Goodbye Priscilla the Pee Hat - You Served us well

What goes in must come out.  During the first several weeks of transplant recovery this balance is carefully measured.  We celebrate half-liter pee productions with joy and song.  Output is very important for obvious reasons.  The better your new kidney works, the more urine is produced.  Pee is no longer taken for granted - instead it is a reverent act where prayers for volume ascend to the heavens.  Today we produced enough daily output to retire Priscilla the pee hat.  We initially considered naming it Peter, but considering its perspective from the toilet bowl we decided it should be a girl.  Earning doctor's release from Priscilla was a major goal toward recovery and the dream of finally getting home.  Three weeks more to go, we expect to return to our house on Valentine's day. 

Recovery after transplant consists of blood work three times a week followed-up by transplant team doctor visits shortly thereafter.  It's not like routine lab work at home where you must have blood drawn at least a week or two prior to your appointment.  Here at Mayo you get blood taken at 7:30 am and by 8:30 am the results are ready for doctor review.   Your homework consists of producing daily logs of urine output, estimated fluid input - twice daily vitals are logged and delivered to the appointment.  So far everything is on track for a Valentine's Day release.  We now have the gift of life from a thoughtful donor and must take care of it.  Our routine has changed and things will never return to business as usual. 

Besides the three times a week review of progress with the transplant team, there are classes on how to keep from getting sick.  Transplant recipients are immunosuppressed so the first six weeks are extremely important while your medical team ensures you maintain the right amount of life-sustaining drugs on-board.  Medicine has to be taken regularly and on-time.  Missing a dose could cause you to lose your new organ as the drugs stay in your system for 12 hours only.  Too much and other organs are at risk, too little and you might go into rejection.  We care for our kidney daughter much like new parents hovering over the bassinet watching her every move.  Praying she leads a long and healthy life along with us.  This commitment to her and the required medicines are lifelong.

We are like immigrants coming to a new country called transplantland.  Our normal routines change as we adapt to germ-free culture.   Sushi and buffets are banned here.  Foods must be fully cooked and kitchen surfaces disinfected.  Those soft cheeses and foods we love so much like brie and smoked salmon are off the menu.  Store bought deli meats are heated in the microwave to a safe temperature before making that late night sandwich.  Leftovers are labeled and meticulously tossed after two days.  No more sniff tests to ensure food safety.  There is no room for error here - bacteria is our enemy.  Transplant-life culture believes in regular use of paper towels for had drying, no more cloth kitchen towels.  Hand sanitizer is everywhere.  We don't touch animal feces or live poultry.  People in transplantland although loving and caring individuals do not hug or kiss.  The culture promotes a clean and sterile environment where everybody lives in a bubble and passing through it could be catastrophic. 

What do you say to a friend who really wants to give you a big hug?  Or strangers offering a friendly handshake.  Just as you perfected that European one, two or three kisses to the cheek, these expressions of friendship are now off-limits.  Kissing is reserved for intimate infection free relationships.  Handshakes are OK but must be followed-up by healthy doses of hand sanitizer.  Feel good hugs are not safe for transplant recipients. 

Over time we will figure out this transplantland culture.  In the meantime please don't be offended if we simply wave from a safe distance.