by George Taniwaki

It is still dark outside when my wife Sue and I leave home to go to the surgery pavilion at the University of Washington Medical Center. My check-in time is 6:15am and we left home at 5:30. We have both overestimate the amount of traffic on the 520 bridge this early in the morning. (There is almost none and even though I’m going 65 mph, it seems that what few cars there are, are all passing us.) We get to the hospital easily before 6am.

The receptionist pulls out my yellow chart. She takes the forms she needs and hands the rest back to me. I ask her if I’m scheduled for laparoscopic surgery or open surgery. She looks at a timesheet and states that it says I am scheduled for laparoscopic but the surgeon will confirm. I’m still hopeful about it. She has me fill out some additional forms and puts a wrist band on me. Sue and I take our seats and wait.

****

I am not a happy camper. I haven’t had anything to eat in over 24 hours or anything to drink since 11 pm last night. I’m also still feeling the effects of the bottle of magnesium citrate I drank yesterday afternoon and so have to take a trip to the restroom.

****

After about an hour in the waiting room, I hear my name called. An attendant ushers us to a pre-operative care unit (pre-op). A nurse explains that I can put my clothes and valuables in a garment bag and put on a gown, elastic calf compression socks, and non-slip booties. After I get into the gurney, she starts up a hot air blower that inflates a disposable air blanket. The flimsy blanket is surprisingly warm and comfy while the blower is almost silent.

I have to urinate, so I get up and find a nurse who directs me. But I can’t go, apparently there’s nothing left in me. Slightly embarrassed I get back in my gurney.

Suddenly the room becomes a hive of activity where a steady stream of people enter to check on me and my chart. First, a new nurse takes my vital signs, my BP is 128/90, which is really high for me.

Then the first nurse returns to check my wrist band. She asks me to spell my name and give my birthdate. She then takes a sheet from my chart. She asks me to describe in my own words if I know what procedure I’m about to receive. I say, “donor nephrectomy, right side, possibly using laparoscopic method.” But then I say, “Actually, those aren’t my words, they’re the surgeon’s.”

A phlebotomist takes some more sheets from my chart and takes several vials of blood. My guess is a last set of blood panels to compare to my baseline and a final HLA crossmatch test.

An anesthesiologist, who is not the same doctor who interviewed me two days ago, comes in to discusses my case. An anesthesiology nurse enters and inserts an IV catheter line in my left wrist. Some confusion develops because the anesthesiologist says he was told the surgery was laparoscopic and if I am undergoing open surgery I should get either an epidural or spinal.

The circulating perioperative nurse enters and reviews my chart.

PreOr

Anesthesiologist, anesthesiology nurse, and circulating OR nurse holding the all important chart. Photo by Susan Wolcott

The surgical resident appears and marks my right flank with his initials. He doesn’t know whether the surgery will be open or laparoscopic either. He tells the anesthesiology nurse to stop my IV until he has a chance to confirm with the surgeon, because I need to be coherent when the actual procedure is explained to me. He grabs the chart and leaves. A couple of minutes later he returns and says the IV can start because I’ve already signed the consent form for open surgery.

Finally, the surgeon shows up. Dr. Bakthavatsalam asks me how I am and checks my right flank. He confirms that he will be performing open surgery. He says that is better than starting with laparoscopic and then switching to open if he cannot reach the renal artery using the robot.

He tells the anesthesiologist that I won’t be needing an epidural or spinal. Everything is ready, so I am wheeled into the operating theater (OR). It is a large white room filled with people, bright lights, and equipment. Looking straight ahead I notice the OR doesn’t have a second floor balcony and windows for observers as is usually depicted in television shows. I turn my head to see what’s on the other side of the room and then, nothing…

For more information on becoming a kidney donor, see my Kidney donor guide.

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