So I’m going into surgery on June 1st and I wanted to give people an overview of the process. I don’t know everything; I’ll know more as I go through it.

              Two weeks before my surgery, I am supposed to quarantine to reduce my risk of getting covid. I’m still allowed to go to dialysis, my doctor appointments and things that are necessary, but I’m not supposed to put myself at unnecessary risk like getting together with friends. I knew this well in advance, so I made it a priority to socialize for the last month and a half after being fully vaccinated. I will be tested before my surgery- on May 30th. If I tested positive for covid or my mom, I would have to reschedule a month later for the transplant. The chances of getting covid are low since I’m vaccinated and as of this writing there are about 21k of covid cases per day across the nation- still elevated but far better than it has been. We could have done the surgery several months ago and the doctors were pushing me due to a lack of data on the issue, but I thought it was too great a risk. As data emerged later, it turned out to be the right decision as a quarter of transplant patients who got covid died and transplant recipients who got the vaccine after a transplant, only half produced the necessary antibodies to protect against covid because of their suppressed immune system.

              A week before my surgery I had a pre-op down at the hospital where I am having the surgery -UPenn. They did a chest x-ray, drew over a dozen tubes of blood and I got to sign consent forms with my surgeon. The appointments were in the middle of the day, so I did not have to wake up earlier than normal. Everything in my tests looks good. All the things that should be working are and all the things that should not be working weren’t. The surgeon did not say anything too surprising about my operation. My mom will go first, and they will do it in a way known as laparoscopy, which is where they fill her abdomen with Co2 to distend it so they have more room to work. She said my mom has the typical anatomy for a kidney- one artery, one vein one ureter and for that reason it should be a straightforward operation without much risk. With my surgery the incision is not in my abdomen but around my pelvis. The incision will be one long and curved cut that runs from the midline of my pelvis to the lateral portion of my pelvis, right up until the abdomen and they will place the kidney inside my pelvis instead of going behind all my abdominal organs and attaching it there which is where the kidney normally sits. The news about the incision brought me some relief because cutting through the pelvis as opposed to the abdomen is less painful and restrictive. I had a PD catheter placed in my abdomen early on in this journey and it was uncomfortable. My other two kidneys will still be inside me and still attached so they will still work. My kidneys still have residual function, as do most patients with kidney failure, they just do not work well enough to sustain life. The surgeon said that as time goes on it is normal for the body to stop using them and solely use the new kidney for all functions. She said given my low level of body fat and my high level of muscle mass I may feel the kidney when its placed inside. As long it doesn’t restrict my mobility or cause pain and damage to the kidney It should be ok. I’m sure the sensation will simmer in the background at some point.  She said that there is a 99% chance that after the surgery I should have a working kidney.  After that there is a whole host of small risks such as rejection, clotting, bleeding. She said that if I can go the first year without any serious complications the average length of time a kidney transplant works for is 19 years – a 90% chance. Though I am relatively low risk because of my health and age. Given my health focused lifestyle I think I stand a good chance of having it last greater than 19 years. There is also the issue of recurrence of my condition. I feel confident that it will not based on what we know but we are dealing with something very rare so no one can say for sure.  

               Our arrival time for our surgery Is 6 AM. If we were to drive from our house to UPenn it would take an hour and we would need to wake up at 3 to get there. So we decided the day before the surgery me, mom and dad will drive down to my brother’s and stay the night. We will drive down in the evening after my dialysis. UPenn made it clear that I needed dialysis the day before surgery to have as little excess fluid as possible because they will be giving me lots of fluid during surgery. To not have dialysis the day before risks fluid overload which can cause complications. The day before my surgery is Memorial Day but the dialysis center is open that day. They are open on most holidays as the health of a kidney failure patient does not rest.

 My brother Jordan lives in Media PA which is 20 minutes from the hospital. It would save us an hour-long drive when we will all be tired, and by staying down there we can get more sleep. At 3pm, the day before the surgery, my mom will need to begin fasting and she is supposed to take a small bottle of magnesium citrate to clean out her colon via diarrhea. I start fasting at midnight.

