Merry Christmas everyone!

We would like to say a huge thank you to all our family, friends and colleagues for all your love and support the last few months. Also to all the staff at the Royal London Hospital for the amazing work you have done for us to give Pieter a normal life, and for all the other lives you help make better.

Merry Christmas!

Personalize funny videos and birthday eCards at JibJab!

My first check-up

The donor's first check-up is usually a week after the operation, but because I was feeling poorly for the first, week I wanted to wait until I was well enough to make the 90 minute journey to the hospital by train. So I went back ten days after the operation. Natasja came with to make sure I was okay and to keep me company. She even kept some food, sweets and water in her handbag just in case I needed it.

When I arrived at the hospital I checked-in at reception and asked for Sister Lilly, who in turn referred me to Dr. Hector, the surgeon who looked after Pieter. He had a look at the wounds and took my blood pressure, and was very satisfied with my progress, saying everything look extremely good. He told me again how proud he was of me for my sacrifice, by not only saving Pieter's life, but also prolonging it. It's was so nice to hear how much Dr. Hector cared for the health and well being of Pieter, and that he understands everything that the donor goes through to make such a sacrifice. I reiterated again how grateful I am for being in a position to make such a donation to Pieter, and that I would gladly do it again. He also felt that now that we've paved the way for Directed Altruistic Donations, more living donors may come forward.

After my check-up Natasja and I visited Pieter, Lizelle and mom Marietjie. Lizelle was kind enough to drive us to and from the station as by then it was freezing cold and I had done more walking than I should have in one day.

It was amazing to see the transformation in Pieter in only a week since I last saw him! His skin colour was back to normal, he looked healthy and energised, like he just returned from holiday! It brought tears to my eyes. They were all so happy and in such good spirit, which was wonderful to see.

One week after the operation

The first few days after the operation felt like a lifetime while I was struggling with the sickness caused by my bad reaction to the anaesthesia, morphine and pain medicine. I had never felt so sick and weak for so long.

This was largely due to the fact that I was constantly encouraged by doctors, nurses and patients to use the kindly supplied morphine button as often as they allowed it, which was every 5 minutes. With every press of the button a small dose of morphine was injected into my arm. So for the times on the day of the operation that I was awake, and during that night when I awoke, I pressed that button. On top of that I was given oral pain medication every 6 hours too. In hindsight it was obviously too much for my system to handle, and I probably didn't need that much as I wasn't in that much pain. The aim seemed to be to stop the pain from starting instead of relieving it as and when it started. My advice to anyone else would be to use it only when needed if your tolerance for pain is higher than that of sickness and nausea.

Thankfully exactly a week after the operation all the pain medication is out of my system, the sickness and nausea is completely gone, my appetite is back, and my digestion system is back to how it was before the operation.

I was told by my surgeon that the intestines don't like being touched or moved. They apparently react by going into a sleep mode. This coupled with the gasses created by the anaesthesia make for a very uncomfortable stomach, especially when you are forced to eat all your meals and drink as much fluid as possible. For this reason the doctors force you to get out of bed and start walking as soon as the next day after the operation. This helps the intestines move and re-align to a new comfortable position, and to kickstart it back into action. Mine wasn't so co-operative so I was given some laxatives, not great if you find it difficult to move anywhere fast, but it certainly brought some relief.

Now that the internals are working well again, I'm looking forward to the wounds healing so that I can have my movement and flexibility back to normal. I'm not allowed to bend down too far or lift anything heavier that 2kg for 4 weeks. I went for a few walks during the day but with Winter well and truly here and temperatures not much higher than freezing during the day, I decided to give the elliptical cross-trainer a go this morning. It went better than expected and I managed a whole 2 minutes all the while staying warm and comfortable inside.

I'm extremely grateful for making such a speedy recovery, it certainly helps to have a positive frame of mind and so much love and support. Thanks to each and every one of you.

We made UK history!

On the 27th of November not only did I hear that the transplant operation was a success, but also that it was the first of it's kind the United Kingdom!

