Bye Bye Gall Bladder

Hi, this is Jenny, Nathan's wife. He asked me to write and let everyone know how his gall bladder surgery went this morning. He was in surgery for about an hour. The doctor said things went well and there were no problems or complications. His blood pressure dropped once during the procedure, but it came back up when they gave him some extra saline. They think he was probably a little dehydrated from a combination of not eating and last night's dialysis.

Nathan has minimal scarring; four tiny incisions, two of which are on the kidney scar. He is pretty uncomfortable, but we're at home resting. He's hoping to be well enough to return to work on Tuesday. He was glad to get Monday off as a holiday.

We talked to the transplant coordinator this morning to let her know about Nathan's surgery. She said she temporarily changed his status on the transplant list to Level 7, which is like being on hold. She is going to check for us to see how long he will remain at that level. I would guess 4 to 6 weeks. She explained that even though he is “on hold” that he is still accruing time on the list. He will not have to start over with his amount of time spent on the list.

Please pray that he recovers quickly and will be able to return to work soon. We're hoping to be at church on Sunday if Nathan feels up to it.

Thanks for coming by to read! I'm glad Nathan allowed me to be a guest writer. Maybe I'll get to come back again when he gets his transplant. :)

Laparoscopic Cholecystectomy

I went to see my vascular surgeon Tuesday afternoon to talk about my fistula and my gall bladder. The appointment was originally set up so that the surgeon could say that it was okay to start using my new upper arm fistula. However, since my catheter was not working as well as hoped on Saturday, they used one needle in the fistula then. The appointment turned out more to be us talking about my fistula and us setting up a surgery for my gall bladder.

I’ll start by telling you about the gall bladder. I am having a “Laparoscopic Cholecystectomy”, which just means that they are using four very tiny incisions to remove my gall bladder, rather than slicing me open to fish it out. I have been having a lot of nausea and stomach pain since my kidney was removed last year (it has been almost exactly one year). The gastroenterologist had done several different abdominal scans, and she decided that my gall bladder could be the cause of my problems. A couple of stones showed up on the scans (I saw them) and it seems that removing it would be a good idea. The surgeon said that he would rather take it out now then to have it cause an infection after I get my kidney transplant and cause me to lose the graft (“the graft” is what people in the kidney transplant business call the transplanted organ, just so you know).

I have an appointment for Friday morning (11:30am) to have my gall bladder removed by the same surgeon who has done all of my fistula surgeries. By using the same surgeon, I don’t have to add any more doctors’ business cards to my already full wallet. But, it also gives me the assurance that this doctor knows about my other conditions. I also trust his surgical abilities, as he has not had any problems, yet.

Additionally, the surgeon and I talked about my fistula. My nephrologist had been worried that the new fistula was too short and curvy to be of any use. The surgeon explained to me what had happened. When he laid the vein after moving it closer to the surface of my arm, he put it in a nice smooth arc. He said that after you connect it to the artery (making the vein a fistula) that it can get “scrunched up” a little bit. So, rather than maintaining it’s perfect arc, it ends up with a small curve. He showed me the vein on the sonogram, and it seemed to be fairly straight. He said part of what the nephrologist might have seen was some bulged areas of the fistula. The fistula is a little wider in some places than it is in others, and that might feel like curves if you are in a hurry (which the nephrologist always is). The surgeon said not to worry about the vein. If the technicians do have problems with sticking it, then he can always go back in (another surgery) and tie the vein down in a straighter line. So, the nephrologist said to leave my chest catheter in for a few weeks while we start using this new fistula. That way, if the surgeon needs to put in some ties to straighten it out, I will still have an available dialysis access (regardless of the fact that it does not work too well).

The nephrologist also prescribed Fosrenol for my high phosphorus. Since my calcium was near 10, he did not want to have me add more PhosLo. Instead, he added a new medication to take after meals that will help bind the phosphorus in my diet. I will probably send that prescription off tomorrow and will have it in a few weeks. It won’t be early enough to help on my June labs, but maybe by July my phosphorus levels won’t be so dangerously high.

Please pray for me as I have surgery on Friday. Also, continue to pray for my dialysis treatments. They are running me slowly with this new fistula, and I don’t think I am getting as good of a treatment. I have not felt well since Saturday. Hopefully that will clear up as my fistula matures and it can run a faster dialysis treatment. And, continue to pray for my dad’s lab results. I will let everyone know as soon as I hear something. Thanks!

Started New Fistula on Saturday

I had another exciting dialysis treatment on Saturday. Normally, the dialysis treatment runs without issue for four hours, and then you go home. On Saturday night, however, I was not so lucky. My machine was having trouble with the arterial pressure. The arterial pressure is the amount of suction that the pump has to use to remove the blood from your body. If the pressure gets out of range, that can be very dangerous, so the machine stops drawing out blood. I was having problems with my arterial pressure after about five minutes on the machine.

The nurse tried everything she could think of, including laying my chair down flat and switching the lines on my catheter. Since nothing was working, she called the on-call doctor and asked if she could use one needle in my new fistula. This is the fistula that was placed above the elbow on my left arm almost seven weeks earlier. The doctor said yes, so the nurse placed one needle in my arm, and left the other in my chest catheter. The needle did not hurt too much going in, which was nice. I still had pressure problems with my catheter, and they ended up switching which side of the catheter they used about three more times during the next three hours of my treatment. The bad part of it all was that I don’t think I got as good of a treatment with the machine running slower and it stopping all the time.

Sunday morning when I woke up, I felt sick (which is not abnormal). Before we were ready to go to church, however, I began to vomit. This did not make me feel better, so we stayed home from church. I felt pretty sick for a couple of hours, and did not try to eat again until almost 11:00 am. The soup stayed down, so I figured that I was better. I did not really feel better until after I took a nap (I hadn’t slept well Saturday night). By Sunday evening, I felt better, and I did make it to work on Monday.

I have an appointment with the vascular surgeon Tuesday morning. I’m not really sure how it is going to go. Since they have started using my fistula, I don’t suppose I really need his permission to use it. I have to make him page my nephrologist so that they can talk about my fistula, but aside from that, the fistula information should be easy. I am also supposed to talk to the vascular surgeon about my gall bladder. The GI doctor thinks that it needs to come out, so I have to see if he has read my records and if he agrees. If so, that’s one more surgery that I have to schedule and another delay in the transplant (if my dad is approved as a donor).

Please continue to pray for the transplant team as they process my dad’s results. I would like to know as soon as possible whether or not he will be a good donor for me. Also, pray for my appointment with the vascular surgeon on Tuesday morning. I don’t enjoy talking about having more surgery, but I want to do whatever will be the best for me. And, pray that my arm will finish healing. The needle didn’t cause many problems for me, but the skin is still quite sensitive around the surgical incision, so the tape that holds the needle in place was kind of painful to remove. The skin was red for quite a while. I am hoping that it will heal or toughen up a little.

Thanks for reading with me today.