It May Not Be the Bee's Knees, But I Hope My Knee Will 'Bees' Better

This is about how my knee feels now. Every day.

I am scheduled to have left knee replacement surgery this Wednesday (April 14, 2021) at Carle Foundation Hospital in Urbana, Illinois. A few random thoughts:

• This will be my first major operation since my kidney transplant at Barnes-Jewish Hospital in St. Louis on November 18, 2011. (Great Googly-Moogly! That was 10 years ago! I just realized that. Suppose I should think about doing some sort of anniversary tribute later this year.) And to tell you the truth, I really don't know how I feel about this week's procedure.

• My surgery initially was scheduled for March 2020, about a week before the world as we knew it flipped upside down and corona became way more than the name of an imported beer. My joint replacement was canceled due to a sudden, urgent need for hospital beds. Then it was aborted a second time in November when the virus spiked again. As a result, I have been in relentless, agonizing leg pain for more than a year, Biofreeze and IcyHot my constant sidekicks.

I have not been a happy cowboy.

As another result, I find myself approaching this week's operation with a feeling of...well, really, no feeling at all. I'm not excited or anxious or nervous or relieved. I was bitter for quite some time over the cancellations and the knowledge that my suffering continued through no fault of my own. But when you've been in pain day after day for months, it sadly becomes part of your normal existence. You learn to live with it. If you can call that living.

(Many deep thanks to Danny McFarlin –– absolutely no relation, unless his family once owned mine –– the physician's assistant who kept me reasonably sane between surgical disappointments with a series of cortisone injections in my knee. He really gave me a leg up.

My Surgeon: 'No-Pain Bane?'

(Too much?))

And while I'm told the pain will be worse after the procedure, at least initially, at this point it's all relative. Besides, fool me twice, shame on everybody. When I'm actually on the gurney with an IV in my arm and being wheeled into the OR, then I'll know it's really going to happen. Until then, I'm keeping my emotions on lockdown.

• The orthopedic surgeon performing my procedure (a total left knee arthroplasty) is one Dr. Robert Bane, who by all accounts is the Dr. Kildare of east central Illinois. I am not exaggerating when I tell you every single person who's asked about my operation has broken into a broad, knowing smile when I answer, "Doctor Bane," followed immediately by, "He's the best."

OH! I misspoke. One woman at my church replied, "I tried to get Dr. Bane, but I couldn't get onto his calendar. (Pause.) He's the best, you know."

Even other doctors praise his holy name, which is rare indeed. Last week my cardiologist broke into a broad smile when Bane's name came up. "You're in good hands," he reassured. Ironically, I have yet to meet him: we conversed briefly via Zoom many months ago, but due to COVID I will not meet the man in person who's going to cut into my flesh until I'm on the table preparing for the anesthesia. I'm in the hands of a near-total stranger. He is, quite literally, the Bane of my existence.

I am absolutely positive I am not the first one to come up with that.

• I know times change over the course of a decade, but I don't remember ever jumping through as many pre-surgical hoops as I have for this procedure. I have had a complete pre-op physical, new X-rays, bone density screening, blood pressure monitoring, a consultation with my cardiologist. Bathe with a special soap the night before and the day of surgery. Sleep on clean sheets. Stop taking vitamins and all supplements. And, of course, the obligatory COVID-19 test. 

Good news: here you can take the COVID test without having to leave your car. Bad news: It entails pulling into a line as long as the ones giving out free food these days and enduring what seems like a drawn-out, confusing and disorganized process. Very good news: The Carle system requires patients to simply run a Q-Tip around both nostrils, rather than jamming a stick past the eye and into the brain. Extremely good news: I tested negative, so we can continue to communicate.

• I suddenly came to realize one reason so many pre-op tests are required is because I'm not as young as my brain keeps telling me I am. I was blown away by the number of contemporaries who responded to my Facebook announcement of impending knee replacement with comments like, "Had mine done years ago," "Had both of mine done" or "You won't regret it." One friend even sent me a book of healing techniques after surgeries! Good Lord – my friends are getting so OLD! So thankful I'm retaining my youth.

My knee, without a scar. For posterity.

• I am also required to watch a video on knee replacement surgery provided by the hospital. Now, I expected a slick, well-produced instructional piece; after all, Carle owns about half the property around these parts and as a foundation pays no taxes. Instead I got a droning, hour-plus YouTube lecture apparently pulled directly from a long-ago seminar. What a disappointment! I have drifted off every time I've tried to watch it. The clock is ticking. 

• I was grateful that my pastor, Herb Coates, specifically mentioned me and my upcoming surgery during his congregational prayer last Sunday. Prayers are always welcomed. However, since I was manning the Welcome Desk next to the front door after the service, I was an easy target for every parishioner who wanted to inquire about the operation –– which seemed like every parishioner. I swear, I think some of them seemed to care more about my surgery than I do. Is that a good thing?

• I am also so, so grateful for the advancements in medical science. Knee replacements are commonplace now but practically unheard of in America until the 1970s. I think of my Aunt Carrie in Palmetto, Ga., God rest her soul, who made her living by cleaning the local movie theater. In those days you were lucky to have any job, so she worked on her hands and knees, picking up candy and all manner of filth brooms couldn't reach, well into her 80s. What unbearable pain she, and so many other laborers, must have endured! 

