Liam and the Lighter Side of Donating

Most of the stories I have read here are touching and endearing, showing thanks and appreciation but I do find them a little lacking in exactly what to expect or at least what happened in one case. When you go for a donation you are walking into an unfamiliar world of tests, more tests, operating day and recovery and the experience will be whatever you want it to be. Whatever you expect it to be. I know most recipients are so grateful that words can not express what they feel and some see the donors are a hero. So if you are looking for a hero feel good story then please stop reading because this is the lighter side of my kidney donation and will detail what to expect. I do not see myself as a hero any more than anybody else because the choice was very simple. Give my brother my kidney or he dies. It was really that simple. So bear in mind that if you decide to donate a kidney you will have two choices. Either feel nervous and anxious of what could happen or sit back and enjoy the ride. Either way the exact same things are going to happen. How you chose to look to them is up to you. Be assured that this ride will be bumpy and at times not enjoyable at all but it sure beats the merry-go-round.

I moved abroad to The Czech Republic 17 years ago and got married. Prior to leaving my older brother (let’s call him Andy, since that’s his name) suffered kidney failure from his juvenile diabetes. However my oldest brother (Nick) stepped up to the plate and boldly announced that he would go under the knife and help our brother out. Well after living in Prague for over 2 years I decided to call my brother Andy and see what’s happening. I then discovered that Nick had chickened out! He didn’t even go for 1 test! To be fair I was surprised but I understood. He was scared. That is a legitimate reason to not have elective surgery. It is also a good reason not to jump out of or ride in planes. Well the only other 2 choices at that point were our 2 other brothers and both had drug addiction problems. This wouldn’t really be a problem if you didn’t mind having the munchies upon awaking from surgery but why roll the dice.

So I checked with the missus, and volunteered. This was the easiest part of the entire thing. The biggest problem with my oldest brother backing out however was not that he had, (as it is understandable) but that he had waited so long telling Andy so that when he went on the “cadaver list” (which is a terrible name by the way. I would prefer almost any other name including “Well they ain’t using it anymore list”) he was right on the bottom and not getting any healthier. The hardest part so far was actually trying to get back to Canada from Prague with a pregnant wife and no money! But I was young, strong and full of piss and vinegar. (After the donation I was only full of vinegar) But to get a jump on things I started all the tests in Prague. Since most medical journals are in English the Czech Doctors speak, read and write English. They also have the extra benefit of prescribing beer after surgery to help get those kidneys going! Seriously. I don’t know if they still do but if California can have medicinal marijuana then I say go for it!

My first test was a lot of blood letting. And I mean blood letting. You know how they have these little vacuum tubes that suck out the blood they want to test? Well in Prague they stuck the big needle in my vein and I bled straight into the test tube. They would wait until it was almost full and they quickly switch it out like a plumber switching a bucket under a leaky faucet. Trouble was that the Canadian Medical Association didn’t recognize any of the results. They treated them like Paraguay at a United Nations cocktail party. (Don’t look now but here comes Paraguay with his cousin Uruguay. Those two are so guay) So when I finally raised the cash to get a bus to Antwerp and a plane to Montreal and had a friend from Toronto drive 6 hours to pick up me, the wife and our cat with all of our worldly belongings. Then I had to do the tests all over again.

So we started the tests right away. One of the major tests was to get a picture of my kidneys while radioactive dye coursed through them. This requires you to drink a solution the day before that induces your bowels to evacuate. And I mean evacuate. The embassy roof in Saigon had a more orderly evacuation. Being ridiculously poor (living in Prague means you earn about $10 a day) I was given the cod liver oil prescription which consisted of 2 small bottles of a foul tasting oil that the pharmacist had thoughtfully flavored with mint. So it tasted very much like the oil runoff from a lube job at the Wrigley’s Gum factory except without all the twins dancing around. Apparently they now have a different solution to drink that merely tastes like crap and smells like a fart but 15 years ago it was 1 cup of oil and I was the dip stick. This had to wonderful effect of making me super clean inside. Once you overcome the gag reflex and hold it down for 20 minutes it will make a reappearance at the other end to make you completely forget the taste. If you thought the 3 day old Mexican food was jarring you are in for a shocker. I would not have been surprised if my shoes had come out. It was certainly slippery enough back there. So the next day I headed over to the hospital and had the test. I first had to change into the garment provided which I am sure you are fully familiar with. This is the one done up at the back that makes you feel more naked than actually being naked. The technician told me that they were invented to take your mind off of the medical process since you were too busy hiding your butt to be concerned about the large needle the guy behind you was holding. The test does not hurt at all and is actually kind of interesting as you get to see a very detailed picture of your insides including any pocket of air that magically isn’t there in the second picture but from the smell in the room the technician has a pretty good idea where it went. (Hey! I’ve been drinking oil! What do ya’ want?!?!)

