Thursday, December 30, 2010

Living Donor Pioneer Dies

I was going to write about something else today but I thought that this was an interesting article about really brave man.  I can't imagine how much controversy and concern what he did would have caused back in late 1954. I bet he had to deal with a lot of Negative Nellies! The fact that what he and his brother did (with the help of their doctors of course) has lead to thousands if not hundreds of thousands of successful transplants (kidneys and otherwise) is amazing. I would think that indirectly, advances in transplants have also impacted other fields of medicine as thing does lead to another sometimes. Organ donations aside, I've always admire people who take risks like this for the greater good-I've never been that brave. I can't imagine making a choice like this without an internet to us for research or even a fraction of the medical knowledge we have today being available to the general public.

On a side note, if the first successful living donor made it to 79, I think that bodes well for people like me who also chose to donate, especially with the advancements in medicine.
Here is his story (borrowed from the UK Daily Mail):

A kidney donor who helped doctors carry out the world’s first successful organ transplant has died following heart surgery at the age of 79.

The brothers in 1955, six months post op
 Ronald Lee Herrick, whose gift  helped his twin brother Richard survive 56 years ago, had been suffering from complications since his operation in October. He died on Monday at the Augusta Rehabilitation Centre in Augusta, Georgia, his wife Cynthia said. Mr Herrick gave a kidney to his twin brother at what is now Brigham and Women's Hospital in Boston. The five-and-a-half-hour operation on December 23, 1954, kept Mr Herrick's brother alive for eight years and was the first successful organ transplant. Lead surgeon Dr Joseph Murray went on to win a Nobel Prize.

The operation proved that transplants were possible and led to thousands of other successful kidney transplants and ultimately the transplant of other organs. Doctors had tried a handful of transplants worldwide without success up to that point, said Dr Murray, who went on to perform another 18 transplants between identical twins.‘This operation rejuvenated the whole field of transplantation,’ the 91-year-old said from his home in Wellesley, Massachusetts. ‘There were other people studying transplants in four or five different countries, but the fact that it worked so well with the identical twins was a tremendous stimulus.’
Herrick was raised on a family farm in Rutland, Massachusetts, where he graduated high school. He later served in the U.S. Army and retired to Belgrade, Maine. At 23, Mr Herrick was glad to give up an organ if it would help his brother, who was dying from chronic nephritis, an inflammation of the kidneys.
Dr Murray thought the odds of a transplanted organ being accepted would be enhanced since they were identical twins. Before the operation, many people opposed the idea of transplanting a body organ, equating it with desecration of a body.

Others felt it was unethical to operate on healthy humans, and respected editors of medical journals wrote that it was contrary to the Hippocratic Oath's vow to never do harm to anyone. But Mr Herrick never wavered and the operation went on as planned with no complications. Richard met his future wife, Clare, in the recovery room, where she was a nursing supervisor. ‘He was the only one in the world who could save his brother's life, so he was going to do it,’ said Cynthia Herrick. ‘There was no question about it.’

Tuesday, December 28, 2010

Dominos and Do-Gooders

There were two things said to me this week in regards to my desire to donate a kidney that really made me pause-in two very different ways that in the end are connected.

The first was a comment left on here by my birthmom Judy.  She said "it also again caused me to wonder at how the world turns: decisions are made, lives are changed and because of that other lives are changed and so on... providential I think". It made me wonder if there is some kind of greater plan or, in other words if indeed everything does happen for a reason. Small events and decisions lead to other small events and decisions in a seemingly linear fashion. I'm not one to believe on a daily basis that everything I, or people around me do leads to something else which in the end leads to something greater. But I do have to wonder-had I not been adopted by the family I did, experiencing the childhood I did (reading personal interest stories about organ donation at a young age-ha!) as well as the illness and death of my Dad (etc) would I be here now contemplating organ donation? Maybe. But maybe not. Is there such a thing as providence or at the very least the "domino effect"?

The second comment was made by someone else who said "I am inundated with do-gooders telling me how they run their lives and how I should run mine. If you want to do a selfless act, then do it, but don't expect me to care, because then its no longer selfless". My initial reaction to this was great sadness as well as anger. The comment upset me more because of who it came from and the level of support I expected from them. But that aside, they had a point.  I too, am bothered by the "do-gooders".  Not all but most.  They get on their soapboxes, they want you to join their cause and they try to save the world.  Bleck.  Sure it's noble and often the right thing to do-but I think we'd be lying if we said there hasn't been some point in our lives where we've loathed a do-gooder or at least eyed them with a healthy dose of cynicism. I have never thought of myself as a do-gooder and it's not a label I want to wear. So why do we hate the do-gooder? 

A recent series of studies found that those who volunteer to take on unwanted tasks or give gifts/aid without being prompted, quickly alienate themselves. Psychologists believe this is because it makes the rest of us feel guilty and puts pressure on us to behave in an equally selfless fashion. Researchers say do-gooders come to be resented because they 'raise the bar' for what is expected of everyone. They even went as far as to suggest that people might want to think twice before talking about their charity work or volunteering to help out in front of others. The study showed that it doesn't matter that the overall welfare of the group is better served by someones unselfish behaviour. What is objectively good, we see as subjectively bad.

