Tuesday, July 11, was an anniversary of sorts for me. It was three months ago to the day that I received a call from St. Michael's Hospital in Toronto advising me they had a kidney for me.

After more than three years of hemodialysis sessions -- 715 of those performed at home with the help of my wife -- I was in no way prepared for the call. Some of you who have read my earlier contributions to the Your Words section at RenalWEB might recall me being in a similar state when my kidneys failed.

I waited until now to write this article for a couple of reasons. First, I wanted to be able to report my progress over a reasonable period of time and not jump to conclusions or make assumptions. Secondly, it's taken me this long to come anywhere near to terms with this marvel.

As my wife and I headed to hospital in a mid-April snowstorm (uncommon even for southern Canada) we were stunned, elated and sad -- sad for the donor making this transplant possible and sad for that person's loved ones.

Last week I wrote a letter to the donor's family. As is the practice, each of our identities was kept secret from the other.

I don't know whether that made the task tougher, but no words seemed adequate.

While I've always been an advocate of organ donation, being on the receiving end gave me a much different perspective.

On arriving at the hospital, I was put through a slew of tests to confirm compatibility. The doctors were delighted with the results.

In fact the doctors were so pleased it lifted some of the doubts that had begun to creep into my mind. Would the operation itself, considered major surgery, be a success? Would there be any postoperative complications? What about the much ballyhooed and diverse reactions to the anti-rejection drugs?

Now, after three months, I am happy -- no overjoyed -- to say that all my doubts were for naught.

I have my life back.

After the operation, the impact on me both physically and psychologically were immediate and profound. Emotionally, I was flushed with excitement.

For example, I was immediately aware of my improved blood circulation. My feet, fingers -- even the tip of my nose -- were no longer cold to the touch. My mind was clear and the fog was lifting fast. I wasn't tired or nauseous; I was hungry. I mean really hungry, something I had seldom felt in the previous three years.

Best of all, my body was once again ridding itself of the poisons that had threatened me for so long.

Prior to the surgery, I asked one of the doctors when they would know if the transplant was a success. He replied with tact that if all went well I "could start producing urine on the operating table." While I tried not to conjure up any mental images of that eventuality, I was certainly "producing" when I came to.

In the end, I didn't feel as though I was recovering from major surgery. I was recovering instead from something more threatening and debilitating.

During the next few days, I enthusiastically dragged my IV poles behind me as I walked the hospital corridors. It was then that I started noticing the toll dialysis had taken on my body.

Today, I am exercising regularly, seldom run out of steam and looking optimistically to the future. And I feel at least 10 years younger to boot.

When released from hospital only six days after the operation, I was, like all other transplant patients to varying degrees, put on a stiff regimen of medication with names like Prograf, CellCept and Prednisone. Along with other, more common drugs like antibiotics, I was gulping down about 30 pills daily.

As for side effects, I've had two:

I developed a bacterial condition in my mouth called thrush. While that doesn't sound very pretty, it's quickly and easily combated with a somewhat foul-tasting medicine.

I was also admitted to hospital on one occasion when a routine blood test showed an increase in my creatnine level, one of the early indicators of rejection. To my embarrassment and relief, it turned out I had become dehydrated, another condition that increases your creatnine. I simply hadn't been drinking enough. I was released from hospital the next morning and now six to eight glasses of water a day has become my mantra.

I have not experienced some of the common side effects, like weight gain, hair gain or loss and rising blood pressure. In fact, before starting dialysis, I had been on blood-pressure medication for almost 20 years.

My prognosis remains positive and I am down to just one visit a month to the transplant clinic at St. Mike's. I still have blood tests taken a couple of times weekly at a local clinic, but those will decline, along with the amount of medication.

As I have written earlier, I lost both kidneys to Polycystic Kidney Disease, inherited from father's side of the family.

When my kidneys first began failing, I was living in Vancouver and waffled about starting hemodialysis. (Peritoneal dialysis was never an option for me because of previous abdominal surgery and the size of my PKD kidneys.) Most evidence now shows the earlier you start dialysis -- whatever the modality -- the better.

By the time I was prepared to admit my fate, I really didn't have much choice. My wife and I had tried to squeeze in some travel and by the time we returned home, I was exhausted.

It made the transition to dialysis that much more of a challenge. A fistula had to be created in my arm and I started the thrice-weekly, four-hour sessions at hospital.

Eventually, they removed one of my kidneys and the postoperative problems that ensued made me swear I would not have the other removed.

Then I moved back to my home town of Toronto, where I learned about and was admitted to a test project called Nocturnal Home Hemodialysis (NHHD). My wife and I spent six full weeks of training before we were set up at home for me to dialyze at home six nights a week while I slept.

Oh, there were some adjustments, but after a couple of months, I began feeling much better. More proof to me that the more dialysis the better. The diet on NHHD is not nearly as restrictive, either.

Doctors then approached me about having the remaining kidney removed. It had taken on gross proportions and wasn't providing me with any meaningful residual use.

I was reluctant until I talked with a surgeon specializing in laparoscopic, or minimally invasive surgery. Using this method, the surgeon enters the abdomen through one tiny incision and a couple of other minor holes for inserting a camera and lighting.

On a monitor above the operating table, the surgeon has a far better view of the organ to be removed. It is literally taken out in pieces, leaving the patient with a barely visible three-inch (or 7.5 mm) scar. I was in and out of hospital in three days.

I firmly believe that NHHD, which is gradually catching on in other centres in North America, Europe and Australia, was instrumental in sending me into the transplant in better physical condition and has since continued to contribute to my recovery.

While home dialysis is not for everyone, I urge anyone reading this article who thinks he or she might be a candidate to bring the modality to the attention of their nephrologists.

Laparoscopic, or keyhole, surgery as it now is sometimes called, will, I think, revolutionize how we view surgery. Living donors now can have their kidneys removed with far less inconvenience and recovery time.

I sometimes scratch my head wondering why these new techniques are so frustratingly slow to catch on.

There is one sad not to my overall experience that I feel I cannot avoid mentioning.

As many of us have experienced joyous times are often tempered by unexpected events.

Two days after my transplant, my mother, who had been weakened by what we thought was a successful radiation treatment for lung cancer, died in her sleep.

I had talked to her after the operation and, while still recovering herself, she was delighted. I was released from hospital in time to attend and participate in my mom's service.

Almost without exception, every doctor, nurse or technician that I dealt with during my kidney failure acted with compassion and understanding. They, along with my wife of five years, my family and friends all contributed greatly to my mental healing during a difficult time.

Over the last years, I have also come to know many people through the Internet -- some near and some far away. These exchanges have often lifted my spirits or made me view things from another angle. I don't take delight in knowing there are people worse off than myself, but I am determined not to forget that.

I encourage anyone having second thoughts about a transplant, to submit their reservations to the Discussion Group at this site. And remember, people with a transplant are still patients and their experiences would also be welcome.

Meantime, if anyone has any questions that I might be able to answer, please send your questions to the Patient Discussion group or e-mail me directly at mallan_1999@yahoo.com.

Return to RenalWEB Home Page