I Think I Can

Actually I know I can.

I will admit I am still a little intimidated about walking 100km with a bunch of strangers for a cause I didn't even really know existed a year ago. This afternoon, I was in my car, fretting about sharing a tent with a stranger, meeting new people and how to perfectly duct tape my feet to prevent blisters. As I drove to the kick off "Day Zero" meeting I wondered, yet again, what have I gotten myself into-what was I thinking?! Talk about distracted driving.

Then exactly halfway down to the hotel where the meeting was being held, a pretty strong inner voice spoke:

"Um hello!?!? You donated a kidney. You got through that. This is no big deal".

My friend Crystal posted a very timely quote this afternoon on Facebook. "It's not who you are that holds you back, it's who you think you're not." I am starting to realize that I am a lot more than I give myself credit for. I've accomplished a lot (not just kidney related) and I can do a whole heck of a lot more. It's taken me almost 36 years to realize this and really believe it.

So this 100km should be a piece of cake*.


*My feet do not necessarily endorse this last statement .

Walk This Way

In about 34 hours I will be on my way to the starting line for the 2011 Kidney March. The march will raise money for the Kidney Foundation of Canada. Why? Well to start, two million Canadians have chronic kidney disease or are at risk of it (and don't even know it). For a lot of people (this can mean you too)they won't know they have it until it's too late. See the thing with kidneys is that once they are damaged, they are damaged and while they are awesome, mighty filters, they suck at self repair (in fact they can't do it at all). According to the Kidney Foundation, in southern Alberta alone, the number of people living with chronic kidney failure has doubled in the last ten years. 70% of people who are on the organ donor waiting list are waiting for a kidney. Every year, thousands of Canadians die because their kidneys fail them.

Not only does kidney disease cost enormous amounts of money for our health care system, it devastates individuals and their families. More than half of the people living with kidney disease in southern Alberta live on or below the poverty line. Entire families are impacted when one member has kidney disease, and it can be a lifelong illness. It impacts a person's ability to work, to spend time with their families, to go on simple vacations healthy people take for granted.

I donated my left kidney three months ago today (wow time flies!!). So because of that I am also marching in honour of Leftie (my departed kidney) and for the thousands of people like Leftie's new owner who have been impacted by kidney disease. As strange as it sounds (being one kidney down and all) I actually have yet to meet anyone personally affected by kidney disease. I'm looking forward to hearing some wonderful stories of resiliency and strength on this walk. There are also some other people I've gotten to know online that I am looking forward to meeting in public.

The walk itself will be tough but I know I can do it. At least the weather is looking promising-high 20's and no rain in the forecast. We'll be walking through the beautiful foothills of southern Alberta. It looks like a really well planned event and I'm actually getting excited about it. Here is what the route looks like:

There are cheering stations if you want to come out at any point over the weekend. They are as folllows:


Saturday September 10, Morning
Allen Bill Picnic Area, across from Ranger Creek Road (along hwy 66)

Saturday September 10, Afternoon
Bragg Creek Strip Mall, right beside main 4-way stop

Sunday September 11, morning
Springbank Parks for all Seasons/Springbank Community High School (Range Road 33 and Springbank Road)

And finally, they have a closing ceremony at Canada Olympic Park. Family, friends, coworkers and anyone else can come and cheer on the marchers (or heckle). Spectators are advised to be at COP by 2:15 PM Sunday. Come one, come all.

Thanks again to everyone who sponsored me, told me I was crazy, gave me words of encouragement and/or promised me they'd come along next year.  I'll be updating Facebook and Twitter (@laurenherschel) along the way when I can (I even brought a special battery powered iPhone and Blackberry charger as we all know I'd go twitchy without them after about 24 hours). Wish me luck!

The true charm of pedestrianism does not lie in the walking, or in the scenery, but in the talking. The walking is good to time the movement of the tongue by, and to keep the blood and the brain stirred up and active; the scenery and the woodsy smells are good to bear in upon a man an unconscious and unobtrusive charm and solace to eye and soul and sense; but the supreme pleasure comes from the talk. ~Mark Twain

Good Deed Challenge

About a month ago, I decided to be a part of a 28 Day Good Deed Challenge. The idea was that everyday, I would do one random act of kindness for another person. The recipient could be known to me or a complete stranger and the act could be as simple as holding a door open for someone. Each participant in the challenge was expected to enter their daily deeds into a communal Google Docs spreadsheet. We were encourages by the project organizer, DJ Waldow, to review each others acts of kindess for inspiration and feedback-comments were encouraged. Participants were spread throughout North America and we had every demographic covered from students to parents to Dilberts like myself.

