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Maintaining Long Term Health
Common Living Donor Concerns Post-Surgery:
1. Surgical Pain. How much depends on the procedure used (laparoscopic or open), and the living donor's personal pain threshold. For the first 24 hours, the living donor will have access to a morphine pump, an IV and a catheter. After approximately 24 hours, the catheter will be removed, the morphine pump replaced by oral pain medication, and the kidney donor will be expected to take her first post-surgery walk.
According to one study, the surgical scar and incision site caused occasional pain for 31% of living kidney donors and chronic pain for 2%(4).
Of 167 living kidney donors at The Cleveland Clinic from 1983-1995, surgery and recovery were more painful than expected for 34% of LDs.
Sara was admitted to hospital in October and she described her stay ‘‘as a truly horrendous experience.’’ She described the pain after the operation as severe, intense, and distressing. ‘‘It’s like a knife going into you, no one could tell you how bad it is, I thought I was going to die, I was terrified, I really didn’t expect it to be like that’’(92)
See Risks page for more on Chronic Pain.
2. During a laparoscopic procedure, a living kidney donor's abdomen is pumped full of CO2 (carbon dioxide) to give the surgeon plenty of room to work. This gas will remain in the living donor's body for approximately two weeks. For some inexplicable reason, it manifests in shoulder area, causing discomfort and pain.
3. The pain medications used in the hospital and taken after discharge are opiates, and they can cause constipation. Certain foods can usually alleviate the problem. If not, prescription medications are available.
After approximately 48 hours, barring any complications, the living donor will be discharged. Usually the living kidney donor and the recipient are on different floors of the same building and the staff will gladly take the LD to visit the recipient before leaving the grounds. The wheelchair is your friend, take advantage of it. You will be amazed how easily you tire.
Post-operatively, 6-8% of living donors felt ignored by medical staff, as if their welfare was no longer important.(4,5) (See Psych Recovery for more)
IMPORTANT: Some transplant centers will refer a living donor to their primary care physician in the case of a post-operative complication. Do not allow this to happen. It is their surgery and therefore their legal responsibility!
1. Headaches and Back Pain have been reported in the first couple of weeks following surgery. These are usually the side effect of pain medications, or the unconscious shifting of posture and movement to prevent pain at the incision.
2. Some living donors experience fatigue and lack of energy post-donation, manifesting itself in reduced endurance for sports and exercise, lack of concentration for work-related activities, and the need for more sleep than before donation. These symptoms can persist for weeks or months, and could be the result of low kidney function, adrenal gland damage/dysfunction (see risks).
Living Donors have reported physicians denying the phenomenon being linked to kidney donation. Be persistent in regards to your symptoms. You are your best advocate.
3. Sleep disturbances. Insomnia, inability to sleep, sleep cycle interruptions, waking up in the middle of the night, shortened sleep cycles. If these symptoms continue for a significant amount of time and/or adversely affect daily functioning, please see a physician. It could be the result of damage to the gonadal vessel during surgery (this impacts both men and women). See Risks for more.
5. Thigh pain: Some living donors have experienced limb or thigh pain as a result of the position they were placed during surgery. This should diminish within days. However, lower limb pain can also be a symptom of nerve damage as reported by some living donors, so it is important to contact the transplant center if pain is extreme, numbness occurs, or normal sensation does not return quickly. See Post-Operative Complications
Those living donors who experience a post-operative complication or post-operative chronic pain are more likely to experience depression after donation.(15, 21)
Best Tips For Recovery:
1. Don't rush it. Your body has been through a traumatic experience. Allow it to heal.
3. Eat. Your body needs nutrients to facilitate healing.
4. Even small amounts of walking promotes circulation and tissue growth.
5. Avoid alcohol, tobacco and other substances.
6. Don't suffer. Take pain medications if necessary. And don't be afraid to contact the transplant center or seek medical attention!