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Wednesday, April 27, 2011

PTA (Post-Transplant Anatomy)

There is some confusion, even among medical professionals not directly involved with transplant patients, about the number and location of a typical transplanted kidney.  Fewer are even aware a pancreas can be transplanted, let alone the specifics.  So, to clear up some of the myths and mystery involving my two “carry-on bags,” I’m going conduct my own Q & A session.  Don’t worry; there won’t be any diagrams, graphs, or gory photos.

Why didn’t you get two kidneys?  Because you can live with just one.  In fact, even if that one is only working at half capacity, you’ll still be OK.  It’s one of only a few body parts to have a spare.  In some cases, when the donor was elderly, both kidneys are given to the recipient, but that’s pretty rare.

And they took out one of your kidneys that didn’t work and replaced it with the new one, right?  Wrong.  The new one was placed in one side of my lower abdomen; the pancreas went on the other side.  Your kidney is only about the size of your fist.  Your pancreas is about the size and shape of a deck of cards.  That’s small compared to other internal organs.  There’s room for them in front.  And, no, there isn’t a lump in the skin above each one.  Surgeons leave the old, failed kidneys where they are (except for rare instances when they are causing pain or some other problem).  Eventually, they shrivel up like a prune and get smaller.  To get to them would mean cutting through several layers of back muscle, which is why donating a kidney can be harder for the donor than the lucky one who gets it.

So, you have three kidneys and two pancreases?  Yep.  I’m like those packages of chicken you find at the grocery store with six wings or four drumsticks.  That must have been one strange-looking bird.  From the outside, no one can tell my “innards” are out of the ordinary.

Why did you get a kidney and a pancreas at the same time?  The hospital had a “two for the price of one” sale.  Not really.  I just like to see how people react when I tell them that.  I was diabetic for 21 years.  That’s what caused the kidney failure.  With a new pancreas working properly and keeping my glucose normal, it helps ensure the new kidney will last longer.  There are still a number of things that can go wrong, but at least high blood sugar won’t be one of them.

Do you still have to take insulin shots?  No.  The new pancreas takes care of that.  I can eat as much of whatever I want and I don’t have to stick my fingers several times a day to test the blood sugar.  Life is sweeter when your blood isn’t too sweet.  But, in place of insulin, I take several pills a day to keep my body from rejecting the transplanted organs.  Until they figure out how to clone those two parts, I’ll always have to take the pills.

Did you pick up any of the habits, tastes, or personality traits of the donor?  That’s a good question.  The pancreas (and first transplanted kidney, which only lasted five years) came from a young man in his early 20s.  That’s about all I know about him.  One interesting change I noticed a few months later was that I liked heavy metal rock more than before.  Back in the 80s when it was popular, I could take or leave most of it.  Six months after the transplant, I was rocking out to Van Halen, Aerosmith, Nazareth, and a bunch of other “hair bands” with the volume turned up high.  I also started to have an interest in martial arts.  A year after the transplant, I was taking a non-contact kickboxing class.

One of the meds is prednisone, a steroid, which I took in high doses the first several months.  It makes people more aggressive.  So, my personality changed for a while, but (I guess) more or less returned to what it had been before.

I also found that I didn’t like Chinese food as much as before.  I mean I didn’t like as many different dishes of it.  The ones that I still like, I like very much.

My second transplanted kidney came from someone I know (though I didn’t know her when she offered to donate it—but that’s a topic for another post).  It’s nice having a living donor and being able to know more about them.  She’s a Gemini, same as me, and our personalities are similar.  She’s feisty, quick-witted, spontaneous, creative, and a big fan of change, often redecorating her home.  One thing is certain—this kidney is much healthier than the last one.  It has already lasted almost three years longer than the last one and with no problems at all.

Life must be easy now, isn’t it?  Well . . . it’s easier than being a diabetic on dialysis.  It’s easier than being a former diabetic on dialysis.  But I have to be careful to avoid sick people.  The anti-rejection drugs lower my immunity.  If I get sick, it takes my body longer to fight it off.  The prednisone has side effects, one of them being loss of bone calcium.  I take supplements after having had a broken right foot (once) and broken left foot (twice).

Any final remarks?  Yeah.  Be an organ donor.  All you have to do is sign the back of your driver’s license (or state-issued ID) and—this is very important—tell your family that’s what you want in the unlikely event of a tragedy involving you.  The people who would benefit from it will never be able to thank you themselves, so I’ll take this opportunity to thank you in advance for them.






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