Kidney for Kaiser

Just a warning but I'm pretty sure this post is going to get wordy. There are some friends and family curious about this and I'm thinking this is will be a way for me to tell the story in completion so I'm sorry if it gets long and/or boring and/or repetitive. Whatever. Here goes...

About 4 or 5 years ago Derrek's cousin, Chris Kaiser was diagnosed with a rare kidney disease. He's only 35 now but has known for a few years that dialysis and/or a kidney transplant were most definitely in his future. Well the time has come and Chris needs a transplant as soon as possible. For multiple reasons, they hope to completely bypass dialysis.

When Derrek and I started dating three years ago, he knew then that he wanted to give Chris one of his kidneys if he was a good match. Chris and Derrek are the same age and grew up in Fredericksburg together. They've made alot of memories together (some they'd probably like to forget) and although they don't spend as much time together these days (now that they're old farts), they will always be such a big part of each others' life. And even though the need for a transplant came much sooner than everyone anticipated, Derrek is still as sure as he was before. In fact, I'm not sure Derrek has ever been so determined and sure about a life choice as he is with this one.

About a month ago, Chris was finally able to get into the Texas Transplant Institute to get things going. He started all of his testing and got information for anyone that wanted to be a living donor for him. This is when Derrek realized he had some "competition". Five people close to Chris went through the initial screening to see if they were a match to donate: Wanda (Chris's fiance), Sean (Chris's brother-in-law), Tony, Jeff (long-time friends) and Derrek. The other three guys grew up in Fredericksburg with Chris and Derrek and they all really like to give each other a hard time. It gets completely ridiculous at times. They're all very macho, as guys like to be when traveling in a group. And just to make sure that the beautiful, sensitive, caring thing they were doing absolutely did not mask exactly how macho they are, they turned it all into a competition. Who knew you could talk so much trash about your friends' kidneys? They competed just making the first call to the Transplant Institute. Poor Tina (the nurse at TTI) was bombarded with calls before they went to get tested, then bombarded again after requesting results. Unfortunately, Jeff was the first "loser" because he was the only one that didn't match at all. You can only imagine how much crap he had to take for that. Wanda (who tested a week or so earlier when she went with Chris), Derrek, Sean and Tony all matched! At this point, the four of them had to choose the person to move forward in the process. It was a tough decision because there were definitely arguments for and against each one. After you choose who moves forward, they are tested further and if at any point, the doctors feel this person's health is too risky or that their kidneys are not ideal for Chris, then they can pull the plug on that potential donor. Then we'd move onto the next donor. So one of the deciding factors was that fact that it was anyone's best guess who could make it through the physicals for sure so essentially Derrek going first would be beneficial to us because of the baby on the way. If he goes first and gets knocked out, we know. If he goes first and makes it through, its very likely the surgery will be over and Derrek will be somewhat recovered before the baby comes. If, however, he was third in line and two others were tested then knocked out, the surgery and baby may be really close. Although we had talked about it and even if things were close, Derrek and I were not really worried about the timing. Of course, it's not ideal but if we could just avoid the two things falling on the same day, I think we're good. So there was much discussion and many things other things considered but the decision was made to send Derrek through first.
So the choice was made last Thursday night and Derrek was scheduled for the majority of his testing this past Monday. I decided to go to make sure he asked all the right questions and that he actually paid attention to the answers.

Here comes some gory details but re-read the first paragraph again. It's been a long time since you read it the first time.

Derrek had to do a 24-hour urine test from home before showing up to his appointment on Monday morning. Essentially, he carried a huge bottle of urine around in an ice chest for 24 hours. When we arrived they got him registered and took some blood. We were then sent to eat some breakfast, get a chest x-ray and an EKG. We hardly waited anywhere in the hospital. I was sure I was going to knock out a big chunk of my book but I don't even think I read one full chapter! Everyone just kept us moving. After those tests, we went back to transplant center and we both met with Tina, the nurse. We had the opportunity to ask all the questions we had and she asked Derrek a million questions about his health history and family history. She took his blood pressure 3 times during this interview (it was normal all three times). Then she sent in the doctor and he gave us the opportunity to ask all of our questions again. One of our main/only concerns is the likelihood that Derrek will develop high blood pressure at some point and be put on medication that is hard on kidneys (Derrek's brother is on the meds right now). He explained that they, of course, cannot guarantee anything but if you were to be on the medication with two kidneys that reacted adversely to those meds or the high blood pressure, you may have a month longer before dialysis or transplant with two kidneys versus just having one that couldnt' take it. The other thing is Derrek is now at the top of any transplant list if, God forbid, he ever needs a new kidney. So the doctor listened to his lungs and did a little bit more poking and prodding and then told us he really liked everything he saw except for one thing. The urine test had been tested and his protein levels were a little high. He said 250 is about as high as he likes to see but 200 is usually the cut-off they use for donors and Derrek's was 202. It could have been his diet (we realized he had beefed up on protein that day) so he's currently carrying his ice chest around again. So, he sent us through to the next test (sometimes they know enough that morning to just end it), the CT scan. This is where they inject dye into his bloodstream and look at his kidneys and their blood supply. We had a couple of hours before they could fit us in so Derrek met with the social worker in the meantime. They assign a social worker to each potential donor and ask questions about your financial situation (you have to take care of your travel and missed work; there's no help for those things), your situation at home and your emotional state.

The CT scan was the only physically uncomfortable test Derrek endured. The discomfort only lasted about 30 seconds but apparently, your body gets really hot very quickly when they inject the dye. He just tried not to throw up and luckily it didn't last very long at all.

Overall, the day went really well. Derrek had promised himself that this year was the year he was going to have a physical especially because of the heart disease in his family. So he got an extensive physical, pretty much for free. Tomorrow, Derrek goes back to return his urine test, have some more blood taken and let them check his TB test. Most of the results they know the same day but we'll have to wait on the results for communicable diseases. We're not sure what they saw in the CT scan either but Derrek may get some information on that tomorrow.
Once Chris is finished with his testing (he thinks he'll be done tomorrow) and all of Derrek's results are in and nothing comes in that automatically rules him out then the doctor will present them to a team of surgeons, nurses, social workers, and nephrologists (that meet every Monday) and it must be a unanimous decision to send them through and schedule the surgery. One vote against Derrek will rule him out. In fact, they remind you a few times that they could pull the plug even up until the day of surgery if there is too much doubt about Derrek's well-being. They really have Derrek's best interest in mind and it doesn't seem like they will leave any stone unturned to make sure there's as little risk as they could possibly foresee. So, at the latest, we should know with some certainty if Derrek will be the donor or not by Labor Day. There's a slight chance it could happen this coming Monday but alot would have to come together quickly.

Hopefully, my future posts will not be this wordy or long or contain as many sentences that start with the word, "so". Hopefully.