The Procedure

[C904]

Rodneyss1 asked about the medication and the procedure in another thread and I don't want to high jack the other thread, so I wanted to start this for people curious about the transplant procedure.  I am sure there are other threads about this somewhere, but I am too lazy to search for them and resurrect them.

Everyone is sure to have differences in their transplant surgery and what follows over the next several weeks and I think for the most part I had a pretty normal average experience.  First thing is the operation and the aftermath in the hospital is really no big deal and I was surprised as to how easy it turned out being in many aspects.  I had a central line put in the night before and a central line is a procedure where they put a catheter into a large vein, they put mine in my neck and it was a tiny bit of pain when they numbed it up.  Really no big deal, sounds worse than it is.  They use the central  line as a large iv line to administer medicine and fluids.  I had a chest x- ray the night before and they took a little blood.  The usual of no food or drink after midnight before the surgery and in the morning I had to shower with a substance that kills bacteria and germs on your body.  They wheel you down to pre-operation in the morning and do the usual temp, blood pressure.  They did a sneaky move which worked great and maybe they do it all the time I have not had many major operations.  The move was hey while you are here in pre-operation we are just going to give you a little something to get the ball rolling, and I thought sounds good.  Well that little something knocked me out, so no anxiety waiting longer or being wheeled into the operating room and waiting a few minutes.  Next thing I know I come to in the icu and NO PAIN really groggy and still out of it, but no tubes in your throat, just some oxygen on and a blood pressure monitor and a heart monitor.  They also put some pads on your calves that inflate to help with blood clots.  You a have a catheter in that runs to a bag that measures your urine.  The bladder catheter is put in while you are knocked out.

I had the surgery Monday morning and Tuesday night they took me out of the icu and moved me to the floor.  Monday is a fog, but Tuesday I started coming around and not really that much to it.
The only pain I had was from some dry heaves and that hurt where they did the transplant, but that was for only a few minutes.  If everything goes good the kidney is making urine that first day and they are constantly measuring the amount and telling you how it is doing.  I think I had solid foods on Tuesday night and I walked some on Wednesday night.  They took out the bladder catheter on Friday morning and I went home on Saturday night.  On average they keep you anywhere from 5 to 10 days if everything is going good.  I would say the biggest pain is the iv line alarm going off when it gets air in the line and this happened to me many times each day.  The heart monitor also seems to lose its reading many times throughout the day and the alarm goes off.

As far as the meds you really just have to wait and see what they put you on and it affects everyone differently.

Hope this helps and the more you dig around here especially in threads where people inform everyone they are going in for the transplant you will see a ton of info about what their experiences were like.  The main thing I can't say enough is that your mind will paint a picture that is way far worse than what the actual procedure is.  It is a major operation but somehow it really is precise procedure that is not that difficult for you as a patient.

[rsudock]

My living donor and I went in June 21st early 6 am? Anyway took him for 2 hours before they started prepping me. The started an IV in my arm and Jeff's. Then they gave me some Delauded and I was out! I woke up in the surgery recovery and the only thing that hurt was my lower back. They kept giving me hot pads to put back there. I saw my sister, boyfriend, and mom. Besides the IV I now had a catheter in my bladder, central line in my neck, heart monitor, and compression socks on.

By the time I made it to surgical ICU it was 3 am. The nurse was super cool, his name was Dan. Around 4:30am he helped me out of bad and sitting in a chair. The best feeling ever!!! Then next afternoon I was back in a regular room, with a regular diet. 3 days later back at home recovering....the only thing that really bothered me after being home was the stint they put in the ureter. so glad to get that out after about a month!!!

LIVING DONORS ROCK!!!

xo,
R

[Rodneyss1]

Thanks for the wealth of information!! Rsudock....you have been an angel and I appreciate all you have to offer on this site. C904.....the information given is priceless.  I am a little nervous as the day approaches, never had major surgery before. I am excited about starting my life over!!!!

[RichardMEL]

Good posts. thanks guys.

I'd agree that the hospital experience was really not too bad.

