Evaluating My Marbles

This morning was my psych evaluation at  the South Tower at Foothills Hospital (I think I have 2 more buildings left and then I have been in them all for this "Kidney Thing"). The purpose of this test was to make sure I wasn't textbook "crazy" and also to identify any psychological risks that might be increased for me if I was selected as an organ donor. In my case because I am a non directed donor, the interview was a little more simple as the doctor did not need to evaluate whether or not I was being coerced or guilted into donating by my family.

The interview itself was made up of several different type of discussion and short answer type questions.  I was asked a range of questions about my family, my relationship with my immediate family and their thoughts on my decision.  I was also asked about any previous experience I may have had with mental health which I talked candidly about (I saw a child psychologist when I was about 8 a few times, grief counsellors after my Dad's death and had a bout of depression in my late 20's that was untreated but resolved itself).  We also chatted about my propensity to worry about stuff.

We spoke about risks and regret and how I would feel if in 20 years I had issues with my one remaining kidney.  Would I feel regret?  Well yeah, a little probably but at the same time, you need to live with the decisions you make in life which is why you need to think things through before you make decisions, especially ones of this magnitude.  I feel like I am doing that by researching both the medical and personal experience stories out there.  I feel like this is an informed decision with calculated risks.
There was a brief question and answer period somewhere in the middle which was clearly a "CYA" (Cover Your Ass) for the doctor.  Do you hear the radio or TV speaking to you? Do you use IV drugs? Do you think you are being followed, think that your phones have been tapped? (I LOL'd to that one because if an imaginary person was tapping my phone, they wouldn't hear much of anything). Have you every been so happy you've scared people? Do you think you are God? Do you compulsively worry about doors being locked, things being put in their place, the stove being left on? (Another LOL there).

We wrapped things up talking about support from my family, my "people" here in Calgary as well as my work (check, check and check).  He ended with the option that he could write me a letter telling the program I was not medically fit and no one would question me wanting to opt out.  I said no and he said he wasn't surprised.
To be honest, I think I was most worried or apprehensive about this test as it is the most subjective of the lot.  A blood test is a blood test and your results either fall within normal or they don't-same thing with the x-ray and the ultrasound.  But a psychiatric evaluation is so subjective, especially in 45 minutes or less. 
The good news though is that I passed with flying colours.  He said we all would have risks in this situation from a mental health perspective but mine are on the low side and he feels like my self awareness mitigates a lot of that risk.  He said that he's be leaving a message for the transplant program that I was 100% cleared and would send the official letter once he is back from vacation in a week.

He added that in his practice he works mainly with people hospitalized for serious mental illness and also with people with serious, long term illnesses such as liver & kidney disease.  He said it's nice for him to see the other side of things from time to time and meet people like myself who are wanting to do something selfless like this. He said he thought I was an ideal candidate and it was a pleasure for him to have met me.  He thanked me for the opportunity to get to know me a little and said someone was going to be very lucky to get my kidney.

I'm still not sure I am comfortable with the "selfless" label or the feelings the doctor expressed at the end but I guess I'll need to get over that.

“Being normal isn’t one of my strengths"






"No Doctor, this is not what my kidney
 looks like in my mind..."

  Insane people are always sure that they are fine. It is only the sane people who are willing to admit that they are crazy. ~Nora Ephron

On Saturday I get to go for the "crazy test".  At Foothills they prefer the term "Psych" but either way, we know what they are after.  I will have to rein in my "One Flew over the Cuckoo's Nest" mannerisms for 45 minutes bright and early on a Saturday morning. At least I have 3 days to practice.

In all seriousness, from what I have read the psych test is really just an interview with a psychiatrist or psychologist-I can remember which one is covered by Alberta Health. The good doctor will just be looking to see that there is no coercion, history of depression etc that could jeopardize my emotional well being should the transplant move ahead. From what I understand, they also want me to have a realistic view of the outcome.  This is important for for altruistic donations I guess because I may not find out who receives the kidney or how it turns out in the end (I might though as they are loosening up guidelines around that should all parties be willing). They probably will dig to see if any major life event like a family death or something has triggered this decision. So in reality I should be fine.
It is funny but I think that being adopted has actually been the best preparation for this psych test.  I grew up not knowing my birth relatives and had to accept that.  Then in my 20's when I was given the opportunity to reach out to them through the Ontario government, I had to be prepared for the chance that they may be a) dead or b) unwilling to provide any medical information or c)they might not want any kind of contact.  I also had to be prepared that they might want contact but that they themselves might be crazy (I see a theme here! LOL). My point is that I am not donating a kidney for any reason other than giving a kidney and hopefully helping someone who needs one.  I am OK if I never find out where it went or if it worked. I am also OK if the recipient wants some form of contact whether it be a letter or an in person meeting.  I do have to say that I'd have to draw the line at the telephone though!!. 