It was tougher than it sounds. In some ways it was tougher than the whole kidney donation-that was very much planned and not so random. Hear me out on this...

A challenge like this doesn't really allow for those "keep to yourself, head down-bad days". You have to have your eyes, ears and heart open to not just spot the opportunities for random acts of kindness, but to actually get them done. A lot of the time this can involve taking the high road and putting someone else before you-even someone you don't really like. Now, I like to think of myself as a good person and I do like to try to help other people when I can. But what I realized in doing this challenge is that I am not as prepared to walk the talk as I thought I'd be EVERY SINGLE DAY.

There were days when I was so busy I didn't know which way was up and I would realize by dinner time that I hadn't done a single thing that would qualify as a good deed. Crap. Those days usually meant my family would be on the receiving end of the act of kindness sometime after my arrival home which didn't seem as random as it should/could have been.

I'm also a fan of being original so I wanted to try to come up with something new everyday rather than repeat a previous good deed or borrow a good deed idea from another participant. This also added to the challenge because some days we don't have a creative bone in our bodies. I'd find myself frantically looking around my home, workplace or environment searching for something I could do that was "good enough". I felt more than a little crazed at times (in a good way of course...).

Another challenge I was presented with a few times in the last 28 days occured when the good deed opportunity was as clear as day-it might as well have had a neon sign flashing and pointing over top of it...but the potential recipient was in my bad books for whatever reason. My friend Joe used to tell me that the high road might be a bit bumpier but it always has the better view. That's view doesn't necessarily make it easy to choose being the bigger person. I am proud that in each of the opportunities presented I did take the high road to help those people out-even if they weren't my favourite people at that moment in time. Even if it hurt a little.

I think that is the lesson in this social experiment. Everyday we all are presented with opportunities to help other people in many different ways. Some are so small they might seem insignificant  at first glance (telling someone they look nice or holding a door for them). Others are bigger, more obvious  (like a kidney donation or the more common/less crazy option of a charitable donation). I don't think the act itself is the hard part...it's making ourselves do it that is the challenge. It is almost always easier to be lazy, to rationalize that we are too busy, too tired, too old, too young-that there are other priorities. Most of the time whatever the good deed is in reality takes less time to do that it does to think about doing it and wrestle that inner you that is trying to reason why not to do it. Some of us are better than others at doing the right thing but it does take effort to be that way, and more importantly to do it everyday.

Even though yes, I am a kidney donor and yes, I do regular volunteer work and I try to be good to people as a rule, I learned that I have a lot of room to grow in terms of consistency and frequency of my good deeds. Practice makes perfect I guess.

That best portion of a good man's life; His little, nameless, unremembered acts of kindness and of love. ~William Wordsworth

Surgeon's Choice

I am pretty sure I can speak for quite a few donors when I say that outside of the obvious health/surgical risks, there is also something else we are concerned with: Where and how big will our scars be? Women probably lead the charge on this worry more so than men, although I am sure there are both genders have people who concern themselves with it, and those who don't. I was moderately curious where my scar would be and what it would look like so I attempted to research it before my surgery. (Note: I don't want to post pictures here in case people are a bit squeamish-if you see a linked word when I am describing an incision or scar, only click on it if you are wanting to see a photo example. I tried to pick well healed ones that weren't too "new").

If you donate your kidney through an open surgery (not laparoscopic) the incisions tend to be bigger and a little more standardized in placement. Most pictures I found online showed a horizontal scar that would start on the front of the body blow the rib cage and wrap around to around the same point on the back. As you can imagine, this surgery is much more invasive than its laparoscopic counterpart and the incision size plays a big role in recovery time being so much longer (2-3 weeks for laparoscopic vs 6-8 weeks for open).

