Day Before Living Kidney Transplant

May 31, 2011 – Day before surgery:

5:45am – wake up and eat as much breakfast as humanly possible. I had two big waffles with peanut butter and honey and a big cup of tea. I forced myself to eat every bite I could, since that would be my last meal for the next couple of days. I took my kids to a family friend’s house for the day and headed off to work. It was a fairly slow day at school, but kept myself busy and not too hungry by drinking a half-gallon of juice. I then realized I was on pace to drink the whole thing, which was going to be 1500 calories and more carbs and sugar than I had consumed in the whole week leading up to it. The last thing I wanted was a sugar high on top of the empty stomach and nerves so I switched back to water, and drank only a few more diluted glasses of juice.

The nerves I was feeling for the day were mostly stemmed from the bowel prep that I was about to go through. The nice thing about where I work is that most of my co-workers are in the colonoscopy age range so I spent my spare time asking each and every one of them about their experience. I can honestly tell you I have never talked about poop more in my life. I wasn’t so nervous about the pooping as I was about having to get to Seattle that night, and hoping that I would be able to make it w/out incident (or should I say accident?). Each of my co-workers were so nice, I was expecting to be laughed at, called a sucker or taught the secret handshake of those in the colonoscopy club but I was just reassured that it was not that bad and that you need to stay near the toilet while the magnesium citrate works its magic then I would be able to travel after that. There was definitely a range of times people thought it would start working- some said 20 minutes and others said an hour or two. And the same was for how long it would last, but all assured me that they were able to sleep through the night without having to get up and go, so it would come to an end at some point.

As the students left for the day I hurriedly cleaned my desk and took care of last minute details that needed attention. I snuck out the door and tried to avoid teary-eyed hugs from work friends. I knew if I started crying I might not be able to pull it together. One of those days!

As I was picking up my two little girls from the babysitter the most amazing (need a different word) thing happened. As I mentioned much earlier in the blog, my college roommate’s dad had a heart transplant now 23 years ago and that greatly influenced my decision to donate. Well, that man lived two houses down from where my children regularly play for the day. In the last 10 months of picking up and dropping my kids off three times a week I have never seen him until that day. He was standing at the fence between the yards and I saw him as I pulled in. I was on the phone with Cherina and we were both nervously talking about our days. I hung up with Cherina and I walked over to John to give him a huge hug and tell him about how he inspired me to give life the following day. He was thinner, a little greyer, and looked a little less healthy than the last time I saw him but he insisted that he was doing well. He told me that he was just at UWMC the week before and his cardiologist couldn’t believe how well he was still doing. John said that they had expected him to live five years at most after the transplant and that if he died tomorrow he would be okay with it because he has seen all of his kids graduate, become a grandpa and had 23 more years than anyone had expected. He said that he was one of the first transplants that his surgeon had ever done and he’d been going to the same doctor all these years. He told his doctor that he couldn’t retire until he died because he didn’t want to have to “train another one of you” and he said his doctor’s reply was, “you’d better hurry up then”. I hope that I can some day look at my life and say that I was thankful for every day, that I wasn’t afraid of the unknown, that I was content with what I had and who I was.

Talk about seeing God’s plan unfold in front of me. God put John at that fence on that day for me to hug and see first hand how one incredible gift can shape the future. God put John there to ease any nervousness I may have had, to fill my heart with hope and to understand His plan and feel His love. We might be looking at a situation and ask how God could let someone like Cherina have so much pain in her life, but what he is really doing is showing us how perfectly he can orchestrate her recovery. She may have been born, for lack of a better word, broken but through His grace He put her back together.

Back to my day– I picked my kids up, was home minutes later and started drinking the magnesium citrate – the sparkling lemon laxative according to the label. It was AWEFUL. Super bubbly like an extra fizzy pop, super lemony and sour and excessively salty. Like someone poured all of the salt into the margheritta instead of putting it on the rim, and then left out the alcohol and replaced it with a laxative. I drank about half of it and was struggling to go on so I sent a text to my family asking them to cheer me on. After funny replies about remembering my college days, or suggestions about pouring it into margheritta or martini or shot glasses I was able to get it down and immediately had to go to the bathroom. Turns out that was just nerves getting the best of me because I certainly FELT it when the they hit about an hour after the bottle was emptied.

