Surgery Update/Complication

[BASSMAN]

I just wanted to send you guys a note to let you know what is going on.  The surgery has not gone without complications.  Immediately after the surgery my kidney function returned to normal.  A few days after surgery my kidney function started to decline slowly.  The doctor order an ultrasound which showed a collection of fluid around the transplanted kidney. This fluid was putting pressure on the kidney and was affecting the kidney function.  The doctor decided to remove the fluid by inserting a needle and draining the fluid off.  The fluid was sent to the lab for testing and was determined to be lymphatic fluid.  The fluid was sterile.  No bacteria or infection in the fluid.  This condition is a common complication called a lymphocele.  It is lymphatic fluid leaking from lymph tissues that were cut during surgery.  I have a test tomorrow that will determine if the fluid has returned.  In some cases it has to be drained several times and an iodine solution has to be injected to stop the flow of lymphatic fluid.  Once this condition is corrected my kidney function should return back to normal.  I could also have a drain tube inserted for several days or weeks.  I will know more tomorrow as to what action they will take or if it has stopped leaking.  I feel good,  Better than I have in years.  I do have quite a bit of pain at the incision site and the pressure of the fluid was causing a lot of additional pain.  I am tolerating the anti-rejection drugs very well though they give me tremors.  My hands shake a little but not too bad.  (a common side affect of the drugs).  So far, they believe that this is not a rejection episode.  If the fluid is stopped and my kidney function still declines they will do a biopsy to determine if there is any rejection going on.

Colleen is doing a little better every day.  Her pain is more severe than mine.  Which is normal for the donor to have more pain than the recipient.  They have to really get into the donors abdomen and stir things around to get the kidney out.

Thanks for all of the thought, prayers and well wishes!  I will keep you posted!

[monrein]

Thanks for the update and continued improvement for you both as you return to "normal".   

[okarol]

I am glad they took car of the leak right away. Yes, it's not uncommon but can be bad if not dealt with quickly. I know a couple people who had drains and now, years later, they are just fine!
Best wishes for a speedy recovery. Tell Colleen she ROCKS!!! 

[MooseMom]

I feel good,  Better than I have in years.

All the other stuff will pass.  This is what is most important.  I am so very pleased for you and am eagerly awaiting further updates!!  I hope your wife will get something expensive and sparkly out of this deal!

[Jean]

Please do keep us posted. Like getting info straight out of the horses mouth so to speak.

[Sluff]

I just wanted to send you guys a note to let you know what is going on.  The surgery has not gone without complications.  Immediately after the surgery my kidney function returned to normal.  A few days after surgery my kidney function started to decline slowly.  The doctor order an ultrasound which showed a collection of fluid around the transplanted kidney. This fluid was putting pressure on the kidney and was affecting the kidney function.  The doctor decided to remove the fluid by inserting a needle and draining the fluid off.  The fluid was sent to the lab for testing and was determined to be lymphatic fluid.  The fluid was sterile.  No bacteria or infection in the fluid.  This condition is a common complication called a lymphocele.  It is lymphatic fluid leaking from lymph tissues that were cut during surgery.  I have a test tomorrow that will determine if the fluid has returned.  In some cases it has to be drained several times and an iodine solution has to be injected to stop the flow of lymphatic fluid.  Once this condition is corrected my kidney function should return back to normal.  I could also have a drain tube inserted for several days or weeks.  I will know more tomorrow as to what action they will take or if it has stopped leaking.  I feel good,  Better than I have in years.  I do have quite a bit of pain at the incision site and the pressure of the fluid was causing a lot of additional pain.  I am tolerating the anti-rejection drugs very well though they give me tremors.  My hands shake a little but not too bad.  (a common side affect of the drugs).  So far, they believe that this is not a rejection episode.  If the fluid is stopped and my kidney function still declines they will do a biopsy to determine if there is any rejection going on.

Colleen is doing a little better every day.  Her pain is more severe than mine.  Which is normal for the donor to have more pain than the recipient.  They have to really get into the donors abdomen and stir things around to get the kidney out.

Thanks for all of the thought, prayers and well wishes!  I will keep you posted!

Thanks for the update. Sounds like a minor bump in the road but it sounds like you are still on the positive side and that is good. Keep positive and know that we are praying and thinking of you and Colleen often.

[Romona]

Best wishes as both you continue your recovery.

[BASSMAN]

Thank you all for your well wishes, thoughts and prayers!

