Welcome to the third installment of my weight loss series. That’s right – I’m on a mission to lose about 1lb by getting rid of this extra kidney I have.

Now before you start wondering if I have a 3rd kidney…I don’t. BUT what you may not know is you only need one kidney to lead a normal life. In fact many people are born with only one and never have any idea. It often isn’t determined until an autopsy is done.

Kidneys (like most of our bodies) are very efficient. If we view the average, healthy person as having 100% kidney function, we only actually need about 40% to lead full, active, healthy lives. In fact: kidneys are SO efficient that once I donate one, the remaining kidney will likely grow bigger and gain an additional 10-15% efficacy.

This means that pre-surgery I’ll have 100%, post surgery I’ll have about 50%, and once my remaining kidney adapts, I’ll live the remainder of my life with about 60-65% kidney function.

Some of the considerations for potential donors are the risks, lifestyle changes, and feasibility of the time of work or your normal routine in order to undergo testing, surgery, and recovery.

There are 2 major lifestyle changes a donor is asked to make:

1. Drastically reduce or eliminate the use of NSAIDs (ibuprofen). These are tough for the kidneys to process and they need to be used very sparingly after donating a kidney. Use of Tylenol is still A-OK!

2. Many doctors warn against participation in sports with aggressive physical contact.

With both limitations there are a group of people who may need to disqualify themselves (or their transplant team may) due to these required lifestyle changes.

If you have migraines, bad knees, or another condition that can only be treated with Motrin or ibuprofen, you’re likely not a great candidate.

Baseball, basketball, and soccer are all still ok. My doc gave me the ok to ski and snowboard. If you’re a boxer, MMA fighter, or similar – and unwilling to give it up – you’re likely not a great candidate.

Sports such as football, hockey, and rugby are frowned upon by many doctors. I play rugby. Before my marathon appointment, I researched the incidence of renal trauma in rugby players. When we began discussions on this part of the risks, I told the nephrologist (kidney doctor) that I play rugby. I told him that I had researched the risks and frequency of traumatic renal injury in rugby players and that it was a lower risk and frequency than renal trauma in car accidents. As I could demonstrate that I had done the research to truly understand the risks, he accepted my choice to continue playing after donation but advised I needed to wait until the following year.

This week I received the results of my more comprehensive testing. My donor coordinator called me to discuss them and I’m good to go! Clear chest X-ray (to check for TB), kidneys look great (with no stones!), perfect EKG, etc.

At this time, my donor coordinator will now present the case in its entirety to the transplant panel tomorrow. If the panel determines that moving forward is the right decision, it will come down to a matter of timing.

Timing is determined by the donor and the surgeon. That means if you have a busy season at work, a preferred time of year, or an expensive vacation planned – you can still consider donation. YOUR schedule is the primary consideration.

I’ve let my Donor coordinator and the remainder of the team know that sooner is better for me. This is for a primarily selfish reason: I LOVE snow. I teach skiing and snowboarding and my season typically begins around the second week of December. I’ve been told that I will need a full 8 weeks of recovery before I can consider skiing or riding.

This means ideally I’ll have the surgery (at the latest) by the first or second week of October. The secondary benefit to this is my recipient will have a chance of feeling better soon!

Look for the next installment as surgery day draws close!

So for those who are just tuning in – I’m donating a kidney. This is the 2nd installment in my experience as a series of blog posts. This one will focus a little bit more on what’s entailed with the screening process and my goal is to inspire more people (minimally) to sign up to be organ donors upon death.

In my case, this is the second time I’ve been through the screening. I started the process three years ago and underwent all of this same testing. My intended recipient actually had her kidney function increase around the time I went through initial testing. As a result, we delayed the donation. Recently, her kidney function deteriorated to a point where she is both on the list and in pretty bad shape.

There are a number of requirements in order to be considered both a donor and a recipient. To be a recipient, you must be on the UNOS (United Network of Organ Sharing) recipient list: https://unos.org

Getting on this list has a set of requirements. These include regulating the severity of organ failure before you can be placed on the list. The list requires you to be a certain amount of ‘sick’ before you can be considered for a deceased (or living) donor organ. There are also limits to HOW sick you can be and remain on the list. This is to ensure that a recipient has a decent chance of surviving the transplant surgery.

There are many ethical, moral, and scientific considerations in the creation, maintenance, and administration of the organ donation process. My biggest take away from learning all of this is that living organ donation is the single greatest opportunity we have to:

⁃ Save more people

⁃ Reduce the wait time for recipients to receive an organ

⁃ Improve the overall health of these patients and longevity of their lives

In rough estimates, there are 100,000 people on the kidney recipient list. In any given year fewer than 20,000 people receive a kidney (these are ballpark numbers). Many of these come from deceased donors (donors who have selected to be organ donors on their drivers license). There are also a rotating number of people added to the list each year and taken off the list because they had to wait too long and are now too sick to meet the criteria to receive one.

The average wait time varies by state and region (although UNOS is considering adapting the “hard” state line rules for a more regional approach). In all cases though the wait time is measured in years.

Years.

During the wait, these patients are continuing to fight their diseases and conditions causing additional stress and strain to their already taxed systems. In many cases of kidney disease, people are forced to begin dialysis while waiting for a transplanted organ. Dialysis is incredibly difficult on the system in addition to being incredibly time consuming. Patients who receive a transplant prior to starting dialysis are typically able to lead healthier lives and live longer with their received organs.

