Right Kidney For The Trail
On a special day, 8 February 2020, I ran my first serious run since donating my left kidney on 16 October 2019 – just 16.5 weeks later. At 73 years old, a half marathon trail run (my first trail run) on one kidney is a significant achievement. I ran the Rotorua Ultra Half, one of the more picturesque trail runs in our country, renown for inspiring runs.
Special, first, because this is the last 22 km of The Miler, a 100 mile run my son would finish 24 hours later. Also special because with me on our 22k was Amanda (my daughter-in-law) and Andrew (her brother). I finished in a satisfactory 177 minutes. Just a little irony, I ran my best road marathon nearby, finishing in 178 minutes, 31 years ago. To counter, I managed to finish ahead (by a few minutes) of Amanda and Andrew.
I was especially conscious of having only one kidney and the extra need to keep hydrated. With a 9.5 k gap between aid stations, I chose to carry water – normally unnecessary for me on a half marathon.
Today, I’m 10 months post-op. A 73-year-old, 71 kg (skinny) male with a long history of orienteering, including Mountain Marathons (similar to today’s Rogaines), a few road marathons and numerous half’s, road cycling including 160 km events, and a 100k with 2500 m of climb. Multi-day tramping (wilderness hiking) and other New Zealand (NZ) native forest activity such as 2.5 – 3.5 hour exotic pest baiting on lines in rough terrain forest. 3 hours approximates a road half marathon.
Let’s pause and reflect, from whence I have come, to be on the path to donate a kidney.
I began donating blood in 1970, this week will be my 435th donation; mainly plasma. Perhaps 20 years ago, I registered as an organ donor; our family knows the hospital / research gets to take all the useful bits and family get the ashes of the rest. Although I had not considered living donation, it was a small step, not a giant leap.
As the recently elected treasurer of an endangered species restoration group, I, on Monday 8 October 2018, met to discuss account options with Chantelle; The Good PA. I’d known Chantelle through a local business group for some eight years. Over that time we built a comfortable, friendly relationship. On the morning of the 8th, it felt appropriate to ask about a scar on her neck from recent surgery. She told me of thyroid gland surgery related to poor kidney function, a genetic condition, and that she has dialysis several times a week. “But it is part of life,” and she simply gets on and does it, as the other option is not attractive. Words to effect of, “if I don’t do dialysis I die!” She then had been on the wait list for a kidney for six years.
A surprise to me; Chantelle, such a positive, pleasant, go-get person has also to contend with the rigors of regular dialysis.
I got to thinking about this; considered if I could spare a kidney. While the initial idea gelled almost immediately, the subsequent SWOT analysis took some weeks to precipitate. I am good at looking after myself, so well equipped to care if I have just one kidney. At 72, if I’m going to do this I better get going!
So began the process. In January 2019, I wrote to siblings and children, “I’m planning to donate a kidney; are there any family members who may now or in the next 5 to 8 years need a kidney?” Unanimous “No,” and only one, the one who does donate blood, questioned how well I had considered donating. I chose not to share my plans with Chantelle perceiving it a conflict of interest as our restoration group was in business with her, ‘The Good PA.’ I was confident, if Chantelle accepts it, she will care for the kidney even better than I have.
The next step; determining if > 72 year old’s are suitable kidney donors. About the time I got the age “ok,” I received information on donating which included the remote chances of matching a non-family recipient. At this point my impression was about 50:50 – later I found the reality is more like 20:80. Do I want to donate a kidney anyway, if not to Chantelle to whomever? By the time I have crossed all the hurdles another match may have appeared. Reading the Live Kidney Donor literature prepared me for the three options; Direct, Paired Exchange, Non-Directed.
From outset in October 2018, I had in mind donating to Chantelle. From February, as I learnt more about the process, my first option was a direct donation to her, second option a paired match donation including Chantelle and very much the third option a non-directed donation. Clearly, I would like some confidence that the recipient is going to care for it, with a life-style similar to the kidney’s previous owner.
Sometime about May my clinical nurse specialist (CNS) suggested I may not be a match for Chantelle, which was confirmed in June with words I heard as, “your kidney would be immediately rejected by Chantelle’s body!” I requested that we don’t share this with Chantelle as I could see no benefit to anyone while Chantelle remained on the kidney wait list. For now Chantelle’s inspiration in my kidney story remains confidential to three in the renal unit and Jill – my wife.
Gutted to be told by my renal physician that I could not participate in the paired kidney exchange donor scheme as we had run out of time! From 1 July 2019, the scheme pool would include Australia and the Aussies weren’t accepting donors older than 70 – therefore we (NZ) would not accept paired donors over 70 either. I felt let down by the system and said so! Renal physician and CNS assured me they knew within two weeks of telling me. Knowing my body; so quietly confident, I cleared all the remaining hurdles in the following four months, including an Aussie flu three weeks pre-op.
It is now the afternoon of 15 October 2019. With Jill (a retired nurse), I’m undergoing my pre-op assessment in Auckland Hospital Outpatients. An opportunity to check the hand size of the surgeon. He will incise a cut large enough to put his hand in to lift my left kidney out. He draws a large purple arrow pointing left on my lower abdomen, “in case I forget,” to ensure he takes the left kidney and not the right one. Then gives me the pen with the instruction to retrace the arrow again after my pre-op shower.
Forgive me for thinking the arrow pointed to where he would put his hand in to remove the kidney. Following the operation and regaining compos mentis, I’m pleasantly surprised to find the 80 mm incision is handsomely central from my navel down.
Post-op 2.5 days, I was out of the hospital, staying locally for 10 days just in case. Green script: lots of walking. Not scripted: hills added from day four. The CNS was aghast when I told her Jill and I had been walking up and down Mt Eden. “But hardly a mountain”, say those who know it! She would barely consider it on her very best day!
On post-op day seven, Jill and I went orienteering (walking pace), in an Auckland city park I know very well. However I forgot there are fences to climb – very gingerly! I was home in time for Labour public holiday weekend with my grandchildren. For the following week, I was flattened by a Kiwi flu bug. Somewhat worse than recovering from the nephrectomy.
Into my fifth week post op, I returned to Brolates (pilates for guys), road my bike for three gentle 30 k rides, and did an 8 k track walk with a steep section, and did the 6 k Round The Bridges street walk. I also did my first short and flat sidewalk jogs: 4 x 100 m in a 3 k walk including some moderate street hills.
The most special part of this week was the very emotional news that Chantelle received a donor kidney on 11 November. At last I could say, “Chantelle, you are my inspiration! Congratulations on the new kidney!” It was special to receive her email reply, and to realize we can now share our kidney stories.
Our stories are well told by our local newspaper: The Te Awamutu Courier.
I am now almost 11 months post-op and my recipient and I remain anonymous to each other. I am comfortable with this and have little desire to know anything about my recipient. I do have a surrogate recipient in Chantelle: my Inspiration. She may say she has a surrogate donor in me, as her deceased donor is anonymous. Our families are meeting in a couple of months.
I am hard put to say how my life has changed. Perhaps I puff more on exertion. Perhaps I still get a bit more tired. I have three rapidly disappearing scars to remind me. There are simply no other effects so I carry on my life as before my nephrectomy.