Hello Morton Kidney Transplant supporters!  Here’s another supplemental entry for anyone who has occasionally pondered, “I wonder what’s going on with Lance?”  This is a brief overview of the current “sitch” (this is shorthand for “situation”— it’s what the cool kids were saying five years ago, and lame adults say it now)

Since my last entry, I’ve been bumbling along and enjoying life on the other side of renal failure.   There’s a lot to be said for having a working kidney.  I highly recommend it and give this version of life a 5-star review, two thumbs up, and a smiley face sticker.  (THANK YOU, LAYNE!)   

That’s not to say there aren’t some issues here and there.   A variety of side effects from medications have made things interesting and occasionally challenging.   Additionally, there’s a non-stop dialogue with insurance, pharmacies, and doctors’ offices.   And, of course, I still spend a heap of time getting stuck with needles and filling up specimen cups.     By the way, have you ever noticed urine sample containers look very similar to the pudding cups you get in the hospital?   (This is one instance where I’m entirely against recycling.)

Speaking of hospitals, I did enjoy some time in the big white hotel last July and again in November.  

The issue in July was due to an infection.   I don’t think anyone ever really got a good sense for where the infection started, but it settled in my brand new (to me) previously owned kidney.  Fortunately, the doctors beat the infection into submission with antibiotics running into my arms for the better part of a week.   Aside from a little concern about the infection setting up permanent residence, it was a fairly restful week.   They fed me well, too (although I gave the pudding cups a suspicious side-eye glance).      

The hospital stay in November was due to pain and swelling in my right leg.   The pain started the previous week, and I noticed swelling starting over the weekend.   I took a photo on Monday morning, sent it to my transplant team, and drove into work.  They called me almost immediately after I arrived at work and told me to “Get to an emergency room as soon as possible!” 

The symptoms presented as deep vein thrombosis (DVT), a blood clot that can be serious.   While I’m not sure just HOW serious this can be, I bypassed the line in the ER and was given a shot of Dilaudid (this is the big brother to the drug they used during the Civil War when cutting off limbs, doing surgery, pulling teeth, or simply looking for a totally groovy way to pass time.)     

As a teaching hospital, they brought in a dozen or so DITS (doctors in training) to see a real-live blood clot in action.   They all took turns looking at my leg and touching it, feeling for hot spots. Being quite high on a potent pain killer and essentially naked, I told these eager youngsters, “Look with your eyes; touching will be an extra charge.”       

It turns out, the painful swollen right leg wasn’t a blood clot.       

Just over 24 hours later, they cut me loose from a hospital room with my arms full of needle holes and a calendar full of appointments for future testing.   At that point in time, the doctors had a strong belief this was a vascular issue, so I went through a lot of imaging work.  

Eventually, I found myself going through a procedure where a surgeon made a small incision in my groin and went exploring through blood vessels.   After being prepped for the procedure, the surgeon came into the room for the traditional pre-game pep talk.  It’s interesting to me that after time in the hospital, a half dozen imaging processes, and lot of doctors looking at my leg, he diagnosed it with just a quick glance.  He took one look and said, “That’s not vascular, it’s lymphedema”.   Then, he said, “Let’s get cutting!”, and I was wheeled into a surgery which confirmed it wasn’t a vascular issue.

Follow up testing confirmed it’s a case of lymphedema (an unusual acute onset).   Lymphedema is swelling caused by an accumulation of fluid that's usually drained through the body's lymphatic system.  Somewhere in the lower right quadrant of my body, the lymphatic system has stopped functioning.   This is often caused by surgery, an injury, cancer, or cancer treatments. 

There’s no real cure for lymphedema.  It’s treated with compression wrapping, manual drainage (a very light massage where the skin is pulled towards unaffected parts of the body), pneumatic compression therapy (a machine), and compression clothing. 

I’m doing some additional testing in February and getting set up to see a specialty surgeon later this year who might be able to improve the situation with some cutting-edge work.  He’s known for his work in lymphovenous bypass and lymph node transplants.  I’m keeping up some hope for improvements.    

So, to cut this long story short:   since mid-November, the pain and swelling in my right leg has increased.   Motion has become limited and moving over any significant distance has become more challenging.   I’m now walking with a cane (totally rocking that look!) and doing a couple of treatments each week with an occupational therapist.

I started this update with a comment about lame adults.   That’s me; I’m a lame adult.   But, I’m still happy to have a working kidney and every day since 6/21/2021 is bonus time.    I hope you’re all doing well and 2023 brings you only blessings and joy!