Friday 23 November 2012

Dates for ultrasound, renogram and GFR!


Why is it I wonder, why hospital receptionist don’t seem to be a particular happy bunch of people, rarely in my recent experience are they jolly folk who are happy and contented with their jobs. My most recent experience, this morning has amplified this notion, you see on Wednesday I received a couple of letters to contact the department of Nuclear Medicines to make appointments for a renogram and a GFR test, although why they didn’t just make the appointment and write to tell me, like all the other departments have done, is well, frankly beyond me.  Anyway, the weather was fairly clear and free from the horrendous downpours that have afflicted elsewhere, so I decided to cycle the six miles to the hospital, thinking that not only would I make my appointment in person at the department, but I’d also get some exercise at the same time.
Brighton's big wheel. Image from Sussex Police Helicopter


I arrived there, the department is in a rather shabby temporary building,  the waiting area was practically full and rather stuffy with no sign of a reception desk.  I spoke to one of the nurses,  who told me it was through this door,  which she knocked on and opened for me.   I waited for a few moments before an obviously put out lady asked if she could help me,  I entered the office,  saw two rather unsmiling ladies,  I informed the first lady that I had received a couple of letters and wanted to make those appointments if that was possible,   “Well,  it’s not!” was her blunt reply,  no apology at all, just that they don’t make appointments for people in person, just over the telephone. I studied the letters carefully and nowhere in them did it say making appointments in person was prohibited and jolly well unwelcome. I wish it blooming well had, for that would have saved me a twelve mile round-trip bicycle ride and a load of aggravation.  The reason the receptionist or appointment maker gave for this odd state of affairs is that she’s too busy making appointments to make appointments! Everything seemed to be too much effort to do it in person, although had I called, of course, I would have also taken up just the same amount, if not more time, so the logic of not having the time to make appointments seems slightly warped to say the least.  Oh and while I was in the office and during the time I spent in the department, not once did I hear her phone ring!  It was all rather annoying, but more than that it was upsetting, it was the first time in this whole journey to become a living kidney donor that I wondered if it was all worth it.  I mean, I didn't need this aggravation, it’s not like I have to have these tests for the benefit of my health, to make me better or anything, in fact having small amounts of radioactive material injected into my veins could be seen as being ever so slightly detrimental to my health. I know it’s only a small amount, but you know what I mean. I really felt like telling her this,  but of course I didn't  frustrated I may have been but I thanked her for her help. Anyway the appointments have now been made and another few steps on this journey have been made.

I'm having the renogram MAG examination first thing in the morning in a fortnights time and then right after that, on the same day I’ll be undergoing the four hour glomerular filtration rate tests.  I’ll have to wait almost another couple of weeks before I have a full ultrasound examination of the kidneys and urinary tract to provide pictures showing their size, shape and structure of my kidneys. Apparently I've got to drink at least two pints and have a full bladder before for the ultrasound, plus I’m not allowed to have a pee in the hour preceding it, gosh at the end of it I’ll be at bursting point! 

Wednesday 21 November 2012

Third appointment, head check and look ahead!


This morning in the post I received a couple of letters from the department of nuclear medicine at my local hospital,  The Royal Sussex County.  I’ve to call them to make appointments, first for my NM Glomerular Filtration Rate (GFR) Cr51 EDTA and my Renogram MAG3 examinations, which is all jolly exciting. Especially as only yesterday I was almost bemoaning the length everything was taking! From what I understand the GFR is likely to take around four and a bit hours and is all to assess how well my kidneys actually do work.  A small amount of a radioactive isotope is injected into a vein in my arm and then at regular intervals throughout the four hours they’ll take a sample of blood from my other arm which is then tested to see how much of the radioactive material (that‘s the Cr51 EDTA bit I think!), if any, is still there in my blood.

The other one, the renogram MAG3 starts off in a similar fashion, in that a radioactive isotope (the MAG3 bit) is injected into one of my veins, probably in the arm or the back of the hand then they give me a jolly good scan. Apparently I’ll probably be on the table or couch as they call it, for about twenty-five minutes, although sometimes they take delayed images of the kidneys,  so I might have a second scan, either way it will all take about an hour from start to finish, so not too long at all. This test evaluates the functioning of my kidneys as well as providing images of my kidneys inner bits and bobs so the doctors can make sure they are healthy and normal and both work fine enabling me function properly when one is snipped out!  


Rear view of the Royal Sussex
I know this sounds odd but I’m rather looking forward to these tests,  not because I have a freaky fascination with hospitals and medical procedures, as I really don’t, but because they are two very big steps to take on this road to donation.  There is still a long way to go yet but with each passing day and each passing test I feel more positive and energised about the (hopefully) eventual outcome, of me waking up after the surgery one kidney lighter.  This was made more apparent to me today as I had to visit the renal centre at the hospital to give another urine sample and have my blood pressure taken before a session with one of the counsellors to evaluate my psychological state of mind and make sure I'm going to be all right,  in the head, after the donation.  It took a bit of time,   there was quite a wait in the reception area before I saw the counsellor who lead me to the nurse who took my urine sample and cuffed my arm with one of those fancy electronic blood pressure machines or sphygmomanometer’s if you want to be precise,  I was a little high at 133 over 80 but then I had just cycled from home to the hospital (about six miles) and climbed two flights of stairs and of course there is always that slightly anxious sensation of having the test taken.  Although perhaps the fried egg sandwiches for breakfast weren't such a good idea!