An upadate.
My creatinine continues to rise.  I am at 1.8 now.  The fluid has returned.  I am going to have it drained again and possibly have a drain installed as well as a biopsy to check for rejection on Tuesday.  I still feel good except for the fluid that is causing pressure and pain.

Colleen continues to improve each day!  I will give her some kind of special gift for sure.  It may well be sparkly and shiny. 

Thanks again and I will keep you posted!

[jbeany]

The shaking goes away as they lower doses and you get used to it.  I was still jittering a bit as much as 4 months later, but not enough to really notice, and it's faded completely since then.

Have you got one of the horrible little JP drains that look like a grenade attached to you on rubber string?  Those caused more pain for me than anything else!

[Rerun]

You will be just fine.  Things will even out.  One day at a time.  Give Coleen our best!

             

[Sunny]

I hope the fluid clears and your kidney begins to functin well soon.Take care.

[edersham]

BASSMAN

As far as the creatinine goes, in four months mine has bounced around between 1.3 and 2.2 all due to reactions to prograf, lisinopril, etc. I have had two perfect biopsies during that time so post-transplant creatinine to kidney function is not always a direct relationship.

Ed

[BASSMAN]

BASSMAN

As far as the creatinine goes, in four months mine has bounced around between 1.3 and 2.2 all due to reactions to prograf, lisinopril, etc. I have had two perfect biopsies during that time so post-transplant creatinine to kidney function is not always a direct relationship.

Ed

That is good info.  Very encouraging.  Thank you!

[okarol]

  Thinking of you BASSMAN! 

[BASSMAN]

I had a drain tube put in today so I have this bag of lymphatic fluid hanging off of me.  They will keep it in until it stops draining.  If it doesn't stop draining they will inject an iodine solution to stop it.

On the upside my they lowered my Prograf to 4mg twice a day and dropped my Prednisone to 15mg once per day and my creatinine went down from 1.8 to 1.6.

Thanks okarol!!!!

[Ken Shelmerdine]

Keep on trucking Bassman here's hoping for a speady recovery for you and colleen.

[jennyc]

good luck and best wishes

[BASSMAN]

Thank you all for your encouragement and support.

The fluid seepage is slowing it has gone from 300 mil a day down to about 20 mil in 4 days.  I have an appointment  Tuesday so I hope it stops by then and they will remove the drain.  It's a drag for sure but I am staying indoors right now anyways. IT'S 109 DEGREES F TODAY!!!!

[okarol]

Wow that's hot. Nice you have no fluid restrictions!  Keep your fluids up now!!

[BASSMAN]

Wow that's hot. Nice you have no fluid restrictions!  Keep your fluids up now!!

I am drinking like a camel headed out on a long trip.

[Riki]

After my first transplant, I drank a lot of chocolate milk.. was great for me, no so great for those around me.. *LOL*  I'm sure the air around me was a bit brown, but I didn't care. I was happy, so I could live with the stink....

[BASSMAN]

An Update,

I still have lymphatic fluid collecting around the kidney.  They have tried needle aspiration and it did not work.  Then they tried percutaneous drainage and it did not work.  We are now doing  percutaneous drainage with a sclerosing agent.  They removed the drain bag and left the catheter in place.  Colleen draws the fluid out with a syringe and then injects betadine into the lymphocele.  We do this twice a day.  We are getting out much more fluid than was draining into the bag.  This is supposed to stop the lymphatic fluid from leaking.  We have to do this until it stops leaking.  If it doesn't then I will have to under go another surgery to stop it.

Colleen is improving a little more each day. 

[okarol]

Oh man, why can't it be easy? Is the idea that the fluid build up is going to stop by healing? I read a bit here http://www.medscape.com/viewarticle/443490_13 and it sounds like you're doing all you can. But what surgery might take place (besides a peritoneal window?)

[BASSMAN]

Oh man, why can't it be easy? Is the idea that the fluid build up is going to stop by healing? I read a bit here http://www.medscape.com/viewarticle/443490_13 and it sounds like you're doing all you can. But what surgery might take place (besides a peritoneal window?)

The betadine is supposed to cause the lymphocele to scar up and quit leaking.  Laparoscopic drainage into the peritoneum would be the next step.  Peritoneal window sounds like the same procedure.  It is done under general anaesthesia.  They will give the betadine quite a bit of time to work before going to the next procedure because of the risks associated with surgery.

[Dianejt]

Hope this works for you. Some things take time & it is worth waiting so you don't have to do any more surgery. I'm glad to hear your honey is doing so well.