I spent my time at home that night trying to throw stuff in an overnight bag, hug my kids and using the bathroom. We were able to catch a 7:50 ferry to Seattle and we just sat right next to the bathroom. By that point it had tapered quite a bit and I was able to just quickly go and then get out. At 8:00 I was supposed to drink two liters of water/juice in the next four hours. So full Nalgene in hand the water consumption began, and my bathroom trips were upped again. We got to the hotel a little after 9 and we tried to relax. Cherina and her Aunt Swedini (the one who started it all!) stopped by around 10 and we visited for 20 minutes or so. Mostly just nervous chatter. But it was really good to see her! After she left I showered and used the special antibacterial soap that they gave me, scrubbing for 10 minutes is a long time! Showered, water consumed, bathroom usage subsided and asleep just a little after midnight with an alarm set for 5:30

~Kara

Closing In On Surgery Day

May 30th, 2011 – Dinner at the Baumgartner House:

It probably seemed like a mundane Monday or Memorial Day holiday for most, but for me it sure wasn’t. It would be the day my parents would meet Kara’s family. I knew her immediate family, but I would be meeting many more people near and dear to her. I was definitely filled with nerves. I naturally wanted them all to like me and genuinely approve of me. I mean after all, their beloved Kara was going to go under the knife for a stranger! I felt a pressure, a pressure I of course put on myself. I told myself to just be myself; that was all I could do and hope that I wouldn’t accidentally say anything stupid! When do you ever meet people under these circumstances? There are no guidelines or rule books to look to for help. It’s just an uncharted thing that you navigate the best you can.

I knew everyone would be nice, that wasn’t a concern of mine. So my family hopped in the car and drove the whole two minutes over to Kara’s parents house from ours. We pulled up to their gorgeous home overlooking the water and knocked on the door. Her dad Tim welcomed us with open arms. From that moment on, I knew it would be a great evening. Everyone was so friendly! They all seemed so excited to be a part of this. It was very reassuring for me that her family was so supportive of what we were going to do. We shared a delicious dinner outside, filled with good conversation and even better company. It was a very relaxed atmosphere and vibe, which I knew my parents appreciated.

It was so nice to see all of the children too. Kara’s children, Ainslee and Elise were there, as well as Kara's niece Ella and nephew Kohen, whom I taught at the school I worked at. It was so nice to see them all. The presence of children always puts me at ease. It made me feel so good that little Ainslee was excited to see me, because I was excited to see her too! She is the sweetest child and I was glad she had warmed up to me so quickly. I’ll never forget what Kara’s mother Nikki had said. She said how excited they were to be doing this and that they were glad I was doing it too!! This blew me away! She was happy I was doing this!? These few words spoke volumes to me. These people were some of the most down to earth, kindest people I had ever met. God’s plan really is the best.

Early on, I hoped my donor would be someone I knew really well. Probably because I thought it would’ve been easier or something to that effect. I would have never dreamed it would be someone I didn’t know! I’m so overjoyed that it worked out the way that it did. Kara was for sure divinely picked. The fact that she answered her call, was the true miracle that took place. She comes from a wonderful family that I’m glad I now know and she is such a good hearted person that I really see as a friend! I lucked out, better yet I’m truly blessed. The countdown continued, only 48 hours left until the big event!



