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15 October 2021

TGO Challenge 2021: Shiel Bridge to Lunan Bay

JUST HOW BAD CAN IT GET?


Some eight years ago my brother David gave me one of his kidneys. He quite literally saved my life.

In November 2020 I mentioned in this blog post that things weren't going quite to plan with the kidney. I needed another transplant and my sister Megan quite magnificently decided that she would again volunteer to donate one of her own. She had also made this offer eight years ago. 

Then Covid-19 came along and the proposed transplant date of December 2020 - conveniently chosen so that I would be recovered enough to do the TGO Challenge the following May - was put back to later in the month because the hospital was dealing with the influx of Covid patients. It was then put back again to January but my kidney was failing faster than the operating theatres diaries could manage, and it packed up. This resulted in an emergency admission to Oxford Churchill whereupon they stabbed me in my groin with a sodding great needle for an emergency transfusion and dialysis. All well and good, you might think, until the needle came adrift in the night and I started bleeding from a main artery. I recall staring down at the young doctor who was trying in vain to stop the bleeding and thinking that I hadn't expected to go like this and had a fit of the giggles.

They gave up the struggle of keeping the needle in place and sewed it all up and in the morning jabbed me in the other side of my groin, but this time used a lot more sticky tape. This was replaced a few days later by going in through my jugular, down my chest and out again just above the nipple so that I could be given more blood and travel to Oxford for dialysis and EPO three times a week

The plumbing required for...

...this.

To be frank, this was all a bit miserable. 

The kidney is monitored, in the main, by lots and lots of blood tests, so I'm very used to being jabbed at all times of the day or night. Here are a few sets of results over a longish time frame that show how things after my first transplant in 2013 got significantly better and then suddenly went awry in 2020.


Creatinine is the best routine blood test for measuring how well kidneys are working. It's produced by muscles and put out by the kidneys. The 'normal' range for Creatinine for healthy people is between 60-110. Immediately prior to my 2013 transplant mine reached 445. It peaked this time at 1886. My consultant remarked that this was 'quite sporting.'

My Urea results looked similarly interesting:


Urea is a small molecule produced from protein and put out by the kidneys. The normal range for Urea for healthy people is between 2.5 and 7.0. Prior to my 2013 transplant mine reached 29.4. This time it hit 70. I felt very unwell indeed at this point.


Blood count is next. Haemoglobin is the red stuff in blood. It fills red blood cells and carries oxygen around the body Normal is slightly higher in men than women. Men's results should typically be in the range 130-180. The kidneys produce a substance called erythropoietin (EPO) which stimulates the bone marrow to produce red blood cells. Loss of EPO production is usual in patients with advanced kidney disease, and may be severe. Loss of EPO production is a major cause of anaemia in renal failure Treatment with artificial EPO has been a huge advance for patients with renal failure.

Prior to my transplant in 2013 my Hb had dropped to 87 but with EPO treatment it rose prior to transplant to the giddy height of 108. However, prior to this transplant it had dropped to 60. Consequently I was utterly washed out.

There is one chart that gives a fair indication of how you're doing overall, the eGFR, the estimated Glomular Filtration Rate and loosely described gives the percentage efficiency of your kidneys.


And here's what happened to mine:


My kidney function dropped to about 2% efficiency. This was not good.

******

So - That was the bad news and Megan's kidney changed everything, just as David's had in 2013. 

On March 15th of this year Meg was wheeled into the operating theatre first thing in the morning and around lunchtime as she was wheeled out, minus one kidney, I was wheeled in. I emerged in the evening the proud owner of four kidneys.

Throughout all this time, Phil was becoming more and more uncomfortable with a pretty major hernia that was now becoming a problem. However, his operation was also baulked by Covid and he had no clue when it was likely to be fixed.

He came down to Bracknell at the end of April when pubs were reopening and we spent a cold afternoon under a plastic Wendy House attached to the pub. I had been wondering if he was fit enough to have a bash at a low level route across Scotland, because by now my results were definitely on the up, getting better faster than I had expected. But it was obvious that it was just not a goer for Phil.

Lord Elpus outside the Bull, in the cold, in the pouring rain.

After Phil had driven away back up north, with slightly indecent haste I had the maps out and wondered if it was possible to rejig the route we had submitted all those light years ago to make a slightly easier route for a bloke cobbled together with spare parts and stitches.

When I realised it could be done I contacted Sue and Ali, the Challenge Coordinators, to see if this Cinderella could come to the Ball. They were jolly nice about it and agreed. I love those girls to bits.

A route is born

All I had to do now was get fit - a bit of a problem that, as I hadn't done any exercise for months - find all my backpacking kit - some of which had been loaned to friends - and actually go for a walk across Scotland. 

Actually, the getting to Scotland bit was to prove a bit of a problem, but we'll come to that in the next post.


28 comments:

  1. On several occasions flogging up steep roads in France I have been assailed by friendly motorists' passengers with windows wound down shouting "courage!" I salute you in similar fashion.

