I have a transplant!

Well, 2 actually. This past July 7th, I got a call from Toronto General Hospital at 8:30, "Can you get down here by noon?" I was going to do my best and I checked in by 11:30, with nothing more than the clothes on my back.

Surgery was scheduled for 6PM and took about 10 hours. I had a new, for me, pancreas and left kidney. While they were in there they also fixed up a hernia I knew nothing about. Thank you. What followed was interesting, to say the least. I woke up in mild discomfort. They had inserted a urinary catheter while I was under, so I had company for the next few weeks or so. Loads of fun dragging a tail around! The fist couple of nights were interesting. Prednasone in its liquid form causes weird hallucinations. I didn't get much sleep, but some of those visions were fascinating. I was in the hospital for 11 days.

Since the surgery I've had the classic forbidden fruit, a banana, as well as ice cream and french fries. My blood sugars are stable and I'm peeing every 2 to 3 hours. Its great!

I will be eternally grateful to the anonymous donor who provided the kidney and pancreas. I have a new lease on life. Thank you.

It looks like its been a while since I last posted. Not a lot has changed. I'm still waiting on the dual transplant list. I've had my dialysis line changed 4 times. The previous one caused an infection and had to be replaced after only 3 weeks. The latest one is working great. Its back to working straight, as opposed to reversed connections, so that's a good thing. I still have no intention to get a fistula installed. Some of the other patients are having issues. Others work great. Its a divided issue, but despite the fact that I'm working on line #5, I think I'll stay the course.

This coming Monday, the entire region is switching to new machines. I think the current machines will be sent out to other countries to help patients in other parts of the world. I think they still work great, they are just a little finnicky at times.

Angioplasty

During the process of transplant workups, it was determined that I needed an angioplasty. For this, a small tube was inserted through the groin into a blood vessal.Monitoring the progress, a small balloon could be inflated at the point of constriction. Unfortunately, this was not enough. A stent was also required to prop the artery open. I am now on Plavix to thin my blood until the stent has been incorporated into the lining of my artery.

The procedure was quite routine. I checked into the hospital on a Monday, the procedure was done on Tuesday, and I was released on Wednesday.

Coincidentally, two weeks later, I had to make an emergency trip to the hospital. I was retaining too much fluid. My real weight was not keeping up with my dry weight.Athough I thought I was being careful with fluids, I still wasn't taking enough off. I spent 6 days in the hospital and had an extra dialysis session. They ended up taking an extra 3 kg of fluid off. This was the first major incident since the initial incident over 2 years ago. So, lesson learned. Don't get complacent with the dry weights. Always push.

Last of the Procedures?

Tuesday was what should be my last trek to the big city. On my previous visit to the hospital, I had to get a cardio-angiogram. This was to validate me for a transplant. Unfortunately, they found some boderline blockages. Further testing was required. The latest procedure required the use of a drug to open my blood vessels. CT scans and radioactive tracers were then used to check my cardio system. Overall the procedure took about 5 hours. It took almost 2 hours to get there, the first radio-tracer was administered, a 45 minute wait while it circulated, and then a 20 minute session in the scanner. I was allowed an hour to get lunch before the next session. After this, I got another radiaton tracer and then a second drug to dilate my blood vessels. A doctor was nearby if I had problems and my bllod pressure and ECG was checked for about 30 minutes. I did request the antidote for the dilater as my head was throbbing. Finally. another 15 minute session under the scanner. Done. I called my froend to come pick me up. He had nothing important to do in the city, so he had returned home, It was a long day for him as well, for which I am grateful. Total time away from home, 10 hours.

So now I wait. If everything goes well, I get put on :The List". Once on the list, my position is determined by when I started my dialysis treatments, almost a year and a half ago.

Transplant Coordinators

I now have a "nurse for life"! At least thats how I was informed. I went to visit a few people a couple of days ago. One presented herself as my nurse for life. Now that I am on the kidney/pancreas transplant list, she has been assigned to follow me from now until, as she put it, I am beyond waterproof again. This is in reference to the chest catheter I have for dialysis. I seem to be in rather good shape for a diabetic!

Being a long term Type 1 diabetic, I decided to opt for a dual transplant, both a kidney and a pancreas. My reasoning is that if diabetes killed my kidneys, then replace the pancreas. I will be on anti-rejection drugs for the kidneys, so how bad is it to be on drugs for both?

The other person I met with was my new social worker. There were the usual questions. Are you covered by insurance? Do you have a job? Are you depressed?, etc. As it turns out, I'm looking forward to the process. I feel good about it. Money has always been a concern, which is one of the reasons for started my online presence with pdhquick.com and this blog site. I have had it with the regular commute!

