Out of Order

Okay, I lied. Sorry. 

In this post I indicated that I'd post periodic updates, and then I went and had a triple bypass and took a three month break with no updates at all. 

No one was more surprised than the cardiologist by the results of the heart catheterization. He detected four "old" blockages. These were candidates for being stented, but this approach would have required multiple procedures and necessitated being on blood thinners for an extended period after the last procedure. This would have put me out of the kidney transplant window for a longer period, with the added risk of additional kidney damage from the dye needed for each stent procedure. He and my nephrologist recommended bypass surgery, and referred me to a cardiac surgeon. 

Turns out my referral was to the best guy in town. He consulted closely with my nephrologist. He would install a dialysis port as part of the surgery, as kidney failure is a real possibility with bypass surgery even in people with normal kidney function. It was not at so great a risk for a heart attack that they needed to do it right away. The first date they offered me for the bypass was my birthday, and I didn't see any point in delaying it further so I could celebrate another completed trip around the sun. 

It turned out they only needed to bypass three of the four blockages. My kidney function held steady enough that they didn't need to dialyze me. My previous post covers the immediate post surgery experience. I'll share a little more about recovery in a future post.

Another hiatus

Well, the previously mentioned bypass surgery knocked me out of the communication loop for a long time, although it isn't entirely to blame for my absence. Priorities, I guess. I think a few notes to remind my future self what this was like are in order.

First of all, this isn't something I ever want to do again. When they're preparing you for a surgery like this, they don't do a very good job of explaining how traumatic to the body it is. I knew about and dreaded having my sternum sawn open. That in itself worked its way into every dream I had for half the summer. I didn't realize how sore my leg would be, where they got the blood vessel from for my three bypasses. I almost couldn't feel the incisions themselves, especially the one up in my groin. But the bruising extended the entire length of my leg down into my foot. Any my right arm was a lovely thing due to the blown IV on the third or fourth day after surgery. The most intensely painful thing was definitely the chest tubes. It was frustrating having my blood sugar checked before every meal. The food in the hospital was good, though my appetite wasn't. The most depressing part was the extra hospital time waiting for my blood count to return to normal. Finally they just sent me home on iron because it wasn't happening.

Those are the negatives. There were many blessings, too, though. My health going into the procedure turned out to be a great positive. The rehab folks who came up to the room could tell I'd been pretty active prior to the surgery, even the day after surgery. My dear wife was concerned over how long it took me to come out of the anesthesia and get my tube removed, but when they took it out I tried to sing to her almost right away, attempting to croak out "I Wanna Hold Your Hand." Before that, I faintly remember being frustrated as I tried to write on her leg with my fingertip, "PAIN." They brought me some of whatever they were giving me for pain. They don't really use opioids much, which helps with the bowel recovery. They were surprised at how quickly that bodily function bounced back. 

All in all, I think the experience has me more prepared for what I'll go through with the kidney transplant.

Recovery is going nicely. I'm not running as much as I expected to be by now,  because it's hard to keep the heart rate in range. But I was able to get back on my bike for the first time yesterday, which felt great. That was a matter of waiting for my sternum to heal sufficiently, and the recumbent riding I've been doing in rehab had my legs well prepared for that activity. 

 

Hiatus over

Over a month later, finally back in business with a computer after the cat flipped our old one off of the coffee table where about three inches of it had been hanging off. I was hoping it would be salvageable, but alas, no. 

Now I can resume reading my book and reflecting on it. So much happening though, including upcoming bypass surgery.

Finally catching on

This was probably about the fourth Lenten season that I started reading Death on a Friday Afternoon. I started even before Lent this time, thinking that this would finally be the year I finished it "on time." 

Well, I still didn't. 

But fortunately, the time I spent with Fr. Mike Schmitz doing the Bible in a Year program last year taught me to stop thinking in terms of "on time." Fr. Neuhaus has made clear that it's always a good time to think about Good Friday, and that the Crucifixion and Resurrection are each best contemplated in the light of the other anyway. They each provide the context in which the other should be understood, and they both provide the meaning for my daily life. 

So I have some of the book left, and will continue to read and share from it during this Easter season. This will probably give me time to soak in some of the content that I've rushed through in the past because I was "late" finishing up.