              On the day of the surgery while my mom is undergoing her surgery. I will be taking a drug through an IV which is supposed to wipe out my immune system and it takes about 4 to 6 hours. The purpose of this is because my mom’s kidney will be detected as a foreign body by my immune system, and it needs to be wiped out and then later suppressed so it does not attack and destroy the foreign kidney. I’m expecting my surgery to start in the afternoon and conclude in the evening. Both surgeries are about 3-5 hours in length and both me and my mom will be under general anesthesia. This will be the first time my mom has gone under general anesthesia, I have been under it a few times in the past year and have built a tolerance to the after effects, but its rather unpleasant, you feel like all your organs are asleep upon waking and you wake up in a bath of pain.  Both of us during surgery will have a catheter placed in our bladders inserted through our genitalia. The catheters will be kept in for 1 to 2 days. This was something I did not expect nor am I looking forward to.

              My mom’s hospital stay should be around 1-2 days and mine will be 3-5 days. While in the hospital, I will receive a few IV infusions to wipe out my immune system and will start on a whole new medicine regiment. Sometimes it takes time for the kidney to kick in so I may need some dialysis after surgery. There are instances where transplant patients will need to go back to a dialysis center for a period before the new kidney starts to pull its weight. I will be on four different types of immune suppressants and will be on them for life with the dosage tapering downward over time. I will also be on pain meds, anti-infection meds to help provide support to my immune system as well as supplemental meds. Unlike the immune suppressants, I will only be on them for up to 6 months post-transplant and they will taper down with time. While in the hospital they want to get me on my feet walking as soon as possible to prevent clotting and to help get me out of the hospital as soon as they can. Me and my mom will be in separate rooms, but we will both be in the same wing. Both me and my mom are allowed one visitor so it will either be my dad or my brother as they will be my caregivers post-transplant. Every transplant patient needs to have two caregivers designated before the surgery.

              When I get home, I won’t have an immune system, I will be isolated for 6 weeks, I can’t drive for 8 weeks and I will be able to emerge back into public life after 12 weeks. I will have weekly visits down to UPenn for 6 months to make sure my meds are properly dosed, and that the kidney is working as it should, and then monthly visits for the next 6 months and then it becomes once a year.

              Based on what I’ve heard from others a kidney transplant is supposed to make a substantial difference in how people feel. Dialysis only accounts for 15% percent of total kidney function but a new kidney will be 50%. I already feel good and am capable of a lot physically and mentally so I am curious about how I will feel after. There is also the freedom of not needing dialysis, but dialysis hasn’t been an obstacle for my lifestyle. I just drive there and do all the things that I want to. With the pandemic nothing substantial is going on, and only now things are starting to return to normal. I have been asked by many people if I am excited or nervous about the surgery and the days ahead. I am not either of those things. Over the last 1+ year I have developed a defensive stance against the tides around me. I do not get beat up if bad things happen and I do not get too happy from potential positive things either. I learned to stay in the present and I enjoy where I am at rather than waiting for a kidney transplant to be happy. I do want the kidney, and I am sure I will feel better, but I also appreciate the moment. I do not know what the future holds, and I don’t want to wait to enjoy life. I want to enjoy it now and to treasure every moment. Most people know that they are going to die, but unless they sit down and contemplate their mortality, the thought of dying is nary a thought nor an action. Most people act as if they are going to live forever. But death is a very real thing for me. Something that I must live with day to day. And when I get a kidney transplant, I will always be living on borrowed time, knowing full well that it could last until tomorrow or twenty years from now, and I’ll need to put my life on hold again to get a new one. I’ve learned to cherish the good days and the bad, finding value in both and I burn with the will to not just live and let the days go on by, but to do things that resonate with the deepest parts of my being. Not just to live, but to feel alive.