For this exercise, you are required to suspend your belief mechanisms. Forget about your life for just a few minutes.
Forget about your normal comfort zone, or at least what used to be your normal comfort zone before 2020 arrived.
For the purposes of this exercise, you and your husband have three daughters. Despite having not yet turned four years of age, the youngest daughter has been doing peritoneal dialysis (PD) at home since she was 14 months old. Yes, she needs a kidney transplant. Other than a brief spell this season, she has been on the deceased donor list since early this year.
The summer of 2020, pandemic aside, hasn’t been much of a summer for you, at least not until the last couple of weeks. There were weeks spent in Vancouver after the youngest developed a PD-related infection.
You were able to return home in mid-August and you have worked to get the family unit back together while spending a week camping. It was great.
The plan was to come home for a day and then head out for another four-day camping adventure.
And then the phone rang . . .
Your youngest daughter is small. She has trouble putting on weight and keeping it on. This has been a major concern with the nephrologists and transplant surgeons. But her weight now is at a point where they feel that she is ready.
But you also know that a kidney from a live donor is the ultimate gift. Yes, a deceased-donor kidney is good, but one from a live donor would be so much better.
So you got home from the first camping trip at 3:30 p.m.
And the phone rang 30 minutes later. . . .
It was a nephrologist from B.C. Children’s Hospital (BCCH) telling you that they had a kidney. If there is to be a transplant, you are going to have to hit the road to the big city, like, right now.
But this nephrologist is a favourite and your brain is going a million miles an hour and you need to unpack from camping and you need to pack for another long stretch in Vancouver and . . . and . . . and . . . what about the other girls . . . what about the four-day camping trip . . . and . . . and . . . and . . .
The nephrologist, one you really trust, spells out everything. He explains that your daughter isn’t hard to match; in fact, there have been other potential deceased donors who have been rejected, mainly because of concerns over her size. He points out that she really hasn’t been on the kidney wait list for all that long, and adds that more time for her to grow isn’t a bad thing.
He explains that this particular donor was of ‘exceptional distribution.’ That means that there would be a higher risk of that person passing a disease along to your daughter. Yes, that is one of the risks associated with transplants, but you have known that from the get-go and haven’t looked at it as a deal-breaker.
Oh, what to do!
You’ve got camping behind you. You’ve got camping ahead of you. Or do you? Are you ready to walk away from that and spend another couple of months, or more, in Vancouver? And what of your daughter? You want to fall on your knees and ask: “Why me? . . . Why us?” But you know you can’t do that. You know that this is the responsibility that comes with parenthood. Maybe not to all parents. But it has happened to you and you know that you have to deal with it.
Over the past two years, you likely have cried more tears than there are stars in the heavens. And, yes, you knew the day — the moment — when you would be faced with this decision likely was going to come.
The responsibility that comes with being parents in this situation borders on soul-crushing. But you know one other thing . . . life goes on.
Before the phone call ends, you make the decision. You take a long, deep breath and you decline the offer of a kidney from a deceased donor.
At the same time, you know there is a live donor engaged in the testing process. You had hoped that it all might have gotten done while you were in Vancouver earlier in the summer. But it didn’t happen, something you found oh, so disappointing. Your understanding is that the testing has gone well, but you think that final results still are a couple of weeks away. At the same time, you know that things can change. You know that in your game nothing is certain. You have your fingers and toes crossed; the rabbit’s foot is in your pocket. You are hopeful . . . but you just never get entirely used to living with all of the uncertainty.
You only hope that you made the right decision in declining that kidney. As much as anything, your gut told you which way to go, and you are prepared to live with that.
So you unpacked and packed, and you got ready for four more days of camping.
You got everyone to bed, but . . . the youngest awoke at 1 a.m. One of the devices used in PD needed changing. So you changed it. Finally, it’s time for you to go to bed. But you check on her one more time. And you find that the transfer set has disconnected and she is soaked in dialysis fluid.
You are ready to tear out your hair. You are ready to scream to the high heavens. But there isn’t time for that. You know that a disconnection such as this could be a disaster because of the risk of contamination.
You clamp the line and get her to the hospital where a new transfer set will be installed in a sterile procedure. By now, it’s 3 a.m., and when you get to the hospital you find that it is busy. Lots is going on. But they find a nurse who has PD training and, between the two of you, the job gets done, and you are home by 4:30.
You still can’t go to bed, though. You have to do three flushes of the system and then collect a sample that can be checked for infection. You are in bed, finally, at 6 a.m., and up three hours later. You have to get the sample to the lab, fill prescriptions . . . and get packed . . . and leave for the lake.
While at the lake you are flooded with emotions. You realize the enormity of the decision that you made. You know that you have to live with it. All the while you are keeping a close eye on the young one because of the fear of infection. You’ve already dealt with one infection this summer; you really don’t want to see another one. But you know that you have to play the cards that are dealt. So . . .
Still, your brain won’t shut off. When you made the decision, it just felt to you that if the transplant was complicated or didn’t go well you’d never forgive yourself for not waiting for a live donor.
But with the decision made and days sliding by, you are thinking that if an infection rears its ugly head you may have made a huge mistake.
Despite everything, the four days of camping are great. The only complaint is that they fly past. The five of you hung out together and it was fun. The two older girls are amazing and for that you are forever thankful. The way they cope with all that swirls around them is a story in itself. When you think about what they have gone through over the past couple of years it’s hard to keep the mist from your eyes.
With the camping days behind your family for now, you are thinking that you made the right decision. The little one is almost back to her old self, before that infection hit and stole her energy. Her mood is better, more positive, these days, and she isn’t as withdrawn as she had been. Even with all that she has been through over the past couple of months, she has made progress as a person and her personality has grown. Yes, she is shy, but there are signs that she is coming out of her shell around other people.
And now you’re home again. It’s the last long weekend of this crazy summer, and you know that things are about to get nutso. School. Your work. Your husband’s schedule is in the mix. There is care for the little one to consider. There was a lot of support for you during the last school year, the one that ended prematurely, but some of that won’t be there this time and you’re not sure how it’s all going to come together.
But you have learned over time that life goes on. Yes, it does.
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OK. You got all that? Now take a minute and think about it all. Think about having to make a decision of that magnitude. We’re not talking about standing in front of a cooler and deciding whether to buy one litre of milk or two. This is about having the life of a child in the palm of your hand. Think about having to make that kind of decision.
That’s what Lindsey Backmeyer, her husband Pat, and their two older daughters, Ksenia and Tavia, have been through over the last while as Ferris, the youngest member of the family, continues to deal with health issues.
With the calendar having turned from August, Lindsey wrote on Facebook that she “really hadn’t looked at September at all until this past week because, well . . . it’s September. So yeah, we got this. We totally got this.”
Yes, Lindsey, you do. You really do!
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If you are interested in being a living kidney donor, more information is available here:
Living Kidney Donor Program
St. Paul’s Hospital
6A Providence Building
1081 Burrard Street
Vancouver, BC V6Z 1Y6
Tel: 604-806-9027
Toll free: 1-877-922-9822
Fax: 604-806-9873
Email: donornurse@providencehealth.bc.ca
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Vancouver General Hospital Living Donor Program – Kidney
Gordon and Leslie Diamond Health Care Centre
Level 5, 2775 Laurel Street
Vancouver, BC V5Z 1M9
604-875-5182 or 1-855-875-5182
kidneydonornurse@vch.ca
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Or, for more information, visit right here.
TAKING NOTE 