Psychosocial Appointment

Part of the transplant evaluation process is to sit with a social worker to discuss the support system that the patient has. Once the transplant is performed the recipient has to go through a very strict regimen of medicine that has to be taken every day for the rest of their lives. After the transplant the patient has to go the transplant clinic every week for at least the first 6 weeks. The patient would be unable to drive until the surgeon clears you, which is normally about 6 weeks to 3 months. So the patient would have to have a reliable transportation to a from the clinic site, which could involve some travel. They also have to have lab tests twice a week. The social worker also asks questions about your past, like whether you’ve taken any recreational drugs, the amount of alcohol that you drink or when you quit. They want to make sure they the patient is the type of person who will be able to perform the necessary things in order to live as long as possible after the transplant.

My appointment was this past Friday at the UC Davis Transplant clinic in Sacramento, CA. It was originally schedule for 11 am but was reschedule for 9 am, so my mom and I had to leave Gardnerville at 6 am. The drive wasn’t too bad. It was early enough that there wasn’t a lot of traffic to deal with. We ended up getting to the clinic at 8:30 after being worried about not getting there on time.

I finally met with the social worker and we went through the interview, which lasted about an hour. She asked me how the kidney failure happened and about my history with kidney problems. She asked me if there was someone around who would help me keep track of my medications and if someone was available to drive me to my clinical appointments and blood tests. Part of the reasons we picked having the transplant with UC Davis is we have a lot of friends and family that live in the general proximity of the medical center, so transportation and lodging would not be a problem. I told her that at the very least, my grandma and aunt and uncle live in Yuba City, which is just an hour away from the clinic, so transportation wouldn’t be a problem. Also, my mom is moving to Reno to be closer to me and would be available to transport me if necessary. And there’s always my dad. If dad isn’t my donor, then he’s going to be the one who will take care of all that.

After the interview, we talked a little about what the next step would be. The social worker said she didn’t see anything that would be a problem when my case goes in front of the selection committee this Thursday. After the selection is made, I should be contacted within the next couple of weeks. The committee will make a selection that could be more involved then just a Yes/No answer. They might say that I’m approved but need some additional tests, like a bladder test or a specific blood test. They might say that I’m not approved at this time, but if I complete some certain criteria. They could just say No. So, all I can do now is play the waiting game.

Stay tuned for the next episode, which will probably be in mid November after I receive my answer.

Initial Examination

Today I had the initial consultation and exam for consideration to become a transplant candidate. Before I describe today’s activities, let me explain how I got to this point. The story of my kidney failure is well known among my friends and family, so I won’t bore you with those details again. Check out the “about me” section on the right side of the screen.

When you are diagnosed with kidney failure, your first priority is to get healthier. Obviously, you can’t get completely healthy right away. A person who is going through undiagnosed kidney failure is miserable. They have little or no energy, they’re always feeling tired and they start to retain fluids in your abdomen and ankles. You start to feel bloated and tired. Also, your skin color is very pale and sickly looking. You start to feel sick almost every day. The toxins that build up in your body begin to cause your skin to itch.

Dialysis treatments are used to filter the blood of a patient. This is a process that takes your blood out of your body and goes through a machine that cleans the blood and removes excess fluid from your blood. The dialysis process can also be used to put other drugs that your body needs into your blood when it is returned to your body. The entire process can take between 3 ½ hours to 4 hours. You will usually have dialysis treatments at a dialysis center 3 days a week. There are a couple of other options for home treatments, but I don’t know enough about them to describe them.

After a couple months of treatments, your nephrologist will discuss the option of getting a kidney transplant. If it’s decided that’s an option, the nephrologist is supposed to contact the nearest transplant center and they will contact the patient to schedule an initial evaluation, which is what I had today. Normally, the patient will travel to the transplant center for appointments and other services. However, UC Davis will periodically travel to Reno for a day to perform the initial evaluation, which is a lot more convienent then traveling to Sacramento.

The initial treatment involves a nurse who will get your vital signs like weight and blood pressure. This nurse is also the one who will have all the various forms for you to sign your life away. She will answer any questions and give you lots of reading material to read. After that process is completed, you will have a physical exam from a doctor who is on the transplant team. He will get some information about your medical history and will also answer any questions. You will also need to get some heart tests done before you will be considered for candidacy. After a few weeks, you will be contacted by mail whether you are eligible for transplant candidacy. This is determined by a panel of medical people that looks at your medical history, insurance and other factors.

Today’s appointment was pretty straightforward, except for being 1 hour behind schedule. I was done with the evaluation and physical going well. While the doctor can’t guarantee that I will be candidate, he did say that he didn’t see anything, physically that would be cause for concern. I was out of the doctor’s office after about 90 minutes, and that included the delay. The transplant group did want me to get an EKG and some chest x-rays, which I was able to get done pretty quickly. Overall, my appointment was at 10:30 am and I was home just after 2 pm, which was a lot shorter than I anticipated.

So, how do I feel after today’s events? I’m cautiously optimistic. I don’t believe that there is anything that will cause me to be denied candidacy. The only issue that I think I will have is finding a living donor. I’m seriously hoping that I can have a transplant by the end of 2010, if not sooner. I know that’s really optimistic, but I think that it’s defiantly possible, especially if the donor is a family member. Otherwise, I’ll have to wait for 3-4 years.

I will be updating this blog whenever I have a transplant appointment so be looking every month or so. Thanks for reading and I look forward to your comments.