Did you know that lightening can strike on a blue-sky sunny day? It isn't common, but when it happens it is called a "bolt from the blue." It's name has become synonymous with uexpected events, but most people fail to remember that it still means "I've been struck by lightening." Struck by a Bolt on a bright, sunny, safe day.
Phone calls can bring such strikes.
Dr B. called me right before lunchtime. I had already received Babygirl's Monday lab results from the team, and although no one was happy with her creatinine, the plan was to observe and repeat in two weeks. So an unexpected call from the transplant lead physician sent my heart straight up into my throat.
"You know that we periodically check for antibodies that would indicate that Babygirl's immune system is reacting to the kidney transplant." Yup, I know. And last I knew there weren't any. Apparently I was under-informed. The first couple of times they tested there were no antibodies. Last time, there were a few. This time, the number has risen. This is not good. Babygirl's immune system knows that the kidney is there and is preparing to destroy it.
The call was informational only. Nothing will be done at this time, and the kidney will be observed for additional signs of stress (protein in the urine, increasing creatinine). In time (when, he couldn't say) she will need another biopsy. Based on results, they will institute more aggressive therapy. The plan is to remove the antibodies from her bloodstream using plasmapheresis, the same basic technique that the Red Cross uses to harvest platelets from donors. Then they will inject her with anti-antibody antibodies (follow that?) to remove more of them. Then there is another medication they can use, but they'd rather not.....
Bottom line: Rejection is inevitable.
This, of course, was true from the moment the kidney was placed. The time frame was unknown, but all transplanted kidneys eventually die. Now it seems unlikely that we'll be the ones who keep a kidney for 15+ years. And no, this information did not come with a useful timeline. It's not Dr. B's style to be pessimistic or discouraging, but I know bad news when I hear it.
I'm guessing that the real purpose of this call was to give me lead time. Any time a doctor gives a patient bad news, every bit of information that follows resembles a lecture by Charlie Brown's teacher: Wah Wha, wahwha wah wah wha. I'll be able to hear better and follow instructions more accurately if I get that reaction out of the way BEFORE our next visit. I'll be easier to deal with if I get hysterical on my own time and get it over with. Or something like that.
This is not easy news to digest. especially since it was my second Bolt in less than one day: My dad had a heart attack yesterday and is in the hospital, also fighting pneumonia. We're in the midst of Winter Storm Nemo - who knows if I'll be able to make the four-hour run into the snow belt tomorrow.