We've had 3 clinic visits since we were discharged- Monday and Thursday of last week and then again this morning. Everything looks great. There's a lot of numbers they still have to watch for in his blood work to make sure his levels of medication stay right within the necessary range. His urine output is slowly improving- last week he was at about 100mL a day. They put him on a water pill over the weekend (he takes them on his non-dialysis days) and they've gotten him up to almost 300mL a day now. Yay! They told us they had 2 patients that had a DCD kidney transplant 2 weeks before Bryce and both of theirs started picking up to making almost 2 liters of urine by week 3 and 4. So. We are hopeful. It's going to take his bladder some time to get used to working again too. It's a muscle that hasn't been used for 4 years, so it's weak and small, can't hold a lot yet. But it will.
On Thursday they did an ultrasound of the kidney. There was some fluid around his incision just under the skin that isn't a concern. The kidney looks great (like a little PacMan actually). It's getting good blood flow and there is no fluid around the kidney itself. Bryce asked him if we should worry. These poor doctors, I'm sure they spend half their life telling their patients to relax and be patient. Luckily, we had Dr. Anand so he was super patient as always. He said they have done every test to determine that everything is going as it should. They did a biopsy and there is no rejection. They did a blood compatibility test after all his transfusions to make sure his antibodies were still lining up. They did multiple ultrasounds to check blood flow. They're monitoring his medication levels. His urine output is starting to pick up like it should. Clinically, there is absolutely no reason to expect this kidney will not work. In 99% of cases such as this the kidney opens up and everything is great.
We asked for clarification for what they mean when they say the kidney needs to "wake up" or "open up". He said the filtering parts of the kidney, called the nephrons, are similar to our brain cells. They get their oxygen to function from the blood flow. When the donor passed away and the blood flow to the kidney was cut off for 15-16 minutes, the nephrons died. The good news is they can regenerate, it just takes some time. What we are specifically waiting for is the nephrons to grow back and start filtering! The first sign of kidney function improving will be increased urine output, the filtering of the blood will follow a few days later.
For now he is still dialyzing Monday, Wednesday, Friday afternoons. He is having more energy and less pain (although still some), and working on being able to sleep on his side. He's feeling well enough he might even try to go to work for a few half days this week to stay on top of things and not use ALL his vacation time. We are hopeful this week will be the last dialysis EVER! Or at the very least for 10-15 years.
Dozing while we wait for the doctor
Just some good, old snuggle time
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