I'll think of you Wednesday, Auntie. Just before the lights go out.

Yet ANOTHER Advantage of Kidney Transplants – New Friends!

My budding bud, Wayne: Sox and Tigers fans, united by kidneys!

At this age I'm not accustomed to getting all giddy over the making of a new friend. That's typically the province of grade-school boys at their first Cub Scout meeting. However, I recently forged a new acquaintance, and I've got to tell you: I'm pretty jazzed about it.

Meet Wayne Meyer II (says Jimmy McFarlin III), baseball coach for small-town Le Roy Junior/Senior High School ("Home of the Panthers") about a half-hour drive from where I live. Now, if Wayne was only a baseball coach and former player, that surely would be enough to curry my excitement: as anyone who knows me will attest, I am an absolute geekazoid when it comes to America's (First, Last and Always) Pastime. For my birthday in June, the only present I really asked for – and received, thankfully – was the commemorative bobblehead of Detroit Tigers righthander Michael Fulmer, the 2016 American League Rookie of the Year. 

What does that say about me?

Anyway, I feel pretty confident that Wayne and I will have a lot to talk about going forward, which is important after the getting-to-know-you period has subsided. But here's the kicker: this tall, extremely healthy-looking man is, like me, a kidney transplant recipient!

Small (Wayne's) World, ain't it?

He and I met in the usual way: standing in line for tests at a hospital laboratory office. I was in line behind Wayne, and regardless of what all those signs say about patient privacy and HIPAA regulations, you cannot possibly whisper softly enough at the check-in desk to avoid being overheard by everyone in a small waiting room. 

He answered all the same medical questions I have been asked at that desk at least once a month for the last six years. I was so familiar with them, I knew the basics of Wayne's condition before he ever turned around to face me.

"How long ago was your transplant?" I asked him.

Came to find out he was a "newbie." He underwent successful transplant surgery on Dec. 3, 2016, and, like I did the first year or so, has to come to the hospital every week for blood tests. The transplant team wants to make sure your foreign "tenant" is making itself comfortable in its new home. For Wayne, that means making the 70-mile round trip from Le Roy every seven days. 

I learned that not only do we share the same local nephrologist, the wise and compassionate Dr. Abdel-Moneim Attia, but we had our surgeries at the same hospital, Barnes-Jewish in St. Louis. We were like renal relatives! Kidney cousins! Since our lab schedules were certain to dovetail, I invited him out to coffee at some later date. To my great delight, he accepted.

My favorite birthday gift. Is something wrong with me?

Weeks later, at an Einstein Bagels restaurant in the shadow of the hospital, Wayne and I got better acquainted. It's fascinating to me how many different ways people come to the point of needing a kidney transplant. In his case, he was actually born with only one kidney! 

Wayne said he was never made aware of it – and since he was a young, healthy, athletic fellow, who would think to look? – until his overworked organ began wearing out. "I had the kidney of a 90-year-old man," he told me.

In 2015, Old Man Kidney decided it had labored long enough. "I started feeling sick," he recalls. "I powered through the end of the school year, and the baseball season, of course, but my feet started to swell. My energy went way down." By the time his wife, Victoria, finally convinced him to go to the hospital, "I was struggling," he admits. "I needed to know what was going on, but I was scared to find out."

Not only did Attia calm and encourage him, but he also made a prediction. "Dr. Attia said from the get-go, 'a year and a half, two years,'" until he received a transplant, Wayne says, "but everything from Barnes-Jewish said it was going to be at least a three- to four-year wait. But Dr. Attia knew what he was doing. He called it from the first time he met me when I was hospitalized."

Wayne spent that year-and-a-half wait on peritoneal dialysis – just like me! – and dialyzed at home with his wife's valiant assistance. "The quality of life did not change much at all," he says. "That's what made the transition so much easier." 

Beyond the steadfast support of Victoria and their two sons, Trey and Colin, the outpouring of concern and care from his tiny town was overwhelming, he says. Clearly, LeRoy adores its high school baseball coach and his family. 

"Some guys at school organized fundraisers to help cover medical expenses," Wayne says. "It seemed like everybody knew about it. I still get people from around town, even other towns, asking me how I'm doing. People who I had no idea knew anything."

And how is he doing? "I feel great," he beams. "Never had a sick day because of it. My energy level is great, though I'm not in shape like I used to be."

None of us are, Coach. Although I'll bet his superior conditioning played a big part in his recovery and present state of health.

His health and happiness come tinged with just a touch of regret, however. Wayne doesn't know who his kidney donor was, but "I do know the kidney was supposed to go to a family member, and for whatever reason it didn't work out," he says. "It's an odd feeling, knowing that it was designated for someone within the donor's family and I ended up getting it. It's kind of a touchy situation. It's one of those cases where you're excited, but you still feel bad." 

Of course, we also talked a lot of baseball. He is a Chicago White Sox fan, but he's such a nice guy that I'm willing to forgive that misguided life decision.

Wayne has invited me to speak to his English class, which will happen in the very near future. I'm so excited! I love talking to young people about the power and passion words can carry, and the remarkable career opportunities I've enjoyed from being able to write good.

