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.