It's an awful feeling when you know the odds are so against a kidney transplant

[okarol]

James Hipwell: It's an awful feeling when you know the odds are so against a kidney transplant

Eight years ago a kidney donated by his brother saved the life of journalist James Hipwell. Now he needs another operation – but the lack of donors has shortened his chances of survival

The Observer, Sunday 20 June 2010

We all have at least one story about where we were or what we were doing during a certain World Cup game. Maybe it's sitting A-levels or maybe someone you know got married on the day of a big match.

I remember one World Cup match very well. Minutes after the final whistle in the goalless draw between England and Nigeria in 2002 my brother and I found ourselves on the sixth floor of the Middlesex hospital, off Tottenham Court Road in central London. We were in neighbouring operating theatres, each undergoing major surgery. He was having a kidney removed. I was next door, waiting for it to be transplanted into me, waiting for it to save my life. And save my life that one selfless act undoubtedly did. As a poker player and gambler I know a thing or two about odds. I wouldn't have fancied my chances without that operation.

Kidney failure had hit me in my early 30s and had stopped my life in its tracks. But within hours of coming round from the surgery I felt completely normal again, as if someone had flicked a switch to make me feel well. I got my life back, met a journalist called Rachel and got married. Illness and hospitals and dialysis became a distant memory.

Eight years later, the 2010 World Cup will imprint itself on my mind for a different reason. The dreaded auto-immune disease that wiped out my kidney function in the first place – IgA nephropathy – has returned, and aided by the severe toxicity of the immunosuppressant drugs we transplant patients must take every day, I am once again in what they call end-stage renal failure.

The telltale signs are back: the tiredness, no matter how much sleep I get, the nausea and vomiting, the itchiness, the weight loss, muscle wastage, the headaches and anaemia. I have had shingles for four months and can't shake off the virus. I can barely work. I can't concentrate or focus on anything. All I feel is listless, with sickness creeping all over my body. My kidney is hardly producing any red blood cells so there isn't nearly enough oxygen being carried to my muscle. The hospital give me pre-filled syringes of erythropoietin, or "epo", which I inject into my thigh every week. It helps, but it's not as effective as having fully functioning kidneys. They are called vital organs for a reason.

A foul, ever-present metallic taste in my mouth caused by the high buildup of waste products in my blood has long since killed my appetite. I also now have dangerously high levels of potassium in my bloodstream because my transplanted kidney is no longer filtering it out. It means I must avoid all foods with a high potassium content or risk cardiac arrest. So bananas, avocados, melons, tomatoes, orange juice and many kinds of meat and fish are off the menu. Just a mouthful of wine or beer makes me feel like I have drunk a bottle of poison. My skin flushes and prickles, and I am violently sick. A bowl of cornflakes washed down with a glass of water is about all I can stomach at the moment.

During the summer of 2002, the future had seemed so bright. I had been diagnosed with kidney failure two years before and it had been a huge shock. I'd been feeling unwell for months but had put it down to my exuberant lifestyle as a tabloid journalist. By the time I was diagnosed, my kidneys were wiped out and I had to start dialysis straightaway. I was 34, with no history of kidney problems in my family. It took a while for the testing to be done, but my brother Tom was a perfect match in terms of blood group, tissue type and cross-matching, and he agreed to be a donor. My nightmare seemed to be over – the doctors thought the transplanted kidney might last 20 years. Unfortunately, it hasn't turned out like that. In the next few days I will have to start dialysis once again.

I am no stranger to challenging times. I was a financial columnist at the Daily Mirror and was involved in a share-tipping scandal at the paper. After a five-year investigation, I was eventually prosecuted and jailed for two months for my part in the affair. It is an episode of my life for which I am deeply sorry and I have been trying to put my life back together ever since. Now I have to dig even deeper to get through what is in store.

Dialysis is like a form of medieval torture. You are a chained to a machine for six hours a day, every other day. You develop other conditions, too, such as renal bone disease, diabetes and heart problems. For two years before my first transplant, I had to go to the Middlesex's dialysis unit every other day. I came to hate the sight of the hospital's brooding Victorian presence in my life and the knowledge that missing a single session could kill me.

Often, leaving the hospital at 3am, I would have to be at work a few hours later. Poor Max Clifford, the PR consultant for whom I worked at the time. On many occasions he found me asleep at my desk but he was good enough to continue employing me until I was able to have the transplant. This time, I have decided to try peritoneal dialysis, which can be done at home. It will mean having surgery in the next few days to stick a tube into my belly. Then I'll be given a machine that will pump fluid in through the tube to clear out the toxins in my blood.

