On Thursday, I mentioned that there had been a couple delays and surprises in the run-up to my surgery. Let me explain:
When I first made my decision to donate, back in April, I thought I would need to use up vacation time at work to donate my kidney. Accordingly, I planned on doing the operation in mid-December, allowing me to use Christmas and New Years to minimize the amount of vacation days I’d have to spend (My Judaism renders Christmas insignificant to me except as a chance to tell people about Hanukkah Harry). Once my work informed me that the surgery would be covered as paid medical leave, I modified my desired time slightly to be shortly after Thanksgiving, with a hoped-for donation date of either November 29 or 30 (Beth Israel does surgery on Tuesdays and Wednesdays). My parents, who moved to Florida last September, would be up for Thanksgiving, and I couldn’t think of anything that would make my mom more thankful than surgery for her oldest son. She’s not the strongest advocate of donating a kidney to a stranger, but she wanted to be here to take care of me while I was in the hospital and convalescing at home.
My goal for the Thanksgiving donation, was to create a chain of “paired donations.” Paired donation is a fairly new but very valuable trend in the transplantation. Here’s how it works: say that I would like to donate to my brother, Bob, and you’d like to donate yours to your sister, Sue. If I don’t match Bob, and you don’t match Sue, but I do match Sue and you do match Bob, we’d pair off and swap kidneys, you to Bob and me to Sue so that each of our intended beneficiaries ends up with a transplant that we couldn’t give ourselves. If an unpaired donor puts in a kidney, it creates a chance to make longer chains of donation, and allows multiple exchanges.
I had hoped to be that unpaired donor, and my name was submitted in a drawing to match up pairs on October 18th. The next day I discovered that I’d be starting a a chain of, I believe, five people and that we’d likely be able to do the surgery on my desired date. I was obviously excited, both to get the day I wanted and to be able to contribute to multiple transplants. I quickly gave a blood sample with which to run a cross-match that would ensure that the intended recipient had not built up immunity against markers on my kidney. This test came back positive, and that’s bad: it means that their body would reject my kidney. Because their personal information is understandably confidential, I have no idea what happened to whoever I had been paired with, nor to the other recipients with whom the chain had been made, though of course I still speculate.
Rather than wait another month for another drawing of paired matches, I instead decided to try my luck with an individual recipient on Beth Israel’s internal waiting list, still hoping to make the post-Thanksgiving date. I submitted samples to be matched against five potential recipients: each test came back negative (that’s good), and I was set to give my kidney. By then, however, the operating dates I had wanted had been booked up, so my surgery was pushed to December 6th. A fairly small inconvenience. The main effects were: (1) to extend the dead period at work where I’d be sitting on my hands because I couldn’t take on new deals and (2) to require my mom to stay at our family friend’s house for another week rather than head back to Florida with my dad . This made the delay last week (which I wrote about on Thursday) more than a bit irksome to her.
Minor issues all, but they point to medical care’s unpredictability that I as, luckily, a novice, have only recently and mildly discovered. I’m undergoing an elective surgery, have as much support in as idyllic a set of circumstacnes as a patient is likely ever to have, and have experienced only minor deviations to my plan for how my surgery would work out. For me, it’s been less emotional roller coaster and more emotional Ferris Wheel. The potential recipients of my kidney, however, have a bit of a different story. To them, the best case scenario for such delays, reversals, and surprises is brutal,vertiginous, worry; the worst consequences are deadly. My mom’s heart jumps to her throat at even the mild bumps in the road I’ve experienced; how much worse are the feelings for the families of those for whom this surgery is not a choice?
In order to end on a slightly more happy note (I hope), my transplant looks like a go for tomorrow. Wish me luck.