Rejection. It’s a word none of us really like. I mean, come on. Rejection sucks. As a teen and young adult it usually means someone you’re interested in has said “thanks, but no thanks” or successfully friend-zoned you. Professionally it can mean all kinds of things–you didn’t get that job you thought you had in the bag, you were fired, or someone didn’t like your work. As an author rejection means an agent or editor decided–for a variety of reasons–they don’t want your story. In the world of organ transplants, rejection means the recipient’s body has suddenly realized there’s a foreign organ and has decided to fight against it.
Unfortunately my husband and I have been dealing with that last form of rejection over the past week (which is why I got really quiet all of a sudden). Transplant rejection is something I think most of us are vaguely familiar with–we’ve at least heard the term before, even if we don’t exactly understand all that it entails. Phillip and I kind of got thrust into the world of transplants last summer. And by thrust, I mean we had our hands and feet tied up and we were thrown into the middle of the lake and told we better learn how to swim.
Okay, maybe that’s a little melodramatic, but at times it definitely felt like that.
Even with us being in the world of transplants, rejection is still something that’s a bit mystifying and foreign. I mean, we knew the statistics–about 30% of kidney transplant recipients will experience rejection at some point, and the first three months (some say six) are the most critical. We knew rejection could be treated, but we weren’t sure how. And I don’t think we realized there were so many varying levels of rejection.
We knew a week ago that we could possibly be looking at rejection after we found out last Friday that Phillip’s creatinine had jumped up suddenly (for kidney transplant recipients, creatinine is one of the the most important numbers to monitor, as it tells doctors how well the kidney is functioning…although, to be fair, even those of us who aren’t transplant recipients still have our creatinine levels checked during comprehensive metabolic panels, because elevated levels can indicate kidney disease), but his nephrologist in Austin and his nephrologist in Dallas both wanted to have another set of labs and a renal ultrasound done Monday. Well, on Monday his creatinine was still up and the ultrasound didn’t really show anything that could cause elevated creatinine levels.
We had an appointment already scheduled with his doctor in Dallas at the Dallas Transplant Institute (DTI) on Wednesday, where they did more labs and another ultrasound just to be on the safe side. Creatinine was still up, ultrasound was showing old fluid but not a whole lot. So my husband got to have a kidney biopsy on Wednesday. DTI told us to stay in Dallas Wednesday night rather than going back home to Austin (it’s about a four hour drive, for those of you unfamiliar with Texas cities and where they are), which created a bit of a conundrum since we’d only expected to make a day trip; our dogs were still at home (and crated) and I’d had the foresight to pack an overnight bag with one change of clothes, but hadn’t packed up laptops (don’t worry–we had friends checking in on the dogs, and were able to drive down to Austin yesterday to get them and some additional clothes).
Thursday afternoon we got the call that Phillip was in rejection. Ends up it’s super mild, classified as a 1A (this is one of those things we’ve just learned about rejection–that there are very different levels), and affecting less than 10% of the tubules in the tissue biopsy. They started him on treatment right then and there–a super high dose of steroids, which he gets five days in a row–and they’re obviously monitoring his creatinine (and other labs) to make sure the kidney’s responding to treatment.
So far, so good. Fingers crossed we continue to see a downward trend.
In the meantime, we’re stuck in Dallas until at least Monday–part of that might depend on what the final biopsy results show.
Needless to say, it’s been an interesting and somewhat stressful week. And no matter what form it’s in, rejection kind of sucks.