Only a quarter of people who need dialysis choose this method. You'd think it was a no-brainer to be in the comfort of your own home and avoid all that dead time in hospital. But you have to store litres of dialysing fluid and not everyone wants to turn their home into a medical centre.

For me, it means keeping a measure of control over my life that I would lose if I had to go into hospital for more than 20 hours a week. After being trained to use the machine I will be able to dialyse for eight hours a night at home while I am asleep. But dialysis can only just about keep me alive. What I really need is a new kidney.

Once again my gambling friends, with the typical gallows humour you find around a card table, have been pricing up my survival and have made me no better than a 6-4 chance to last five years. Actuarially speaking they might be on the money because as the charity Kidney Research UK told me last week I will be joining a list of almost 7,000 people in this country waiting for a kidney transplant. On average 300 of them die every year before they can receive an organ. For liver and heart transplants, and more serious combinations such as kidney-pancreas transplants, the figures make even grimmer reading.

The frustrating thing is that around 65% of British people say they are prepared to donate an organ after their death – but only a quarter are registered donors. My wife, Rachel, wants to be tested to see if she can act as a donor. But you might say I am struggling with the concept.

After my brother donated his kidney to me, we took ourselves off to the south of France to recover, parading our 10-inch scars on the beach like men. The thought of my wife having a perfectly healthy organ pulled out of her on my account sickens me.

At my new hospital, the Royal Free in Hampstead, the doctors tell me that surgical procedures have moved on in the eight years since my last transplant; incisions are smaller and scarring can be kept to a minimum. A donor may be out of hospital within three days and back to work within a month. There is no lasting physiological damage – my brother is living proof of that. But it still seems inhuman to me to contemplate putting the person I love most in the world through this.

She is, however, from a long line of Ulster Protestants and has an iron will that would terrify even Ian Paisley. So she tells me I have no choice, just like I have no choice about putting out the bins or hanging up towels properly or watching Brothers & Sisters on More4.

For me, it seems so selfish to ask her to be a donor. But she says she is the one who is acting selfishly. She wants her husband back. She wants us to have a future. A life spent sitting in death's waiting room, she likes to tell me, is not something she will accept without a fight. If she is not a good enough match for me, it's possible that we could go into a pooled donation. This would mean matching us up with other donors who are also not a match with their loved ones, and everyone swaps. Meanwhile, my thoughts are inevitably turning towards going overseas for a transplant in Pakistan or Iran, where organs are for sale. If people are willing to sell them, why not? I mentioned this to my doctor at the Royal Free in jest – but he tells me in all seriousness that they often have to pick up the pieces of botched operations overseas where someone has paid for a kidney. One can only imagine what has happened to the donor. If only people weren't driven to such lengths. That is the real tragedy.

I understand that people don't like thinking about meeting a grisly end. But you lose all sense of squeamishness when you need a lump of tissue to survive. Medical science has all the skills, all the knowledge, all the ability to fix me and the other people on the transplant list. All we need are organs.
ORGAN DONOR FACTS

■ There are 7,951 patients on the transplant waiting list: 6,867 need a new kidney, 370 need a liver, 268 need a kidney and pancreas, 231 need a lung or pair of lungs, and 118 need a heart.

■ The UK has one of the lowest donor rates in the western world. About 1,000 people a year die waiting to receive one.

■ There were 2,640 transplant operations between April 2009 and April this year, involving 1,057 live related donors (relative, friend or stranger). A healthy person can survive donating part of their liver to someone else, as theirs grows back quickly to full size, as does the donated section.

■ The number of people who have signed the organ donor register has risen from 8 million in 2001 to 17.1 million – about 27% of the population.

■ Traditionally, organs have come from road accident victims and brain haemorrhage patients. Improved road safety and medical intervention mean fewer are dying.

■ Kidney failure cost the NHS in England more than £600m in 2004-05 – about 1% of its total budget. There are close to 21,000 people on dialysis. The number rises by about 5% annually.

http://www.guardian.co.uk/society/2010/jun/20/james-hipwell-kidey-transplant

[cariad]

Right, so I thought this was going to be someone with a real medical condition preventing him from transplant, like high PRA or other serious co-morbidity. Misleading title. This person is just waiting on the list, and he even has a potential live donor but doesn't want her to go through the operation (join the club!) I think he should take his wife up on her generous offer.