According to the Human Tissue Authority (HTA)'s Code of Conduct (which can be found here), and is summarised below, there are two basic types of living organ donation:

Types of living organ donation:

1.  Directed donation: A form of donation where a healthy person donates an organ (usually a kidney) or part organ (for example liver or lung lobe) to a specific recipient. The recipient could be known to the donor (in the case of genetically or emotionally related donation) or unknown to the donor (in the case of paired donation).

• genetically related donation: where the potential donor is a blood relative of the potential recipient

• emotionally related donation: where the potential donor has a relationship with the potential recipient, for example, spouse, partner, or close friend

• paired donation: where a relative, friend or partner is fit and able to donate an organ but is incompatible with the potential recipient, and they are matched with another donor and recipient in a similar situation, so that both people in need of a transplant receive a compatible organ

• pooled donation: a form of paired donation whereby the pair are matched with other donors and recipients from a pool of pairs in similar situations, and more than two donors and two recipients are involved in the swap, so that more than two people in need of a transplant receive a compatible organ

2.  Altruistic non-directed donation: A form of living donation whereby an organ (usually a kidney) or part organ (for example liver or lung lobe) is donated by a healthy person who does not have a relationship with the recipient and who is not informed whom the recipient will be.

Seeing as I had only met Pieter twice before offering to donate my kidney to him, I technically did not have a relationship with him therefor it could not be a Directed donation. It could also not be an Altruistic non-directed donation seeing as we do know each other. What swayed the HTA was the fact that we had grown to become very good friends in the 3 months of tests and built an emotional relationship. On this basis it was approved as a Directed Altruistic donation.

A situation like this has never occurred in the UK, and was not allowed by the HTA until now, because it's would encourage the unlawful sale of organs.  Thankfully they saw the sincerity of my donation and approved it, making my Directed Altruistic donation the first of it's kind in the UK!

Post-operation

During the night after the operation all the drugs and painkillers were taking their toll. I had really strange and upsetting dreams about the operation and complications as a result of it, but I wasn't able to tell the difference between the dreams and reality. What made it even more stressful, was that just about every hour there was a doctor or nurse waking me up, wanting to check my vitals, my wounds, ask me questions, take blood, give injections etc. etc. I knew they were all concerned for my well-being but I really felt like chasing them away at least during the night so I could just rest.

The day after the operation I woke up, saw a doctor by my bed and immediately asked how I was doing after the strange dreams. He told me not to worry, that everything was good, and to stay positive. What a relief! I immediately felt great, and just wanted to get out of bed to go visit Pieter. Unfortunately with so much staff, and each person doing only one task, by the time my vitals were checked again it was mid-day.

Getting out of bed wasn't as bad as I thought, and my body and neck & shoulders were more sore from lying down for too long, than my wounds. I was helped into a chair beside my bed, where I sat for a few minutes to gather my strength, when Natasja helped me up to take the short walk down the corridor to my dear friend Pieter.

When Pieter and I saw each other, we couldn't help but smile with a huge sense of relief that it was finally over, and that it had gone so well.

Pieter and his family were in such good spirit, it gave me goosebumps, and made me feel incredibly honoured to have done this for him. He told me how even though he felt ill from all the medication, he could feel this amazing energy inside of him, and could already feel the transformation happening. Small things that we take for granted like a smooth, soft, oily skin, he only just started experiencing again!

We all sat there talking about this wonderful miracle that just happened with huge gratitude to everyone involved.

Unfortunately within minutes I was starting to feel quite ill. I said my goodbyes to everyone and returned to my bed. For the next three days I had a very bad reaction to the combination of anaesthesia, morphine and painkillers. I felt nauseous, weak and feverish. That coupled with all the hourly tests, being overloaded with saline and glucose through a drip, being forced to eat and drink at every meal, forced to get up and walk as much as possible, and forced to go to the toilet and release my bladder and bowels regularly, really took it's toll on me and I had never felt so poorly in all my life.

My aim was to go home on Thursday, but there was no way. I could barely speak. Thankfully Natasja, Lizelle and Marietjie took turns to be by my side, encouraging me to get better and stay positive. More friends of Pieter kept stopping by to wish me a speedy recovery.

