September 9, 2019, I saw a tweet from a man on the East Coast who was desperately searching for a living organ donor for his toddler daughter. She needed a liver. I considered it, shrugged, and filled out the screening form on MedStar Georgetown Transplant Institute’s website. It asked for height and weight in order to calculate potential donors’ BMIs, and as I submitted the form, I was fairly sure my BMI was going to rule me out.
A few days later, I got both an email and a voicemail. Thanks for applying, they said. Your BMI is too high. Again, I shrugged.
The shrugs didn’t come from a place of nonchalance. More of a “decision made” then “decision accepted” kind of thing. My life seems to be a series of shrugs that happen involuntarily, like my body is saying Why not? before my brain has the opportunity to kick in with the panicked what ifs.
Fast forward to Friday, April 17. I read a tweet from a woman I follow who lives in San Diego. She’s excited because she’s just been accepted into UC San Diego’s transplant program. She needs a kidney. Again with the shrugging, again with the application asking for my BMI. I submit my application, a good family friend and my mom listed as emergency contacts.
I text my friend to ask her permission to have her as an emergency contact. She’s a nurse practitioner with years of experience, she knows me well, and she’s met my family. Not only does she happily agree, but she also gives me some insight into what it’s like for people who need transplants. Nurses and NPs know and see things the majority of the general public will never see, and her insights open a door into a world I’m completely unfamiliar with.
Days later, I get a voicemail. The transplant center wants to set up a phone screen. “Oh cool,” I think. “I might actually be able to help this time.” My heartbeat picks up for a moment as the weight of the situation hits me — my brain is catching up to what my heart is telling me to do.
I tell my roommate, Kris. She responds, eyebrow cocked, with “Whoa.” After a few concerned questions, she’s fully supportive.
That weekend, while on a walk, I call my mom. “I need to tell you something, and I need you to not react,” I say. Mom, who has listened to all my wild ideas over the years, immediately understands when I tell her what I’ve applied to do.
“I don’t want this to be a big deal,” I tell her.
“I get it. Your dad and I are the same way. When people need help, we help,” she says.
Mom listens and asks about the procedure, then asks what she can do to help. I ask her to help me fill out my family’s medical history. She tells me she’ll call my aunt to find out my dad’s side of the tree and call me back the next day.
On Sunday afternoon we spend a couple of hours creating the most extensive family medical history I’ve ever seen. It spans generations and a few cousins who are so far away from me on the family tree we’re basically in different forests.
The phone screen is the next day, Monday, April 27, with a Donor Coordinator. He talks me through the process of living organ donation, what it’s like to be a living donor, that sort of thing. I ask if they would take out my left kidney so I can have a scar on that side that matches my appendectomy scar just above my right hip. I also make a surprisingly appropriate poop joke. He’s professional, I’m obviously very at ease, and I even make him laugh.
He asks if I have any questions. I don’t. Not yet, at least. My medical history doesn’t come up, but I assume it’ll be addressed later.
My next call is about a week later on Tuesday, May 5, with a Donor Advocate. She’s a social worker meant to help me through the emotional aspects of donating. My DC and DA have zero contact with the Recipient and are there to help me. Technically, I could never know anything about the Recipient — never know her name, meet her, never interact with her team at all. This separation of church and state exists to protect the donor so I can bow out at any point with no emotional repercussions. The goal is to ensure there’s no pressure — emotional, financial, or otherwise — to donate. Ethics and all that.
Of course, I mangled that rule by messaging the Recipient with updates. I see no reason (for me personally) not to.
All that happened two months ago. After those calls, I didn’t hear anything. Last week, on July 2, I finally messaged the Recipient to tell her I hoped everything was going well on her end. She was surprised I hadn’t heard anything, so I told her I’d check on things. I left a voicemail for the center and emailed my DA right at the start of America’s July 4th holiday weekend. My DA texted my DC, and he said he’d call me as soon as he got back into the office.
On July 8, my DC and I talked for a good half hour. He told me they were finishing up the evaluation of another potential donor, and that after they were done, I’d be up next. He’s going to call me at the end of next week or during the week after that.
The first round of tests includes a range of blood work, a chemistry panel, health screen, fasting glucose test, and hemoglobin A1C. It also requires a full day’s worth of a urine sample. They’re screening for diabetes, circulatory system health, kidney health, and other general health markers.
The kidneys filter waste out of our blood, and that waste comes out in our urine. When kidneys fail, it can be for a range of reasons, but once they’re incapable of working, their human has to go on dialysis. I’ll talk about all that stuff later, though.
This post is meant to be the long-winded announcement that I’m being evaluated for living organ donation. I’ve learned a lot in the last two months about kidneys, organ donation, and living organ donation, and everything I read and learn and see and watch and hear finalizes my decision even more.
Right now, my biggest concern is that I’ll test positive for Covid-19 or its antibodies. If I have or had the virus, that’s almost guaranteeing my dismissal from the program, since I can’t have any antibodies the Recipient doesn’t have — especially Covid-19. This is excellent timing, as Arizona is, from the perspective of epidemiologists, a Covid-19 disaster right now.
My other concern is my BMI. I can’t put off taking care of my weight any longer. Since I’m not pre-diabetic, have never had a baby, haven’t had major surgeries in decades, and am generally in excellent health, I’m hoping the tests will go smoothly. They’ll work with me on reducing my weight, which will help me give the Recipient a kidney that’s as healthy as possible, help the surgeon maneuver around my abdomen more easily, and help my long-term health with a single kidney.
I’ll document the process on Instagram and here, although I won’t share visuals of the full pee jug with anyone. When I asked Kris if she would mind a big container of urine stored in the fridge (which I don’t even think is necessary) she got bug-eyed. My nerd brain, though, is interested in knowing just how much I pee every day. Science!
In case it’s not obvious: Living organ donation is a big decision, and I don’t take it lightly. It’s an option for a lot of people, but it’s not the right option for a lot of people for a variety of reasons. I don’t judge people who don’t want to donate just as much as I expect people to respect my decision to donate. The process could be a speedy four months or a much longer, drawn-out ordeal due to insurance and pandemics and other hurdles. I may spend New Years Eve making inappropriate jokes with a surgeon as I’m being wheeled in, or on the couch with a glass of port watching Netflix. It’s all up in the air.
Once I have an update, I’ll update this blog, which will hopefully soon be about my kidney emigrating to a new human. If I can’t travel, maybe one of my organs can.