Uh, well, I mean. (Just wanted to see if you were paying attention.)

I think the hardest part will be not spending the entire class time talking about our transplants. For both Mr. Meyer and me, it's been an education.

HAPPY NEW YEAR, CHEYENNE! (Sorry About Missing Your Birthday)

You know that feeling that washes over you when you are shocked and embarrassed at the same moment?

It happened to me last month as the result of a single, four-word midday text from my amazing Bewee (Best Wife Ever), Karen.

"Happy Transplant Day, Darling!" it read.

Holy dialysis, Batman.

November marked the fourth anniversary of the organ transplant that undeniably saved my life, the introduction of a kidney that was described as "near perfect" by the surgeon who performed the operation on my failing body.

It was donated by a six-year-old girl – or more accurately, her parents, after their child suffered a brain aneurysm one horrific day and died on her school playground. Karen and I dubbed the kidney Cheyenne, reminiscent of a Western hero who gallops onto the scene in the darkest hour and saves the day, as a tribute to her and the unbelievable display of benevolence by her parents in the face of devastating grief.

And until I saw Karen's text message, I'd completely forgotten. Cheyenne's tenth birthday, her fourth inside of me, a true modern-day miracle if ever there was, and the anniversary just slipped my mind.

What does that say about me?

This is the photo I posted on Facebook that week to observe #TBT, or Throwback Thursday:

It's one of the last pictures of me with the two most important people in my life. It was taken at the going-away party for my mother, Caribell, and father, the original "Mac" McFarlin, from the retirement home where they lived for several years before moving home to Georgia and, eventually, going home.

Had I been thinking or retained even an ounce of memory, however, this is the personal history photo I should have displayed:

It's one of the first pictures taken of me and the lovely Bewee in the recovery area of Barnes-Jewish Hospital in St. Louis after I emerged from the dense fog of anesthesia with a nearly-new little transplanted kidney. (Did you know that if a child's organ is sewn into an adult body it will increase in size by itself to accommodate the needs of its larger host? Somebody try to tell me there's no God!)

Yet now, four years later and feeling great, with outstanding monthly lab results and an unrestricted diet, I seem to have kicked my kid kidney to the curb emotionally.

Am I ungrateful? Unappreciative? Have I begun taking my unbelievable blessing for granted?

Actually, I think it's just the opposite.

Ever since my 2011 transplant, and the arduous recovery and constant monitoring that followed, I believe my life dialed up to a sharper focus. I was so happy to be off years of daily dialysis, and I heard myself being thankful for what may seem like the smallest things – even going to the bathroom to pee, knowing that there are so many patients on dialysis who cannot.

I remember reading that Jack Benny, the late, great comedian of the '40s-'60s, used to drive his friends crazy extolling the wonders of the most mundane life events. "You know," Benny would enthuse, "that may have been the greatest ham sandwich I have ever tasted. The ham was sliced just right. And the cheese! My goodness!" That's how I felt, and still feel today: everything is a wonder.

The sky is a little bluer, the air just a bit sweeter. And as I weave through the renal community and meet so many people who are desperate for a kidney transplant or faring poorly on dialysis, my blessings leap into focus once again.

Whenever Cheyenne causes me a bit of sharp or prolonged pain – she's only 10, after all, and adopted, so she does become defiant from time to time (fellow transplant survivors, does this happen to you?) – I'm reminded that her stay is not guaranteed, or necessarily permanent. For any reason, or no reason at all, she could decide one day to reject me and just stop working.

So while I may not think about my transplant as much as I did three or four years ago, I do think about it every single day, whether gobbling down my handfuls of pills, monitoring my vital signs or remembering to squeeze in some exercise. However, as in most relationships, it's not enough to just think about how much your beloved means to you. You've got to express it as well.

Hey, I'm really forgetful, and I am sorry.

Happy Belated Birthday, Cheyenne. And Happy New Year, too.

Funny, You Don't Look (Barnes) Jewish

I have a deep, abiding affection for Barnes-Jewish Hospital in St. Louis. I imagine I always will. It's hard for me not to think of that sprawling medical complex in the shadow of the Gateway Arch as the place that saved my life.

B-J was, and still is, my kidney transplant center. My wife and I chose it over hospitals in Chicago and other cities for many reasons: its sterling reputation and record for successful transplants primarily, but also because we figured it would be easier and cheaper to get in and out of St. Louis for our many medical appointments and eventual surgery. And, although this is impossible to quantify, we thought the people in the St.L might be nicer and more accommodating as well.

Dr. Jason Wellen, right, and Happy Patient

Like I said, we can't tell if that's true for certain. But after our experience there, we suspect it might be. Surely Dr. Jason Wellen, the Barnes-Jewish surgeon who performed my operation,
is the kind of standup guy you'd love to have a beer with – if, of course, you could drink beer right after having a transplant.

So when Barnes-Jewish senior media relations coordinator Anne Bassett and her department asked me if I would contribute a guest blog to the hospital's website in honor of April as National Donate Life Month, what was I going to say? "Hold up, let me think about it?"

I don't know if other transplant recipients are as passionate about increasing the ranks of organ donors as I've become, but by the same token I can't imagine how they couldn't be. A successful transplant is more than even the "gift of life:" it's a life utterly reborn.