He told me that this procedure actually reveals to some people that they only have 1 kidney to begin with. He said some people are born with only 1 and some people with 4 little ones much to my surprise. I was a lucky one with two but only one could be used as the other had an artery going into it that split in two just before entering so the left was out and the right side it would be.

They other major test was going in to have them run a scope up my artery and take a direct look at the kidney. This procedure may seem daunting but it is pretty straightforward. You climb up on an operating table, (it’s actually fairly comfortable and the warmest spot in the room) they freeze the area, make a tiny incision and insert the scope. You actually get to see the monitor and the cameras journey to the centre of the earth which is this case is your kidney. I actually got to have the following exchange.

Me- Excuse me, Doctor. Is that the inside of my body?

Doc- Yes, it is.

Me- Wow! I’m even good looking inside!

Come on, when am I ever going to get another chance to say that?

When she had finished pulling the scope out she had to apply direct pressure for about 20 minutes before she could suture it.

(Doctor, I don’t want stitches! Suture self. <Bahdum BUM>)

After about 15 minutes she took a peek and that’s when my blood shot out like a scene from M*A*S*H*. More interesting then anything else and in the end I didn’t care since they had given me something to relax. I suggest saying yes to anything that can help you relax. And this tablet could have relaxed a horse. (Cool, a red fountain. Is that Hawaiian Punch?)

The only other procedure worth mentioning was that they wanted me to provide my own blood for surgery. This meant that I give blood twice in 2 weeks. First I would go and donate one unit and then go back the next week and give again. And after 5 weeks the blood was no good anymore and so once again I had to go back. The reason was my brother was failing fast. He was not strong enough to receive the kidney. This kept up for 1 year until it was “do the operation” or “sign the death certificate”. Public Healthcare, ya’ gotta love it, eh? This entire time I was unemployed and not enjoying it. I did go for interviews but they all said. Come back when it’s over. And I did, and I started my new job 4 weeks after the operation. But in the meantime I was on welfare. That was one hell of a year.

But what was the most bizarre thing about donating so much blood was that the nurses at the Blood Clinic never seemed to recognize me. They saw me 20 times over the course of 1 year. I became a pro at giving blood. And they always take you into a private room and would ask all sorts of personal questions. This is where I thought they would at least recognize me. They would ask me a question like, “Have you ever had unprotected homosexual sex?” and I would say “No” and then they would look at me like they were thinking “Oh come on. Who do you think you’re fooling? Liberace was straighter than you.” Once in a while I would point this out and they would only answer, “We are not here to judge you.” Well that made me feel more at ease.

One time they asked, “Would you consider yourself in a high risk category to contract AIDS?” and so I finally said, “Well my gay, Haitian, drug addicted friend licks my wounds for me but other than that I’m good”. She was not amused.

So the day finally arrived and I went into the hospital. You go in the night before since the operation is early in the morning. They woke me up the day of the operation and said, “Have you heard?” Considering the nurse was the first face I had seen that day my answer was some kind of gurgled response punctuated with snorting. So she said Andy was too ill to receive the kidney so I would have to go home and come back in 5 weeks. This was indeed a let down. What was worse was the nurse wouldn’t take out the IV they had me on from the night before. She said I had to wait for the Doctor and they would take it out. Well 5 hours later I was still waiting and I finally had enough so I just pulled it out myself, put some gauze on it and walked out. I also discovered that those IVs are long! It was like pulling out a tape worm. Needless to say the nurses were surprised when I walked on by.

Now I do need to state for the record that nursing is a thankless job and it is tough work with sick people and people in pain and people who are scared and nervous and on prescription drugs and that and I hated them. I am normally a nice guy but when I am bullied I respond by being uncooperative to say the very least. But I will get to that later. Nurses have a tough job. I would not want to be a nurse.

