Donating via open nephrectomy

[samatra]

Hi all, I am donating a kidney to my aunt on July 15th at Legacy (Portland, OR). Unfortunately I have to have a right-sided open nephrectomy because I have multiple arteries on the left; the transplant center doesn't want to do a right-sided lapararoscopic, which makes sense given the length of renal artery and vein. I am planning on returning to work (clinic job, not too physical though) after 6 weeks. Anyone else been through an open? How was it? Did anyone have on On-Q pain pump placed for post-op pain? Am NOT excited about a PCA, I feel like crap on opioids. S

[Fr Pat]

Dear "Samatra",
     I donated by the "open" method, 11 years ago, but it was the left kidney. The surgeon said that he prefered the open method because it considered it somewhat safer for the donor. He explained that in the laporoscopic method the surgeon works via a TV screen and remote control instruments, so if sudden bleeding "blinds" the scope the surgeon must change rapidly to the open method mid-surgery. He also said that he personally preferred to be able to directly see everything before closing up, to better check for any bleeding or any damage to nearby organs or vessels. The data I have seen so far indicates that there is a slightly lower risk of complications in the open method. However, the rate of complications in the laporoscopic method varries widely according to how many laporoscopic surgeries the doctor has previously done, as there seems to be a "learning curve" even after the surgeron has been trained in the laporoscopic method. Of course, my surgery was 11 years ago, and a lot of development and experience have taken place since then, but I pass on to you whatever info I have.
    I'm not sure of the meaning of the terms you use regarding pain control. I had what we called "dope-on-a-rope": painkiller on a pole that I administered to myself as needed y pushing a button. (Won't give you any if you push the button again too soon.) Worked pretty well, although moving around and getting in and out of bed sometimes caused sharp temporary pain. After one day I was taken off that and given pills (can't remember what kind.) On leaving the hospital on the 3rd day I just used Tylenol, but had a prescription pain med on hand to use if needed (never used it). The nurses suggested that getting off the prescription pain meds would help get the bowel funtion back in action sooner.
     I recovered well, and was back to office work in a week. Needed naps and an early bed-time. Had occasional SHARP pains with coughing, laughing, some movements, etc. but not too bad.
     From what I have read, my recovery was much quicker than average.
     My fuller narration is posted in the "experiences of other living donors" section of this site, under "Fr. Pat's non-directed donation".
     Hope this is of some help. As I said, this is 11-year-old information. But from all I have read since then I would choose the open method if I had to do it again. I just like the idea of the surgeon being able to actually SEE everything and use his/her own hands. But that's just my own preference.
     For what it's worth (and not meaning to play down the small but genuine risks involved in donation) I donated at age 56 and have run 4 annual full marathons since then, and am still running half-marathons now at 67. (No, you don't HAVE to run marathons after you donate.)
         best wishes,
            Fr. Pat