Prior to my donation, I was hopeful (as many donors are) that I would be a good candidate for a laparoscopic procedure. Most of the decision is based on which kidney is healthier/does more work if there is a difference. If they opt to use your left kidney, laparoscopic surgery is much easier and is usually the preferred method assuming to transplant hospital has surgeons who practice that style of surgery. In the US it is very commonplace and in most Canadian transplant hospitals it is as well. Foothills Hospital (here in Calgary AB) for example has been doing it almost exclusively for left side nephrectomies since 2000. However other centres may have only some surgeons who can perform the procedures do depending on who is assigned to your donation, you may not have the option (I have heard for example from another donor that Edmonton has only one doctor on their team who does lap kidney removals).

In doing my research and talking to other donors (before and after my surgery) about their laproscopic kidney removals, I started to realize that there didn't appear to be a standard spot for the larger of the incisions. The smaller incisions or "ports" where the laparoscopic instruments are inserted into the body, vary slightly in location based on the number used (one to sometimes 4). That made sense to me. But what I didn't understand is why some people had larger incisions tucked neatly away, closer to their groin and others (like myself) had scars closer to the navel, much higher in the abdomen.What was different from my surgery to the next person's that would result in so many different incision locations?  I tried to find out more online but wasn't coming to any kind of clear answer. So I asked my friendly neighbourhood transplant surgeon. 

It turns out it is a "surgeons choice" situation. Where the incisions end up and even the number of ports used are dependent on the surgeons preference/style.  He said that there are two distinct kinds of laparoscopic kidney surgeries: hand assisted and not hand assisted. Both types can have a range of "port" holes used as well (the least I've read about is zero, the most is four plus the larger incision). My medial incision (up and down at the navel) was hand assisted meaning that they used the ports for the laparoscopic tools and the larger incision was used to both dissect the kidney (cut it away from the body and close off any attachment points left behind if required). The kidney is then removed from the body by hand. I've read that this type of incision can make the patient more prone to hernia during recovery because of how the abdominal wall and muscles are affected.

When the scar is found lower down, closer to the groin or bikini area, this indicates the surgery was "hands free) and was done entirely using the laparoscopic tools. In this case, the larger incision was an extraction point for the kidney after it was dissected using the tools. This type of scar is normally more horizontal (aka  phanestil/pfannenstiel depending on language preference of your friendly neighbourhood surgeon) and is similar to what is used in a c-section. It is thought that this type of incision is slightly easier to recover from. It also is far less visible than the medial incision by the navel. Bring on the bikinis! However I have noticed a few donors mention that they have had numbness (temporary or semi permanent) as a result of nerves being affected by the incision. For some, the numbness has been localized to the wound area and others have had numbness in the upper leg area. In contrast, I haven't read of any medial incisions having that side effect (and I haven't experienced it either).

The type of larger incision used, their locations and the number of accompanying ports all comes down to the surgeons assessment of the best, safest and least complicated way to remove your kidney based on the particulars of your anatomy, factors like weight and body fat and the surgeon's own level of comfort with laparoscopic tools. Some surgeons might prefer to do the entire surgery with the tools whereas others might prefer to have some "hands on" contact with the surgical area. Both methods are commonplace and acceptable. Depending on the  logistics surrounding your kidney donation, you may not know ahead of time who your surgeon is and what his/her "style is" and you more than likely won't get a say in the matter (although they will advise you ahead of time if an open surgery is required so you can prepare for a longer recovery). If I recall correctly when I had my preoperative meeting with Dr. S, he showed me where I might expect my scars to be but couldn't say for sure-all was "depending on my surgeon and how things went". 

I do find it kind of interesting that there are several surgical routes to take with kidney donation surgery with the same end result. The medical world has always struck me as being very standardized and process based. It hadn't occurred to me that there was any room, particularly in well established, frequently performed surgeries like nephrectomies, for personal style and choice. The nerd in me would like to explore this a bit further and find out what makes the individual surgeons adapt their specific style and when they opt for which type of incision-what make them choose their choice. I'm also curious to see if a transplant team at a hospital like Foothills has a huge variance in style or if they are all similar-if each program has informal standards or best practices they adopt as their "surgeon's choice".