Day 3- 10

This was perhaps the worst time off my hospital stay and at times caused me much apprehension, pain and problems. I am going to describe what happened in detail so if you don't want to read the specifics miss the section.

On day 3 I was starting to get out of bed and move around more. My urine at the start of the day was clear and passing well and my creatinine was down to 167, things seemed to be going well. Then things started to change during the afternoon and evening my urine started to turn red and darker red. I had a tube into my bladder that was taking the urine straight out. This makes it easy to see how much urine you are passing and how much blood is in it.

During the night things got worse - I raised it with the nurses saying that my urine amount was dropping and I think I had about 4 hours of passing basically no urine. They flushed the tube once and drew off urine and some blood clots. This relieved the pain, but it soon blocked up again, the nurses said they did not want to flush because it was a risk of infection. I was getting more and more in pain and had to take more and more painkillers to cope. Eventually I was in so much pain and internal pressure that I had to basically shout out in pain - the night staff basically said to be quite and that they were doing hand over and would get to me afterwards. Basically ignoring me. Thankfully one of the day staff said "he does not complain like that!" Something is wrong and she came and spoke to me to see what they problem was.I explained about the blood clots and not passing urine and the pressure. Within minutes I had another nurse around me and a doctor. They did a proper flush and drew off over a litre half a litre of liquid more than my bladder could take at the moment. It was clear that there was a problem. The doctor organised another doctor to come and replace the tube that passed up my *enis and into my bladder. He arrived and attempted it twice but could not manage to get the tube in. He urgently called a specialist urologist to come and do the tube insertion. He arrived with 10 minutes and managed to get the tube into my bladder with much pushing and shoving. I had basically a bladder full of half clotter blood. He then spent 10 minutes pushing saline into my bladder and pulling with a syringe this liquid out - under great pressure. He managed to get the main clots out and then set up an irrigation system that basically continually flushed my bladder for the next 8 hours. The tube that he had placed in me was about 3 times the size of the original tube and was very very uncomfortable causing bleeding in the nether regions that was not nice - but at least the clotting and pressure problems had been stopped.

The pain I had during the pressure build up was unbelievable - but I was not so worried about the pain I could feel the pressure in the bladder and then up into the kidney and this worried my greatly. It was a relief to have that pressure relieved once they had sorted out the irrigation and removed the clots. I suffered for a further 3 days from bladder spasms which are very uncomfortable. If you have them I have realised that you should just go with the pain and relax and this makes them less painful and scary. Apparently what I went through that night was more reputed to be more painful than giving birth. I am glad I am a male...

The next morning when the doctors came round they were discussing what my creatinine that day would be, I don't think they had realised the problems I had the previous night - I knew that I had been in problems and that I had not been passing urine. I told the doctors that my creatinine would be up and why. They disagreed.

My creatinine had risen, and risen dramatically. From 167 to 330 which should not happen over that time scale even if you have no renal function. There was original panic but the main doctor decided that I had had a urine leak inside me from the pressure and that this was reabsorbed into my blood putting my creatinine up.

I started to pass urine again at good rates with less blood and my creatinine started to drop down to 180.

I had the tube removed on day 6, this was a great relief and allowed me to move around freely and to feel a bit more human again.,

I also had a potassium scar in which a potassium result came through at 6.5 which for some people can be life threatining. The doctor said that this was probably lab error but they had to check it again. They did an emergency ecg which can show high potassium and sent off urgent bloods. It all can back normal.

On day 7 my creatinine jumped up again unexpectedly and they decided that it may be down to high tack level but they wanted to be sure and did a biopsy of the kidney.

A biopsy is not a nice thing - it does not hurt that much but does carry the worry of a big needle shot into the kidney via a gun system - this can cause more bleeding and damage in about 4% of cases. I did actually agree with the decision to do a biopsy and was rolled of to the minor opps room for the biopsy. It was funny because I had to registrars take me down on my bed to the room. They were both ultra keen and nervous to do a good job for a number of reasons. One being that they knew the effort and emotional energy that had gone into the transplant preparation and following days of treatment.

During the biopsy procedure they use a echo machine to locate the kidney which is just under the skin on the fron side of your stomach above the groin area. They spent some time being sure where the kidney was and the best place to do the "gun shot". The doctor inserted the needle gun into my skin and wobbled it so he could see it on the acho machine. This is uncomfortable and worrying because you don't know when the shot is coming. After about 6 insertions and wobbles just above the kidney he eventually did the first shot. The needle/ gripper get shot into the kidney and then draws out. He repeated this again so that he had 2 core samples. The actually procedure was flawless and we were all relieved. Now just had to wait for the results. I had to lie completey still for 6 hours.

The following day was crucial both to see what my creatinine was doing and the results of the biopsy. My creatinine had dropped slightly to 191 which was good news and the doctors were pleased to tell me that the biopsy was all clear with no signs of rejection in the cores. This was good news and it was prob my tack levels.

Over the next 2 days I began to get more strength back and was up walking around the hospital and basically wanting to go home. I still had a neck line (line going into my jugular vien) and also had stitches in.

On the monday - day 10 I was allowed home, had my neck line out and stitches removed. All fine - these things are not painful but you can let your mind think that they will be. Left hospital with a creatinine of 165.