May 31st, 2011 – The day before surgery:

Of course the surgery was on my mind at every turn. I was also extremely busy packing for the hospital and my long hotel stay in Seattle. I decided I would recover in a hotel with my aunt Swedini, the aunt that wrote the initial email that was sent out to everyone. I stayed in Seattle because after surgery, I had clinic appointments two times a week for about the next 3 months. The plan was to stay close until I recovered a bit and could make the commute. Living in a hotel seemed easier too because there was no cleaning or cooking etc. So I stuffed my car with all of my dialysis stuff, a months worth of clothes and all of the other things I rationalized as necessities. I kissed my mom goodbye and hopped in my car and headed to Seattle. My aunt flew in early that day and had been waiting for me at the hotel. I was so happy to see her waiting for me! I was glad she came to take care of me. She is one of the best advocates I know. If you want someone on your side, it’s her.

We unpacked, got some food with my boyfriend Cody and his dad Jim. After our delicious meal, we returned to the hotel to unwind before the big day. I did my last round of dialysis the night before which was sooo liberating. If I could’ve bottled that feeling, I would have. I think to myself all the time how grateful I am to Kara that I don’t have to dialyze anymore or plan my life around it. I tried my best to get some sleep before the surgery. I wasn’t exactly successful seeing that I got a whopping two hours worth! It was one day or less until the surgery now!

~Cherina

Kidney Transplant Operation Preparation

May 23, 2011 – Pre-Op appointment:

Today was my nerve recking/exciting/over whelming pre-op appointment! I went in early Monday morning. Kara also had her appointment on the same day, so I was happy to know I would be seeing her. I met with my transplant team which consists of the fellow Nephrologist, the attending Nephrologist, the surgeons, the Post-Transplant Coordinator, nutritionists and social workers. We discussed the details of the operation at length, as well as the post-op expectations and guidelines. I was anxious to get the ball rolling! I think both of us felt that way from what I recall.

I did the routine blood draw, except they filled around 13 vials, versus my normal two to three. It was so amazing that all of the doctors were discussing my transplant as if it was definitely going to happen! This was a major moment for me. Everything was really coming together now. It was no longer an idea or a hope; It was a reality. There were only nine more days until surgery!!!  The Lord was really watching out for me! Now I would wait, which proved to be one of the most difficult pieces of the puzzle.

~Cherina

May 25, 2011 – Anesthesiology appointment:

Two days closer until the big day!  I woke up that morning with more butterflies than the day before. I actually was excited to go to the University of Washington Medical Center for once! I had an Anesthesiology appointment and so did Kara. I was thirsty for as much new information about the surgery I could get. Kara knew more about the surgery than I did! I would ask her questions or she would inform me about all the information she had learned. As the recipient, the team told me very little. After all, Kara was the one making the ultimate sacrifice. I HAD to have this transplant no matter what. I’m just so thankful that she didn’t pass on me! I think the general thinking is that the team didn’t want to get my hopes up or provide me with any details when everything could be subject to change. I think everyone is thinking that all I should be concerned with is getting the kidney and nothing else. So I just stayed out of it and stopped asking questions that proved hard for them to answer. Patience was the key; easy to think, but challenging to do.

I went in for my appointment and the nicest RN assisted me. She reminded me of all the pre-op procedures. Wash with the special soap, don’t eat past midnight and take all the laxatives. That was fun! I felt so bad because Kara had it way worse! Our surgery was on a Wednesday and Kara couldn't eat past 6am Tuesday!! Of course I forgot this bit of information and tried to make dinner plans with her the night before the knife! I’m lucky she’s an amicable person.

The nurse went over the risks and concerns as well. Although I’ve heard all of this ad nauseam, it was different to hear it one more time, one last time. It kind of validated and confirmed it all for me. She gave me a small book that explained my surgical experience, and I was on my way. I was overflowing with enthusiasm and fervor.

~Cherina

Transplant Surgery Date Set

5/6/11           

For the third time I will try to sit down and write this entry. Friday, April 29^th, I received a call from Kami and she said that the transplant team reviewed my file and approved me for transplant. She told me I was a very healthy person and was an excellent candidate for kidney donation. The next step was for them to contact Cherina’s transplant team and set a surgery date. If all is going well with her then we could have surgery as early as June 1^st. She asked if I wanted to call Cherina, or if I would rather have them call and notify her. Of course I opted for telling her myself.