And like I say in my post on the Barnes-Jewish website, which I do hope you'll read by clicking here, it's a cause I feel so strongly about – especially for people of color – that I was willing to endure frostbite and the potential loss of body parts earlier this month to sign up potential donors.

My sincere thanks to Anne Bassett and all the extraordinary people at Barnes-Jewish Hospital for the opportunity to invade their online space. They may be residents of the heartland, but they do mighty fine with other organs, too.

Happy Birthday, Cheyenne! (and Me)

Surely some scalawag must be playing tricks with my calendar. It cannot possibly be one entire year since I was flat on my back in a hospital room at Barnes-Jewish Hospital in St. Louis, feeling like I had been sliced open from hip to hip (because I had) and giving thanks every moment for the numbing release of a morphine drip.

"If this is what a kidney transplant feels like," I remember thinking, "maybe dialysis wasn't so bad after all."

That, of course, was the drugs woofing. Cheyenne, the little kidney that can, has officially been inside me and functioning flawlessly for 12 months now, and we couldn't be happier together.

What's the symbol for a one-year anniversary? Paper? That's so passé. Let me write words on this computer screen instead to celebrate this mini-milestone and praise the miracles of modern medicine. 

Happy Birthday, Cheyenne! And by extension, because a transplant literally is the gift of a second chance at life, Happy, Happy 1st Birthday to me as well.

The months of wound care and recuperation, the constant doctor's visits, the adjustment to taking and coordinating an avalanche of new prescription drugs – it all feels like a hazy memory now, as if I was observing somebody else's life from afar. Everything has settled into a natural, comfortable daily routine (although I still can't remember how long to wait after taking my anti-rejection pills to eat; I really like eating).

The moral of Year One for me is that it always gets better. It may not become perfect, or even great – perfect or great for me would be an unscarred body and never having had Stage IV kidney failure in the first place – but it, whatever "it" is (life, relationships, job, finances) never remains the same. Sure, it may get worse for a time: the realization that my kidneys had shut down to the point I needed dialysis was one of the lowest moments of my life. But if you "wait on time," as my mother used to say, and trust your faith in God, your circumstances eventually will improve. Honest.

As you may know, I have been a strong supporter and advocate of the American Foundation for Suicide Prevention for many years, ever since the teenage son of dear friends took his own life inside their home. Nothing breaks my heart and shatters my soul more deeply than youth suicide: the kid who decides to end it all because Chloe broke up with him, not realizing a dozen more Chloes may come along before he becomes a man. If I could, I would reach out to every person whose psyche is in that much chaos, give him or her a big hug and just whisper, "Hang on. Please. It always gets better." I believe that to my core.

One more huge chunk of news: Because an experience like a kidney transplant gives one a startlingly clear vision of life and time and how precious both are, my adorable wife, Karen, and I have decided to mark Cheyenne's birthday by launching our own home-based business. We're blessed to both have jobs we enjoy, but money provides choices and ultimately we want the freedom to spend more time together and rejoice in each other's lives.

Besides, this is a company we're both incredibly excited about and have leapt into with all four feet. Rodan + Fields, the extremely smart Stanford dermatologists who created the phenomenally successful Proactiv solution, have developed a prestige skincare line to benefit women and men of every age and skin condition. And because the earliest advice I can remember my mother giving me was, "Moisturize," skin care has been a priority most of my life. And these are some of the best products I have found.

I hope you like them, too. Maybe you'll even join us on this incredible business journey. Tell you what: Check it all out at Karen's R+F Consultant Page. Take the "PerSKINality" test and see what condition your condition is in.

Then, let's talk.

One Is the Giddiest Number

Spent one full day this week under the sheltering shadow of the Gateway Arch, receiving my quarterly kidney checkup at my transplant center, Barnes-Jewish Hospital in St. Louis.

Now, I think I'm doing extremely well. All my vital signs appear normal (I take them myself every day), I'm in no pain to speak of (well, not around the transplant site, anyway), and my urine is generally clean and pure. (Sorry: TMI?) But this week's medical inspection confirmed my beliefs far beyond my wildest expectations.

The incredibly fetching LPN, Skye Smith, carefully reviewed all my significant test results and gave Karen and me three pieces of very good news. One, my blood work has been coming back so consistently within accepted ranges that I may now push back my blood tests from every Monday to every other week. My battered and beleaguered veins breathe a sigh of "Thank you."

Two, from now on my quarterly trek to St. Louis can become a semi-annual journey.  In fact, Skye suggested, if we prefer we can check in with my in-city kidney specialist, Dr. Abdel Moneim Attia, every six months and only make the drive to Missouri once a year! All the hotels and restaurants in St. Louis are breathing a groan of, "Awww, we'll miss all that money."

The third item, however, was most astonishing to me. My level of creatinine – possibly the body's best barometer of kidney function, a range that should fall between 0.9-1.3 for a healthy man of my age, a number that soared past 4.0 at the height of my kidney failure – is now standing at 1.0! Unbelievable! Hallelujah!

With God, my friends and neighbors, all things are possible.

