The Road to Recovery

Well, today is Wednesday, and it's already been a busy week. I had an appointment with my nephrologist on Monday, a follow-up with the surgeon that put in my AV Fistula yesterday, and an appointment with my boss this morning. I think everything is going well, so far.

They ran blood work at the nephrologist's office, and my creatinine is down to 5.1, which is just amazing considering that I just lost a kidney. Now, normal is still around 1.0, but I did not expect to be down to 5.1 this quickly. My hemoglobin count is 12.3, which means that I am still slightly anemic. But, the anemia is not nearly as much of a lifestyle problem as the low kidney function is.

The fistula surgeon took a detailed look at my arm yesterday. He said the the fistula is developing well and should continue to do so as long as I keep taking care of it. It takes a fistula about 6 to 8 weeks to mature to the point where it can be used for dialysis access. All my doctors hope that I can hold out for dialysis until this fistula is developed. That way, they will not have to do an additional surgery to put a temporary access into my chest (above the heart). The fistula should be ready (at the earliest) by the end of July.

I also went in and talked to my boss at work today. Now, I have been off of work (on disability) for a month now. He has been very supportive and even came to see me in the hospital a couple of times. He said that he does not want me to rush back in to work, and that I should ask my nephrologist about when I can come back to work. I see the nephrologist again on July 6. The company is doing a good job of looking out for me and they are saving me a position that I can ease back into as soon as I am ready to come to work.

My prayer requests are as follows:

• Pray that my remaining kidney will continue to heal!
• Pray that the fistual will develop properly for the day that it will be needed
• Pray for Jenny (my wife) as she is taking care of me

Good Reports from the Neurologist

I had an appointment with my neurologist today. This was a follow-up appointment from the minor stroke that I had back on February 22, 2005. I recovered from that stroke in about a week, with no left over problems. However, I did have to start taking a blood thinner and a statin to help lower my cholesterol. The doctor did not have a reason for my stroke, but they figured that they might as well give me those medications just to be safe. The neurologist told me today that I am doing well and that she didn't see any more problems. I am now supposed to take some vitamin supplements to help lower my homocystine levels.

I am doing well today, I think. I still feel pretty weak and am not eating as much as I should, which is probably not great. Back in May, I weighed 165 pounds. Now, I am doing well to make the scale hit 150. Now, not all of that is the 15-pound kidney, I also lost a lot of weight due to not eating. Hopefully, that won't be a problem and I'll be able to gain back some of that weight.

Thanks for reading and for your continued prayers.

Visiting the Surgeon

I had an appointment with the kidney surgeon today. He removed the staples from my abdominal scar and taped it up. I had 27 staples in all. He said that the tape will be on the scar for the next few days and that I am okay to shower and let it fall off. He also said that I have healed remarkable well, and I do not have to come and see him for three more months.

I am slowly recovering (physically) and I am actually starting to feel better again. I am able to eat a little bit more food every day (which is nice). My wife and I are trying to take a short walk every night to help me get some strength back up, since I was just basically laying around in the hospital for the last two weeks.

I have heard many, many friends tell me that they are praying for me. Also, my family has told me that they have shared my story with their friends, and that there are several churches all over the country that have me on their prayer list.

If you are praying for me at this time, please continue to pray for:

1. healing (both physical and emotional)
2. that my remaining kidney to continue to work well enough to keep him off of dialysis
3. if my right kidney continues to fail, I will be able to get a transplant

Released from the Hospital

I was released from the hospital at about 2:00 pm on the 14th. That put me at being in the hospital for 16 days. I had never been in the hospital that long before, and this was the only time I had ever remembered having surgery (since my only other surgery had been as a small child).

The AV Fistula surgery had been finished in about an hour on Monday morning. I was told to be very careful with my arm for the next couple of weeks as the surgery was healing up. I am going to go see the kidney surgeon on the 17th to see if I can have the staples removed from my abdomen. Just for an idea, the surgical scar goes from the bottom of my sternum to right below my navel. I also have an appointment for the 28th to have my fistula checked.

I just have to say that one of the most important things that you could ever sign up for with your job is short term disability. If you have the option for this at your job, you should get it. I don't know how anyone could make it, financially, without getting any income for 90 days.

I also want to say that I dearly love my wife. She is a school teacher, so she has been off work all summer. But, instead of getting to have a vacation, she has spent the past 16 days with me in the hospital. We had planned a couple of trips this summer to see some friends and family, but we are going to have to cancel all of those plans. But, my wife has been a blessing to me every day as she has stood by my side. I thank God for His gift of her in my life.

A Radical Nephrectomy

On Monday, June 6, 2005, the doctors came to get me for my surgery. The procedure is called a "radical nephrectomy", which means that they are going to remove an entire kidney. I was in surgery for the entire morning, but there were no complications. They took me out of surgery and sent me off to the ICU for the next two days. I don't really recall anything that happened those days. I do not recommend that as a way to forget your troubles, however.

They told me that my kidney weighed 15 pounds and was 10 cm x 20 cm x 30 cm. This is bad, since a normal (non-cystic) kidney is the size of your fist (see below). So, it was a necessity to remove this giant kidney from my body, even if it meant that it would reduce my kidney function. After the surgery, my serum creatinine dropped down to 6.5 (which was an improvement from the 9 it was when I was admitted to the hospital).

According to http://www.nhpress.com/pkd/kidney/kidney.html:
In the average adult, each kidney is only about 4-5 inches long and about two inches thick (this is about the size of a human fist). Each kidney weighs about 4-6 ounces.

The doctors also told me that I was going to need surgery to give me dialysis access. They call what this surgery would give me an AV Fistula. Basically, they tie an artery and vein together in the forearm. The extra blood flow from the artery causes the vein to grow larger and to become tougher. Since dialysis requires that your blood be removed, filtered, and then replaced, you have to have both vein and artery access for the dialysis needles. The doctors always use a single vein for this access, if possible. The best type of access that can be created is an AV Fistula (which is all natural). There is no graft or stint that has to be put in, which means a quick recovery time from the surgery and that the fistula will have a long life (as there is nothing artificial to wear out). The surgery was scheduled for June 13.

The Kidney Swells

So, I was in the hospital receiving IV fluids to help hydrate me. I had also been passing blood from my kidneys for the last week and was therefore quite anemic. So, during my first three days in the hospital, I received four units of blood. (On an interesting note, I found out that I have the A Positive blood type). Unfortunately for me, my infected cystic kidney was not doing well at all.

My creatinine level had dropped from 9.4 when I was admitted in the hospital to about 8.0. This is not a good level for creatinine (since 1.0 is normal). My kidneys were not faring well at all, sadly.

It seems that some of the infected cysts, instead of just being in pain, were actually be a problem. Your kidney is supposed to filter out excess fluid and waste from your blood stream. My cysts were bleeding into each other, causing the kidney to swell up. And, as the IV fluids and blood was being put into me, it helped my kidney swell very quickly. By Wednesday, my abdomen was severely distended, and they stopped the blood and cut the fluid input to barely a maintenance dose (to keep me from being dehydrated).

The nephrologist talked to me Saturday morning (the 4th) and said that he thought that my left kidney would need to be removed. He conferred with a surgeon and they agreed. The only way to help me have any chance of recovering was going to be to remove the entire kidney. This didn't sound like good news, but it was certainly better than the alternative.