Kidney transplant status

Background here

I was 26 when I was diagnosed with polycystic kidney disease. I'd known my mom had it. She called from Georgia to tell me she'd had a transplant, it was successful, and that her nephrologist advised that her kids get tested for it because it is caused by a dominant gene. The Air Force tested me using an Intravenous Pyelogram (IVP), and it was clear that I had cysts on my kidneys. So we've basically been monitoring a slow, steady decline in my kidney function ever since. I have now reached the point at which my nephrologist recommends that I try to get a transplant before I reach the point of needing dialysis. 

I've had a few people volunteer as potential donors. To protect their privacy I will be cautious about how I talk about them. The first to be identified as a possible match went for evaluation earlier in the month. They determined that this individual was at long-term risk for diabetes, so they will not approve them as a donor. The team indicated to this individual that there were at least a couple other potential donors who had signed up.

Meanwhile, I am being evaluated as a transplant recipient. As a result of my initial tests, the transplant team has referred me to two specialists. Due to an irregularity in my stress test, they referred me to a cardiologist, indicating that when he cleared me we could proceed. I've met with him twice. He indicated that my strong heart functionality outside of this test led him to believe that, for now, we should just keep an eye on things, monitoring my heart functionality over time and taking further action when there is some other indication of a problem. He indicated that he would approve me for the transplant, but prepared me that the transplant team might nonetheless want a more definitive test before accepting his recommendation. The transplant team has since indicated that they will not approve me without my having first undergone a heart catheterization procedure to make sure there isn't a blockage to be addressed. This procedure requires dye or contrast that will need to be cleared through my compromised kidneys, but my local nephrologist will issue pre- and post hydration orders that will help with that.

The second specialist they've had me see is a neurosurgeon. PKD is associated with increased risk of aneurysms, and the MRA they did in my evaluation testing showed a spot they were concerned about. I expected this because of an issue shown on a previous MRA that was subsequently definitively determined not to be an aneurysm. I've met with the neurosurgeon, and he is confident that the area they are concerned about is also not an aneurysm, but rather an irregular but non-concerning deviation in the junction of a couple blood vessels. I'm still awaiting clearance on that. 

Meanwhile we continue to monitor my kidney function to make sure I'm not seeing enough of a reduction to need to start dialysis, while the transplant team continues to evaluate my remaining potential donors, either as direct matches for me or for the donor swap program.

I appreciate your continued prayers and support. Part of the reason I'm posting this update today is that Easter seems an appropriate time to mention that I am not afraid of what lies ahead. I am confident in the One who holds both me and those whom I love.

I will post periodic updates. 

Kidney transplant background

I was 26 when I was diagnosed with polycystic kidney disease. I knew my mom had it. She called to tell me she'd just had a transplant, it was successful, and that her nephrologist advised that her kids get tested for it because it was caused by a dominant gene. The Air Force tested me using an Intravenous Pyelogram (IVP), and it was clear that I had cysts on my kidneys. So we've basically been monitoring a slow, steady decline in my kidney function ever since. I have now reached the point at which my nephrologist recommends that I try to get a transplant before I reach the point of needing dialysis. 

Knowing our story

The gospel is the story of the world and of everyone in the world, whether they know it or not. Again, in the words of (St.) John Paul II, "Christ is the answer to which every human life is the question." The mission of the Church is bring the world to itself, as we are told that the prodigal son in that distant country "came to himself." . . . Again, the Church does not have a mission, as though missionary work were one of its programs or projects. The Church is the mission of Christ, who continues to seek and save the lost who do not know their story." - Fr. Richard John Neuhaus, Death on a Friday Afternoon

I don't know how closely related this prior post is, but it seems relevant. 

There is this train of thought in the world today that no one knows us as well as we know ourselves, and that this self-knowledge should be sufficient to justify every decision we make. We see this approach at work in many different contexts. I'm sure my mom had similar thoughts when she engaged in the illicit relationship that produced me. Often we arrive at a later point in our resulting story realizing that we didn't know our real story at all. Many times we find that we have written subsequent chapters in our own lives and in others' that have resulted in very painful repercussions. 

The truth is that none of us know our story until will know our Savior. There is no part of our story that does not need to be redeemed and brought to completion in him, to be united to his story (history). When he has brought us to ourselves, we find that we enter into the mission of helping others discover their story in him, too. 

It may seem arrogant from the outside, but I suspect it's more arrogant by far to think that my story matters in any other context.