Tuesday, June 21, 2011

Surgeon Time

This blog will be posted some time after it was written due to an outside directive to not talk about my living donor experience until after I have donated.  If you are reading this, it is because I have completed the donation process.
April 28 2011

After what seems like more than a couple of months, I was back at Foothills today to meet with one of the surgeons (Dr. S), supposedly the last official step in the evaluation process. I never did write down any questions for him; I was feeling pretty calm about everything.

I first chatted with the program coordinator. She was still talking in "ifs" and "when's" -I know she is supposed to but it made the rejection fear kick in. She reminded me again that the next match period isn't until sometime in June so there was some time for more tests of required, albeit not a ton.

She left and I waited in the room for Dr. S. It was snowing...again.  I think every time I've been to the living donor program offices it has been -30 degrees and/or snowing.  Doesn't matter that its end of April...snow. I reread the liver poster on the wall-I think I have memorized the anatomy of the liver-not sure where that will come in handy as a skill. I could hear Dr. S going room to room checking in with his other appointments-he seemed like he was having a busy, frantic morning. About 45 minutes later, he paused outside of my room and came in. He looked different than the last time I saw him...he was in scrubs versus the polo shirt and khakis of our last visit. His hair was a bit wild, probably a reflection of the morning he was having. As he greeted me his face seemed to relax and he smiled, happy to see me. Maybe he was happy to have an appointment longer in duration than the quick check-ins he seemed to have had thus far.

He started by asking how I was, how work was etc. One of the things I like about Dr. S is that he seems genuinely interested in me as a person not just what we are trying to achieve-it doesn't seem like scripted small talk. From there we went on to my file.  He review it, asking the usual medical questions and summarizing the tests I had gone through and how I did on each one. He was concerned because despite the "approval" from Dr. N, she hadn't recorded any notes (grrr) which I guess was atypical. He said as far as he was concerned I was a good candidate and while he would follow up with her to see her thoughts, he believed I was good to go. He was very optimistic and for the first time in months, I felt optimistic about this "kidney thing" maybe happening.

Dr. S said that both my kidneys are the same and both only have one vein and artery each, making removal simplified compared to those people with multiple veins and arteries (it is still possible to work with donors in that situation but obviously the simpler, the better). As a result, he said if they went ahead, they'd like to use my left kidney. This would also be better for me as the surgery can be done laproscopically which is far less painful and invasive thank open surgery, and has a faster recovery time. Yahoo! I was on the fence about what my decision would be if they couldn't do this via scope-I'm glad I don't have to make that decision.

He then logged on to this very cool medical site that did a step by step breakdown of how the surgery would go-complete with pictures-both real and computer graphic models. I don't want to gross anyone out with the details but it was neat to see how they would "get to" the kidney. Obviously it involves moving the other organs that are in the way out of the way so they can have easy access. he also was able to show me the difference in anatomy on the right vs. left side so I could better understand the pros and cons each side has as a donation candidate.  I had already read about all of this but it was very neat to see at a much more granular level with pictures. At the time I remember thinking "this is cool!  I want access to this site so I can show people" but then I realized while there are a lot of people interested in how I do in this surgery, there are very few who want to know how the surgery itself is done.  Especially not with pictures.

He also did a quick physical exam-the usual listening to me breath. He checked my ears, throat check and feeling around my belly region. He took the opportunity while I was lying down to show me where on my stomach I could expect to see incisions and roughly how big they'd be. I found that helpful as it was much easier to appreciate the incision size when he traced the spots on my abdomen with his had than it is reading random measurements on a website. I have heard that each surgeon has their own preference for where they opt to cut and each area has pros and cons associated with it. While it might not be Dr. S who operates on me, it was still good to know what he would do.

Towards the end of the appointment he asked me when I'd like to do this.  I responded with a question "When do you want me to do this?  Isn't this kind of up to your plans?". He kind of laughed and didn't respond. I told him the the program coordinator had mentioned June being the next national match up. He said it was but that he was also thinking of doing something local with me-perhaps starting a chain which might take a little longer to put together. I told him I was flexible and that he should just figure out what's best. I then thought to ask him how much longer his idea would take (I mean are we talking months here?) and he said just a few weeks longer-maybe late June early July, that it depends. I asked him on what and he said the size of the chain.

"How big do you want the chain to be?" I asked.  He kind of laughed at me and made some comment about how I never have questions about the procedure itself and now I have all these questions about what he's putting together. He seemed reluctant to tell me but there was excitement in his eyes and face - maybe he didn't want to come off as the surgeon who was excited about surgeries? I don't know. He eventually answered "Four".  That's pretty neat. They probably won't tell me what it ends up being or if I am even a part of it but its a cool idea. I love the logistics behind these chains-it amazes me that places in the US have done up to 16 transplants as part of a chain in a couple of medical facilities in one city, same day. It is mind blowing the amount of planning that must go into these kind of things.

The appointment ended with his promise to follow up with Dr. N about her notes and he said the program coordinator would be in touch when they had an idea of timelines. I am feeling really good about things-maybe I am finally getting somewhere? Regardless, Dr. S made me feel better about things and back on track! Phew.

1 comment:

  1. I would love to see the pictures of how they do it!