[MooseMom]

Right, so I thought this was going to be someone with a real medical condition preventing him from transplant, like high PRA or other serious co-morbidity. Misleading title. This person is just waiting on the list, and he even has a potential live donor but doesn't want her to go through the operation (join the club!) I think he should take his wife up on her generous offer.

Agreed.  Why are the odds so against him?  Is it because there are so few donors?  I know I am not the most optimistic, cheery person on the planet in the first place, but this article makes me want to go hang myself.  Jeez, like cariad said, he's got someone who is willing to be tested and to donate.  Well, I guess if this article moves a few people in the right direction toward donation, then good.

[okarol]

I found it interesting that he throws in that he went to jail after getting his transplant.

This part seems overly dramatic:

Dialysis is like a form of medieval torture. You are a chained to a machine for six hours a day, every other day. You develop other conditions, too, such as renal bone disease, diabetes and heart problems. For two years before my first transplant, I had to go to the Middlesex's dialysis unit every other day. I came to hate the sight of the hospital's brooding Victorian presence in my life and the knowledge that missing a single session could kill me.

[hemohortensia]

I haven't been around in ages. However, I did read the article and wrote them that he should be thankful he lives in a country where they have dialysis and is able to do SIX hours at that. 

[okarol]

This is part two. First part in series: http://ihatedialysis.com/forum/index.php?topic=19262.0

Life on the waiting list: the effects of kidney failure

In the second part of his fortnightly blog, James Hipwell describes the symptoms he's suffering as he waits for test results on a possible organ donation from his wife, Rachel

    * James Hipwell
    * guardian.co.uk, Wednesday 7 July 2010 15.23 BST

A tired man. Kidney failure leaves sufferers with a feeling of all-round wretchedness. Photograph: Kevin Jordan/Getty images

Imagine the worst hangover you've have ever had. Well, that's the best way I can describe the feeling waking up every day when you have kidney failure. But without the fun part of getting drunk first – and sadly, nor does a fry-up make it any better.

The feeling comes from the build-up of toxins in my blood, similar to too much alcohol. The millions of tiny nephrons in my kidney that filter out the bad stuff have been destroyed by an auto-immune disease. So my blood has become a ghastly stew of waste products, which cause nausea and headaches and general all-round wretchedness.

A simple measurement of how well kidneys are working is the level of creatinine in the blood. Creatinine is a waste product produced by muscles and got rid of through the kidneys. A "normal" level depends on how much muscle you have, so a child's will be around 60 while a bodybuilder's will be as high as 130. Mine is currently around 700 and getting higher.  The only thing that is going to bring it down permanently is another transplant.

Last week, I saw my brilliant consultant, Professor John Cunningham, at the Royal Free in Hampstead, London. He and his team are helping to put my mind at rest about my wife Rachel being a potential kidney donor for me. As I have already described, I have serious reservations about her going through this.

When my brother donated one of his kidneys to me eight years ago, he was left with a 10-inch scar on the right side of his torso that wouldn't look out of place in a gallery of shark attack pictures. I couldn't bear to put Rachel through the same amount of pain.

The Prof told me that kidney removals are now much less invasive. The surgery is done laparoscopically, with small cameras inserted into the donor, and then the kidney removed through an incision in the lower abdomen. My brother was laid up for three months after the operation, whereas Rachel could be out of hospital in three days and

back at work in six weeks. Rachel met with Alison, the sister from the live donor team, who talked her through the process ahead.

It starts with a blood test. This will check whether our respective blood groups are compatible and, most importantly, whether or not I have antibodies that will react against her kidney and cause my body to reject the transplant.

After this, there will be a whole round of scans, x-rays and tests. The hospital will check the strength of both her kidneys separately to make sure that if she is left with just one, it will cope on its own.

She will also have to see an independent doctor to check she isn't being paid to donate or making the choice under duress. I took my brother away for a holiday to the south of France after he gave me his kidney – Rachel is demanding at least the same, if not better. Does that count as a financial inducement? Maybe she shouldn't mention it, just in case.

Uncomfortable as I still am about Rachel donating, I know I am lucky that I have this option at the moment, as well as the national transplant list. If I only had the list to rely on, I wouldn't fancy my chances. Three people die every day in the UK waiting for transplants.