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    Replies
    1. Thank you, Conrad. I think we've both been through the mill. It's good to see you our and about on your travels.

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  2. Glad you're feeling better! Sounds like quite the ordeal. It's nice to see that you felt well enough to do the Challenge this year. Looks like I'll be coming back for 2022, as long as covid cooperates!

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    1. I've just had a wonderful read of your last crossing, Brian. Large chunks of which seemed to be epic! Will you have the same team with you this time?

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    2. Leslie will be back and I'm bringing two more backpacking friends with me from the US. Kenny and Ava will be on the TGO as well, we're trying to coordinate walking with them for at least a few days.

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    3. That's brilliant news!
      And the very Best of British to you all!

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  3. Replies
    1. We've all seen some pretty tough times over the last year or so, Al. It's good to see you're out and about again.

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  4. It,s good to see that you,re better and what a very kind and loving family you,ve got

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    1. Hi Chris, and thank you for your comment.
      You are absolutely spot on, Sir. I have a truly amazing family. It always brings me to tears whenever I think about their incredible generosity.
      In return all I can offer is to live my life to the full and enjoy these new chances they have given me.

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  5. What an amazing family you have. Looking forward to the next instalment 😀

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    Replies
    1. They're not a bad bunch, eh?
      ;-)

      If you click on the red 'Newer Post' link below this comment section you'll find I've already sneakily published the next episode.
      Cheers Emm
      x

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    2. That is pretty sneaky 😅

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  6. Well done you and amazingly well done Meg. May your glass remain half full. I love your fantastic can do attitude.

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    Replies
    1. Half full? It's brimming!
      Dave & Meg have filled it right to the top!
      😂

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  7. Holy crap sir, I knew it wasn't good, but I had no idea it had got that bad 🙆

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  8. So then - how's that knackered old frame of yours? Phil's has now been repaired - is there any sign that you'll be in full working order any time soon?
    🤣

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    Replies
    1. It was all going so well until the ****ing Covid 🤦
      Still, I should have learnt my lines by the time I'm allowed out 🤔

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  9. Great news - great to see you back in action. Scary times though and a reminder as per your comment replies to always live life to the full and enjoy every minute

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    1. Indeed, Andy - Now then: Have you put your entry form in, Sir?
      🙄
      It would be great to have you on the Challenge!

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  10. Really Alan. Please could you submit your blog posts to that board that gives films a rating before allowing public viewing? This should have been X rated. Not for the photo of you in your nightie, or that of Phil who looked as fragrant as ever but for the graphic blood and needle related details. How horrendous.
    A great read, as always.

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    1. It's just as well I didn't mention waking up at three o'clock in the morning thinking I had wet myself, as the bed was soaking. Turning on the light it took me a while to realise I was lying in a pool of blood.
      I won't mention that, then...

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    2. Thanks because I wouldn't want to hear about it. But glad you are now so much better. I'll bet you are too.

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  11. bloody hell, you really are a Living Legend!!
    I don't work at the Churchill any more, but it could've been me doing the dialysis if I had been!! That's my job, as I'm sure you remember.
    I can tell you, a Urea of 90-odd is pretty desperate! I think that's a touch higher than the highest one I've had to dialyse. It's scary, as a dialysis at that level can kill you, if we're not really, really, careful. As can not dialysing you!
    For the sake of accuracy though, there are no needles left in the groin after the insertion procedure (and that uses a bloody big one!). Just a flexible plastic tube, but, occasionally they do bleed. And very occasionally, they bleed quite a lot!
    But bloody well done for carrying on carrying on! And massive Kudos to both your brother and your sister for giving you back your freedom - they're heroes just as much as you are.

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    1. Hello Paddy! Or is it Gillian?

      I may not be your record breaker for Urea, the figure was 70, not 90.
      *sigh* I've never won anything in life...

      Now there's a thing: No one told me that dialysis could kill me! Mind you, they made me sign all sorts of disclaimers before they jabbed that elephant needle into my groin, so it may well have said something along those lines in the sheaf of papers?

      A plastic tub, you say. Well that's a load off my mind.
      😂

      It's lovely to hear from you - and yes, I agree totally. David and Megan are the heroes in *all* these tales, as without them, there wouldn't be any at all.

      Great to hear from you.
      Alan
      x

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  12. The key words there are - it can kill you "if we're not really, really careful". And of course, us dialysis specialists are really, really careful! All the time! Oh yes!
    Didn't realise it didn't put my name up - it's Caburn here :-)

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    1. Caburn, you Sweet Thing!

      I had, rather embarrassingly forgotten your splendid occupation. There are now three TGO Challengers who are dialysis nurses! I ought to find out each of your routes and tag along. Do they do lightweight, titanium dialysis machines?
      Oh, Hang on - I now remember your colossal routes - maybe we could meet up in the pubs?
      It's lovely to hear from you, Sir!

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