I called cherina and left a message, and waited impatiently for an hour or so for her to call back. She called from her car in the parking lot of a restaurant where she was having dinner with friends and we talked for 30 minutes or so, and even cried a little. We thanked God for his miracle that he is letting us live, and decided that we would forever be friends.

On Tuesday, May 3, I was at school talking with a co-worker about a surgery date, and not two minutes after our conversation I received an email from Kami with a letter attached on official UW letterhead thanking me for my generous gift of life. The letter was to inform me that the surgery date was set, and the operating room was booked for June 1^st. Irene from scheduling would be notifying me soon with more specifics. For now I should stop taking birth control pills (as it can increase the possibility of blood clots in some women) and two weeks prior to the surgery I am not to take any Ibuprofen, aspirin or the like.

Immediately after reading the email, tears welled in my eyes and I had to blink them away as I wrote Cherina the following texts:

I got you a present for your birthday

A Surgery Date!!! June first!

Immediately Cherina replied:

Omg! Omg! Can I call u?

I was at school, but stepped out on the front porch of the portable to take her call. We both cried and again rejoiced in God's plan. As we talked, Cherina told me about her dialysis class she is in right now, learning how to administer at-home peritoneal dialysis. She said that she would certainly be able to do it, because that is what was going to keep her alive, but my kidney was going to be able to save her from doing it for long. She said “if you only knew what you were saving me from doing every day…”. What a joy this is to give her. I have always felt that our purpose in life, our one job as humans, was to make each other’s lives easier. To work together and figure out how to keep life from being too much to handle. To share ourselves with those in need…

My work held a Bon Voyage kidney party for Sydney my kidney. The kidney that I will be giving to Cherina. They made placemats with clever sayings and a picture of a kidney, a kidney-shaped red velvet cake, Rice Krispy treats with two red jelly beans that looked like kidneys, cards adorned in Kidney’s and two of the staff members even preformed a song about my kidney. There are some pictures below. It was a beautiful celebration of the extra organ that God gave each of us so we might be lucky enough to one day be able to share

~Kara

Two Good Kidneys

4/24/2011

On Thursday Shane and I went back over to UW for our last appointment before the surgery. I had a 12:15 appointment for a CTA (I think the A part designates the contrast dye, opposed to a normal CT where there isn’t any. The contrast dye allows you to see veins and arteries in the scan) and an appointment with a surgeon at 3:00. I was instructed to fast (clear liquids only) for 4 hours before the CTA.

We arrived right on time to the CTA scan, and this time we knew where we were headed. Second floor, radiology department, near the Pacific Elevators. We checked in and waited for a few moments while I filled out a questionnaire about being allergic to iodine or other contrast dyes, a short health history about heart and kidney disease and why I was having the scan done.

I was taken back to the CT waiting area and a nurse came out and started an IV and instructed me to drink a full glass of water. After the cup was empty I was lead back to the CT room, laid on the table and just had to pull my jeans down so the zipper was no longer covering my bladder. With a blanket covering me I began the scan. I was told to listen to the machine and hold my breath when asked, and they would warn me before the contrast was injected through the IV. I was told that I would experience a “warm sensation” immediately following the injection. The table began sliding back and forth through a giant white donut. After a few slides I was told that the dye was about to be injected and again I would feel “warm.” What she forgot to say was that the warmness would only be felt in my trunk, and I might feel like I was peeing my pants! After making sure that I didn’t have an accident, round 2 of the dye was injected and more sliding through the Krispy Kreme look alike. After fasting for four hours I felt like Homer Simpson lusting over the doughnut (MMMM doughnuts!) The whole process took about 15 minutes.

We had a quick lunch in the cafeteria of the hospital, called to check on our sweet little Ainslee who had pneumonia and was at home with grandma and her sister, then we headed up to find the 8^th floor transplant clinic.

