As part of my job, I am fortunate to have a platform to communicate to our entire company. The following is an excerpt from the message I sent on Friday, July 31, 2020 as part of our weekly internal e-newsletter:
I stared across the hall and into my bedroom, not really looking at anything in particular. Sitting in what’s been my work office for the past four months, my mind was overwhelmed. I thought to myself, “I can’t recall the last time I had cried or came close to it.” As I put down my phone, my eyes welled up. Over the course of the next four weeks, that would happen several times.
The date was July 2, 2020, and the nurse coordinator at the University of Kansas Health System had just told me was I was a match to donate a kidney to a friend. I could schedule the transplant at any time. That’s heavy news. Emotions came rushing in from all angles. In that moment, it’s hard to distinguish what’s joy, what’s fear, what’s anxiety, pride, love, apprehension … all the feelings. Moments later I found myself lying face down on the bed I had been staring past earlier.
This possibility hadn’t seemed real for the several months leading up to that July 2 call. But the weight of it became apparent very quickly. My emotions have ebbed and flowed since, but pending a negative COVID-19 test this afternoon, I will be donating one of my kidneys on Monday.”
(Spoiler alert: the test was negative, and I did donate my kidney Monday, August 3.)
***
The first time I had considered donating a kidney was on a plane. I was flying Southwest like I used to do frequently going back and forth between Kansas City and Denver for work. I was listening to the Freakonomics Radio podcast “Make Me a Match.” It described how Al Roth won the Nobel prize for economics by designing a matchmaking market for kidney donation. This was in 2015, and at the time, I told myself that I would be open to donating my kidney. I wasn’t going “altruistic,” which is what they call someone who donates to a stranger. I decided to save mine in case someone I knew developed a need.
Actually, my first reaction was that I would save my kidney for a close family friend. My memory is a little fuzzy on this detail, but I believe we had learned that my friend and her family had a history of kidney disease, and I thought I would feel horrible if I gave a kidney away only to find out a dear friend needed one. Unfortunately, by 2019, the family did have a need. Actually, two from the family went on the kidney donor list, and I was a match for one of them.
By 2020, the recipient’s PKD had reduced her kidney function enough that the nephrologist told her on February 3 that she’d ideally have a new kidney in six months. The fact that our transplant happened on August 3 (exactly 6 months later) is incredible.
Right After the Surgery
I went in for surgery on a Monday, and I was home on Wednesday. They have you up and walking the day after surgery, and if you can pass just a few tests to prove everything is working as it should, they let you go home. It’s not necessarily easy, but it was all very doable. Clearly, there were times when I was uncomfortable, but when you think about how much better her life will be (and her three little kids), the discomfort is a blessing.
By about a month out, I was physically feeling fine overall. At that point, a good-sized incision through my belly button was not fully healed, but I was doing well. What I underestimated—even though I was warned—was the fatigue. I would tire easily, and keeping focus was a struggle. It seemed like I was forgetting what I was about to say at least once a day. But, as it was explained to me, this was all normal, and I can confirm that you do overcome that fog. The fog just lasted longer than I expected.
Honestly, I was a bit overconfident in my ability to return to work. I was in shape and healthy, so I thought I’d be back to work after two weeks. After all, I have a desk job, and during the pandemic, we were still working from home. I figured I’d be part-time the third week and back at it on the fourth week. In reality, I worked very little that third week, and I was still part-time on the fourth week. But again, it wasn’t my body that held me back; it was my brain. The fatigue and fog made it hard to keep up with a job that requires tremendous focus.
Return to Fitness
“As far as your fitness, you’re going to have to start from square 1.” This is what the nurse coordinator told me to expect after donation. The care team at KU Health System wanted to make sure I understood that this would be an uphill journey, but as my wife said, “what fitness journey isn’t?” I had four incisions. Three were small, but one was a few inches long and right through my belly button—clear through the abdominals. As any athlete will tell you, trunk stability is exactly where everything starts.
I was instructed to refrain from lifting anything over 10 pounds for six weeks, and for six weeks, I was diligent. Then on the night when six weeks ended, I decided to try an assisted (meaning my feet were anchored) sit-up. I remember sitting there on the ground almost in disbelief as my body failed me! It’s a bizarre feeling when your body doesn’t respond the way you think it should. Just weeks earlier, a sit-up was an easy task. And on that day, my first attempt was a fail. I did eventually do one that night, but I had to focus so hard and really think about engaging my abs.
For those six weeks, I had basically disconnected the mind-to-muscle connection with my core, and it took a minute to get it back.
