The Gift of Life

Christians all over the world will celebrate tomorrow the birth of Jesus.  Through Him, the gift of life is made available to all who believe.  This life is not merely an extension of existence, but a fullness of experience.  It is freedom from what once bound a man, the sins that he cannot part with.  It is a restoration of relationship and fellowship with God and one's fellowmen.  It is a life of quality, a life worth living.

While God's gift cannot be equaled by anyone, another gift of life, no less important, was given to my wife by her sister.  She parted with a kidney, so that another life is not merely extended, but experienced to its fullness.  It meant freedom from impurities that no machine can fully remove, impurities that will slowly suck the life out of her in the long run.  It is also freedom from being tied down to something that takes away quality time that should have been spent with her family and herself.  Indeed, it meant a life of quality, a life worth living.

Both gifts came with a price. With Jesus, it meant death.  For her sister, it meant time away from work and personal stuff as they undergo test after test to ensure her fitness for the donation.  It meant pain in the recovery, not to mention having to face the uncertainty of a surgery.  

The support of everyone who went with us through this ordeal cannot be repaid, and for which we are truly grateful.  But the gift of life, that donated kidney, was the key to a new day for all of us.

Merry Christmas everyone!

Home

We got discharged from the hospital Monday, December 17.  My wife's donor, her sister, was with us as she had her first checkup with the doctor after the transplant.  Things were quite normal for her, although she was told to lay it easy on fruits for the meantime, as her potassium levels are quite high.  Her creatinine also went up to 1.3, whereas she had a creatinine of 0.7 prior to her operation.  All these were expected, though, as the body adjusts to having just one kidney.  I've read several articles that said the lone kidney will start to grow and, if necessary, be twice its original size to compensate.  I guess that's what we can expect for her in the coming days.  She was also advised to not return to work up to one month from date of operation, to give the body some time to rest and recover.  Finally, she was congratulated for the fact that her kidney was accepted by my wife's body.

On the way home, it was only then that we realized how little we prepared for this day.  We don't have any food ready for dinner, and our initial reaction is to just buy some grilled chicken along the way.  But I guess each one of us felt that it wouldn't be the right thing to do, given that this is the first time my wife will be eating non-hospital food after the operation.  Of course, it was also playing in my mind if we are setting ourselves up for a habit along this road of easy yet not necessarily ideal scenario.  Without verbally expressing these things among ourselves, my sister-in-law volunteered to cook for the night, and we will pass by a supermarket to buy the ingredients.  I guess everybody felt relieved that we will be doing this rather than settling for the easy way to get to dinner, one that can become a slippery slope along the way.

It took a while after we got home before I began to realize how clouded my mind felt, and how much I am laboring to breathe.  I began to realize how different to the outside world is our sterile setup in the hospital ward.  It gave me an appreciation why isolation is the first order of the day after one get out of the hospital.  There are simply too many factors to consider that it's best to mimic  as much as possible the hospital scenario and ease the patient slowly into the new environment.

The next morning was also the time to realize that we now need to do what the nurses and doctors were doing for us while in the hospital.  The first order of business for my wife was to get her temperature to ensure that she's not running any fever.  Next, she weighed herself to determine if there were any significant weight gain (a kilo or more from the previous day).  Lastly, her blood pressure must be taken.  There was also the matter of monitoring for the meantime her intake and output of fluids.  We were having troubles with the accuracy, with her records showing she's taking in quite more than she's urinating.  Good thing we can use the weighing scale to double check if there is indeed significant weight gain at any point in time during the day.  

Realizing the need to ease her into the new setting also made me more conscious of disinfecting myself and putting on a mask before entering her room, as well as limiting the amount of time I am inside.

Personally, I also started to recover physically, being able to sleep in more familiar and comfortable surroundings.  Of course, it helped that my wife is showing good signs physically.   After two nights of rest, I was energized enough to start cleaning and disinfecting the house.  I started looking at every nook and cranny and still found some old and dusty stuff that we missed during our cleanup before the transplant.

