So, for the last week to week-and-a-half, I fully expected that today I’d be posting something about how we’ve been sent home where we’ll be meeting with doctors and school officials and whatnot to establish the next couple of months’ worth of care.
Well, I couldn’t have been more wrong. The following is a little more detailed than it needs to be probably — but it was one of those days where all the details mattered — and we were left feeling like ping-pong balls bouncing around, so we might was well share a bit of that feeling.
The morning starts off with the us at the clinic visit waiting to talk to the person who’d be giving us most of the “here’s the nitty gritty” about that aforementioned establishing. Only to hear that she’s not meeting with us today, she’ll see us Tuesday. Which really isn’t how you want to find out that your plans have been changed on you. At this point, we’re annoyed — yes, we knew it was possible, but not probable; yes, we signed on for this and were game for whatever; but we want to go home, and it seems like the reasons for keeping us here are for a couple of tenths of a point on a lab result that we can get just as reliably back in Idaho as we can here.
Then the nephrologist comes in and she’s prepared to send us home today, assuming the labs look like she think they will and she didn’t know that wasn’t in the cards. So she makes a call and tells us that we’re staying because everyone wanted to be sure that a pain Machen had last week had been resolved. It was news to the nephrologist that it hadn’t been — news to us, too. What pain? Don’t worry about it, it was such a minor blip, I didn’t even bother to mention it here (and I was more concerned about it than the surgeon). So, we’re back to maybe thinking (probably wishful thinking) that we might get the green light today.
The nephrologist does her regular exam, tells us everything looks fantastic and starts typing her notes — at a couple of points, she stops and asks a question or two before carrying on. One of these questions, it turns out, was really important. She finishes her notes and tells us that she’d like us to get an ultrasound. To us, this seemed like something routine, and that it was one last thing we had to do before being sent off.
Machen gets the ultrasound — it takes 30-ish minutes and is frankly a lot more interesting to watch, but far less emotionally gripping and nowhere near as fun to listen to, than one of a pre-born infant. We’re sent back down to the other end of the hall to wait for the nephrologist to send us back to the Ronald McDonald House (which I haven’t mentioned before, and I should fix soon) or home. After longer than we anticipated, the nephrologist comes out and asks if she can speak to us in one of the exam rooms.
Two thoughts occur to me about the same time:
- That’s what we’ve been waiting for
- Well, this can’t be good.
During the exam she’s heard something in the kidney, roughly equivalent to a heart murmur. I can’t remember the term she used, I think it starts with a “b.” Which, coupled with our answer earlier that he’d never had high blood pressure before the transplant, got her to order the ultrasound. Essentially — and she showed us a lot of ultrasound pictures to illustrate this, and then decided to draw something which was a lot clearer on the exam table paper — the blood is moving through the artery at a rate of 160 something per second, but then when it gets into the kidney it moves at 280-330 something per second. That increase in speed may indicate a restricted or obstructed blood vessel in the kidney. What this means, she’s not sure. What the next step is, she doesn’t know — testing, more imaging, who knows. How serious this is, she doesn’t know. She’ll talk to the surgeon and call us later.
She stressed that the kidney is functioning fine, and actually the lab results from this morning’s draw were probably the best he’d had yet. There might be another tweak or two to the medication that we’ll be informed about this afternoon. Basically, we’re just supposed to go back to the RMH and not worry.
Yeah, no problem.
Now, about this time, someone returned a voicemail I’d left on Monday — it was absolutely the right time and a very pleasant distraction. I’ll tell you about it in a day or two, when it’s a complete story. It’s going to be a fun one.
Honestly, at this point, we’re not freaked out — the nephrologist has this incredibly calm and reassuring demeanor (she was the one who started calling the kidney beautiful). My wife and I are pretty sure that if it was any of the other doctors we’d dealt with here who’d said the exact same things she said, we’d be fretting, we’d be complaining that they hadn’t answered our questions more clearly or definitively. But somehow, she can get away with it.
We’re not happy about the delay, but this is one of the things we’re staying around for — making sure that the kidney is fine and working okay. Yeah, we were grumbling when it seemed like a misunderstanding was keeping us here, but for this? No complaints — just wondering what our next step is.
A couple of hours go by, and we get a phone call from the nephrologist. The surgeon and a different radiologist (one who spends more time looking at blood vessels, apparently) have decided that it’s not a concern at this time, and they see no need for further testing or imaging or anything as long as his blood pressure stays where it is. Nice little caveat, eh? She didn’t stress that part, but I’ve been ruminating on things for a bit. Oh yeah, and she made a tweak to the one medication getting the most fine tuning. Because, of course.
Anyway, assuming every thing is pretty much the way it was when we left the clinic visit this morning on Tuesday, we should be headed home then.