We're all crazy and the only difference between patients and their therapists is the therapists haven't been caught yet. ~Max Walker

Awareness

I've never been much of an activist. I think I attended a rally once in university in Ottawa...something about protesting tuition hikes. I left as soon as the crowds started throwing macaroni at the federal Education Minister-the same guy they had been demanding come out and speak to them for over 3 hours.

That being said I have been a quiet supporter of charities via donations and participation in a handful of community events usually for causes that have directly affected me (like Cancer or Heart & Stroke or pet adoption agencies) or are near and dear to a friend or family members heart (like MS). So its kind of funny that the first thing I am really going to step into the spotlight on relates to something that has never impacted anyone I have known.

The more I read about Kidney Disease, particularly the need for more donors, the more I want to do what I can to help. I've learned in my many years of marketing that the best way to generate awareness about something is just to get people thinking and talking about it. And while it might take a little longer, if you start with the "low hanging fruit" which are the people already engaged with you, the discussion and awareness that spreads will be more authentic and have a longer life span than trying to get your message out to a world that isn't even looking for you to be saying something.

I know that donating a kidney is a serious decision and in no way have I deluded myself that I am going to convince anyone else to do this. Its not even something everyone can do. However if I can get people more aware of the need for kidney donors and how living donation isn't as risky or crazy as it might sound, then I will be happy. Its a start and at best it may mean a donation or two "extra" to the Kidney Foundation or some random chain of events that helps someone else.

Here are some facts about transplants with an Alberta spin (think of how crazy those doctors in 1954 sounded!):
1954 First successful kidney transplant performed.
1966 First successful kidney/pancreas transplant performed.
1967 First successful liver transplant performed.
1968 First successful heart transplant performed.
         First pancreas transplant performed.
1971 First kidney transplant performed in Southern Alberta at the Foothills Provincial Hospital.
1974 First living related donor kidney transplant performed in Southern Alberta.
1983 First successful single-lung transplant performed.
The first medication for treating transplant organ rejection was introduced.
1986 First successful double-lung transplant performed.
1987 First living unrelated donor transplant performed in Southern Alberta.
1988 First successful split liver transplant performed.
1989 First successful living donor liver transplant performed.
1995 First laparoscopic nephrectomy performed on a living kidney donor.
1998 First simultaneous kidney/pancreas transplant performed in Alberta at Foothills Medical Centre.
1999 First pancreas after kidney transplant performed in Southern Alberta.
2001 First laparoscopic nephrectomy performed on a living kidney donor in Alberta at Foothills Medical Centre.

A Thumbs Up From Grandma

The most awesome Grandma
in the world (and my brother)

I got a call from my Grandma today. Seems she was out for lunch with my mom, my aunt and my uncle. My mom let them know what I was considering.  I hadn't told my grandma yet for a few reasons.  First of all she is 86, my biggest champion and I don't want to do anything to wreck that.  She also worries about everyone and everything. She's had a bit of a tough year and I didn't want to add to that by making her...well worry. It turns out I didn't need to be concerned.

Grandma let me know how proud she was of me and what a good thing she thought I was doing.  She mentioned that her financial planner's wife got a kidney last month-like it was an everyday thing.  She has been waiting for at least 8 years.  They have 2 teenagers and basically they haven't been able to travel or do anything families do for over 8 years because of her dialysis. They have machines in the house and everything for it.  A month after her transplant, she is a new woman. She is off dialysis and her machines at home can now go to someone else who needs them (I didn't realize that in some cases there are even waits for machines in order to do dialysis at home but that makes sense as I imagine they aren't cheap). Its amazing how many people I am coming across who know people affected by kidney disease.

I made sure to tell my grandma how worried I was that she would worry (gee, where do I get my worrying from!) and she said "Laurie, I worry about everyone and everything all the time anyway.  Its nice to have such a positive thing to worry about". She also made a comment about how its typical Lauren to plan to do something like this and be so quiet about it...not want any fuss or talk about it.  I told her this time I am going to be different.  I want to talk to people about it and I want people to ask questions. I would like people to understand and at the very least least not look at people sideways when they say they want to do this.  So in the coming days and weeks regardless of how my donor eligibility goes, I am going to star spreading the word.

Grandma reminded me of something I said to her in the summer when I was in Ontario for a visit. I had told her I had a feeling there was something else I was supposed to be doing in my life, there were important things I still needed to do but I didn't know what they were yet. But that I would know when the choices were in front of me.  The more I think about things the more I think this is one of them. Grandma agrees.