By Friday I had a huge conversation with myself, and told myself that I had to beat this thing if I wanted to get out of there to the peace and comfort of my house, with only my amazing Natasja to take care of me. Then I remembered my mom always giving us ginger ale to drink for nausea, and I asked Natasja to bring me some. And what I difference that made! I was gradually beginning to feel better that day and started eating again, and by the evening everyone was saying I looked like the old John. What a relief! On Friday afternoon Lizelle brought me some South African Biltong (Beef Jerkey) and Fanta Grape soda.  It's something I grew up with in South Africa, and brought back so many fond memories that it boosted my energy and made me feel so much better. So much in fact that I decided come hell or high water, I would go home on Saturday.

When Saturday finally came, I was up at 06:00 and felt so much better. I had a wash, walked over to Pieter, had a nice conversation with him, and when I bumped into my doctor told him I was going home, no questions asked. He was very happy to see my progress and ordered one final round of tests before I got the all-clear. I was so positive that I told Natasja to come to the hospital earlier to help me pack as I was coming home! With all the paperwork, medication and transport finally arranged by 13:00, I said my goodbyes again to Pieter and his family, and I was finally and literally on my way home to a speedier recovery!

The hour cab ride home was quite painful and uncomfortable, but all worth it when I walked into my house, and received a huge hug from Natasja. She made me sit on the sofa, wrapped me up in a blanket and made me a nice cup of tea! I was so happy I could literally cry.

For someone who is always healthy and fit to go through such a huge operation took a greater toll that I could've imagined, both physically and mentally. I am grateful to infinity for all the support I have received, and for my lovely Natasja who has been at my beck and call every second of the day, never getting tired or irritated, even on my toilet runs during the early hours!

But from day one I told myself that even if that type of discomfort and pain lasted a few weeks, it would be nothing compared to what Pieter had gone through over the last few year, and still be worth every minute.

There are no words that can describe the joy that I feel for helping my friend, nor for the incredible bond this has forged between us. You are a true hero and inspiration to me and many others Pieter, for never letting your health get you down, and for staying positive and fighting through all the illness and symptoms for so many years.

Here's to seeing you healthy and happy well into your twilight years.

The Operation

I was woken up at 06:00, and had my heart rate, blood pressure and oxygen levels measured. The saline drip that I was attached to during the night to hydrate me was removed and I was asked to take a quick shower and to return to my bed in only my hospital robe.

The next two hours was a sensory overload. I had so many nurses and doctors asking me procedural and medical questions, had more blood taken, and more injections I can't even remember what for anymore.

The reality of it all was starting to set in. I never hesitated for a moment, but I was definitely anxious to have my first operation done. I was so happy to have Natasja, Pieter, Lizelle and Pieter's Mom, Marietjie by my side. They tried their best to keep me calm and positive, and it certainly helped. And knowing that I had my family, friends and colleagues wishing me all the best gave me great comfort.

Just before I was wheeled off to surgery I had to endure another 40 minutes of pain for the trial experiment. At least it made me focus on something different than what was about to happen. There were so many people around my bed by now, including Ray, Lilly, a few doctors and nurses. I felt really well taken care off and in extremely good hands.

The big moment we've been waiting for 4 months finally happened. I was wheeled off to the surgery theatre, to be held in a waiting area. I remember Natasja, Pieter, Lizelle and Pieter's Mom gathering in the hall and I gave them a round of high-fives. Lilly was so kind she waited in the waiting area with me for about 30 minutes, keeping me company while the theatre was readied. We said our goodbyes and I was taken to a small room adjoining the theatre where I was met by the Anaesthesiologist and an assistant. She again asked me many health and medical question such as allergies, previous reactions to anaesthesia etc. I was asked if I had any questions, and all I could muster was: "Be gentle, and don't let me wake up during the operation." She snickered and promised.

When done, she gave me an injection, supposedly 1 of 3, and an oxygen mask was placed over my face to "help me relax and breath better". Thanks doctor I heard all these tricks before I thought, waiting for injection no. 2.... Well I don't know if it ever came, and the next thing I remember is waking up in the recovery room.