When we got there the nurse/receptionist told us that we would have at least a half hour wait – our first wait in seven appointments at UWMC. The wait ended up being 1 hour and 45 minutes, but was well worth it. Dr. Bakthavatsalam (don’t even ask how to say it – I had to check the spelling three times while typing it!) was the surgeon that we met with, and he did a short physical, checked breathing and pulses and things, then sat us down to talk about the specifics of the surgery. It would take about 3 to 4 hours and would be done mostly lapriscopicly. I would have 4 incisions, 3 for the scopes and one where the whole kidney would be removed at the end. The surgeon said if my kidney was cancerous then they could chop it up inside me and suck it out a tube in one of the holes, but we need my kidney intact and in good condition so they will have to make an opening big enough for it to be removed. They will go in and shove (or gently nudge) the neighboring organs aside and inflate my belly with carbon dioxide, clamp off the veins and arteries running to and from the kidney, then detach the uriter from the bladder and clamp off that opening, then make a big slice and take the kidney out. They would move everything back into its original place, sew me up and I’d be done. Sounds pretty routine.

He went over risks and complications and said that chances of anything going wrong were like two in every 10,000. Sounds like pretty good odds to me, but to Dr. can’tsayyourname, he said that is too much for a healthy living donor. According to him, there should never be anything that goes wrong because this donor is putting their healthy life on the line for no physical gain of their own and even one mishap ever is too many in his mind. He said that each donor surgery he does takes 2 days off his life because of the stress it causes him. In his strong Indian accent he said that he does surgeries all the time in cancer patients where he stops the heart, but that is not stressful, just a challenge. He knows that it beats the alternative. But for a donor, the alternative is to live a healthy life with 2 kidneys if they do not do the surgery. I don’t think he was trying to scare me out of it, but simply saying the true facts. With his religious views silently displayed in the white and red markings on his forehead, he must understand the compulsion to fulfill God’s will, even if we do have different Gods.

After talking about the surgery, he showed us pictures from the CTA scan. Hopefully I can get copies of them so you know just how cool they were. He was able to scroll through a series of pictures, starting at the top of my diaphragm and ending at my bladder. We saw my two beautiful kidneys nestled in close to my other important organs. Then we moved on to a screen shot of my bright pink kidneys isolated from everything but the aorta and some veins and arteries. He could spin my kidney’s 360 degrees so we could see all sides and angles of them. They looked like a textbook pair to me. Lastly he showed us a picture of my white bones of the ribcage and vertebrae, white aorta and other veins and arteries, and the rest of my organs- minus the intestines because they cover everything up (those were digitally removed) in various shades of pink and red. We couldn’t believe we were looking at my insides. It really looked like a picture from my high school anatomy book. At the end he told me that the radiologist has to officially read the scan, but he thought I had two beautiful and donate-able kidneys. Perhaps he didn’t call them beautiful, but I am sure he thought they were. He said that they usually leave the better of the two kidney’s for the donor, but in my case, one wasn’t necessarily better than the other. Not sure which one, but there was one slightly bigger than the other, but the smaller had two sets of veins and arteries so that one had a better blood supply. He said it was normal to have different numbers of veins leading to either kidneys, so it was nothing to even think twice about.

Shane and I left the hospital on a huge high, and a very empty stomach. We ate dinner at the RAM in U-village and excitedly talked about the days events. We both still feel really good about giving a kidney to Cherina and can’t wait to move forward.

I talked to Cherina the for most of the drive home and recounted the days events. She was excited to hear the news, and I was excited to be able to share it with her. Her creatine levels are out of control and she needs to start dialysis soon. She hasn’t been feeling well and it is starting to take a toll on her. The poor thing needs a kidney as soon as possible, and she was on the phone worrying about me, how long my day was, the time I spent away from my kids and the time I will be spending away from them. Once again she wanted me to know that she would still appreciate everything I have done for her if I decide to change my mind, and to make sure that I didn’t feel any pressure to follow through with the donation. Seriously? She is amazing and I can’t wait to be able to change her life!