October 1, 2024
Hospital, Day 4... Third round of dialysis first thing this morning went rather smoothly. No nausea, no headache. Mainly just the expected fatigue. The process of having all your blood cycled out through a machine and back is not something that is supposed to happen, and it's taxing on the body. But it also appears to be something it gets somewhat used to. After three times, I feel a lot better than when I was admitted. This evening, I ate a full plate of food for the first time in over a week.
The biopsy on my transplanted kidney was done late yesterday afternoon and sent off to be resulted overnight. The nephrologist who's been looking after me came to my room as soon as they came in. My kidney has definitely been rejected, which was nearly certain anyway. It sucks, but I knew this was basically a 50/50 probability for months and months, so I've had time to prepare myself for this. There are things to do about it, which is getting set up for ongoing dialysis. I'll have that three times a week at an as yet undetermined dialysis center close to home, and eventually I'll be able to transition to doing it at home. A new routine to get used to.
I was told a couple days ago that if the kidney was rejected, it may be removed, but behind the scenes chats between nephrologists and surgeons have gotten them to recommending it stay in place so I don't have to do a third major surgery right in a row. I've been taken off two of my immunosuppressive drugs and am being tapered off a third, to eventually be left only on prednisone, to get them out of the way of the immunotherapy for my cancer.
This is the big upside of a very bad turn of events. Now the main emphasis can be on the last (and longest) phase of knocking back this melanoma, and the dialysis will help get me past that and on to eventually getting another kidney transplant.
Not exactly sure when I'm going home. At some point tomorrow, a surgeon is going to replace the temporary dialysis tubes that were put into my neck when I was admitted with something still temporary, but longer-term for use while I'm going to the dialysis center. I get the day off from dialysis here tomorrow to give my body a little break. Other than that, it's monitoring how the rejected kidney responds as the immune suppression is dialed back. If it gets more inflamed, and starts causing me pain, then it will come out after all. The vague impression I have is maybe going home Thursday, but nothing definite yet.
