IV The Transplant Nurse and Testing

Donation involves a lot of tests. The first tests however are very simple and I did them in London. I needed a blood test, urine samples and especially blood pressure readings.  High blood pressure is bad for kidneys and as a result people with high blood pressure may not donate. This alone accounts for many family members including Taro’s, being eliminated as unsuitable candidates for donation. Mine was low to normal so I had no fears on that score.  Before I could consider myself a donor however I had to repeat my offer to the transplant unit at NIH and specifically to the transplant coordinator Trish.  She is a nurse and her job is exactly as stated – she coordinates everything to do with  transplants including the testing.  Importantly, she serves as an intermediary between the donor and the recipient.  It was clear from our first conversation that she was checking on our relationship to be sure I was not being unduly pressured or paid (which is illegal).   She asked where Taro and I met and how many years we had been friends?  Later in the process she told me that if at any point I wanted to back out she would take care of it. This demonstrated another role  – as a potential buffer. 

In September I told my office I was going to a wedding in the US and flew to NIH in Washington for testing.  The tests lasted for 3 days and they were an ordeal.  I needed to fast quite often (not easy for me!) so I was terribly hungry.  Many of the tests were very uncomfortable and some even a little painful. Storing urine in a fridge was embarrassing and at one point I found myself strapped to something that resembled a spit having swallowed a liquid to make my insides light up and glow so the technicians could see more easily what was inside. I admired the technology but I was especially pleased to be released that day. The advantage – and it is a tremendous one for a donor – is that the tests are very thorough which increases your confidence.  All tests are not as long as the ones at NIH however.  NIH is first and foremost a national research facility and receives US tax money as such.  Due to its’ status, all patients are part of the research. They sign an agreement which allows their results to be used for research. In return all treatment is free and then some.  Taro warned me that because of the research protocols they would take more blood than was normal for transplant patients. As a patient I also signed the agreement and soon felt I had donated a lifetime’s worth of blood.

After the three days I felt bruised and exhausted but my tribulations gave me renewed respect for Taro who had been in and out of hospitals all of his life.    With one or two exceptions the staff doing the testing were not chatty and they were busy so when they spoke it was to issue instructions. All day long people told me to  “drink this” “hold still” “lie down.”  Only once was there a human reaction to what I was going through. It was during the preparation for the test on the “spit”. A nurse and her aide were inserting things in my arm and getting me ready.  She looked at my chart but not at me and said “you’re the kidney donation.”  She continued in a dull six o’clock in the morning voice (it was in fact 6 am) “what is it a family member?” When I responded that  I was donating to a friend she stopped what she was doing  looked at her assistant whose mouth was open and then she looked at me. “Wow!” she said.” You’re a really AWESOME person to donate to a friend!” I found myself justifying it by saying that we had been friends since college but she and her assistant continued to look at me in amazement.  To my surprise their reaction frightened me.

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