So 5 weeks later I was back in and the same thing happened but this time they realized he was either going to get the kidney or die so they went for it. So they gave me this rather large black pill to help me relax because for the first time I was nervous. Wow! We’re really doing this! Well after 20 minutes I was NOT NERVOUS. Whoa! What was in that pill? It was awesome! I asked for 3 of them to go but no dice. So they wheeled me down the hall and the Anesthesiologist joined us. Even masked I recognized him and had met him the day before so I knew he spoke Czech. So I started babbling like an Irishman on his wedding day since I was feeling just fine with pupils the size of pie plates! And it is a strange feeling moving down a hallway while lying on your back. Things go by like you’re on the train except without all the commuters. Finally they wheeled me into the operating room. I had already decided that I would play a joke on the surgeon so I had brought with me a 10 inch zipper and taped it to my side earlier that morning. When they pulled back the gown I said, “Just zip me up when you’re done Doc!” The surgical team was in stitches (no pun intended) and I heard that the head surgeon kept the zipper pinned to his wall until the day he retired.

So they hooked me up to the drip and said, “Tell us when you feel sleepy”. After about 5 seconds I said, “Actually I am start……” (Fade to black)

When I awoke it was in stages. At first all I was aware of was this very deep pain. I took a mental inventory one limb at a time and thought, yup, they finished and I am lying somewhere and damn is it ever cold. And all I could hear was some old man groaning and groaning. After a while it was annoying. I mean, I had just had a major operation and I wasn’t groaning so suck it up old man! When I asked later who the old man was they looked puzzled and said that nobody had been in the recovery room. So that old man was me! That’s how disjointed you are. It’s like you are standing aside from your body. Mentally, not in the spiritual sense. Well I faded asleep once more and awoke to a nurse shouting my name. Oddly I could hear everything perfectly clearly and I actually felt normal except for the pain and the fact I could only whisper and wantd to keep my eyes closed. The nurse kept yelling and I finally got her attention that I was actually speaking but in a whisper. So she leaned over me and put her ear close by and I whispered that she didn’t need to yell as I could hear her fine. So she asked how I felt and I quietly said fine except for the tremendous pain in my side. She said they would give me some morphine as soon as they checked my blood pressure. So these two nurses started talking and then one exclaimed that my blood pressure was extremely low. So they tried again and with the same result. Maybe they should call the Doctor because they had never seen results this low before. Meanwhile they forgot I could hear them perfectly and so I whispered up. “I am fine. Try a different machine. If my blood pressure was that low I would be unconscious so try a different machine”. They did and were surprised I was right. So they gave me the morphine and the next time I awoke I was in my room.

I actually had a private room. I don’t know why but I was sure glad I did. Recovery is tough and I had problems with the morphine. It made me itchy or nauseous. So if I was nauseous they would give me Gravol in the drip and if I was itchy Benadryl. However when they gave me one the other would return. I can not stand being itchy or nauseous. I would rather be in pain.

On the day after the operation a nurse marched into my room and clicked the drip and then came back 8 minutes later and clicked it again and then said, “I’ll be back in 15 minutes and you had better be sitting in that chair.” pointing to the one in the corner. I was actually glad to hear this since I hate being in bed (alone, hubba hubba) and I was wondering when I could see my brother. So slowly I sat up higher and higher until I was able to slowly swing my legs over the edge and then gingerly over to the chair. Did it hurt? Well, ya, but you gotta do what you gotta do. So the nurse walked back in15 minutes later and said, “Ok, I guess when going to have to do this the…huh?….Oh there you are. You’re actually in the chair.”

So they brought me over a wheelchair that I could stand behind and attached my drip to it. I was now mobile! Yes!!! I prefer moving to sitting. I am the type of guy that wanders around the room while on the phone. So I got directions and headed over to another wing where my brother was recovering. He was not doing as well and moaning like wounded cow while 4 nurses tried to get him up. I said something like, “Hey, Bro. Where did you get that awesome dressing gown? We must use the same tailor.” He was less amused then the blood donor woman.

