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Tuesday, January 4, 2011

The Social Worker Step


Ok not really but this picture is great

Today I had a very informative meeting with a social worker from the Living Donor program.  She was able to answer a lot of my questions and give me a much clearer understanding of where I am in the process.  Of course it wasn’t all about my wonderings (it’s not all about me!); she had several pages of her own questions as well.
Her role in the process is to review the risks (things like relationships, financial, health, emotional etc.) and any potential concerns I might have with any of those categories as it pertains to my decision to donate. It’s another checkpoint to make sure I’m still okay with the decision and also to help me now or down the road with the tools I might need to deal with any of those risks. She asked detailed questions about my friends and family (some of you were named!) support, about my work support and the things that most worry me about the process. She asked about hobbies and values and what I wanted to achieve from the process. I also got to pick my “ultimate surgery date” and a back up date too.  I can’t say ultimate is an adjective I would use but I gave her a couple of dates (“I don’t really care” was my initial answer but she seemed to really want something more definitive to write down).
We also discussed the “travel factor”.  She told me that because I am an altruistic donor they do actually try to keep me here are less likely to want to push for me to be sent elsewhere in the country.  That did kind of contradict what I was told earlier.  You may recall I was told how my fabulous blood type and the fact I’m not attached to a recipient made me a good addition to the national pool and I could even perhaps start or end a domino (paired) exchange. She said from her perspective, her biggest fear is sending me somewhere that doesn’t offer me the same level of support as I would have here.  If something was wrong or even if I just was feeling terrible, I would do better if I had “my people” or at least a person around to make sure I was ok. I told her that Calgary would be ideal but that I am virtually as open to anywhere in and around Toronto, Hamilton or even London Ontario because I would have great support there.  That being said, if there was a really compelling reason for me to go elsewhere (like I am a perfect match for someone who is incompatible with virtually the whole country’s population) then I would consider going elsewhere.
She also let me know that the next “National Pairing” is the end of February and she’s be really surprised if they tried to squeeze me into that given that the timelines are so tight.  So if they did opt to put me as part of a chain, it would likely be much later in the spring (all of this is dependant on me being okay with their choices). That does not rule out me being part of a local chain sooner though (as in not late spring).  And of course I may just be part of an everyday “the recipient and I” kind of transplant.
It was confirmed that all the tests I have done are indeed sequential.  I would not have been scheduled for each test had I failed or even yellow flagged on any of the previous ones.  A doctor has been scanning the test results as I’ve moved along although he/she will still do a final review once all the tests are back. She said the only time I kind of went out of order was with the psych test and that was because the doctor had a free day which he didn’t think he was going to have again for awhile.  She said they have recently decided that any anonymous donor MUST have a full psych evaluation-if I was giving my kidney to family I may have skipped that part.
At this point she said I was 80-85% done and she’d be surprised if medically anything would be found at this point.  I have an MRI on January 23rd (yes, a Sunday and I can’t eat all day as the appointment is at 7pm!!). The MRI will count the veins and arteries leading to each kidney to determine which one is “better” and also what type of surgery I will require.  Laparoscopic surgery (vs. a big cut) requires me to have more simplified vein/artery action going on so I’m crossing my fingers that will be what they see.   About a week or so after the MRI I can expect to meet with the Nephrologist  (Kidney doctor).  They will want to review the test and meet me.  After that it’s a (the??) surgeon.  I think that might depend on where I am going. And from that point forward it’s all about logistics and scheduling. Oh la la I’m getting closer!