I had a cadaveric donor, so I really had bugger all time to prepare anything - physically or emotionally though there were many tears around me - happy tears

Since I really had only about 4 and a half hours between the call and actually being wheeled into the ER - and that involved finishing up D, getting up to the ward, being poked, tested, having blood taken, and doctors coming by asking this and telling me that and the other....

Anyway I was put under... woke up... and yeah nowhere near as much pain as I expected. I had the morphine machine handy.. you know.. press button for relief .... I maybe used it once or twice... then it broke down 18 hours later... (hahah! public hospitals!) and I said don't worry about it. It was TFF. I really felt fine biggest problems were with the drain bags (which were in for a few days) and the catheter (ugh!! I had that sucker for nearly 10!!! OMG). made showering annoying carrying around those things but one of my fave nurses came up with a cool way to sort that out.

Really though it was pretty easy apart from worrying about the urine output or lab results or being woken every x hours for obs or whatever... really it was pretty painless. Staff were really good and usually explained things and helped me out. I couldn't complain.

I do agree that meds are different for everyone, and certainly initially post-tx they would chop and change depending on labs, what was going on etc but in general things settled down reasonably quickly.

I do agree that in general the miracle of a transplant, from my experience, is pretty straight forward. Quit amazing given what is actually going on and what you come out with.

[jbeany]

I'd agree that the hospital experience was really not too bad.

Or you can have my experience, where pretty much everything that could go wrong, short of actually needing a funeral, did go wrong.  My first coherent memory after surgery was hallucinating giant spiders climbing out of the walls.  The next thing I really remember after that was screaming in pain for hours, until a nurse finally asked me what I thought he could do about it.  I distinctly remember grabbing him by his shirt, pulling him toward me and growling, "KNOCK ME OUT!"
After that, I don't remember much for most of the next month.  I went in for surgery in the summer and woke up in the fall!

[rsudock]

I'd agree that the hospital experience was really not too bad.

Or you can have my experience, where pretty much everything that could go wrong, short of actually needing a funeral, did go wrong.  My first coherent memory after surgery was hallucinating giant spiders climbing out of the walls.  The next thing I really remember after that was screaming in pain for hours, until a nurse finally asked me what I thought he could do about it.  I distinctly remember grabbing him by his shirt, pulling him toward me and growling, "KNOCK ME OUT!"
After that, I don't remember much for most of the next month.  I went in for surgery in the summer and woke up in the fall!

OH NO Jbeany!! What the heck happened? Some sort of surgery or medication error?


Rodneyss1 no problem it gives me great comfort to know I am able to help the renal community with the wealth of lifetime knowledge I have acquired since being a kid...don't want it to go to waste!!!    It seems to me kidney transplants are pretty straight forward now a days. Of course their is risk going into surgery but that is for anyone. You have so much more to gain and so many brighter days ahead. Even if you only get a small amount of time away from the machine embrace and enjoy them. You will get through the surgery just fine...I know it. I just remember telling myself "They are going to knock me out, so I won't remember anything. One second I will be out, the next I will be waking back up."  You can do it!!

xo,
R

[jbeany]

OH NO Jbeany!! What the heck happened? Some sort of surgery or medication error?


xo,
R

The giant spiders were my own personal Dilaudid reaction. I woke up from transplant surgery paranoid and hallucinating.  I accused the nurse of trying to kill me, and keeping my family away so they wouldn't know what she was doing.  I tried to yank all my tubes out and get out of bed to run away.  When it finally wore off, I was in restraints (and distinctly embarrassed!)  My sister graciously informs me that I was babbling about giant raccoons attacking me as well, and as I started to come down and they released the restraints, I waved my hands around for quite a while, and when she asked what I was doing, I told her I was wrapping all my Christmas presents.

