[Note: This entry was actually written in Feb 2014. I changed the posting date to keep my blog entries in chronological order.]

by George Taniwaki

The story of my recovery at the hospital starts in a Sept 2010 blog post.

Day 2

I had a very difficult night. I was uncomfortable and in pain and didn’t sleep well. Despite that, this morning although I’m not feeling refreshed, I still feel a lot better than yesterday.

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Feeling much better on the second day. Photo by Susan Wolcott

Kidney pillow project

I’ve brought one of my kidney pillows (see June 2010 blog post) from home. As a souvenir of my stay at the University of Washington Medical Center, I am asking every person who visits my room to autograph it. I missed all the people yesterday before my surgery and immediately afterwards. But I have started this morning. I already have three signatures.

KidneyPillow

Kidney pillow. Photo from Shumsky

Pain control

I’ve been up most of the night pushing the button on my PCA pump. I feel less pain and have less nausea this morning. I actually look forward to switching from clear liquids to having a full liquid meal. I have a cup of yogurt for breakfast. Throughout the morning, my pain level continues to drop. I still push the button, but am not in constant pain between doses and am not miserable if I forget to push it regularly.

Later in the morning, a nurse comes in and asks my name and date of birth. She then disconnects the PCA pump and gives me two 5mg tablets of oxycodone (a synthetic opiate sold under the trade name OxyContin).

No more monitoring

Another nurse comes in and asks my name and date of birth. She then removes the cannula so that I am breathing without any assistance. Then she removes all the electrodes connecting me to the monitoring device. She wheels the monitoring device out of my room.

Walking therapy

A bit later, a physical therapist comes in and says she wants me to get up and walk at least once every eight hours or a minimum of three times a day. The rolling IV pole in my room is designed to hold my IV bag and my Foley drain. It has a handle that I can hold onto for balance.

IVPole

IV pole with handle. Photo from ivpolesonline.com

She helps me sit up. This makes me dizzy, so I take several seconds before standing up. Slowly, I get out of bed. Once up, I find it hard to move. But with my wife’s help, I can shuffle to the end of the hall and back. That little walk of less than 100ft (30m) round-trip leaves me exhausted and I want to get back in bed.

Walking serves several functions. It improves breathing, it helps heal the abdominal muscles damaged by surgery, it improves circulation and the immune function, and it improves urinary tract function.

Breathing therapy

The physical therapist also gives me a deep breathing exerciser. She tells me that I should inhale deeply enough to cause the yellow ball to rise to the top of the column. This indicates my air flow exceeds 1,200 ml/sec. Deep breaths will reduce the chance of congestion and lung infection. I need to use the deep inhaler at least four times a day for the next week. Oddly, although it doesn’t hurt to breathe deeply, I find it difficult to perform this task and it tires me.

DeepBreathExerciser

Inhaling through the deep breath exerciser and watching the yellow ball rise. Photo by Susan Wolcott

Flowers and card

In the morning, I have a visitor, a fellow UWMC volunteer. (I became a volunteer this past summer while waiting for my surgery.) She brings me a pot of chrysanthemums along with a thank you card from the family of the recipient. How very thoughtful and nice. I ask her if the recipient’s room is nearby so that I can thank them. She says no, they are on the transplant floor. This leaves me puzzled. I ask her where I am. She says I am on the oncology floor. Apparently, since my donation is nondirected, to avoid the possibility of the donor and recipient accidentally meeting, they are assigned to different floors.

Surgical consult

My second visitor today is the urologist who performed the donor nephrectomy, Dr. Ramasamy Bakthavatsalam. He checks the incision. He says it looks very good and should heal nicely. He asks how I am, and I say doing well. He thanks me for being a nondirected donor and looks forward to seeing me in two weeks.

Food

By lunch, I am actually hungry. My choice is cream of vegetable soup and a cup of tea, with pudding for dessert. This soup is also bland with too much salt.

The nurse tells me that starting with dinner, I will be able to order any meal I want from the menu and they want me to get my digestive tract back to normal activity.

Living donor advocate visit

The living donor advocate, Paige Kayihan, drops in for a visit. She wants to make sure my recovery is going well and that I don’t have any problems. Everything is fine I say. I will have a follow-up meeting with her next week.

Day 3

I feel a lot better on the third day and look forward to going home.

No more urine monitoring

A nurse comes in and asks my name and birthdate. She then removes the nearly empty IV bag from my arm (about the 10th one I’ve had since being in my room) and removes the catheter. She also removes the Foley catheter from my bladder and empties the collection jug one last time. She says she will be back later today to confirm that I can pee. I feel somewhat inadequate. Really, she wants to know if I can pee?

Physical therapy

I’m now able to walk all the way around the hospital floor without stopping. However, I do stop and look at the art on the walls and read the curator’s tag on each one. I’m also finding it easier to do my breathing exercise, though it still tires me. My therapist tells me that I am doing great and can be discharged as soon as I can urinate on my own and have a bowel movement.

Transplant rounds

Today, a group of interns and residents in the transplant program come to see me during their rounds. They are led by Dr. Stephen Rayhill, the attending kidney transplant surgeon at UWMC. I assume he was the surgeon who transplanted my kidney into the recipient. He asks me how I am. I say I am doing fine. I ask how the recipient is doing. He says that he can’t tell me. (I knew that.) I tell him that’s okay, because I can tell from the demeanor of the other doctors that everything must be okay. He smiles. I ask him to sign my kidney pillow.

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Stephen Rayhill. Photo from Seattle Children’s Hospital

After Dr. Rayhill leaves, I wish I had asked him two questions. First, since my nephrectomy was delayed, is the patient who received my kidney yesterday the same one who would have received it in June? That is, did the original patient who was offered my kidney wait three months for my kidney or go with a next available deceased donor? (For my original thoughts on this, see July 2010 blog post.)

Second, was he involved in the decision to perform open surgery on me. (For my original thoughts on this see Sep 2010 blog post.) I think his answers to both questions would make excellent blog topics. Oh well.

Discharge instructions

The living donor coordinator, Kami Sneddon, drops in to visit. Like everyone else who visits, she thanks me for being a nondirected donor. She gives me a set of instructions for my continued recovery at home and reviews them with me. She gives me prescriptions for narcotic pain relievers, antibiotics, and stool softeners. She also sets up an appointment for my one-week follow-up consult with the surgeon.

Discharge

It is almost 6:00 pm and I’ve finally had a bowel movement. The nurse agrees that this is the last milestone that indicates that I can be discharged. I start to get dressed and realize that I can’t fit in my pants. My abdomen is distended from a combination of the IV fluids and the inflammation caused by surgery. I have to borrow a hospital pajama bottom to wear. I promise to return it when I come back for my follow-up physical exam next week. Looking quite dignified in dress shirt and pajama bottoms, I walk out the hospital with my wife, who drives us home.

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

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