My Cheyenne, which Detroit News columnist Neal Rubin referred to recently as "the world's most famous aftermarket kidney," is kicking some serious booty. I belong to the local support group chapter of the National Kidney Foundation of Illinois, and at most of our monthly meetings the members, almost all of whom are dialysis patients or transplant recipients, discuss their creatinine levels like they were comparing golf scores.

Can't wait till our next meeting. I don't know their numbers, but I'm betting my 1.0 will make me the medalist for this round.

Liquid Courage, or The Rinse Cycle

Last month we celebrated the life and legacy of that immortal American and civil rights icon Dr. Martin Luther King Jr. by purchasing a gleaming white new Speed Queen washer and dryer at a local appliance store in Champaign. Gotta love those MLK Day sales!

Because I have taken on the role of househusband during my two years of dialysis treatments and subsequent kidney transplant, Karen's excitement over our new acquisition made me feel a little like a character out of The Help: "Look, Jimmy, we bought you a brand-new washer and dryer so you can do more loads of wash for us than ev-ah!"

Oh, joy.

Truth to tell, I love doing laundry. There's a certain zen tranquility for me in making dirty things clean again and folding them with the precision of origami. What I didn't love even a tiny bit was schlepping pounds of clothes to the laundromat every couple of weeks, hoarding quarters and surrounded by strange smelly people.

But the laundromat was a necessity, because (and here's the tie-in to my kidneys, in case you were wondering) up until the transplant, we had to use the utility room in our apartment to hold all the cases of my dialysis solution.

In the way that life works, two days before we received "the call" that a donor kidney was available for me, the company that made my dialysis supplies dropped off its monthly shipment of 32 boxes of Peritoneal Dialysis fluid, about 2x2 feet each, with two five-liter bags of liquid in each box. I had used exactly one case before the transplant team called.

When we returned from Barnes-Jewish Hospital in St. Louis with my gleaming new kidney, we called the dialysis company and explained the situation.

"I'm sorry, sir, but we can't take the cases back."

"But they're unopened. Maybe someone else could use them."

"I'm sorry, but there's the possibility of contamination."

"Contamination? The boxes have the original factory tape on them! The bags of fluid are sealed in a second plastic bag to keep them secure! How on earth could they get contaminated?"

I'm sorry, sir, but that's our policy."

Somebody please, tell me again why the cost of health care in America is so high?

We called my dialysis nurses at DaVita Champaign. Same story. I never fashioned myself as the sadistic poisoner of Peritoneal Dialysis bags, but I must look that way to a sizable group of people. We're still looking for takers for the drainage bags, extension tubes and other paraphernalia that accompany the PD process. No questions asked. Just come get 'em! We'll even deliver!

So, discouraged by having no other option, Karen and I staged our own Seven Percent Solution at our kitchen sink: the Great Dialysis Juice Dump. Each of us armed with a tiny Olfa Touch-Knife (that I extolled in a December 2010 blog titled "Flashes From the Frontline"), we attacked the cases – slicing open the cardboard boxes, flattening them, cutting open the hard plastic coverings and piercing each five-liter bag, letting the dialysis liquid goosh into the sink. What emotional release!

It was a true team effort; even with both of us working shoulder-to-shoulder and focused on the task, the process took almost two hours to complete.

We ended up with a stack of cardboard boxes nearly three feet high and an overflowing pile of plastic bags. Being the dedicated recycler I am, I personally carried every box and bag outside to the nearest appropriate bin.

Karen applauded my effort.

We were both tremendously saddened to destroy so much lifesaving fluid in such a wasteful manner. However, in a very real way, our new washer and dryer represent far more than timesaving appliances that allow Jimmy to do more loads more often. They stand as constant reminders that the Peritoneal Dialysis that required their space and dominated so much of our daily lives is no more. Hallelujah!

All because of a new appliance of mine that's washing my blood every second. Oh, what a lucky man am I.

Direct to Video

I'm certain that some of you have seen this, but I'm just as sure that many of you have not, and it really should be added to the JK – Just Kidneying archives for posterity's sake if nothing else.

On the morning of Friday, Nov. 18, 2011 – a date that will live in happy history for me as the date of my kidney transplant – I was lying on a gurney in a pre-op area of Barnes-Jewish Hospital in St. Louis, flying high on that happy juice they pump into you to "relax" you prior to surgery, when my artificial bliss was interrupted by a complete stranger. 

Unbeknownst to me, the Just Kidneying blog had become very popular in certain sections of Barnes-Jewish, including the hospital's public relations department. My unknown visitor was a PR person for the hospital who had heard I was in the complex for my operation and wanted to interview me for the Barnes-Jewish transplantation blog, "The Rare Gift". 

Now? Right this very second? 

Karen, who was interviewed for the video clip as well, had spent the night before with me in this cramped room, losing sleep with nervous anticipation, and like me had not enjoyed the benefit of hot water, deodorant or a mirror. At that moment, I gained an inkling of how celebrities must feel when they are asked for autographs or photos at the most inconvenient times. 

But I have become such an advocate for transplantation, the Barnes-Jewish team and organ donation, I hardly could refuse such a request. 

This was the result:

Needless to say, I think I've been better! 

But as you know, all's well that ends well, and given how the surgery turned out it's been a long time since I've been any better than this.

