Crashing halt.

My whole journey to become a living kidney donor careered to a crashing and crushing halt yesterday afternoon with devastating effect.  I attended the x-ray department on the 5th floor of the tower block at The Royal Sussex County Hospital for the latest and one of the last  outstanding tests on a potential donors schedule - a renal ultrasound.   I filled my bladder with at least two pints of water prior to turning up, as requested, I arrived at the department early for my afternoon appointment. Thankfully being so early paid dividends and I was shown into a lovely fresh scanning suit a whole twenty minutes ahead of my scheduled time.  Cool lighting, clean surroundings and warm atmosphere ensured I relaxed almost instantly and after I’d laid down gel was applied to first right side before the ultrasound wand pressed gently over my skin.  It didn’t feel painful or uncomfortable in the slightest, in fact it was just a little ticklish when the gel was spread about a bit.  When instructed I rolled over and the other kidney received it’s ultrasound investigation. This time I was able to see the screen which instantly made me marvel at what an amazing image bouncing around sound waves can have and also how blooming clever the people are that can see exactly what those images appearing actually are.  It was odd at first, all I noticed was little more than splodges, shadows and grey splashes to my untrained eyes. However with a little prodding and expert positioning up popped an image of my kidney, looking all rather err  kidney shaped, clear and rather well defined. Blood flow was demonstrated by blue and red splashes of colour on the monitor screen and I was informed it all looked good,  both kidneys were just as they should be. A quick scan of my bladder was then completed, just to make sure it was working I guess and that too was up on the screen, then it flashed bright red and blue, like a Christmas tree on speed when I giggled somewhat, proving that A) I’m ticklish and B) It was working fine.    All in all the ultrasound examination lasted about ten or so minutes and was a rather pleasant experience with no pain or even discomfort and being able to see the insides, the kidneys in my case, was rather fun.  I felt light and airy as I walked out of the department are around the buildings to the Kidney centre,  I suppose that’s much like the feeling pregnant ladies feel after seeing their unborn baby on the monitor after a scan.

It didn’t take long to wander around the buildings and before you could sing happy birthday three times I was in the waiting area of the kidney centre waiting on the coordinating sister.  Then this whole deck of cards came crashing down around me as we reviewed my results,  already the report from the ultrasound was in with the sister,  it advised my kidneys are of normal size, shape, appearance and location,  so all was well there. All my urine tests have been clear and in good shape, not showing another other than normal. My chest x-rays showed that my lungs are clear and my old ticker is normal and according to my EKG working perfectly.  My blood work showed clear of hepatitis B, hepatitis C, HIV, human Tcell lymphotropic virus,  whilst both CMV and Epstein-Barr virus were detected,  themselves no barrier to donate, everything was plodding along so nicely and as expected. Tissue typing had been completed and looked perfectly good, although how anyone can say just by looking at all those numbers and dashes is beyond my limited understanding. Nuclear medicine results were now reviewed,  the  renogram MAG3 story told the  renography is normal with a differential of left kidney 51% and right kidney 49%, so working very evenly, either one a good candidate to be whipped out for someone else to take charge of.  However,  the bad news came with the results of the nuclear medicine glomerular filtration rate Cr51 EDTA, it was measured as 71ml/min which was scaled down to my body area to read 64ml/min/1.73 m2. Half time is 159 minutes which corresponds to a GFR per unit extra cellular fluid volume of 61 ml/min/13litres - in short the conclusion of which is I have moderately impaired filtration function,  the lower end of normal, which is considered too low for transplant because my kidney function may reduce during later in life and I may need both kidneys,  so a doctor I’ve never met, heard of or even been named to me has decided that I’m not organ donor material because when I’m in my 70’s my kidney function might reduce, emphasis on the might there I think.  So over six months of thinking, considering and soul searching combined with three months worth of research, two months worth of appointments and countless hours worth of tests were all to no avail and for want of a better expression,  worthless.  I felt my heart sink to the floor and a wave of abject sadness engulf me like the tide covers the beach. All the positivity I previously enjoyed about the whole process and what I was actually doing itself flooded out of me and an emotional empty husk of a man remained.
I asked and there is no chance of them repeating the GFR test,  they simply ’don’t do that’ for they wouldn’t know which result to work with and heaven forbid them doing a third GFR test if the results were vastly different.   

Whilst I have no medical knowledge of such things,  I feel the non-repeat of the GFR test disappointing to say the very least,  I know it’s expensive,  I know it takes four hours odd,  but what cost do you put on the life of the person that may have eventually received that kidney from me as a consequence of the test ?  

I’m also left wondering if the result of the GFR test was somehow compromised by having both the MAG3 Renogram radioactive material injected into my arm at the same time,  through the same entry point as the Cr51 EDTA.  Having two different kinds of radioactive isotopes careering around in my bloodstream at the same time obviously put pressure on my kidneys to filter a whole lot more and I’m also sure that is why I’ve had a dull ache on both side of my lower back since the test.  Or if it had anything to do with my rather full bladder and having nothing to eat for a full twelve hours prior to the test.  

Last night I cried for a person I don’t know, the person that would no longer be getting my kidney,  who may not live to see another spring or summer because of what a doctor says  might happen to me in my seventies.  If it were up to me I’d go ahead with the donation regardless,  I’m not a great believer in what might happen,  only what will happen,  I mean, according to the Mayans the end of the world should have happened today -  which,  whilst it feels like it has for me at the moment,  I look around and see that isn’t so.  So whilst I’d readily agree to the donation now, I’m prevented from doing so because of and I quote - ’It’s not medically ethical to do so’ based on that one test result.   I feel so empty,  so low and so very sorry, especially for that unknown person that could have had one of my kidneys.