The counselling session went better than expected, I felt so at ease and the counsellor was lovely, allowing me to waffle on and on for ages.  Together we explored my reasons for opting for altruistic donation, how ready I am for  all the possible difficulties that might arise as a result of donation, such as  infections, illnesses or even the very very remote one of death. None of which I am overly worried about,  the estimated odds of death during or as a result of the operation are 1 in 3000,  the same odds of getting struck by lightening and oh so much better than the odds of dying in a car crash,  which is a crazy 1 in 200!  We also went over possible anti-climactic feelings I might experience after the operation has been completed, which apparently are quite common and normal, however I think I'm prepared for that possibility by throwing myself in to helping raise awareness of altruistic organ donation as much as I conceivably can in any way I can.  Our session lasted over an hour and I'm sure we covered every single thing we needed to and loads more besides and I'm pretty sure I've passed this mental evaluation. I also learnt more about what life is like on dialysis and the differences after a successful transplant which made me more positive, if that were possible, about what I'm doing, to me this is not an amazing thing to do, it’s just the right thing to do!


Cycling on the way home after today's counselling session I stopped and took a few photos of a slight rough sea and clear yet cold sky.  I missed the sunset but I think I managed to capture the beauty of the twilight time!




Tuesday 20 November 2012

Third appointment - a look at my head!

Things are moving along,  I've got an appointment with the renal counsellor tomorrow lunch time which should be fun, all to do with assessing and evaluating my psychological state, making sure I'm doing this for the right reasons and fully aware of the implications of donating an organ.  I'm looking forward to it,  it's another step down this long road.

I've also got to pop along the corridor and give them another urine sample and have my blood pressure taken again, it's all routine and nothing unexpected,  I'm sure there will be a fair few more of those before we get to the end.

Other good news,  I received a letter confirming an appointment with the lead renal consultant, although it's not till the latter part of January,  which seems so far off at the moment,  although between now and then I'll be having an ultrasound of my kidneys and the glomerular filtration rate tests and scans which have already been requested.

I've got a twitter account now,  you can find me  @donordiary

You can also email me if you want to  donordiary @ gmail.com

Friday 9 November 2012

Second Appointment


Second appointment and results briefing.


It was beautifully clear this morning as I set off on my bicycle heading towards the multitude of buildings in Kemp Town known affectionately and jointly as The Royal Sussex County Hospital.   I thought I’d snap a couple of photos to illustrate the various different architectures employed at this mammoth site of care giving, hopefully you’ll like them.  Anyway,  thankfully Caroline, the coordinating Sister had scheduled my appointment for a lovely and Jason friendly noon, so my morning was fairly gentle and  relaxed,  long hot shower,  play along with ’Pop Master’ on Radio Two after which I read a chapter of one of the current books on my nightstand.




The ride in was uneventful and rather pleasant mainly,  as I said earlier the weather was beautifully clear and luckily the wind was at my back which almost pushed me along the prom without the need for peddling. From my vantage point along the prom, the sea looked as calm and gentle as a millpond and I almost felt like riding down, stripping off and going for a paddle.  Obviously I didn’t,  it make have been rather mild for the time of year,  but it needs to be a good deal hotter before I get my kit off!  I took some photos of the buildings and then headed in and announced my arrival to the camp receptionist, who was having a bad day and he didn’t care who knew it.   I waited about fifteen minutes before Caroline came for me,   it was good to see her and once we were ensconced in her office, which rather oddly, due to a step hill, looks like it is at ground level, with a view of the grass and path, despite being up on the eighth floor!  

The main reason for this appointment was to give me feedback from the battery of tests undertaken last Tuesday, there were a few other questions that she had to explore with me as well.  Carefully and considerately she showed me the results from my blood tests and my urine tests, which were all relatively good,  clear with the exception of showing antibodies for cytomegalovirus or CMV for short and antibodies for Epstein-Barr (glandular fever).  Both nothing to worry about,  it’s estimated that over half the population are infected with CMV and have no idea about it.  My cholesterol level is slightly higher that ideal, which itself is not a major problem, but it will come down as I eat less fried foods and sadly fewer cheesecakes which will also help me loose perhaps a stone in weight during the next few months.

The ECG test last week indicated the old ticker is working in perfect sinus rhythm (normal) and the x-ray of my chest showed a couple of normal looking lungs and proved once and for all that my hearts in the right place.   Once all the test results were given and explained, with everything being good,  Caroline then had to ask some personal questions regarding my sex life and that sort of thing,  all procedural, routine  and not unexpected.  Although rather kindly she did offer of the option for me to see a male doctor if I wanted to, in case I was embarrassed talking to a female about such things.  Now,  you know me,  I don’t embarrass easily so was happy to discuss my sex life or lack there of, honestly and frankly and all is well there,  so that’s another few boxes checked and another step taken.

In a few weeks time I’ll be back at the hospital for an ultrasound, CT, MRI scans and more assessments, and tests,  one of the tests, I was forewarned will take around four hours.  I’ll have to take my Kindle along for that one and they’d better give me a cuppa and a biscuit, or I wont be a a happy bunny.  There is still an awful long way to go, but every step is a step forward, which is a good thing indeed.