Postscript: As we begin 2012 together, this post marks my 100th blog entry since I began Just Kidneying in September 2009. Pretty amazing for someone who never had any intention of ever writing a blog. As Bartles & Jaymes (remember them?) used to say on those wine-cooler TV commercials, "Thank you for your continued support."

The Edge of Darkness

Although it has diminished greatly, I remain in constant abdominal pain as I write this. I just ache. Every now and then, as my severed nerve endings begin to heal, I get eye-watering stabs along my incision line.

For now, most of the area surrounding my hip-to-hip incision is numb. People who've endured similar surgeries tell me full feeling may not come back for years. If ever.

My supply of the really, really incredible prescription painkiller, Percocet, is dwindling rapidly; I cherish every remaining pill like it could pay off the national debt.

My renal doctors in St. Louis have scheduled me for an ultrasound here in Champaign today to rule out the possibility of a blood clot in my new little kidney. Great. A few days later, my PD catheter, now a useless appendage hanging out of my side, will be removed in an outpatient procedure. More pain. More recovery.

My blood pressure, which had been kept artificially low at around 110/70 by medication prior to my Nov. 18 kidney transplant, is now soaring wildly out of control again, Today it was 165/90. The new cocktail of hypertension medicine I've been prescribed has yet to take effect.

Since it was high blood pressure that got me into this mess in the first place, I'm more than a bit frantic over it all. My current health care team doesn't seem to share my sense of dire urgency about the matter. The thought of surging blood relentlessly pounding my delicate, undefiled six-year-old kidney makes me angry and quite sad.

I'm taking more than 40 pills a day, or four times as many as I did on Peritoneal Dialysis (PD). I have become a pharmaceutical stockboy, constantly checking supplies on hand, making frequent restocking visits to my local pharmacy and calling St. Louis for transplant-specific drugs to be delivered by mail. The medications control my day. Half the drugs must be taken with food, the transplant drugs specifically on an empty stomach. I feel like the guy on that antacid commercial: "Eat now, pill now? Pill now, eat later? Wait to eat, pill now? Wait two hours, now eat?"

Until next March, my blood must be drawn every Monday to ensure certain levels are decreasing or maintaining on schedule. For as long as I have a transplant, my blood will be drawn for lab tests on a regular basis.

Did I mention that I can't stand needles?

I don't mean to sound whiny, and if I do, forgive me. I was told before the surgery that depression is frequently a natural post-op emotion, and I may be going through a touch of that right now. I know that ultimately, the pain will end, the medication regimen will become routine, my blood pressure will plunge. But I can't shake the feeling that in many ways, I was better off on dialysis. At least, I felt better. At the very least, I wasn't in pain all the time.

When I was on PD, I didn't worry about much. The daily routine just kind of rolled along, and I pretty much knew exactly what to expect. Now I find I'm constantly worrying about something – organ rejection, my lowered immune system and possible infection (my wife has a cold! Oh, NO!), taking my pills on time, the possibility of a blood clot.

On a conscious level, I know this is a transition period and if I remain patient, much of this will pass. But if having kidney failure has taught me anything, it's that you have to live in the now, that a healthy tomorrow isn't promised to any of us.

Well, I'm in the now. And now sucks.

Fear Factor

A phone conversation the other night with my great good friend over many decades, Larry Kaplan, really served to clarify some issues and emotions for me regarding my recent kidney transplant – emotions I hadn't admitted to anyone, not even myself.

I have known Larry since the first week I set foot in Detroit to work back in 1979. I was the rock critic for The Detroit News then, and the paper's staff photographers deemed it beneath their dignity to shoot rock 'n' roll bands at night for concert reviews. So the entertainment department hired Larry as my full-time freelance sidekick, doing hand-to-hand combat in the photo pit to embellish my meager words with visual splendor. In recent years, he has reserved a bedroom in his spacious condo for me to use upon my frequent return visits to Detroit, sparing me untold amounts of stress, advance scheduling and hotel fees. (Thanks, Larry.)

We hadn't talked since a month or so before the surgery, and he was asking me the kind of simple, direct questions anyone might inquire of an old friend fresh from the scalpel. "Is there a lot of pain?" (Oh, YEAH!) "Will you have to take anti-rejection medication? (For the rest of my life.)"

"Do you feel any different inside?"

Yes, it suddenly occurred to me, I do.

I'm scared.

No, scratch that. Dude, I am terrified.

Beyond the pain of recovery, my body has changed in so many dramatic ways. I'm swallowing three times the medications I was taking while on dialysis – some with meals, some only on an empty stomach, some in the morning, others at bedtime – and until I establish a routine, the sheer scheduling of the doses every day has my head spinning. "You MUST take your medicine regularly!" my post-transplant handbook warns. "Rejection will occur if you skip or stop your immunosuppressive medicine."

No pressure.

But it's more than that. Way more. I have been given an awesome gift – one so precious that sometimes, when I stop to think about it, I am moved to tears. I know that last year alone, more than 4,700 people died while waiting for a matching donor kidney like the one I now have. I know that a family somewhere is experiencing heart-shattering grief for the donor whose organ is giving me a second chance at a full, healthy life.