The screaming the next day was because my intestines had twisted themselves into a knot.  The nurses just figured I was a drug-seeking constipated wimp, and kept ignoring me.  That was the first of the 3 surgeries I had that followed in the several weeks after transplant, as they tried to fix all the snowballing complications.  Among other fun - the connection between my intestines and where they had connected the bile drain for my new pancreas developed a leak.  The contents of my intestines all drained out through my incision and the bile eventually disintegrated a large portion of the flesh of my abdomen.  One of the surgeries was an attempt to remove the new pancreas, but by then, it was already to well seated to be removed without causing more trouble.  In the end, they simply put me on all IV nutrition for 4 months, with no food or drink at all by mouth, and simply waited for the leak to seal itself with scar tissue.  That did finally happen, but in the mean time, all the skin around my incision had come loose because the bile had eaten away the connective tissue.  I had spent so much time laying down/unconscious that it all shifted to the side and healed in place there, leaving the muscle and tissue in the middle exposed.  I spent nearly a year wet bandaging a giant open abdominal wound before they skin grafted over it.  Several months after the skin graft was placed, I herniated, and my intestines began to slide out under the graft.  That's what they finally fixed at the end of June, which of course is what gave me the post-op infection I just had, and what landed me in the emergency room, unable to even keep down water at the end of July.

(I still like the 30 pound weight loss in two months, though.  The free tummy tuck I got out of this was nice, too, even if I don't have a belly button anymore.  And for an added bonus, I'm still slowly losing weight, because repositioning all my intestines back on the inside and pulling all the muscle back to the center and holding it there has acted like my own stomach stapling as well - I get full on much smaller portions than I used to.)

My two year kidneyversary is in 12 days.  It's been quite a ride!

Seriously, back to procedures - I don't mean to scare anyone away from the idea of a transplant.  Mine is actually working fine, in spite of all I've gone through.  I still need no insulin, and my creatinine runs in a lovely sine wave curve between .8 and 1.1 all the time.  But if you are making the choice, you need to understand that it is a risk, not a simple thing.

[MooseMom]

Jbeany, I had never heard the whole story of what had happened to you.  Now I have, and I think I know what I might have a nightmare about tonight.  But you are right...we tend to think of transplants in such cavalier terms these days, so it is good to be reminded of stuff that can go wrong.

I'm glad you are finally on the mend.  It only took two years.

[jbeany]

MM, if you want a nightmare, I'll post the pics I took of my visible guts right before the last surgery!   

[rsudock]

Hhhmmmm no belly button I would like to see that...how sci fi!! I am so happy you pulled through...what a warrior you are JBeany!!!

xo,
R

[monrein]

jbeany I don't think I've ever told you this, although it's occurred to me many times when I read your posts, but more than anyone you seem able to bear in mind and hang on to any bit of good or positive in your situation...without being an "it's all good" (even when it sucks big time) sort of person.

I mean really!   Quote "(I still like the 30 pound weight loss in two months, though.  The free tummy tuck I got out of this was nice, too, even if I don't have a belly button anymore.  And for an added bonus, I'm still slowly losing weight, because repositioning all my intestines back on the inside and pulling all the muscle back to the center and holding it there has acted like my own stomach stapling as well - I get full on much smaller portions than I used to.)"

That's not even a glass half full versus half empty kind of thing...that's more like...glass broke but bottom piece still had a few sips left and the slivers were big enough to strain out kind of thing.

So glad to know you in cyber-space.   

[C904]

OH NO Jbeany!! What the heck happened? Some sort of surgery or medication error?


xo,
R

The giant spiders were my own personal Dilaudid reaction. I woke up from transplant surgery paranoid and hallucinating.  I accused the nurse of trying to kill me, and keeping my family away so they wouldn't know what she was doing.  I tried to yank all my tubes out and get out of bed to run away.  When it finally wore off, I was in restraints (and distinctly embarrassed!)  My sister graciously informs me that I was babbling about giant raccoons attacking me as well, and as I started to come down and they released the restraints, I waved my hands around for quite a while, and when she asked what I was doing, I told her I was wrapping all my Christmas presents.