The grim reality of the transplant list was brought home to me this weekend when I saw a friend whose father also needs a kidney transplant. Earlier that week, he had been called in by the hospital as a cadaveric kidney had become available and if it was a match, they would do the surgery straight away. A transplant would have completely changed his life. In the end, the kidney wasn't good enough to be transplanted and after a few hours of hope, he went home again to life on dialysis, hoping another call will come soon.

If Rachel can't donate, then I will also be waiting for that call, never going too far from the hospital, never knowing when I might get my life back. Or worse, if it will be too late.

• This week is National Transplant Week. You can find out more about the campaign and join the organ donor register here.

http://www.guardian.co.uk/lifeandstyle/2010/jul/07/waiting-list-effects-kidney-failure

[okarol]

Life on the waiting list: dialysis

As James Hipwell waits for a kidney transplant, the time has come to start dialysis again. Here he describes the torturous procedure

  * James Hipwell
  * guardian.co.uk, Wednesday 21 July 2010 15.24 BST

One sign of kidney failure is the effect it has on the bodily functions you normally take for granted. As one of the kidneys' main jobs is to turn waste products into urine, when they stop working, you don't pee so much. So, like various seas around the world, I'm drying up.

As a way of monitoring the decline, my hospital in London - the Royal
Free in Hampstead - asked me to measure the amount I produce. One evening before going to bed, I dug out the measuring jug from the kitchen cupboard and can now confirm that I'm managing around 200ml a time.

Not that I have to confirm this to my long-suffering wife. The following morning, she found the jug and its mysterious contents that I had forgotten to dispose of and had accidentally left on the draining board.

She thought it was unused chicken stock and, after pondering whether or not to freeze it for future use, poured it away. Quizzing me about it later, as it had occurred to her that we hadn't had roast chicken in weeks, I shamefacedly had to explain what it was and why I had micturated into a cooking vessel. I suppose we should be grateful it didn't end up in what would have been a very unappetising version of pee soup.

Now that my creatinine level - a simple measurement of how well the kidneys are working - has soared to above 800, the time has come to start dialysis again. Last time I was on dialysis, it lasted two years. My left forearm is a permanent reminder of this torturous procedure.

The hospital has to create a fistula, or surgically enlarged vein, to provide access to the bloodstream for haemodialysis. Every session, two massive needles are stabbed in to this huge, buzzing vein to draw the blood through the dialysis machine and back in again after cleansing.

Two years of these needles have left scarring that resembles sickly snakeskin. As well as the dialysis marks, I also have surgical scars from the fistula. Rachel calls it my "terror-wrist".

This time, as we are waiting to see if Rachel can donate one of her kidneys to me, I may only have to dialyse for a couple of months until
I can have another transplant.

So, this week it's back to the Royal Free for a small op to put a temporary plastic tube in one of the blood vessels in my neck. This "neckline" will allow me to have dialysis three times a week for around four to five hours a time. I should actually start to feel a lot better for having some of the toxins removed from my bloodstream. At the moment I feel like I'm malfunctioning, running on empty, living life in slow motion.

If Rachel is able to donate one of her kidneys the hospital is keen to do the transplant as soon as they can. They say this could happen as early as September, if everything goes to plan. She is going to the Royal Free for a whole day of tests at the end of July and we should find out soon afterwards whether or not she can be a donor. It is exciting and terrifying in equal measure.

• If you would like to join the Organ Donor Register and help to save
someone's life, you can do so here: organdonation.nhs.uk.

http://www.guardian.co.uk/lifeandstyle/2010/jul/21/kidney-waiting-list-dialysis

[okarol]

Life on the waiting list: action stations
Eight years ago James Hipwell received a kidney from his brother. Now he prepares to go into surgery again, this time alongside his wife Rachel

James Hipwell
guardian.co.uk,    Wednesday 1 September 2010 16.32 BST

When I started this column in June, I was just coming to terms with the fact that I was in end stage renal failure for the second time in my life. I have to admit I had no idea that only three months later, my wife and I would be packing our bags for a stay at the Royal Free Hospital in Hampstead and major organ surgery for both of us would only be a few days away.

Things have been moving very quickly now that Rachel has been given the green light to be a donor. Dialysis has given me a very basic form of kidney function, and so now that my health has improved a little, the hospital is keen to perform the kidney transplant as soon as they can.

They plan to transplant one of Rachel's kidneys – her left one specifically – into me next week. We had our final briefing from Alison, the Royal Free's live donor transplant sister, yesterday.