I know a vast network of supporters I cannot begin to tally – the transplant team, surgeons and nurses at Barnes-Jewish Hospital, my church family at Harvest Bible Chapel Decatur, relatives, friends, relatives of friends, co-workers and clients past and present, total strangers – have been immersed in prayer and positive, affirming thoughts on my behalf. My friend Rochelle Riley, the fine columnist for the Detroit Free Press, summed it up in a Facebook posting this week after my first post-surgery outing: "Yay to Jim McFarlin who's outta the house!" she wrote. "We're all so excited 'round these parts!!!"

No pressure.

I just feel there is so much victory, so much fulfillment of hope wrapped up in all of this. I could not bear the anguish of having to say to these same people at some point in the future, "Folks, my 'dream kidney' is failing...and it's because of something I did."

My immune system is intentionally suppressed. By how much, I have no idea. But living with the idea that a careless cough in the face from a 3-year-old could set my entire personal ecosystem into screaming yellow meemies is going to transform me from Average Sloppy Guy to Anxious Germophobe. I can just feel it. I'm going to make Howie Mandel look like a mud wrestler. I won't be quite as bad as Larry, who used to squirt a person's hand with sanitizer before he would shake it, but I'll be pretty insufferable for a time. Please bear with me.

I'm going to start doing all those things we tell ourselves we need to do to improve quality of life. Make exercise an important part of my lifestyle. Watch what I eat, and eat better food. Balance and manage mind and body, work and leisure. Pray more.

I can do this, Larry, thanks for asking. I have to do it.

I just don't want to screw this up.

A Time of Thanksgiving

Now, let's see: What's different in my life today from one week ago?

• I have a third working, perky little kidney inside of me. Contrary to what most people think, nothing is typically removed from one's body when you have a kidney transplant. Surgeons simply add the donor kidney to the two you already have, and eventually (just like in business) the new guy gains strength and starts taking over. More accurately, the procedure should be called a kidney implant.

• The proverbial racehorse has got nothing on me. I am turning urination into an art form. As kidneys fail, often they lose the ability to manufacture the urine that flushes waste products from your body; in fact, doctors tell me one way they check to see that a new kidney is functioning properly is how quickly it begins to produce urine on its own. Well, since I never stopped peeing regularly, it's like my bladder has become turbocharged. I'm going at least once an hour; I feel like I'm constantly either thinking about going, going, coming back from going or trying not to go on myself. This eventually will taper off, but right now the new member of the body is obviously just showing off. Whiz kid.

• I have two tubes sticking out of my body instead of one. In addition to "YouTube," my PD dialysis catheter and constant companion the last two years, I also now have what's called a Jackson-Pratt, or "JP" catheter, to pull the excess drainage from my incision into a bulb pinned to my clothing to speed the healing process. Eventually both catheters will be removed from my midsection, but the "JP" won't get yanked until its daily fluid output is less than 0.5 percent. Right now it's at 4.0. Grrrr.

• I am now diabetic. At least, temporarily. Because the steroids used during the transplant played hanky-panky with my blood sugar levels, I now have what is called "steroid induced diabetes." I received my own blood glucose monitor, test strips and instruction session at Barnes-Jewish Hospital in St. Louis, and until my levels drop and stabilize I have to test myself in the morning, nighttime and before every meal, just like my wife, Karen, who suffers from the more permanent brand of diabetes. Oh, we're just poking ourselves now all over the house! You know, the family that pricks together, sticks together.

• I am in considerable pain, although amazingly far less than I anticipated. I think I may have written in a previous post that surgeons say the transplant operation generally consists of a small, hardly noticeable incision on the right side of the abdomen where the new kidney is neatly tucked in. They lie. They cut me like I was being dressed for the butcher's window, including a hip-to-hip slice beneath my waistline that's being held together with staples. I couldn't help but mention this discrepancy to my transplant surgeon, Dr. Jason Wellen, the surgical director of kidney transplantation at Barnes-Jewish – or, as one of my pre-op nurses described him, "Our golden boy of kidneys." "Hey, you're a big fellow," Dr. Wellen explained. "We had to go deep to make sure those blood vessels were tied off properly." I knew there'd come a day I'd regret being this tall.

• My daily pill regimen has increased to more than 30, almost twice as many as when I was on Peritoneal Dialysis. It's necessitated a slight change in my pillbox carrying case: old one on the left, new one on the right.

The majority are new drugs for anti-rejection or to suppress my immune system, which I will have to take for the life of my transplant. (Hopefully, the rest of my life.) But there currently are also some really outstanding pain medications, and I can completely understand how someone undergoing major surgery could get hooked on pain pills and not want to stop taking them. They make the pain just faaade awaaayyy...zzzzzz.


• I have an even deeper admiration and adoration, if that's possible, for my incomparable wife, Karen, who will put her life and career on hold for the next several weeks to take an extended FMLA leave so that she can care for my needs. I can't drive for at least two weeks, so she will be ferrying me to my followup appointments in St. Louis and in Champaign, along with doing all the cooking and the housework I usually take upon myself. And all with a smile on her lips and a song of compassion in her heart. (At least, for now!) How lucky can one guy be? I am so looking forward to hanging out with my best friend every day in these days to come and just enjoying each other's company as my health and strength continue to improve.