It felt like I had woken from a very deep sleep, very disorientated, but no pain which was a relief. I was told that the operation was a success and had gone extremely well. I was so happy and relieved it was over. For me anyway. I thought about Pieter, saying a quick prayer for him, and dozed off.

The rest of the day was just one big blur as I slept most of the time, and when I woke there were always very happy and relieved faces staring back at me. Natasja told me at some point that Pieter's operation also went extremely well. The surgeon called it a "beautiful kidney", and it started working almost immediately!

With all this good news I decided to call it a night and let the morphine do it's work, while I started my healing process.

Pre-operation

With nervous anticipation Natasja and I made our way to the hospital this morning. It felt so surreal sitting there on the train, thinking tomorrow is the big day we've been looking forward to for so many months.

When we arrived at Ward 9F of the Renal Unit at 11:30 I was told they were waiting for a bed to become available as they are full. We were told we could go visit Pieter in the meantime. When we got to his bed Lizelle and his mom Marietjie were there. It was so nice to see them all and especially to meet Marietjie in person. Until now we had only talked through emails. She is the same lovely, kindhearted and caring person I had imagined from her emails. She jumped up and gave me the biggest hug and started crying with happiness and grattitude. I was so touched by her emotions and again realised what this means to Pieter, his family and friends. It's such an amazing ability to bring happiness and hope back to these wonderful people. And to now be a part of the wonderful family.

As we sat there casually talking and getting to know Marietjie, Sister Lilly came to say hello. It's always nice to see her. She explained to us that we will have some blood taken, chest X-rays taken and an ECG done during the course of the day.

We also opted to volunteer for a trial experiment during which they restrict the blood flow from one arm for 5 minutes and release it for 5 minutes, which is done 4 times. This apparently forces the body to release a chemical aimed at protecting the arm from a perceived trauma. These chemicals in turn protect the major organs too, keeping it safe during the transplant process. This will be done once again in the morning before the operation.

At 15:00 my bed was finally ready in the room next to Pieter's. Natasja kindly unpacked my suitcase while nurse Jacky took my blood pressure, measured my weight etc. and checked my medical background. When this was done Natasja, Lizelle and Marietjie went home, leaving Pieter and I to sit and reflect on this huge miracle which has finally come to reality.

Pieter left for his very last dialysis at about 18:00, and I received my dinner shortly after. There is a nice selection of food, and I opted for Cornish pie with sweetcorn and mash, and a toffee yoghurt for dessert. Before I was able to start my dinner my surgeon, Dr Roberto Cacciola arrived to run the procedure by me again and for me to sign a consent form. He was again very kind and helpful and I'm very pleased that he will be performing my operation.

An hour later another doctor came to do a quick check-up with some medical history questions. After that I was sent to the X-ray department for my chest X-rays.

At 22:00 I finally had my ECG. Now I can finally get a good night's sleep before the operation. I have to get up at 06:00 to shower, get prepped, arm pressure experiment, see my loved ones, and get wheeled off for the operation at 08:00.

I would like to thank my amazing wife Natasja for all her love and support, she is my rock, and without her it would've been a much harder path. Also to my family, friends and colleagues who have supported me in my decision from day one. You are all amazing. And off course to Pieter, Lizelle, his family and friends for all their love, advice and kind words.

I know this transplant will go amazingly well and that Pieter and I will live full, healthy lives. I'll be doing a post operation post soon!

The boy and the starfish

Final blood tests before the operations

This morning Pieter and I had to go to hospital for what we hope were the last blood tests before our operations. They want to do a final cross-match test to make sure everything is still perfect, and I assume a few other tests judging by the 12 tubes of blood they took from each of us! Usually it's only 6-7!

When we arrived we were met by Ray Trevitt, who took us to his office. We had an informal chat with Ray about the upcoming operations, and he gave us some paperwork containing what to do/ expect before, during and after the operations.

We were also asked to give MRSA swabs to make sure we don't carry the disease. One from the nose, another from the back of the throat, and finally as Ray put it: "Any dark crevice between your legs". Say no more.