Well I went back to my room and tried to keep relaxed but this was difficult since the pain was really making it hard to sleep. I needed to get on some other pain med since I had to keep the morphine to a minimal level due to the side effects. I asked for the Doctor and was told they would come by during their rounds. They didn’t. So the next day I asked again and they said they would come by on their rounds. They didn’t. Then on the forth day I asked again and the Doctor finally arrived and when she looked at the morphine drip which you dose yourself by pushing a button she said I could be taking a LOT more than I was. I was stunned. That meant the nurses didn’t talk to the Doctor at all! I even asked the doctor, “Didn’t the nurses tell you I have been asking for you?” They hadn’t. I asked to be placed on Demerol or something because I couldn’t stand the itchiness or the nausea but instead the Doctor switched me to Tylenol 3. That’s like going from a sledgehammer to flyswatter. Two tablets every 4 hours. It was horrible! I was in pain all the time. And here was the kicker. The after the first 4 hours the nurse didn’t come in right away and I waited an extra hour while I was in agony. She said I should have called them. What was the worst was no matter how bad it hurt they would not give me anything else or get the doctor. I begged, I pleaded for the doctor and I suffered. And to top it all off I was only given the meds every 4 hours if I pressed the buzzer and called them. Maybe they would have come in afterwards by themselves but it was a chance I could not take.

So at the end of Day Four, I snapped. I became the worst patient the nurses ever had to deal with. I would throw anything I could get my hands on at them when they came in the room. I screamed obscenities at them if they passed by the door.  I pressed the buzzer all the time and any time. If they came within arms reach I would take a feeble lunge at them. (it’s hard to lunge when you’re in pain) They still would not get me the Doctor or increase my meds. Fortunately for them I had to be discharged on day 5 (Public Medicare Regulation). Am I sorry I behaved so badly? A little. But I was in a lot of pain and the nurses started bossing me around on day one. It was only a matter of time until I snapped because attitude + bossy + pain + me = A**hole.

About 2 years after that I was speaking with a friend of mine who is a surgeon in a Philadelphia Hospital and told him this story. He said he was shocked to hear that as he said there are basically only a few things Doctors can do well and one of them is Pain Management. He said all it takes is a little follow up and patients can be made to feel a lot more comfortable. He was also surprised that they did not report my outrageous behaviour to the Doctor as my sudden switch in behaviour could have been a side effect to something and the Doctor should have known about it.

On a final note I did get to play one last painful joke on the head surgeon. While I was leaving the hospital (and I should note that I have never been given a wheelchair ride out of a hospital) I bumped into him talking to a guy who was about to be admitted. He saw me and proclaimed that I had set the record in the hospital to be the first person to ever walk unassisted the day after the operation. So I said, “Well you know, Doc. I think there might be a problem. When they sewed the muscles back I think they sewed the wrong muscles to each other.”

“Oh no! Really?”

“Yes, every time I lift my leg I do this.” (which is when I bent slightly to the right) After about 2 seconds he burst out laughing and said he couldn’t believe that he just fell for that. So he pointed out to the guy going in that I was also the most relaxed guy they had ever seen going into the operating room and how they wished they had filmed it since I kept them entertained right up to passing out.

I went home and here I am 14 years later still in good shape. Your final question may be how did this effect my quality of life? Did I ever have any issues later? Well, no I didn’t. I feel totally normal. My calcium is slightly elevated but not dangerously so. But once in a while I will turn or bend or something and then I feel this shifting where my kidney used to be. It’s kind of weird at first and you think, “What was that?” but it doesn’t hurt and doesn’t affect anything. It’s just an odd sensation. So I am now 42, 20 lbs overweight, I run 5 miles four times a week, and I quit smoking a year ago. I still drink (but lately I stopped as I am on a diet trying to lose that 20 lbs) and my remaining kidney works fine.

Take my advice. Be a donor. I sometimes hear about recipients who refuse to take their loved ones kidney because they want them to lead normal lives. What could be more normal about wanting them around longer? And there are very rarely adverse effects. The odds are exceptionally good that both of you will be around for a lot longer. The doctors told Andy that he had a 30 year kidney which they said was about the longest you could ask for. And about 4 months after the donation my wife and I went for dinner and I had never seen him more talkative and bubbly and joking around. I think that the Doctor may have transplanted some of my humour too. It felt really good seeing that.

It almost made me wish I was a nurse.