I know that not wanting to be seen as a "do-gooder" is one of the things that initially made me not want to share my story in the first place. I didn't want to be compared to those people who are always trying to generate social awareness, raise money or get their friends to sign petitions. I didn't want to be seen as someone "seeking attention" looking for a pat on the back or rah rahs from other do gooders. The very thought makes me cringe.

But yet here I am. 

Why?  Well in reflecting on both of these comments this week, I realized that sometimes (not all the time) things do happen for a reason, because of things bigger than you. And I think you know when you are in the middle of one of those "chains" or domino effects when a bunch of small events lead you to doing something that isn't the "norm" for you or even is contrary to what you would normally do (ie: my being a loud and proud "do-gooder").

I was reading a story today about Harold who was a pioneer in altruistic kidney donation in 2000.  In his post he shared his domino effect and how a number of events "bumped" into him, eventually leading to his kidney donation. 
  • He too lost his father to cancer and wished he could have done something to help. 
  • Giving blood since high school bumped him into platelet donations.
  • He saw a news feature on a teacher who donated to her student.  
  • Donating platelets bumped into signing up as a potential marrow donor after he met a couple at a mall desperate to find a marrow donor for their daughter (he was not a match).
  • Signing up for the marrow program bumped into a movie about kidney donation on a plane and the movie bumped him into the National Kidney Foundation.
  • That bumped him into the transplant program, leading to a successful kidney transplant. 
A series of seemingly unrelated small events ultimately took him to a place where he was able to save someones life. He said "I wake up everyday and know I did a good thing. And I’ll be happy to tell as many people about it as will listen. Because my domino might bump into someone else’s domino. And one of them might raise their hand and ask the questions that I asked. And one of them just might make a difference".

I'm still not keen on being a do-gooder.  But if it somehow leads to a domino effect with a better life outcome for someone-well that I can live with.  

Sunday, December 26, 2010

Because You Asked

Here a few more answers to some questions I am getting from people as they learn about my "kidney thing" or who have had questions come to mind after thinking about it for awhile.

Will you still be able to drink?
I don't know what is funnier-the frequency of which this one is asked (i.e almost everyone) or the fact that it usually is in the first three questions people ask. I had the same question (perhaps even in my top three) when I first started looking at this.  The first answer I found was on the blog of the FBI agent who donated a few years ago in the states ('Kidney Chronicles', as found in my "Interesting Sites" links on the right hand side of the page).  He said: "I can think of a million reasons why people shouldn't drink, but this is not one of them".  Why I don't share his disdain of festive beverages, I think it might be a good excuse for me to continue drink less and avoid overdoing it.  A coworker who shared with me that she had only one kidney (reasons unknown to me) said her hangovers are worse as a result.  However another co worker's husband donated a kidney about 10 years ago and he "still drinks like a fish". So I think the short answer is you can still raise a glass as well as the next person, but like they say, everything in moderation.

Would I want to know about who got my kidney?
Yes I think so.  It's not a "must" for me but I think it would be nice. It's a piece of the story right?  That being said if I didn't like the person or their family or worse if the kidney didn't work, I am prepared for that.  I knew going into this that I have to make the decision because its a good ting to do, not because I have a specific outcome and recipient "type" in mind.

How will they choose who gets my kidney?
That I don't know 100% but I will ask. But here is what I know based on the assumption that they'll ask if I am willing to go into the national program (I am even though it may mean travel). My understanding is that they will come up with a short list of people my blood type can help how likely have been waiting the longest and are the sickest or harder to match. They will perform cross matching tests which are used to identify the presence of preformed antibodies that would damage the kidney (cause rejection). The basic test involves mixing the liquid portion of the recipient’s blood (the part of the blood that contains antibodies) with my cells. If their blood tries to kill my cells (or does kill my cells) that is bad and it won't work out between us. I will likely have to give a bunch of blood for this purpose once cleared for donation and then from there they will test against the short list, schedule surgery etc.  If I had been donating to someone I knew, this test actually would have been done at the start to rule me out as a compatible donor for that person, then again right before surgery to make sure nothing changed (pregnancy, transfusions and transplants can change the antibodies in your blood).

What is a Domino or Paired Exchange?
A "paired-exchange" is a technique of matching willing living donors (who had planned to donate to a loved one but weren't a match) to a compatible recipient who also has a loved one willing to donate who is not a match. For example a spouse may be willing to donate a kidney to their partner but cannot since there is not a biological match. The willing spouse's kidney is donated to a matching recipient who also has an incompatible but willing spouse. The second donor must match the first recipient to complete the pair exchange. Typically the surgeries are scheduled simultaneously in case one of the donors decides to back out and the couples are kept anonymous from each other until after the transplant.
When a non-directed donor (like moi!) enters the Registry, they have half the conditions required for finding a match. In other words, because the transplant of their kidney is not conditional on my friend or family member receiving a transplant in return, I have a greater possibility of being involved in whats known as a domino exchange. The largest so far I think has been 16 transplants, involving 32 people (in the US). There are some pretty intense logistics to it (including travel, OR scheduling etc) but its pretty cool.  The Canadian Registry going national in November was a huge step for this as it centralizes the planning a bit and makes the who "matching" process far less manual.  Here is a diagram of how a domino exchange would work:

Keep the questions coming-it's a great learning experience for me and also on some occasions has given me some added food for thought!