Slowly, she's starting to adjust, coming out of her room from time to time to do some light walking.  I myself started exercising again, doing some stairclimbing and weight lifting.  Our kids will also come home tomorrow, after staying with my in-laws for almost three months, just in time for their school's Christmas vacation.  Hopefully the next few weeks will allow us to get back to normal bit by bit and get back on track come new year.

water, water, and more water

One of the first things that changes after a kidney transplant is the requirement for water and other fluids.  Whereas fluid intake is limited when one is on dialysis, the entire thing is turned upside down after a kidney transplant.  Now, one is encouraged to take in as much fluids as possible.  After taking in almost 4 liters of fluids, mostly water, yesterday (corresponding to about 16 glasses of fluids as ordered), my wife's doctor is saying today that she's showing signs of dehydration.  She ordered for a blood test to check on certain indicators.  Good thing the test showed she's not dehydrated and the rest of the indicators are within normal.  But a regimen of 3-4 liters of water a day will be her norm for the rest of her life.  It may sound like a lot, but if you break it down, that's not much more than drinking a glass of water (about 250 ml) every hour, assuming you're awake for about 16 hours a day.  The fluids are necessary to help the body dispose of toxins and other impurities, especially since transplant patients are taking in heavy doses of medications to prevent the body from rejecting the transplanted kidney.  I guess that's a small price to pay compared to being hooked up on a dialysis machine twice a week for four hours at a time.

There's a strong likelihood we will be going home tomorrow.  Some of the regimen we do here at NKTI will have to be continued at home for several weeks.  These include measuring fluid input and output to ensure fluid replacement and prevent dehydration as well as get into the habit of drinking, weigh-in every morning upon waking up to ensure that there is no sudden weight gain which can be likely due to water retention, a sign that the transplanted kidney is being rejected by the body, and getting one's temperature to check for fever so that minor illnesses do not complicate to major problems since the immunity system is compromised.  Then, there's the matter of slowly getting into exercise to strengthen her body and combat the effects of diabetes and other diseases.  Plus, of course, the weekly checkups and tests for several months.  It will also be a time for my wife to learn to be with herself most of the time, as she will be in a sort of reverse isolation until the doses of her medications is decreased, since her immunity is hardly there at this stage.  

For the rest of the family, the next few weeks will be a time of re-integration, as our kids go back to our place and resume a life in their own home.  They've been living with my in-laws for the past few months as we are busy doing the workups for the transplant along with undergoing dialysis twice a week.  Not that their lives were significantly altered, thanks in no small matter to the efforts of the extended families.  I'll probably talk about this more in a later post.  Suffice it to say that because of the efforts of relatives, my kids hardly knew the degree of difficulty that we went through.  

We will probably be accompanied home by her donor-sister, as she's coming to the hospital tomorrow as well for her weekly checkup for the first month after her donation.  The checkups will be spaced further and further apart as the months and years go by.  

We are hopeful we will close this stage successfully, looking forward to a wonderful Christmas and a new year.  

just waiting for monday

My wife and I are currently in a hospital room of the National Kidney and Transplant Institute (NKTI).  Last Monday, December 10, 2012, she had a kidney transplantation coming from her older (and only) sister.  Thankfully, everything went well.  Blood tests showed her creatinine normalized just hours after the transplant and went to the lowest range possible after a full day and stayed there.  The rest of the blood tests (potassium, sodium, phosphorus, etc.) were also within normal range.  Her doctor said her foley catheter can be removed tomorrow (Sunday) and we can go home by Monday.  Her donor sister already went home last Thursday.

There's not really much to do today except process some lab requests for the donor's checkup on Monday so she can go straight to blood extraction.  So I thought starting this blog would be a good way to pass my time today and tomorrow.  I really don't have much planned to write about.  This is really more of a way for me to think on paper, and I might end up with a disjointed set of posts - part-diary, part-documentary.  So, let's just see.