After our meeting with Ray we had our blood taken. Strangely enough I'm getting used to it, as long as I look the other way that is! But the nurse was so good that I hardly felt a thing. Poor Pieter was a little shaky before he even arrived, as the last dialysis he had was on Friday, so to give so much blood really takes its toll on him. But with Pieter being Pieter, he shook it off and carried on. What an amazing person. It just makes every other problem I have that I think is big seem insignificant.

Ray then took us for a tour through the Ward where we will be staying in a fortnight. It was all new, modern and clean, with wide corridors and large rooms. For the past two weeks I've been very tense and anxious over the operation, largely due to the fear of the unknown. But after seeing this I feel much more at ease. Especially seeing how friendly the staff are and how well patients were treated.

Tired, hungry and a little light headed we decided to have something to eat and drink in the hospital restaurant. Wow! We were both pleasantly surprised at how nice it was! It's so modern, bright and spacious, with a great selection of food and drinks, and such a nice atmosphere. We immediately looked at each other and said Natasja and Lizelle would love this place while waiting during our operations. We had another great chat, contemplating the before and afters, and agreed this is such a blessing and amazing event unfolding.

 

We both need to stay fit and healthy before and after the operations, which means we have to avoid public transport and unnecessary contact with strangers. So the next time we'll see each other will be on Monday 26 November, the day before the operation, when I will check-in, so to speak. Pieter needs to be there on Sunday 25 November as there will be a few more tests to be done on him. So until then we just have to wait patiently and calm the nerves.

A huge thank you

I would like to say a huge thank you to the management of PRP Architects for all their support and understanding over the past few months while I underwent all the compatibility test, and for letting me take the recovery time after the operation as company sick leave, even though it's a voluntary operation. Thanks also to my colleagues for your support and comfort, it means so much to me.

PRP are always supporting charities and those that contribute to them, setting a great example for others.

Organ donation survey reveals shocking results

Below is a very interesting yet shocking article from www.kidneyresearchuk.org;

Kidney Research UK has raised serious concerns about public attitudes towards organ donation, after a survey revealed the majority of people in the UK are prepared to receive an organ but not donate one.

Results from the survey, carried out by Usurv, indicate that while 87 per cent of people in the UK would accept a transplant if told they needed one, only one in three are actually on the organ donor register.

Around 50,000 people in the UK require some form of ongoing treatment for kidney failure, of which aproximately 7,000 are currently waiting for a kidney transplant – accounting for 90 per cent of all patients on the NHS’s transplant waiting list.

With more than three million people in the UK at risk from kidney disease and an aging population expected to further increase demand for donor organs in years to come, Kidney Research UK fears demand for organs will continue to outstrip supply – placing the lives of more and more kidney patients at risk.

Professor Tim Goodship, Chairman of Kidney Research UK, said: “The on-going shortage of organ donors in the UK is a problem which is acutely felt by renal patients.

“In light of the results from this survey, we would ask people to give greater consideration to joining the organ donor register. Your organs are of no use to you when you die but could very well save someone else’s life.

“Imagine yourself in a situation where you’ve been told by doctors you have kidney failure and face the prospect of a lifetime on dialysis or even death unless you receive a transplant. Ask yourself, ‘would I accept an organ?’ If the answer is ‘yes’, we would urge you to think about becoming a donor, as this is the very real scenario endured by thousands of kidney patients in the UK every single day.”

Although more than 18 million people have signed the UK’s organ donor register, only around 2,700 kidney transplants are carried out annually.

Even those kidney patients lucky enough to receive a transplant aren’t cured of their condition, as a transplanted kidney only lasts around 10 to 15 years – meaning patients often require multiple transplants in a lifetime and adding to the demand for organs.

Katherine Hall was just eight years old when she was dignosed with kidney disease. Now 30, Katherine is in need of a third transplant but, due to high levels of antibodies in her blood, has only a seven per cent chance of receiving another organ.

“When my parents were told I had kidney failure it came as a complete surprise,” explained Katherine. “Doctors originally thought I was anaemic and by the time they realised it was actually a renal problem my kidneys had stopped functioning completely.

“Since being diagnosed I’ve had two transplants – one which lasted about ten years and another which failed after just 18 months. The antibodies I’ve been left with make it very difficult for doctors to match me up with another donor.

