Five Years after Transplantation
I recently had a comprehensive physical examination at the hospital. The results were quite satisfactory. Five years have passed since I received a kidney transplant. I’m writing this blog post to summarize my physical condition and treatment over the years.
A Chinese version of this post is available here.
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Onset of illness
During a physical examination around the age of 30, it was found that my kidney function indicators were not ideal. So targeted adjustments were made. But as time went on and work got busy, I gradually relaxed my focus on health. Although the indicators were still acceptable in the physical examination a few months before the onset of the disease, the deterioration of kidney disease was extremely rapid at the later stage.
At that time, I had several projects going on and was under a lot of financial pressure. Although my body had sent obvious signals, I always wanted to insist on going a little longer. Even though my family urged me again and again, I never received the necessary examination until I was almost completely unable to eat (I would vomit after eating anything) and had no choice but to go to the hospital. The diagnosis was very quick because there was no need for discussion. At this point, my creatinine was over 2100+, and my hemoglobin was 46. According to the doctor, I was lucky to be able to walk into the hospital.
Due to severe anemia, I received blood transfusions several times, but my hemoglobin did not improve significantly. In order to undergo more thorough dialysis as soon as possible, after discussing with the doctor, despite the hemoglobin being less than 60, I had the surgery to implant the dialysis tube forcibly and began my dialysis career.
Dialysis
There are two forms of dialysis: hemodialysis (the dialysis method most people know) and peritoneal dialysis. Hemodialysis is usually performed at a designated hemodialysis center (or hospital) three times a week for four hours each time. Peritoneal dialysis can be performed at home, with the number of dialyses per day varying depending on the patient’s condition, usually 2 to 5 times, and each dialysis fluid replacement time is about 20 minutes.
I chose peritoneal dialysis. Compared with hemodialysis, peritoneal dialysis has more freedom in location and time. In addition, peritoneal dialysis usually protects residual kidney function better and is beneficial for future transplants. There are also two ways to do peritoneal dialysis: manual, which means manually performing dialysis fluid replacement operations several times a day, and automatic dialysis (APD), which usually means connecting the peritoneal dialysis tube to the equipment before going to sleep at night. During the patient’s sleep, the equipment will perform multiple fluid exchanges. When you wake up in the morning, simply disconnect the peritoneal dialysis tube from the equipment and you can move freely during the day like a normal person. With so many advantages, I naturally chose the automatic dialysis method.
Ideals are abundant, but reality is cruel. After dialysis, I found that my peritoneal permeability was not very good. Relying solely on the dialysis machine at night was completely unable to meet the needs for excreting toxins and fluids. Therefore, on this basis, I gradually increased the number of manual dialysis operations during the day. Before the transplant, I needed 5 manual operations during the day and 12 hours of automatic dialysis by machine at night. I had already set a record for dialysis in my area.
After months of dialysis treatment, as my condition gradually improved, my family contacted the transplant hospital and urged me to have a transplant surgery. However, for some reason, I was not very keen to have a transplant at that time. To outsiders, dialysis is a dull, tedious and restrictive treatment, but to me, it was a physical and mental conditioning. During these years of dialysis treatment, my mentality has undergone tremendous changes and become more calm and composed. In addition, dialysis made my life very regular, laying the foundation for my future healthy lifestyle.
Transplantation
Eventually, after four years of dialysis, I chose to have a kidney transplant. To better cope with this surgery, I had been specifically exercising for a year before preparing for the transplant. Plus, I had “missed” a few transplant opportunities by chance before, so when I received the call from the hospital, I was very calm. I was confident that the surgery would be successful.
However, things did not seem to go as smoothly as I thought. On the day of the surgery, undesirable conditions still occurred. The surgery that was originally supposed to take 4 to 6 hours lasted nearly 10 hours. Moreover, on the fifth day after the surgery, according to many indicators, the surgery seemed to show obvious signs of failure. Most importantly, the doctor suspected that the transplanted kidney might have ruptured,so another surgery was performed. Although there were problems according to various indicators before the second surgery, I personally felt extremely well, so I went into the second surgery with a very relaxed mindset. Later, I learned from my wife that at the time, the doctor had already prepared for the worst with my family. The second surgery took no less time than the first, and the postoperative reactions were just as severe. After being baptized by the ICU, nothing major happened to me. The good news is that the second surgery confirmed there were no major problems with the first surgery, and the transplanted kidney was intact.
After breaking the hospital’s record for the longest stay after a transplant, 35 days later, I finally returned home and entered the postoperative recovery stage.
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Recovery
As soon as I returned home, I encountered several extremely difficult problems.
The first was poor physical fitness. This was because after the second surgery, there was another serious bleeding at the incision site. To speed up, two doctors performed emergency treatment on the incision in the intensive care unit. After this treatment, I was required to lie in only one position. After more than 20 days of bed rest, although the incision was fine, the lower lung collapsed significantly. In the first month after returning home, even at rest, my heart rate was over 100. To improve my fitness, I started physical fitness exercises two months after the surgery and have maintained this habit ever since. Now I exercise for one to two hours a day. The second symptom was neurotremor, a side effect of the drug tacrolimus, with varying degrees of severity depending on the individual. At that time, my hands could hardly grasp chopsticks, similar to Parkinson’s syndrome. To improve this condition, I tried writing with a brush every day, not to practice calligraphy, but to increase my control. As the medication dosage decreased and my body gradually adapted to the medication, this symptom improved significantly one year after the surgery. Now, except for some very delicate operations, there seems to be no abnormality. The third point was problems with my brain. Massive anesthesia and high-dose hormone therapy in a short period of time caused obvious congestion in my thinking. In the three to four months after the surgery, I could hardly send a text message without errors. Basically, my brain knew what I wanted, but the expression always had problems. Fortunately, I had a clear understanding of this situation and tried to improve it by reading, thinking, communicating and learning. Learning Swift, SwiftUI, and Core Data was also an initiative I took on my own to treat this condition. To understand the situation during this time, you can read “Old Man New Soldier — A Development Memoir of an iOS APP”.
Overall, several years of dialysis life gave me considerable help. In the years after the transplant surgery, I maintained a relatively healthy lifestyle and an optimistic attitude. After years of recuperation, my physical indicators have been getting better and better.
These are some of the indicators I regularly check every month. Through these indicators, we can see that my kidney function indicators have gradually improved and returned to normal over the years after transplantation. For most transplant patients, indicators will return to normal in a very short time (days to weeks) after transplantation, and then problems will gradually reappear over time. At least so far, my indicators are still on the rise. I hope I can continue.
Only through long-term accumulation can the value of data be seen. Using the “Health Notes” App, I not only have a clear understanding of my physical indicators, but this data also provides important reference indicators for me and my doctors, allowing me to make targeted adjustments to my body. If you or your family or friends need to track health data for a long time, you can try using this app. Please note that this app was originally written for myself and is not friendly enough for beginners, but the functionality is very practical.
The future
Despite dealing with health issues on and off over the years, I feel very fortunate. I was blessed to receive a kidney from an organ donor, I have a loving family, I always seem to narrowly avoid disaster, I have been under the care of skilled doctors, and I have supportive friends. Next year I will turn 50, so I hope to continue living actively and healthily while maintaining an attitude of peaceful acceptance. I want to do meaningful things that contribute value to society in my own way. I wish you all good health and happiness.
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