Use by Date

I/we have been given a date, 19th May 2010 - coincidentally my daughter's birthday, for the extraction and transplantation of my wife's kidney to me. The magnificence of her gesture overwhelms me. Though routine it is not a trivial operation but more than that I will be no condition to support her when she revives.

There is a slight chance that she may not have to go through with it, if a cadaver with a suitable kidney appears between now an then. This puts me in the morally invidious position of hoping someone kills themselves to spare my wife the operational risks and the loss of her kidney.

A cadaver donor's kidney however has an average life span of 15 years whereas a live donor's kidney has a life span of 20 plus. A second moral dilemma occurs to me. perhaps I don't want some to die and save my wife from the knife after all; perhaps I want the extra years.

In 15 years I will be nearly 80. If I feel as I do now with any further deterioration in health I will welcome the extra years. Unfortunately that isn't going to happen. During the final assessment last week with the renal coordinator, nephrologist and surgeon I was told I already show signs of osteoporosis and the immuno-suppressant drugs I will need to take to prevent rejection will exacerbate this condition.

The drugs (transplant medications) in the supplied guide are frightening. There are 5 pages of them in this small booklet. I wont have to take them all but the possible side effects of any appropriate cocktail is the stuff of nightmares here's one example:

1. increased hair growth
   
2. swelling of the gums
3. hypertension
   
4. diabetes
5. impaired renal function ( they have to kidding?)
6. nausea, vomiting, diarrhea ( all the old favourites. )
   
7. Burning sensation in hands and feet
   
8. weakened bones ( osteoporosis )
   
9. Acne ( and I thought my teen years were over )
   

That's just one drug - other possible side effect of other drugs include: nose bleeds, mouth ulcers, anorexia, hair loss (maybe if I take this with the one above I come out with my hair intact ), joint pain, difficulty sleeping, mood swings and of course susceptible to infection - an obvious result of suppressing one's immune system; stopping T-cells from becoming active in the blood and attacking the transplanted kidney. Most of the drugs to be taken twice a day at the same time each day (yet another reason to get rid of daylight saving time - before some transplant recipient dies of an ill-timed dose)

Assuming everything goes according to plan I will be out of action for a month after I come out of Hospital, with daily early-morning visits. then alternate days etc, etc. This is not going to be possible from where I live so we will be forced to rent accommodation close to the hospital. For the first two weeks we will both be laid up and relying on a roster of relatives for home help.

As Australia's former Prime Minister, Malcolm Fraser, once famously said "Life was not meant to be easy."

Introductory Message

G'day

Yet another attempt to diary my writing experience. The last one "Eye of the Robot" http://eyeoftherobot.blogspot.com/ which I intended to encompass my thoughts on Life the Universe and Everything died then slowly resurrected itself as renal failure diary.

I've decide to leave it doing its thing and start again with the writing blog. In fact I'll probably need three. One for Life (and the kidney problem) one for the Universe (of writing) and one for Everything (else)

Three is good. I like three. I'm writing a trilogy.

Coming soon to a blog near you
The trials and tribulations of writing a trilogy

Ooroo

On the Cusp

Yesterday the bad news.

The remaining functionality of my single kidney has dropped 3% in the last 4 weeks from 15% to 12%. The sudden drop seems to be a feature of my progressively failing kidney. It has been stable at 15%-16% for the last six months after a drop from 23% with the removal of other kidney.

I haven't felt any change. My appetite, weight, and blood pressure are all good. Every visit to the specialist which showed no change in the blood work encouraged an optimistic view; that the daily cocktail of drugs had halted the decline, that this benignly stable state could go on indefinitely.

Yesterday was a wake up call

For starters, I'm six months older. That might not seem like much but it shortens the window of opportunity in which have a transplant from seven and a half years to six. At my age every month counts. Then again maybe that's my particularly dire circumstances talking. 10% kidney function is the cutoff point (transplant, dialysis or death follows) and I just dropped 3% to 12% in 4 weeks. It may stabilize again but I wouldn't count on it. It is more likely I'll be under the knife sometime soon.

There is sense of urgency now that wasn't there before. My next appointment with the skin specialist to check the treatment I had for Bowen's disease has been brought forward from March to this afternoon. The treated ear has been a problem ever since treatment; it itches, feels hot and can't strand the sun. I can sense it now in a way I never could before and can't for the untreated ear.

This could be because the treatment spurs on the immune system to heal the disease. (one reason why the treatment has to be finished before transplant because transplant requires the suppression of the immune system). Equally it could be that I can feel it because I know I have it. In the same vein, yesterday's startling drop in function convinced me I could feel the pain in my kidney.

So here's fate that's worse than death - contemplating it. Young healthy people never give it a thought.