As I worked to get my strength back in the following weeks, there’s one key component I can’t ignore: My wife is a personal trainer. Here’s an excerpt from what she wrote about my corrective exercise program about 11 weeks after surgery: (Rebuilding strength and fitness after surgery – elevatefitnesskc.com)
Our schedules with work and as parents made in-person training difficult, so I started putting together programming for him to do on his own. Then, when the exercises get too easy, we progress as tolerated. And progress he did! Planks, squats, box jumps, pushups, pullups – not much of a hill in the fitness arena, doc. Keeping your body spit-shined is so important for anything, both expected and unexpected, to ensure you come out high on the other end of it. Our bodies are positively awe-inspiring.
BODYWEIGHT SETS: His first set of exercises were bodyweight sets like floor bridges, quadruped contralateral arm and leg raises, isometric planks, squats, step-ups, and just the motion of the deadlift. I was hesitant to give him anything that had weight overhead or weighted dynamic movements until he was able to create and hold onto enough trunk tension. Of course, he hit some of the fun stuff like biceps and triceps, and some easy cardio on our treadmill and elliptical machines. I sent him outside for bike rides whenever the sun was out for that golden Vitamin D. As far as specifically abdominals, we didn’t do anything with spinal flexion the first couple of weeks, aside from the first experimental anchored sit-up.
WEIGHTS AND PLYOMETRICS: Next, came some anti-rotational core work to increase that ever-important stability component. He was able to maintain posture with dynamic movements pretty quickly! As a result, we added a little weight for overhead presses, bench presses, lunges, and some easy plyometrics with squat jumps and box jumps. Those came fairly easy, although there were twinges from scar tissue that got pulled on a bit here and there.
ADDING COMPLEXITY: This week, he’s working on multi-planar step-ups, renegade rows (yep, he can already do those!), contralateral toe touches, bridge pullovers, heel taps, side plank reverse flys (another !) and a bit more complex leg sequences like a reverse lunge to squat right into a box jump. Pretty amazing, guys.
What’s next on the fitness path? We’re going to hit the truly complex movements with multiple muscle synergies, like the classic curl+squat+press , heavier deadlifts, and maybe some hanging abdominal work. As he is a seasoned desk-jockey, we’re always working to reverse those repercussions, like rounded shoulders and forward head. Stay-tuned!
(If interested, I wrote a follow up to that article about a month later: Path to Recovery Phase 2: In-Person Fitness Training – elevatefitnesskc.com)
Life Since
One of the key factors in my decision was that I wouldn’t have to sacrifice my lifestyle. I had read about an American Ninja Warrior who had donated a kidney and was competing again within the year. I don’t take ibuprofen anymore, and I decided not to start a very high protein diet to bulk up, but otherwise, I haven’t sacrificed anything because of the donation. I run. I cycle. I lift weights. I row. I go on hiking trips. I play sports in Kansas City Corporate Challenge like flag football and basketball.
One thing I would encourage is to have realistic expectations about where your kidney function numbers will be a year after the surgery. I was probably told that my numbers would be slow to improve, but I hated that my six-month numbers were about the same as my one-year numbers. I panicked a little thinking my one-year numbers should be much better. I knew they would not reach the pre-donation levels, but I thought they’d be higher after a year. This lab work required a little discussion with the care team at KU to ease my mind, but they were pleased with where my numbers were at, so I trust they know what they’re talking about!
A Support Network
I also need to say that have been incredibly blessed. First off, I had the opportunity and capacity to do something like this, and I’m so thankful that I was a match. Second, I have such a wonderful support system around me. My family—and my wife in particular—encouraged me and embraced the donation. I can’t emphasize enough how much I appreciate my wife. Going through this is not a decision made by an individual; this is a team decision. If she wasn’t so supportive and encouraging, I would have passed on the donation. We talked about what this would mean for us and our two boys (9 and 11 years old at the time), both in the short term and the long. She made both the decision and the recovery so much easier. Again, I’m incredibly blessed.
I was also blessed that my employer was amazingly supportive as well. I initially worried about how this would affect our team and the people we support within the company, but as I shared my plans, it became abundantly clear that work was never going to be an issue. That was a load off.
I was also blessed with a completely new network that developed after the donation. People I hadn’t really talked to before opened up to me about their own experiences. Some had family members that had gone through the process, either as a recipient or a donor. Others were facing this challenge currently and wanted to know more. I am forever grateful to have forged those connections and to be there for others along the way.