I learned all of this during my testing and screening process. The process goes something like this:

1. Complete a basic medical and family history screening with the transplant hospital team.

2. Complete basic health screenings from your regular doctors and forward results to the transplant team. For me these included a Pap smear and a 24 hour urine collection and blood draw along with blood pressure and vitals – depending on your age and gender you may be asked to complete a colonoscopy and mammogram as well)

If these basic tests come back within the normal to healthy range, you will likely be asked to schedule the more comprehensive testing. Because I live out of state, they set up ALL of my testing to occur in one day at the hospital (and they did a FABULOUS job with ensuring I was able to complete everything in that time and with excellent care – probably the best care I’ve received from the healthcare system).

What did this marathon of a day include?

⁃ Meeting with my Donor coordinate (this is the person who’s in charge of your whole process. They schedule and well – coordinate – all the tests and requirements.

⁃ Meeting with my Donor Advocate. The donor advocate’s sole job is to protect the donor. They ensure that you’re doing this of your own free will, that you have the right support system, and overall health profile to ensure you’re not at an unacceptable level of risk as a result of this process or donation.

⁃ Meeting with a social worker. The social worker makes sure you will have the financial resources and ability to donate in addition to the personal family and friend networks to provide adequate care for the procedure and recovery.

⁃ Meeting with the surgeon who will be performing my surgery (remember there are 2: the donor’s and the recipient’s). He explained the surgery and techniques used as well as the risks and benefits. He also covered the recovery process.

⁃ Meeting with the nephrologist (kidney doctor). He also explained the risks and benefits. The nephrologist also completed a physical exam and covered my medical history again. He ordered additional blood and other testing based on our discussion

⁃ I had an EKG

⁃ I had my blood drawn (24 vials)

⁃ I had a chest X-ray (to ensure I don’t have tuberculosis)

⁃ I had a CT scan with contrast to get the image of my kidneys (this is done to check size, placement of vessels, existence and location of any stones, and other factors that can affect the choice in which kidney is selected

While this was a long day, the overwhelming message was that I needed to be well educated about the risks, the process, and every staff member checked to ensure I was interested in donation of my own free will and knew I could back out at any time.

It is important to remember that the recipient must also undergo extensive testing. This testing can sometimes take much longer for the recipient as they are contending with a disease that can impact their ability to be tested at any given time.

I am now waiting the results of my testing. Even if it turns out I’m not a suitable candidate for some reason, I’ll have a lot of very comprehensive testing done. Did I mention that all of my testing is 100% covered by the recipient’s insurance? I pay absolutely nothing out of pocket aside from missed time from work and mileage to/from appointments. There’s also the NLDAC (National Living Donor Assistance Center) which has grants to help with those costs as well as lodging.

If you’re interested in learning more, go check out: https://www.organdonor.gov/about/process/living-donation.html

It’s Friday. I have started my 3 day weekend by waking up at 4am. Why? To drive 3 hours to New Jersey for medical tests and consults.

I’m doing this because someone I love is sick and needs a kidney. My hope is by sharing this experience, I might encourage others to consider organ donation (or heck: I’d be happy with increasing the number of blood and platelet donors!)

The response I often get when I tell people I’m undergoing testing to donate a kidney is “Wow! That’s really generous of you.”

I think it’s a normal response. Most people have not considered organ donation (unless faced with a loved one who needs a transplant). I had never considered it because it’s not talked about much as a “thing you can do.” I’m hoping to help change that.

I’m here to tell you that you can donate and you can donate more than you think. Living donation opportunities include:

⁃ A kidney

⁃ A lobe from your lung.

⁃ A portion of your liver

⁃ Eggs/Sperm

On the ‘less invasive/serious’ side of things, you can donate tissues:

⁃ Skin (this is often to yourself)

⁃ Bone marrow

⁃ Platelets

⁃ Whole blood

How did I get started donating?

In college, my sorority hosted a blood drive. That was the first time I donated blood. I began donating more frequently once I got an office job. After a while the staff asked me if I was interested in donating platelets and they explained what that entailed (it involves taking your blood out of your body, separating the parts of it in a centrifuge, and putting the unneeded parts back in). I’ve been donating platelets and whole blood for a decade.

Admittedly, a kidney is a pretty big jump from platelet donation and comes with a much different set of risks. It’s not a decision to be made lightly (but for me is a no brainer).

The next parts of this blog will involve more detail about my experience through this process. For this first one my goal is two fold:

1. Make more people aware that living kidney donation exists as an incredible thing you can do for someone

2. Pique someone’s curiosity or inspire someone enough to consider donation of some kind.

Whole blood is a great “starting point” for anyone who wants to do some good and make a potentially life saving impact on another’s life.

Things to Know:

⁃ Takes about one hour

⁃ No cost

⁃ They give you snacks afterwards!!

⁃ Frequently donors receive “thank you’s” (t-shirts, small gift cards, etc)

⁃ You can donate every 56 days

⁃ Donation may lower blood pressure, the risk of heart disease, and decrease risk of cancer (mixed studies on this)

⁃ Donation burns calories

⁃ You can help up to 3 people with a single donation of whole blood

There is a screening that takes place prior to donation. Some people have experiences or conditions that prevent them from donating. The criteria for this is reviewed and updated with new standards as the medical community learns more and technologies improve.

If you are ineligible to donate blood you still may be a great candidate to donate an organ or partial organ.

If you can’t donate yourself, most donation centers rely heavily on the support of volunteers.

If you’ve never donated before, I ask that you consider doing so.

If you haven’t donated in a while, I ask that you schedule yourself an appointment (or go walk in).

If you’ve been donating regularly (thank you!) and I challenge you to consider donating platelets or bringing a buddy.

To quote Mr. Rogers, “When I was a boy and I would see scary things in the news, my mother would say to me, “Look for the helpers. You will always find people who are helping.”

Let’s all try to be better helpers.