The Elusiveness of Sleep

Yesterday was simply exhausting.  I think that it might help if I could sleep a bit better—but that does not seem to be attainable at this time.

Dad and I left his house around 6:45 or so and headed to Albuquerque.  My Dad dropped me off at the front entrance and headed to an appointment with his Transplant Surgeon.  I sat in the waiting room just outside of the pre-anesthesia screening area and passed the two hours before my scheduled appointment by catching up on email and writing a quick blog.  It was quite difficult to try and sum up a few days experience and then type it into my iTouch.  I love my iPods—I really do, but I have a love/hate relationship with its predictive text.   Ninety percent of the time it is a gift; it’s that ten percent that is maddening.

After Dad’s appointment, he joined me in the waiting room for his screening.  He needed to do an extra EKG and Chest x-ray as well.  The pre-anesthesia screening was more of a medical history questionnaire writ large.  I cannot remember the last time I had to answer so many questions.  Oh wait, I do remember.  It was when I was doing the initial screening for this entire Living Kidney Donation. J

Next, we met with the Transplant support team.  The team consisted of the Pre-Op Transplant Coordinator, the Post-Op Transplant Coordinator, and two Transplant Social Workers.  Truly lovely women!  They walked us through the entire procedure (for both my Dad and me,) walked us through the recovery process, answered all of our questions, and then gave us a physical tour of the facilities.  There was a great deal more that I didn’t know.  Here is what I learned that was new to me:

v  Dad and I will have to separate just after we check in on the morning of surgery.  He will go to the third floor to do his prep and I will go to the first floor for mine.  I always understood that we would have to separate at some point—after all, his surgery must follow mine.  I just didn’t realize that it would be so soon.

v  My surgery will be longer than my Dad’s.  Mine should last about four hours, with the biggest bulk of time going to the assurance of proper positioning.  They will be positioning me on my side so that most of my organs (intestines, colon, etc.) will fall away from my kidney with the assistance of gravity.  Since the procedure is laparoscopic, they will need to pump my body cavity with CO2 so that their equipment can travel around with no difficulty.  This will mean significant gas pain until my body can collect it and expel it. 

v  My husband will be able to see my father before he can see me.  Why?  Dad’s surgery is shorter (about 3 hours) and he will recover in the Adult Intensive Care Unit (ACIU.)  This means that he can have visitors about 45 minutes after surgery.  For me, the surgery should last up to 4 hours and end in my going to a closed Recovery Unit for up to 2 hours.  Steve will not be allowed to see me until I make it to my room on the surgical floor.  This has upset my husband, but I don’t make the rules.  They must have an important reason for this restriction.

v  Dad is going to have a central line put in his Internal Jugular.  It allows the medical staff easy access for medications and frequent blood draws.  He will look a bit like Frankenstein—and that is important to know ahead of time.  I cannot imagine seeing him, following his surgery, had I not known what to expect it.

v  We are not allowed to be in a shared hospital room.  When the team has allowed this in the past, the Donor and the Recipient have difficulty focusing on their own recovery and instead focus on their worries about the other.  I understand this—because that is what I would do.

v  For pain management, I will have a morphine drip and Dad will have a pain ball (dripping pain medication directly along his incision.

v  I will be allowed to visit my Dad whenever I feel up to it.  I am telling my body that I need to be ready on Thursday night.  We shall see if it listens.

v  The “after care” felt similar to what I already knew.  They just filled in the details.  I will get fatigued easily and need to take frequent naps.  This should improve around 2 months post donation, but not return to normal until around 6 months post donation.

      I will have restrictions on lifting         for 6-8 weeks.    Ten pounds is the limit.  This means that I will not be allowed to vacuum, dust, mop, or even put up dishes.

      I will be allowed a glass of champagne whenever I feel up to it.  There are no restrictions there.

      Lastly, there should be no immune suppression—so I will be able to hang out with my young students (aged 2 ½ to 6 ½) with no worries.

It is no wonder I felt so tired at the end of the day.  It was a lot to take in.

Today my Dad and I had lab tests (pre-surgical chemistry panel and cross-match) at the hospital.  Then Dad had an appointment with the Transplant Nephrologist.  He was extremely informative and went to great pains to explain what Dad can expect after surgery.  It will take me another night to process everything that I heard during that meeting.

Right now, I am waiting for the Magnesium Citrate to do its bowel prep magic.  That will be this evening’s entertainment.  To be repeated again in the morning.

Hopefully, sleep will belong to me tonight.