Seven Years

UPDATE: If you saw this here Tuesday you are right. I was wrong; the anniversary is today June17, 2003. At least I got the year right. Another senior moment. Having too many lately.

Today is the seventh anniversary of my kidney transplant, June 15, 2003. It is a same day anniversary, although I don't know what time; it was sometime after 4 pm.

My kidneys were destined to fail, I had Polycystic Kidney Disease and in my late thirty's my kidneys began to loose function, however very slowly. When in my mid-fifties the deterioration sped up and my kidney function was monitored very closely. The worst side effect from the disease was hypertension, not until I approached the need for hemodialysis that I became very exhausted. I didn't loose any work, even when I started dialysis December 10, 2001. Since I knew that I would have dialysis, I had had surgery earlier that year to create an access, a Arterio-venous fistula. I am glad it was done early so that I didn't have this.

I got called the evening before, so that they test 27 vials of blood, to match as many antigens and confirm my blood type. Sent home about 1:00pm, there were others tested for this set of kidneys. They came from a cadaver and were put on a pump to keep them viable. Called again the next morning for more test, then late that afternoon I was prepped to go into surgery.

Surgery didn't seem eventful but my whole body was swollen and red, a reaction to the unknown kidney. Then started the daily measurement of liquid I took in, the urine I expelled, the taking of my weight and temperature. While in the hospital, blood test and inter-venous pain killers (morphine pump at first). The medication; humongous sized immunosuppressant pills, huge doses, an anti-biotic and anti-viral,  insulin  and heparin shots. I seemed to be recovering well and I was out an about, then I began to feel more pain, very painful cramps on the side where my kidney is. I complained and only one doctor thought that I should get an ultrasound to check to see if any leakage in my abdomen. Somehow his recommendation got lost. I was schedule to go home in two days and that was that, even though the pain was getting worst. After going home the pain became extreme and I began to lose my voice and throw up when I spoke. During my first visit four days later,  I could barely speak and my sister had to explain how much pain I had been in, then the doctor decided to put me back in the hospital to do an ultrasound. They found that the Ureter of the transplant was leaking and they had to drain the urine from my body. Three days later on a Tuesday, I had another surgery. They took the Ureter from my kidney and attached it to the transplant. They completely removed the transplant Ureter, because it was necrotic. The surgery went well, but they cut through the same scar and the nerves were so damaged I couldn't get my legs to move right for a few days. I am still numb right over the transplant.

Even though the transplant has given me the ability to live better, at times it has seemed like that the treatment has been worst that the disease. Constant diarrhea and the onset of type 2 Diabetes from the types of meds I take. The osteoporosis resulting from the massive doses of Prednisone to keep me from rejecting the kidney, has exasperated the back pain I have had of late. When I had my native kidneys removed, that resulted in having to have another surgery to repair a hernia. Four surgeries within five years killed my stomach muscles, another factor of my back pain. I am now going to physical therapy to strengthen my core. Hopefully, year fourteen will be an anniversary like this, but without anymore side effects of the transplant.

The conundrum

I was describing the circumstances, in which I received a kidney transplant. The person I was talking to had a hard time saying the word cadaver. You see, I had a transplant from a cadaver or dead person rather than from a living donor. The person also realized that the persons body may have been kept "alive" until the kidney was removed. My donor did not die an accidental death, but from some disease. I was not told from what. I was also told that the kidney was put on a pump to lengthen it's viability. After I had the transplant, cell death, Necrosis did occur at point the ureter was attached to my bladder. I had to have another surgery ten days later to have it removed and replaced with my own.

I took high school biology in 1959. One of the dissections we had to do was to remove the heart of a gold fish. We had to dissect in such a way that the heart remain beating in order to get a grade. We had discussions about the nervous system, voluntary and involuntary muscle movement. At this time there had not been the first heart transplant, but the fact that you could remove a heart still beating was significant.

The first kidney transplant had been from a live donor and from an identical twin several years before the first heart transplant. The heart transplant patient has no choice but to have a cadaver donor. It still makes many uncomfortable talking about transplants, because for most transplants, someone has to die. Among other reasons, to make transplants possible, there had to be an acceptable point in which the person is living or dead, not if the persons cells are alive and healthy. When death of the brain determined death of the person, rather than when the heart stopped beating and breathing stopped certainly helped in accessing more viable organs for transplantation. The notorious case of Terri Schiavo demonstrated the problems some still have with the definition of life. Cases like this make some of the public fear being transplant donors.

Perhaps it seems that I am presenting slightly disconnected facts, but I think these are relevant to the thinking of what is life and death. Science and technology advances have created new ethical problems that our society has to cope with.