My kidney-donation process officially ended today with a telephone call from the program coordinator. He reported that the review committee had considered my application on Monday and concluded that I was not a satisfactory candidate. The primary reason for this conclusion was my indication to the psychologist that I would be reluctant to abide by their recommendation to reduce alcohol consumption to one or two alcoholic drinks a week. A secondary reason was my self-reporting that, after my knee-replacement surgery a few years ago, I had experienced some minor depression, apparently due to 4-6 weeks of forced inactivity and my weaning from pain medication.
I was a bit surprised by the phone call because I thought they were waiting on me to decide whether I would go through with the donation despite their alcohol warning. They took the decision out of my hands, but I had pretty much decided against the donation unless I was able to find solid evidence that one kidney can be expected to handle as much alcohol as two.
I’m a little relieved because the donation was not going to be a picnic, but I’m similarly disappointed because a chain donation would have time well-spent.
Last week, I had several interviews with members of the kidney-transplant team, including a doctor, an advocate, and a clinical psychologist. Everything seemed fine until the clinical psychologist learned that I typically drink alcohol at a rate of 3-4 drinks 3-4 times a week. She noted that they recommend that people with a single kidney drink no more than 1-2 drinks a week. That would be problematic, I told her.
A couple of days later, the psychologist called me back to confirm that, although their guideline was conservative, she had confirmed that any drinking of alcohol in excess of that would be risky. She suggested that, because my donation was entirely elective, and because my health currently was in such a good place, I should seriously consider whether I would want to do anything to potentially throw my life out of balance.
As I’ve thought about the matter this weekend (and done a lot of internet research on the subject), I am learning against the donation. The 4-6 weeks of post-surgery disability is concerning enough, but permanently and dramatically curtailing my drinking is probably too much. Drinking 3-4 times a week is an important part of my social life. If I had to choose between giving up drinking and giving up yoga, I’m not sure which I would do. Fortunately, I don’t have to give up either.
More time to think.
A few days ago I blogged about contacting a transplant hospital to donate a kidney. During that initial contact, I was given a brief telephone interview and was sent a specimen bottle for collecting urine for 24 hours. The specimen had to be refrigerated, so imagine my perverse feeling in going to the refrigerator every time I felt like going to the bathroom. Today, I brought the specimen bottle in to the hospital and had about a dozen blood samples taken.
If not red flags come from the blood or urine, my next step in a couple of weeks is to have a comprehensive 5-hour examination/evaluation. This will include several medical tests and a psychological one. And then the transplant would be scheduled.
The news today was mostly bad, but with a silver lining:
- The silver lining – I was told that most “undirected” donations, like mine, trigger a chain of multiple transplants that are currently precluded because donating relatives/friends don’t match with the recipient. A 17-link chain that was reported in the local newspaper last year is what prompted me to consider donating, but much smaller chains are more likely.
- The bad news – 1 – The people in the waiting room were mostly obese, and when I got home, I confirmed that diabetes is the leading cause of chronic kidney failure and being overweight is the leading cause of diabetes. I guess I would prefer doing this for a younger person struck down by bad luck than for older persons who let their weight get out of control.
- The bad news – 2 – Kidney surgery is not as simple as I thought it would be. I thought a kidney was a small organ, but learned it is about the size of a fist. Thus the incision to remove it is pretty big – 3 to 4 inches – which results in 2 or 3 days in the hospital. (I was only hospitalized one night to replace my knee!) And finally, the at-home recovery is 4 to 6 weeks, with no lifting over 10-15 pounds. Weight-lifting is obviously out; what about cycling and yoga?
Who would have thought that simply retrieving a superfluous organ would be more formidable than replacing a complicated, essential knee? I’m still leaning toward going forward (guys hate to turn around), but my commitment is a bit shaken.