“If there were more organ donors in the UK I’d have a better chance of getting another kidney, and I’d urge anyone who isn’t already on the organ donor register to sign up. It means so, so much to people like me.”

A third question on the survey focused on people’s views around introducing a system of presumed consent for organ donation, where individuals would have to opt-out of becoming organ donors, rather than signing the register.

When asked whether they would support the introduction of an opt-out approach to organ donation in England, more than half of those polled (54 per cent) said yes, while only 18 per cent said no and 27 per cent were not sure.

“The introduction of an opt-out approach to organ donation is a move that would be welcomed by Kidney Research UK and something we have long campaigned for,” added Professor Goodship.

“We also need to improve the infrastructure in our hospitals to better accommodate organ donors and increase funding for research aimed at making kidney transplants work better for longer.

“Finally, it’s imperative that people who are registered donors under the current system discuss their wishes with their loved ones, as the family will always have the final say on whether an individual’s organs are taken after death.”

HTA Meeting

Shortly after our meeting with the surgeon, we had our meeting with Dr. Matthew Buckland, the Independant Consultant for the Human Tissue Authority (HTA).

I was seen first, then Pieter, then both of us together. The point of the interview was to ensure I knew exactly what I was signing up for, what the risks and procedures are of being a living donor and that I wasn't coerced or reimbursed. I also had to provide my passport as proof if identity. The meeting was very long but thorough, and I'm glad that these checks are in place to keep the process legitimate.

While Pieter had his interview I typed the previous post and let my family know about the good news. I was too excited to wait!

After about 40 minutes Matthew returned for me. He told us he was happy with our stories and motivation, but because I offered the donation to Pieter at the very start of our friendship, and the bond grew strong because of it, the donation will be classed as Altruistic instead of friendship. Altruistic kidney donations means to donate to a stranger or to the hospital who then give it to someone on the donors list.

I don't think this will be an issue, the only difference is that the final decision will be made by a panel of independant consultants, instead of just one. We are confident this will be agreed within a week or two.

Pieter also had some blood taken to test the level of immune suppressant in his system. This level will determine exactly how long before the operation can take place, and will be discussed in a meeting on Monday 1 Oct. 2012 by the Renal team.

Apart from the longer than expected wait, we're extremely happy and relieved to have been given the all-clear by the surgeon.

It's an anatomical match!!

I'm still reeling from the wonderful news as I sit here in the hospital reception room!

We just had our meeting with the consulting surgeon Dr. Roberto Cacciola about our tests. He was very happy with them and told us Pieter is extremely fortunate to have a non-related living donor with such a good match. He discussed everything with is in fine detail, down to the actual procedure and incisions.

Long story short, Dr. Roberto showed me die CT scans of my kidneys and was very pleased. He told us that they prefer to remove the left kidney because it has a longer artery and is easier to access. It wonderfully turns out that my left kidney is slightly smaller than the right one by 1.3cm. They will always remove the smaller or weaker one leaving the best one for the donor. My left kidney is connected to my main artery by only one artery, exactly the same as Pieters! Where the one on the right has two.

This means an easy an smooth operation because there are only these two arteries to connect. It's common to have up to 6 arteries, and connecting those to an odd number is very complicated.

So all my tests have been concluded and the surgeon is happy to do the operation!!!



There is one bit of bad news though; he noticed that Pieter is still on anti-rejection medication for his non-functioning kidney, even though his doctor should have told him to stop it once I started my tests. The medication prevents Pieter's body from producing new cells, which means that the new kidney won't be able to attach to his body. He is very upset about it because we were preliminarily scheduled to have the operation at the end of October, and now we have to wait another 3 months. I feel his anguish, but at least we know it will definitely go ahead!

Nephrologist meeting and CT scan

Today both couples had a meeting with the Nephrologist, Ravi Rajakariar to discuss all the test result to date. Our appointment was for 1pm, but we had to wait about an hour to be seen. But at least we had good company!

