otherwise I would not have been able to get up on my own. Later, with my husband’s help, I walked what seemed like three city blocks to a set of elevators and up to my aunt’s room. She looked beautiful, not like she had just had major surgery and I told her as much! We gave each other a hug and assured one another that we were doing fine! We were not there too long before I got tired and wanted to go back to my room. I walked the whole distance back, feeling very elated at my progress.

I met my quota and was up more than six times with all the bathroom trips. My one kidney was functioning too well by itself, I thought.

Later the second day, I was visited by Dr. Punch, a colleague of Dr. Sung, who explained to me that one of the recipients had a family member contact the media to share our story

He explained that they were interested in doing a press conference with all six of us, but that everyone would have to agree or it would not happen. I was excited because that would mean that I would get to meet who received my kidney. I called my aunt to ask if she would do the interview. Her first answer was no, as she was worried about saying something backwards. Finally, she consented and we learned that the following morning we would all get to meet. I was thrilled. Prior to the media interview, we were all taken to a conference room. Once we were all there, we learned who everyone was. We also learned that a few had reservations and did not want to meet at first. Well, I am thoroughly grateful that there was a change of heart and we were all able to meet. Like I previously mentioned, this was a triple exchange and a special one, because it was the first that was performed at the University of Michigan Hospital. Now, six of us are forever connected as a result of this experience. My kidney went to a 46 year old father of five. His daughter donated to a 42 year old woman whose 43 year old husband donated to my aunt who is 59. A miraculous feat for sure!

You know, I do not really believe the gravity of what I had done hit me, until I received a hug from the wife of my recipient. She tearfully thanked me for saving her husband’s life. I remember swallowing quite hard over the growing lump in my throat and tearfully hugged her. From the conference room, we were moved to the interview room. During this time we each gave our story. When the man who received my kidney was asked what the surgery meant to him, he said it meant freedom, he could hunt when he wanted to hunt and fish when he wanted to fish, I again found myself swallowing hard. The feeling that came over me was amazing, for me to have given him the chance to resume his passion for the outdoors. It hit close to home because of Brett’s love for hunting and fishing and what it means to him. The recipients were asked what they thought about the donors sitting behind them, they all unanimously said they are heroes. Funny thing, I do not feel like a hero, I just feel like me, with an overwhelming feeling of warmth oozing from everywhere inside me.

Later in the afternoon, I was released and went to visit my aunt prior to returning to the room at the Med Inn. We had a great visit, filled with laughter and shared happiness that we had gotten to meet everyone involved in our incredible journey. Everyone was doing great. I slept tons better in the motel room, relaxed and content to be out of the hospital. Before leaving, we journeyed back to my aunt’s room to wish her well and that I would see her on Tuesday for post-op check-ups. She did not want to make the drive 3 ½ hours home to turn around and do it three days later for labs. While visiting with my aunt, a cleaning gal, whose name was Debra was talking to my aunt and I about what we had been through and how everyone was doing well. Debra is one of those people, who lights up a room with her personality and said as through it were a matter of fact, “Sounds to me as if the Good Lord sprinkled blessings down from above on all six of you.” She continued about her business and was out the door just as fast as she had entered, but her words I carry with me today, as they are so very true.

The trip up north was not as difficult or painful as I had thought and passed without incident. I conversed daily on the phone with Aunt Mary Ann, who was feeling great, but sore.

On Monday, the fifth day post surgery I woke up not feeling good, not necessarily sick, but not good either. I was not quite sure what to make of it, until my friend, Tracey told me that I felt warm, when she gave me a hug. Later, my friend Bonny came for a visit, also told me that I felt warm, when she gave me a hug. Ok, so maybe I better take my temperature, which read 101.5. Great, I thought, it is official, I am sick. So, I looked at my discharge instructions, which said to call the doctor if you have a fever of 100.5 or greater. The on call doctor promptly returned my call and inquired about my symptoms, which were none really, other than feeling like dirt. My check-up appointment was for the following morning, so there was no alarm, I could be checked out thoroughly then. Next morning Dr. Lee said he was all set to admit me based on what he had read about my fever. He ordered a urinalysis and a CBC to determine the cause of my fever. We had to hang around until those results were known. The result was that they were absolutely clean, no reason to have a fever. Dr. Lee said my incision looked good and my mobility was great and to just let them know if the fever persisted. We traveled back home and I was feeling pretty good. Later that evening, my aunt returned home and we were elated that everyone received a great report from their labs. Wednesday morning I still felt ill and it was not long before the real reason for the fever was known. I had contracted the stomach flu. Believe me, I was one miserable camper for two days and was wishing that someone would just shoot me. Friday morning I felt 90 percent human again and was able to do some visiting, as we were leaving for Wyoming on Saturday. My aunt was very apprehensive at the idea, believing that I was pushing it leaving so quickly after surgery. I just wanted to get home; I had been in Michigan three weeks and wanted my own bed.

Saturday morning was very difficult for me, knowing that I had to say goodbye to my aunt. I did not want to let her go, when we hugged. We both cried and said we loved one another. She thanked me again for all that I had done, and I asked to please stop thanking me. I thanked her for the opportunity to have shared in such a profound experience. I told her to enjoy her new beginning to her a life, one with more energy and hope, but to please be sure to take things slow and easy for a while. It is amazing to see the change in her health since she has received her kidney. She cannot sit still and is full of energy and zing. I am truly blessed to have witnessed her transformation for myself and to have been a part of this. A journey of love, faith and hope is now entwined forever in the six of us. Truly a gift and blessing for the Lord above.