From this Friday, she told me to start taking a huge dose of Tacrolimus, the main immune-suppressant drug and one of the most expensive ones permitted by NICE. The doctors want to use the "Tac" to batter my immune system to pieces with the aim of reducing the risk of my body rejecting Rachel's kidney as much as possible.

I will be going into hospital on Monday. They will dialyse me that afternoon and again on Tuesday to make sure my blood is in as good a shape as it can be for the op.

Rachel will be admitted on Tuesday. We will be allowed to have a last supper together on Tuesday night before this momentous act in both our lives happens on Wednesday morning. Alison's turn of phrase sounded ominous when she said "they would come" for her at around 8.30am to take her to theatre. I'm not sure why, but I thought of Nazi jackboots clattering up the stairs in the Warsaw Ghetto.

I will be allowed to see my wife one last time before she goes under the knife but I know that we will hardly be garrulous. Nervous as hell and cracking bad jokes in a pathetic bid to ease the tension, I would have thought.

What I won't be able to put into words in the coldness of that hospital ward is the unalloyed love I have for her. That she is making this huge sacrifice for me I find difficult to comprehend. I mean it really is beyond the call of duty, isn't it? It is an extraordinary act and I know that we will have a unique bond afterwards.

She is my hero. As is my brother, who went through the same thing for me eight years ago. I'm one hell of a lucky guy.

By the late morning Rachel's team should have removed the kidney that is destined to be transplanted into me. Meanwhile, I will have been wheeled into a neighbouring theatre on the third floor of the Free, anaesthetised and ready for surgery myself.

Rachel will be in the recovery ward by midday whereas I won't be back in my ward until early evening. When I had my first kidney transplant in 2002 I remember feeling completely back to normal, abdominal pain aside, within a few hours of the operation. All my various blood figures, which before the op had been either far too high or too low, returned to normal almost straight away.

If the same thing happens this time following a successful transplant it will be the nearest thing Rachel and I, atheists both, get to witnessing a miracle.

Thanks to everyone who has left a message of support. See you on the other side, as they say.

• If you would like to join the organ donor register, you can do so here: uktransplant.org.uk

http://www.guardian.co.uk/lifeandstyle/2010/sep/01/life-waiting-list-kidney-transplant

[okarol]

Life on the waiting list: the transplant

As James Hipwell recovers in hospital after kidney transplant surgery, his wife and donor Rachel Stevenson provides an update

    * Rachel Stevenson
    * guardian.co.uk, Wednesday 15 September 2010 15.51 BST
    * Article history

Last Wednesday morning, James and I went into theatre at the Royal Free hospital in Hampstead to undergo transplant surgery. My left kidney was removed from me and transplanted in to James, who has renal failure.

The operation itself went very well and my kidney began working as soon as it was connected up to James on the operating table.

We both came round a bit sore and tired, but completely overjoyed that litres of urine were gushing out of James's catheter thanks to my kidney, beavering away inside him as if nothing had happened.

But unfortunately, there were complications after the surgery. James suffered lots of internal bleeding, which caused other problems internally and he became very sick. I have to admit, I didn't think he was going to make it. Sunday night was the longest and worst of both our lives.

They took him back into theatre for an operation on Monday to remove the blood clot that had formed around the (my) kidney. The good news is that it is still working perfectly.

James is still very weak and I wouldn't say he's quite out of the woods yet, but things have now turned the corner for the better.

I am absolutely fine - still a little sore and tired, but relieved the worst seems to have passed.

So, fingers crossed, we might yet pull this off. We might just get our life back after all.

James hopes to be back writing next week.

• If you would like to join the organ donor register, you can do so here: uktransplant.org.uk

[okarol]

Life on the waiting list: the aftermath
Things were touch and go after James Hipwell's kidney transplant.
Is he on the road to recovery at last?

James Hipwell
guardian.co.uk,    Wednesday 13 October 2010 10.00 BST

Just over three weeks ago my wife Rachel donated one of her kidneys to me. The good news is that she is pretty much back to normal. Now that kidneys are removed laparoscopically, she only has four tiny scars on her torso and one longer one in her lower abdomen through which the surgeons brought the kidney out.

These wounds are healing well and she tells me she is in very little pain, although her stamina is not quite what it was. I guess her body is getting used to its new internal reality.

