Fingers to Keyboard.
It’s a humid Wednesday evening in early February, at our home in the Central Texas Hill Country. I am on medical leave, recovering from my first-ever surgery 23 days ago, and doing incredibly well, minus one kidney. For six weeks, I cannot lift anything over fifteen pounds, and I cannot drive. Being waited on and asking for help is not my style, but doctor’s orders.
In God’s Plan.
My choice to join the One Kidney Club was a pure act of love. It was not something I had planned, but was in God’s plan. Rewinding the tape to early 2017, my 20-year-old niece Lisa unexpectedly goes into kidney failure. Fast forward a year later, I am sitting with my brother John (Lisa’s father) as he explains the Living Donor Paired Exchange process. The words flew out of my mouth, “Do you want mine?” It took me completely by surprise. I said to myself, “Who said that?” I knew at that moment, without hesitation, this would be my life’s purpose. It would become one of the most important task I would do in my life.
All throughout my journey, I was hyper-focused on the logistics. For every hurdle, I asked myself, “Is this the right path that will result in a kidney for Lisa?” Early on, the transplant team had recommended that I register for the Paired Exchange to give Lisa the best chance with a younger kidney, even though I have a universal blood type (O-negative). The benefit of the Exchange program is that if someone wants to be a living donor, but their blood type is not a match for their intended recipient, they can “exchange” their donated kidney with another donor/recipient pair.
At the time of my initial evaluation in June, UC Davis had been doing only locally paired exchanges. I was assured that all participants in the pairings would have surgeries on or around the same day. With that, I agreed that the best option would be to swap for a younger kidney.
The average lifespan of a donated kidney is 20 years, so yes, she could potentially need another transplant in her 40s. A younger kidney, our nephrologist said, would gain her an extra 2-5 years. By the time we got to the month before our transplant, UC Davis joined the National Kidney Registry. Totally different ballgame, because now we were interacting with a national exchange. A swap might happen in New Jersey, which means the extracted kidney travels across the country on an airplane – and who knows what can happen. The exchange is a logistical dance, where all stars have to align, and could take months to find the right pair. We decided that direct donation was the least disruptive; too many things could go wrong after I donate my kidney, only to end up with no kidney for Lisa.
Pre-op, January 9th.
I flew into SFO the day before my pre-op appointment at UC Davis. My brother John picked me up to avoid the risk of picking up unwanted germs riding BART. I was so grateful that John handled all the shuttling to and from my appointments throughout, accommodations before and after surgery, wellness checks, and more importantly his and my sister-in-law’s unwavering gratitude.
At the pre-op appointment in January, the transplant team had a different approach with me as than during my evaluation period. At the evaluation, the transplant team was all about providing me enough details in order to make an educated decision. “Are you still okay with going forward with the kidney donation?,” asked my social worker. “Of course!,” I said.
The nephrologist and the surgeon explained the procedure in intricate detail. Ordinarily, my reaction to cutting anywhere on the body makes me wince, but this time it was different. Seeing the diagram and exactly which artery would be clamped where was fascinating to me. Typically, the surgeon will take the left kidney because it has more artery to graft into the recipient.
Not once was I anxious about the actual surgery. I will admit I had anxiety a few days before, fearing that I had come into contact with people who might have been ill, despite wearing a mask on the airplane, and staying far away from people who were coughing at my SF office. On the Thursday before surgery, I sat in an Uber next to a peer who called in sick with the flu on Monday. Zinc tablets and pure will allowed me to narrowly escape the flu right in the middle of flu season.
I had accommodations with my brother and his family, in Concord, for the two days prior. Glenn would meet us in Sacramento later today – he was flying in from Texas. John and I loaded up the van with Lisa’s dialysis equipment – she would only be required one more evening of dialysis treatment. Louise (Lisa’s mother) and Lisa stayed back to clean up the house – they met us up at the hotel later that evening. Our hotel was conveniently located on the UC Davis Medical Center campus, about a 5 minute walk from the hospital. On Day One, we elected to drive to avoid any mishaps in the dark. It took longer to drive and find parking than it did to actually walk – it didn’t help that we missed a turn.