I have no idea how long its going to take. When it gets close, I will get a pager and it could happen at any time of the day or night. When it does, typically in the wee hours of the morning, I have a 1 1/2 to 2 hour commute (traffic) to get there. The operation is about 7 hours and the hospital stay is 7 to 10 days. I keep hearing stories about how the kidney list is about 10 years long. Apparently its less than half that for dual transplants. None of that bothers me. This would be a major turning point in my life, akin to winning a lottery!

Keeping Busy

Having both diabetes and kidney disease is time consuming. Up until my kidneys failed, I only had diabetes to deal with, as well the failing kidneys. I had a lot of edema in my legs, but I managed the 45 minute commute each way to work. Now that they have failed, I have neither the health nor interest in repeating the commute. Especially since my employer has moved another 45 minutes away! I have no intention of getting up at 5:30am or earlier so that I can be on the road by 6:30 at the latest for the hour and a half commute! The 3 day a week, 4 hour dialysis sessions aren't helping either. These sessions keep me busy from 6pm until about 10:30pm. I eat my supper AFTER my session and may not actually get to bed until midnight. On those days I would need to leave by 4pm at the latest.

My income is provided by Long Term Disability, but it is not enough (is it ever?) To that extent I have decided to go online. That involves setting up this blog site, as well as an affiliate marketing site: http://pdhquick.com Through it I am offering custom searches for electronics at Amazon and Sony and Satellite TV services. I also point back to this blog. Other links I provide are for FreedomSoft and OLPC. With these I'm hoping that others can cut their PC costs, thus reducing their dependence on proprietary software. I've provided links for more information on these topics as well. As interest in my ventures grow, I am happy to discuss these topics.

Chronic kidney Disease

The Diet
Diabetes makes one focus on diet and exercise. The diet should make you conscious of caloric intake and carbohydrates. Carbs come in many forms. There are simple carbs like sugars, ie. corn syrup, sugar, and honey, and there are complex carbs, such as pasta, flour, and pastries. The difference is in how quickly they metabolize. When you take your blood glucose and you find it low, take the simple carbs; they will raise your glucose faster.

I count my carbs and base my insulin dosage on how many carbs I eat. I take two forms of insulin, Lantus and Humalog. Lantus has an approximate duration of 24 hours, so it provides a steady level all day. The humalog dosage is adjusted and added with each meal. After many months of adjusting the Lantus so that overnight I don't plummet, balance is achieved. As long as I don't go overboard on the carbs, I'm stable.

The diabetic diet should focus on a good balance of protein, carbs, and dietary fibre. Veggies are good as they can help fill you up with minimal carbs. There are still carbs in veggies, so keep that in mind. When choosing carbs, select whole grains and less processed foods.

Then along comes CKD. Kidney disease throws another wrench into the mix. A failing kidney means that the body can no longer process whole grains and fibre. Potassium, sodium, and phosphorus are important dietary concerns. One begins to wonder about food manufacturers, as they dump more than a day's allocation of sodium into a single serving! I'm allowed about 650mg of sodium per meal. A single A&W Uncle burger has 1300 mg! A packaged serving of black bean noodles can have 2300mg. I have found that many low-sodium prepared foods are substituting potassium for the sodium. Phosphorus can be found in diet colas. How many diet drinks are available in restaurants, other than diet cola? There is always water. Even soda water ahas sodium, duh!

I have to limit my consumption of potatoes (high potassium). I eat a lot of plain white rice (brown is higher in fibre). All bread has higher sodium levels than I like (white has about 170mg per slice). Have you ever tried to buy breakfast cereal without fibre? Don't get me wrong, everyone should be eating fibre, but it sure limits my selection when I should be avoiding fibre. I am allowed to get fibre supplements from Benefibre.

As part of the kidney diet, I need a certain amount of protein. Shrimps are good as they are low in sodium. Why is it that a fresh steak or hamburger has no sodium indications on the lable, yet once frozen, a burger patty can have 330mg? Throw in a bun for the burger and the sodium level rises to 1300 (see above for the uncle Burger).

Snacking is a bitch! First it has to be a healthy snack, ie no salt added. Candies are out, save them for low glucose levels. Watch the carbs! Fruits and veggies are often the safest, although an apple can have 25 milligrams of carbs. That's almost enough to warrant another insulin shot!

Disclaimer:
Although I am NOT a doctor or dietician, I am talking about real-world experience for over 38 years. Please consult a professional before taking my advice.