In that time Sister Lilly came over to introduce herself to me. We had spoken on the phone may times but never met in person. She wanted to know how we were and how all the tests were going. We told her that we thought things could be done a little faster, and asked if the meeting with the surgeon to discuss the CT scan and the meeting with Human Tissue Authority (HTA) could be scheduled for the following week before I go on holiday for two weeks. She was extremely understanding and went off to make arrangements. She came back in a short while, and confirmed that the meeting with the surgeon will be on Friday 28 September 2012 at 11:30am. She said she would  try to arrange the meeting with the HTA for the same day, which would conclude all the tests, meetings and consultations. We will then be booked in for the operation!

Natasja and I were seen first by Dr. Ravi to discuss my results to date. The meeting was very informal, and over in about ten minutes. Dr. Ravi told us what we already knew, that all the tests results were good. It's the best possible news we could have hoped for! What are the odds that two strangers match so well? Then there was a quick routine checkup and medical questionnaire just to tick a few boxes, and we were done! It was a bit of an anti-climax as we thought it was going to be a in-depth meeting to discuss every aspect of the transplant, but excellent news nevertheless. We already know all there is to know about kidney donation due to all the research I did before deciding to donate a kidney to Pieter.

While Pieter and Lizelle went for their meeting, Natasja and I made our way down to the 1st floor Imaging Department for my CT scan. It was so comforting to have Natasja with me and for her to see the hospital as well.

 

  

 The purpose of the CT Scan is to get a detailed look at the size, shape and health of my kidneys, as well as how they are connected to the arteries and veins. The less arteries that connect to the kidney, the easier the transplant will be. We know that Pieter has one large artery connecting his kidney, so the best scenario will be if mine is exactly the same. This is what we are hoping for.

After checking in at reception and waiting some time, I was called in by a very friendly technician named Neil. Neil took me down the corridor to the preparation room. It was quite daunting because I didn't really know what to expect, but Neil explained the procedure that was to follow which put my mind at ease. He asked me some questions about my health and allergies, and I had to sign a form to confirm everything we discussed. Neil then started prepping me by inserted a canular into my arm into which the dye would be pumped later. He told me that it was quite a long needle so he needed a good vein. It was at that point that I decided not to look at it while he inserted it!

Once inserted, Neil directed me to the waiting area, where I had to drink 3 glasses of water to help circulate the dye through my system. I waited a good 15 minutes before I was called in as there was someone being scanned. I was greeted by a very friendly nurse who asked me to confirm my name and date of birth. I had to remove all metal objects, and lie down on the bed. I also had to pull down my trousers to my knees, with my privates covered by the nurse with a towel. Shame on you nurse for sneaking a peek and thinking I didn't notice!

 

Above is a generic photo of a CT scanner, I didn't get to take a photo. I had to lie on the table with my arms raised above my head, hold my breath, and the scanner passed over my abdomen to take the first scan. Then the nurse came to attach the tube to my arm which was used to inject the dye. I was asked if I was allergic to Iodine, but I didn't know. So I was told to wave my arm if I felt any pain or discomfort as it went into my bloodstream. Fortunately it was fine, and all I felt was a warm sensation as it passed through my body. She disappeared into the control room again, and I was told to hold my breath while the scanner passed over me. This happened 3 times. I had to lie there for 5 minutes while they analysed the images, after which they decided to do one more for good measure. The nurse then told me we were done, and I could pull up my trousers. This time I made sure there was no room for peeking! She removed the canular from my arm, stuck a plaster on the hole, and I was released.

Natasja was relieved to see me as she was told it took 10 minutes, and I was gone for 45 minutes. They obviously didn't take all the preparation into account. We went up to the second floor imaging department to meet up with Pieter and Lizelle, and Pieter finished with his X-rays as we arrived. 

Ravenous from not eating all afternoon we went to the Spur restaurant at the O2 Arena in North Greenwich for dinner. To our delight we were told that there was an "Eat all you can" special on ribs and chicken wings - just what we needed! And what a wonderful way to end another day of test; great food and great conversation. We talked for hours about how far we had come in the past 3 months, and all the wonderful times that lie ahead.

 

Kidney function passed with distinction!