Day One, Admitted, 5:30am, January 15.
My first in-patient surgery experience was relatively smooth. During my check-in, the identification wristband given to me had Lisa’s name on it. This left kidney of mine was already identifying itself with its new host. God has such a sense of humor! In the surgery prep ward, my nurse said that I had plenty of time to visit with Lisa. She and I had a tender moment together, talking about what we were about to do. This young lady was my family. I was about to give her an organ from my body. How do you talk about that without crying? But I held it together. This was such a visceral moment for me, but it seemed for her, like just another surgery. Lisa has the strength of a lion. To this point in her life, she had more visits to the hospital than the average 20-year-old. And she holds it together, with enough positivity to fill a stadium. I knew everything would be alright.
The last thing I remember before the anesthesiologist wheeled me away from the surgery prep room was telling him I had a bit of phlegm in my throat. “We are not calling off the surgery for that,” he said. I dreamt of my dog, Flower, who died in 2018. She was always a calming force.
“Get the family. She’s awake.”
I woke, groggily, as I heard the nurse say “Get the family. She’s awake.” Almost immediately, I see my husband and sister. My heart was so full. I did it! I was well enough to take it all the way to this point, and with success, so far, anyway. My tears flowed. Not tears of pain, but of tears sheer joy and gratitude washed over me. All I could think about was thanking my family for their support and positive thoughts. My important work was done. Now we wait. Several hours later, Glenn told me that Lisa’s surgery went well. Hallelujah! I lay there in recovery for ten hours while they got my room ready. As an organ donor, I was not considered urgent so other trauma patients had priority for the hospital rooms. I was grateful that it was late and the hospital quiet as I was transported to the room where I would stay for the next few days.
My roommate, Lilianna, was a transplant recipient of a deceased donor kidney. She had been in the hospital for three weeks with her adult daughter, who was her translator. It appeared that she was having trouble with the new kidney, and would likely still need some dialysis.
I have a new appreciation for nurses, having used their services continuously for my three-day hospital stay. They serve your every need, at all hours, and with such grace and compassion. Every time the nurse came to see me, she asked about my pain level, which was surprisingly manageable. I was not on morphine but once, and that was only a half dose while in the recovery room, at my request – and only because the trauma nurse forgot to administer my scheduled pain meds.
Then I saw her!. With eyes as big as saucers, she smiled, awake and alert. Her tiny body was having trouble with medications, during the night. Her parents said the new kidney was working great. It would take several adjustments to the meds over several months to get her levels in a good range. Her road was much longer than mine.
Day Two. Walking Already?
I had been wheeled into my room around 10:30pm the night before. The night was long, knocked out with sleep, awakened a few times seeing to the nurse checking my bags in the dimly lit room. After breakfast, the nurse said, “Ready to take a walk?” Now? Yes. There I went, tethered to pole full with bags, and my liquid gold purse (catheter). My brother and husband took turns escorting me on what would be four walks that day. The hardest part was getting up out of the bed.
Discharge, January 17, sometime before 4:30am.
I knew from my night nurse that I was getting the catheter out at 5am. Finally freed from my Golden Purse, and now temporarily detached from my IVs (I had two, but only one was in-use) my nurse handed me several packages of self-warming microbial cleaning cloths. Alas! A sponge bath like no other! I took my morning walk around the ward, untethered, then napped before breakfast.
Glenn and I discussed with the nurse that I would be discharged after lunch. Glenn returned to the hospital after running errands, and calmly reported that we had no back window in the rental car. A limb must have knocked a hole in it from previous night’s violent winds and soaking rains. He was able to swap out the car at the rental agency. After I was discharged, the next morning, Lisa was moved to my old room, but into the bed by the window. This meant that Lilianna was finally discharged. For that I was also grateful.