The screaming the next day was because my intestines had twisted themselves into a knot.  The nurses just figured I was a drug-seeking constipated wimp, and kept ignoring me.  That was the first of the 3 surgeries I had that followed in the several weeks after transplant, as they tried to fix all the snowballing complications.  Among other fun - the connection between my intestines and where they had connected the bile drain for my new pancreas developed a leak.  The contents of my intestines all drained out through my incision and the bile eventually disintegrated a large portion of the flesh of my abdomen.  One of the surgeries was an attempt to remove the new pancreas, but by then, it was already to well seated to be removed without causing more trouble.  In the end, they simply put me on all IV nutrition for 4 months, with no food or drink at all by mouth, and simply waited for the leak to seal itself with scar tissue.  That did finally happen, but in the mean time, all the skin around my incision had come loose because the bile had eaten away the connective tissue.  I had spent so much time laying down/unconscious that it all shifted to the side and healed in place there, leaving the muscle and tissue in the middle exposed.  I spent nearly a year wet bandaging a giant open abdominal wound before they skin grafted over it.  Several months after the skin graft was placed, I herniated, and my intestines began to slide out under the graft.  That's what they finally fixed at the end of June, which of course is what gave me the post-op infection I just had, and what landed me in the emergency room, unable to even keep down water at the end of July.

(I still like the 30 pound weight loss in two months, though.  The free tummy tuck I got out of this was nice, too, even if I don't have a belly button anymore.  And for an added bonus, I'm still slowly losing weight, because repositioning all my intestines back on the inside and pulling all the muscle back to the center and holding it there has acted like my own stomach stapling as well - I get full on much smaller portions than I used to.)

My two year kidneyversary is in 12 days.  It's been quite a ride!

Seriously, back to procedures - I don't mean to scare anyone away from the idea of a transplant.  Mine is actually working fine, in spite of all I've gone through.  I still need no insulin, and my creatinine runs in a lovely sine wave curve between .8 and 1.1 all the time.  But if you are making the choice, you need to understand that it is a risk, not a simple thing.

That is some experience!!  You should have brought that cat in your avatar to chase out those spiders and racoons because that cat looks like it is all business.   

Are you sure it was the Dilaudid because it sounds like a flashback.  Were you at Woodstock back in 69 and you ignored the warnings to not try the brown acid.   

All right enough fun and games, it is great you made it through and now you have a cool story to tell and that is a great creatinine level.

[jbeany]

Are you sure it was the Dilaudid because it sounds like a flashback.  Were you at Woodstock back in 69 and you ignored the warnings to not try the brown acid.   

Hey, I wasn't even born yet!

That's not even a glass half full versus half empty kind of thing...that's more like...glass broke but bottom piece still had a few sips left and the slivers were big enough to strain out kind of thing.

That's part black, warped sense of humor, and part family trait.  When my widowed great grandmother lost a considerable fortune in the Great Depression and ended up living in a tent on the beach in Northern Michigan for most of a year, her prevailing attitude was "Isn't the scenery lovely?"  My mother, on being told she wouldn't be able to walk more than a few steps a day for a large chunk of the summer because of her damaged hips pointed out that she would get two seasons out of her new summer shoes.   I grew up conditioned to be a sarcastic Pollyanna!

[Rodneyss1]

Update:  On September 9, 2011 at approximately 12:30pm, my new kidney started producing urine and filling my bladder before they closed me up.  I am close to three weeks post transplant and the doctors are pleased with the progress that I'm making.  They say my donor gave me a five pound healthy kidney (I've got the battle scars to show for it).  I cannot believe how much my life has changed in the past 3 weeks.....more energy and a passion to appreciate each and every day and not sweat the small stuff.  I have been given a second chance and I'm gonna run with it!!!!!

[monrein]

I'm glad you're doing well but a 5 lb kidney sounds most abnormal since the average weight of an adult kidney is about a quarter pound.

Keep drinking and enjoy peeing!

[C904]

Congratulations on your transplant, and good luck going forward.

[sullidog]

I was told at my transplant center they leave the stomach tube in for a while after surgery to prevent nauzea