There is little I can do the day following my transplant beyond lying prone and observing the comings and goings of the ward. I have a catheter, so my urine output can be monitored (the glamour!), and a neck line through which drugs and fluid are administered. In addition, I have a drain into the operation site, a blood pressure cuff on my arm which takes periodic readings, and a pulse monitor is attached to my finger. I have a morphine pump for the pain which I can administer myself, and this, although effective, also sends me into a doze every time I use it. I am not used to being so inactive, but attempts even to push myself up the bed need to be undertaken with care and cause a lot of pain. I manage to speak to my sister on the phone, and suggest that she visits the following day when I will, hopefully, be more awake. At least I am able to eat and drink now, having been nil by mouth from 5.30 the previous morning, but my appetite is severely dented in the aftermath of the anaesthetic. However, I do have a thing for tea, and drink lots it served in a sippy cup.
Various members of the medical team visit throughout the day, and inform me that thus far things are looking good: the new kidney went pink as soon as it was attached to the blood vessels, and my creatinine levels have already fallen. The nurses and doctors are, for the most part brilliant – professional, approachable and willing to answer all my questions, even if most of the doctors are so young and fresh-faced they look like they should be in school uniform (evidently I have reached that stage in life). Each day one of the devices or tubes will be removed from my body, with the last being the catheter. Following an ultrasound the morning after the surgery to check that there is no build-up of fluid around the new organ, the drain is removed – one down, several more to go. There is to be no driving for the next 6 weeks, and then I all being well I will have a second operation to remove the dialysis tube from my abdomen.
Apart from boredom and inactivity, my biggest problem while in hospital is the inability to get a good night’s sleep. A number of factors combine to make this a problem. Not only is the ward stiflingly hot, but some of the new drugs I’m taking cause hot hands and feet; even throwing off the thin hospital blanket, I can’t seem to get to a comfortable temperature. I am on an acute ward just opposite the nurses’ station: the lights never go out completely (and periodically someone will switch them on and forget to switch them off again), and voices outside the ward are easily audible. All in all, the biggest problem is noise. The aforementioned monitors periodically ding and ping their way through the night – I am never sure whether they are supposed to do this, or if the noise is some kind of alarm. A busy nurse might take 10 minutes or more to get to you to stop the noise, only for it to start up again another 10 minutes later. Further down the ward, another patient calls out to the nurses throughout the night, and won’t stop until someone pays him some attention. From time to time, a patient will press the call button which sounds an intermittent alarm in the corridor – quite understandably the nurses can’t always attend immediately, but this in effect means yet another alarm which can go on for 10-15 minutes before someone is able to switch it off. I begin to wonder whether medical staff become so used to these sounds that they become a kind of white noise for them. However, for the patient, the incessant noise is absolutely infuriating, and I find myself becoming increasingly frustrated and angry. On day 3, I have had so little sleep – and therefore so little opportunity to recover from the anaesthetic – that I start the day with a headache and nausea and a severe sense of humour deficit. I have to fight to keep the bitter-tasting steroid tablets down during the pre-breakfast drugs round, and lie in bed tearful and generally feeling very sorry for myself.
Eventually on the Sunday I am able to get out of bed for a while. I am still in surgical stockings, but now have a build-up of the additional fluids that I’ve been given to help kick-start the new kidney. I am normally a size 10, but my now enormous upper legs bulge over the tops of the stockings, and the skin from my waist downwards is hard and tight. Determined to start shifting the fluid, I very gingerly try taking hourly walks up and down the corridor and the flight of stairs outside the ward. The catheter is still in, so this is a delicate operation to say the least, and I keep away from the public areas of the hospital where a woman waddling around carrying a bag of urine is likely to attract unwanted stares. For all my attempts at activity though, the fluid refuses to shift until, around 2 weeks post-surgery, it begins to fall away in tiny increments.
Five days after the surgery, all still appears to be going well, and I am deemed fit enough to be discharged from hospital. Gradually all the bits and pieces of equipment that I’m attached to have been removed, with the horrible neck line and the catheter the last to go. All the medication that I was taking on dialysis has been stopped, and I am sent home with a carrier bag of new drugs, the names of which sound either like a Roman leader (Tacrolimus was surely a contemporary of Caesar Augustus) or a holiday resort in the Balkans (ski break in Aciclovir, anyone?) These drugs are my new best friends, and I neglect to take them – or simply forget – at my peril; without some of them, my body could reject the new kidney and so I will take them permanently. There is a steroid and an anti-rejection drug, anti-virals, aspirin to prevent blood clots, a blood pressure tablet and a tablet to protect my stomach, along with 2 types of painkiller – 9 items in total, although some of these will be phased out in the first few weeks. I live on my own with no family close by, so the hospital calls a taxi to take me home, and even though I have mixed feelings about going home to an empty house, I can’t wait to get back to my own space. Once home, I unpack, make a cup of tea and collapse on to the sofa with a massive sigh of relief. It is bloody marvellous to be back.