It's been exactly a week since my kidney function tests, so I phoned the hospital at 09:05 as not to seem too eager. To my surprise Sister Lilly answered the phone, who has been on sick leave ever since my very first telephone conversation about the proposed donation. Welcome back Lilly!

Lilly didn't have the results at hand, but phoned me about an hour later to tell me the good news - I have 84% kidney function!! The minimum required before a transplant will be made is 80%. Truth be told on the day of the tests I was only allowed a very light protein lunch, instead I had two lovely sandwiches, one filled with chicken, the other a BLT! I forgot to mention the restrictions to Natasja, so when she arrived with them I was far too hungry to say no. So for all I know I have a higher function! But at least I know worst case is 84%.

What wonderful news! It's so nice to pass one test after the other, with the final goal of getting Pieter healthy getting closer by the day.

The next step is a meeting with the Nephrologist to discuss the results, which has been booked for 20 September 2012, although I asked Lilly to slot us in earlier should there be a cancellation. After that, it will be the CT-Scan.

But first, more celebrations this weekend!

Kidney function test

It was another early morning rise to have the last crucial test done, the kidney function test. The upside was that I got to travel to London with my lovely wife Natasja, who went all the way to the hospital with me, where I met my good friend Pieter, who kept me company the entire day. What a blessing to have such wonderful people in my life.

In short, my kidney function is being tested to make sure that they can both survive and function properly on their own inside Pieter and I. They have to be able to operate at a minimum efficiency of 80% before a transplant will be considered.

This test measures the glomerular filtration rate (GFR). It assesses the ability of the kidneys to ‘clear’ the blood of a substance. A small amount of a harmless radioactive tracer is
injected into a vein and blood samples are taken at intervals over a number of hours to measure the clearance of the radioactive tracer through the kidneys.

We arrived at St. Bartholomew's Hospital, Queen Elizabeth II wings just after 9am. I greeted Pieter, and said goodbye to Natasja, and Pieter and I went on to the reception of Nuclear Medicine Department. How scary are those words?! Nuclear Medicine! It sound like something from a Sci-fi movie.

There were a few patients ahead of me, and I was seen at 9:45am by a lovely nurse named Jo. She took my weight and height, and directed me to dreaded chair for the injection. I know it's not as bad as it sounds, and Jo did explain it to me, but it's still not nice being injected voluntarily with a radioactive material!

 Fortunately I didn't feel a thing and had no reaction to the injection. Once the radioactive material was injected, a saline solution was injected to clear the needle for disposal. Jo told me to come back in three hours for my first blood sample of 7ml to be taken. Four samples are taken in total, at hours 3, 4, 5 & 6.

With 3 hours to spend, Pieter and I went for a walk, and ended up have a drink and a snack at EAT in the recently completed One New Change shopping centre. As usual we ended up relaxing in conversation for about and hour and a half, when we left to visit Natasja at work only 10 minutes away. There we had another relaxing time in their canteen, before heading off for my first blood sample to be taken.

 The needle was inserted into my hand instead of my arm because it needed to remain there until the last sample was taken, which included the white "tap" you can see in the picture below. My hand was wrapped in bandages to prevent any movement or damage to the needle. My body did not like this foreign object at all, and there was a slight burning sensation for the first hour, but then it went away and I forgot about it. After every blood sample taken, saline solution was injected into the vein to stop the blood from clotting around the needle. This was all painless, with only a slight cold sensation.

 After this first sample Pieter and I met Natasja at St. Paul's Cathedral just down the road for lunch. She's so lovely and caring, and bought us sandwiches, drinks and a tub of strawberries and cream! Just what the doctor ordered! The time seemed to fly by and Pieter and I returned to the hospital for more blood samples. During the breaks between the last 3 samples we sat in a little park close by and just enjoyed the quiet surroundings and each other's company.

Before we knew it, it was all over. Thanks again Pieter for keeping me company, even though you were feeling a bit poorly from last night's dialysis. It was very comforting having you there, and a great way to pass the time.

I just wish you would've listened to me, and not made me mad with all the radiation still left in me! You knew what would happen, I warned you! AAARRGGHHHH!!! Now you have to deal with the HULK!!!