The first night at the hotel, Glenn began showing symptoms of an intestinal flu. The next morning, I felt the onset of a chest cold. We kept our distance, despite wanting – actually needing a reassuring hug from one another. We were scheduled to fly back home a week after surgery, but it was clear that this was no 24-hour thing. We bumped the return by five days, just outside of the window that required me to get heparin shots in the gut the day before, day of, and day after flying. Glenn was in no condition to do this with success.
The best decision we made coming home was getting wheelchair assistance at the airport. I had my own attendant, who never left my side. I didn’t have to lift a finger when going through the Security Checkpoint. Being in the wheelchair for that length of time gave me an opportunity to experience how it was to be disabled. You can’t move. You have to rely on others. A very real sense of being paralyzed. After we got through the security, my attendant returned to the checkpoint entrance see what the hold up was with Glenn – he was behind us, and then he was not. My chair was facing the exit, so I could not see what was going on behind me. She returned to say that Glenn could not locate his Driver’s License, so he was headed back on the shuttle to the rental car return. She took me to my gate, parked me, facing the check-in desk, and arranged the carry-on bags around me. Again, I could not see behind me. I sat there, helpless. After a while, I called Glenn once, and he sounded in a panic, “I don’t have it yet.” I decided that worry would not serve me. I am well taken care of here at the gate. I will be first on the plane. It’s not the end of the world. Glenn may miss the plane, and I will be waiting for him on the other side.
Boarding went quickly, as our flight was not full. Not sure how much time passed after everyone was loaded, but just about when I thought they would be closing the doors, by the Grace of God, in walks my husband, breathless and with sweaty brow. He reported that TSA sent him through the wringer – combing through every single item in the bag, and practically undressing him to check under his clothes. He then had to race to the gate – and that is a challenge with a heavy carry-on bag.
Totally recommend getting a wheelchair if you are traveling with anyone who has mobility issues. We got the chair mostly for the assist with the baggage. I could walk just fine by then.
I was glad to finally be coming home. We were gone a long time.
3+ Months Later, Reunited.
In the first week of May, I went on my first business trip since medical leave. I planned accordingly, knowing that Lisa would be off restrictions by then. On the plane, I took the first hour-and-a-half and wrote a letter to her. My aim was to assure the letter would be relevant from the lens of a 22-year-old young lady. She and I would now have a different relationship. Whether she is ready to move into this new realm or not, we are, by default, connected. We are kidney twins. I am part of her and she is part of me. I am not one to want anyone to be forever indebted to me. I was divinely guided onto this path. It is the purpose for which God made me.
“Oh my goodness! She looks so healthy!”
Finally I saw her! Lisa came around the corner of the kitchen at her parents house, while I was talking and eating. I had arrived about 15 minutes before, and was mid-bite, enjoying crunchy appetizers. I looked her over, head-to-toe, “Oh my goodness! She looks so healthy!”, and we hugged tight, feeling her heart beating almost as fast as mine. I was vibrating with the most intensely beautiful moment I had experiences in all my 56 years. I could not adequately describe the feeling, readily. About a week later, I realized that I was likely experiencing a sensation similar to what a new mother would feel at seeing her newborn for the first time.
Almost 6 Months Later.
I am in awe that even now, that I have not fully processed what I’ve done. It’s like my emotions on that front are on delay. But, here I am. God designed me for greater things – things that are way bigger than I could have ever imagined.
All those years of disappointment that my path did not include raising a family flipped end-over-end to right here and now. In God’s infinite wisdom – and sense of humor – I am now not only a step-mother, and grand-mother, but also a surrogate-mother.
Thank you for taking the time to read this post! – Yolanda
Gallery of The Journey to the One-Kidney-Club
The license plate Glenn ordered. “Yo” for me; “L” for Lisa; “19” for the year
that my life was forever changed.