And the good news for me is that her kidney is working brilliantly inside me. It is producing record levels of urine, has good blood flow through it, and there are no signs of my body rejecting the newest member of my internal organs.

However, as Rachel wrote here recently, things didn't go quite to plan as far as my recovery was concerned. Two days after the transplant and after several blood transfusions, they found I was bleeding internally. I became very sick indeed and had to go back under the knife for a second operation.

Although the op went well and the bleeding stopped, I was still in a bad way. My digestive system shut down and I couldn't eat or drink anything. A tube was inserted into my nose and pushed down my oesophagus into my stomach, making it possible to drain a lot of the fluid that was collecting there. I could hardly breathe and had to be on an oxygen mask 24 hours a day.

I had six intravenous tubes in my neck, a cannula in each wrist, the NG tube down my nose, and a catheter up you-know-where directly into my bladder. A ghastly white sludge called total parenteral nutrition had to be fed to me intravenously, which gave me essential nutrients and minerals to keep me going, but wasn't exactly the post-transplant feast I had imagined. This wasn't the start I wanted as the new owner of my wife's kidney.

It took a further week for my guts to come back to life. All the while my new kidney had to be kept as hydrated as possible, by passing a huge amount of IV fluid into me. My weight ballooned, even though I hadn't eaten for days, all through excess fluid. I topped out at 85kg, some 12kg (over 25lb) above what I was when I went in to hospital.

Finally, last week I was well enough to be discharged, although I have been called back into hospital every day since for blood tests and scans.

I still feel weak as a lamb and now my new kidney is free to dialyse all the excess fluid out of me, my weight has plummeted to 65kg. This doesn't create a great physique when you're 1.89m (6ft 2in). For those that have seen it, I look like Benjamin Button at the beginning of the film. My legs look as though they have been through a famine and I can barely walk. Just walking up the two flights of stairs in my flat has me gasping for air.

But I'm alive; and if Rachel's kidney continues to hold its own, there is every chance I can get back to a very good level of health. The kidney seems to be made of strong stuff, just like Rachel. As always, she has been magnificent: unfaltering in her support and care for me despite having just been through major surgery herself.

I am still in the danger zone and the team at the hospital are watching me like hawks. My body could decide to reject the kidney at any time and if I get any kind of infection, it would be very bad news. So the next two months are critical. My wife has given us a chance for a real future together - I just need my body to hold up its end of the bargain.

Thanks to everyone who has left messages of support. We hope a few people might be inspired to join the organ donor register.

• If you would like to join the organ donor register, you can do so here: uktransplant.org.uk.

http://www.guardian.co.uk/lifeandstyle/2010/oct/13/kidney-waiting-list-aftermath?showallcomments=true#end-of-comments

[Lillupie]

Moosemom,
 I am 100% with you. I have been on PD for 3 years now. Count it 3 years. I have not had the chance at 1 transplant! My own antibodies are at 70%. Can you believe that? No transplant. After being on dialysis for 3 years not one person, not one person has gotten tested to donate. I am baffled! He atleast has someone who wants to get tested.

Lisa

Agreed.  Why are the odds so against him?  Is it because there are so few donors?  I know I am not the most optimistic, cheery person on the planet in the first place, but this article makes me want to go hang myself.  Jeez, like cariad said, he's got someone who is willing to be tested and to donate.  Well, I guess if this article moves a few people in the right direction toward donation, then good.

Edited: Fixed quote tag error - okarol/admin

[okarol]

I merged the articles together so you can follow the story from the beginning all the way through the transplant.

okarol/admin

[paris]

Maybe I am reading this all wrong, but he is no Susie Sunshine!   He makes everything sound horrifying!  I don't find his writing very inspiring   

I do hope the transplant works out fine for him and wish him well.

[Poppylicious]

Maybe I am reading this all wrong, but he is no Susie Sunshine!   He makes everything sound horrifying!  I don't find his writing very inspiring   

Ack, that's the British for you ... we're a miserable bunch of folk.

 

It does make for grim reading though, and he does seem to have embellished a few facts, which is a tad naughty.  What gets me is that on 20th June he was struggling with the idea of his wife donating and two months later it was done and dusted.  Um ... hello?  It's been nearly two months since my blood was taken and I am still yet to find out if I can donate to Blokey.  Methinks he had the money to go private (which isn't a bad thing, but not a true representation of what it's like.)  I think I shall write some articles for the Observer and/or the Guardian if I give Blokey a kidney.