• Thankfulness. I don't think I've ever been more humble, thankful or appreciative than I am this holiday season. When you hear phrases like "golden boy" and "you got a dream kidney," you begin to realize that everything fell into place through the power and grace of God. All the prayers, all the friends, all the health care professionals, the surgical team: I could be saying "thank you so much" for the rest of my life.

So I'd better start now. To all of you: Thank you so much. Happy Thanksgiving.

L'chaim: To Life!

By Karen McFarlin
Jim asked me if I would serve as guest blogger today to share the details of our Great Adventure while he continues to try and sneak a peek at his incision. I'm honored, and happy to oblige.
I thought it might be interesting to offer you a timeline of our last 10 wild, wooly, dramatic days.


Tuesday, Nov. 8: My Mom leaves on a dream trip to China. Jim and I move in with Dad to help out with the Wonder Twins, Madison and Emma.

Wednesday: Jim drives to Deerfield, Ill., for three days to give one-man speaking presentations for the company that makes his dialysis supplies.

Saturday: Jim and I, Wonder Twins in tow, drive to Grand Haven, Mich., where we were blessed to attend the wedding of possibly the most beatific couple ever, Andrew & Kathryn Huhn. Ah, young love.

Sunday: I wake up with a sore throat. We drive home with the Wonder Twins, plus six brand-spankin’-new goldfish (originally the wedding reception table decorations, rescued by Jim at the twins’ pleading). I was swayed by the refrains of “Poor, poor Roddy, flushed down his own potty” from that unforgettable film Flushed Away.

Monday: My sore throat morphs into full-blown stomach flu. Five goldfish remain. (R.I.P., Winston.)  Jim drives back home to receive the monthly delivery of dialysis supplies. (If only we could back up that truck now!)

Wednesday, Nov. 16: Mom returns from China. Aunt Marcia arrives for a holiday visit from Ketchikan, Alaska. I emerge from the sick bed.  Four goldfish remain. (R.I.P., fish whose name changed too many times to recall.)

Thursday, November 17: Jim and I finally drive home to Champaign in separate cars after being on the road for nine straight days. Jim goes to Da Vita Dialysis for his monthly checkup with his nephrologist, Dr. Attia, who registers surprise that we haven’t received another kidney call. (This is called foreshadowing.) Exhausted and a bit grumpy, Jim returns to the apartment and ignores his phone when it flashes, “Unknown Caller.” When my phone rings moments later, I answer it. Trish, the kidney transplant coordinator from Barnes-Jewish Hospital, is on the other end. I rush into the living room and Jim is now parked in the bathroom. The call of the lifetime…nearly missed because of a bowel movement. Jim finishes his business – verrry slowly in my opinion – and returns Trish’s call at approximately 3 PM.

3 PM:  Barnes has located a kidney for Jim, and he’s the primary recipient. How soon can we get to St. Louis? “Four hours,” we declare, totally guessing. We praise God that our bags are still packed and in the car from Decatur trip.

3:15: I frantically coordinate logistics with my office. I am scheduled to make two major presentations the next day in Kankakee, Ill., at an all-staff retreat. My brain is stuck in quicksand and cannot find words that I desperately need, such as table, keys and phone.

4:15 – 7:30: We leave Champaign and race to St. Louis. I am furiously making notes and tweaking my presentations to send to my boss. We finally see the Gateway Arch rising over the Mighty Mississippi. In my transplant-addled state, I blurt out, “Honey – the Golden Gate Arch!” and immediately realize that I have mashed up McDonald’s, the Golden Gate Bridge and the Gateway Arch. We laugh and burn off some tension.

7:30: Arrive at Barnes-Jewish Hospital. Wait in Admissions.

8 PM: Admitted. Quickly become concerned that the wheelchair guy, who works here, can’t find the elevator to the 16th floor. I Impatiently show him to the elevator, which is a single turn from where we started. Wonder, fleetingly, if I really might have control issues.

8:05: No rooms at the inn. Miraculously, Barnes received SIX donor kidneys on Nov. 18! Primary and backup recipients for each kidney have filled all available rooms on the 16th (renal) floor. We spend the next 14 hours in a holding room designed for quick assessments with three beds and sliding curtains between them (stable and manger, anyone?). Frustrated that no one is telling us anything, but tempering the frustration with thankfulness. We discuss at length how this time feels different from the non-starter last June. We consider how so many details, great and minute, have worked out this week and conclude this is God’s handiwork at its finest. We start to allow ourselves to hope.

8:05 PM – 10:30 AM: Restless hours. Heavy Facebooking and texting. Little sleep. No food or drink for Jim. Purposely ask family not to drive to St. Louis until we have a surgery time.

10:30: Nurses come in and say we’re going. NOW. Panic begins. Alert parents to mobilize. I stash our worldly goods in a wheelchair and sprint after Jim’s gurney. We rush down to the surgical prep area. The joint is packed and jumpin’. We meet the transplant team together and learn for the first time that the cross-matching is good and Jim is getting a new kidney. We leave nothing unsaid between us and pray together. And then Jim was gone.

12 noon: In the surgical waiting room alone. Massive Facebooking and texting. Prayers pouring out on Jim’s behalf, literally from around the world. I remember that this vast family of faith will uphold us, that God is always faithful, and I relax a little.

12:30: Mandi calls from the operating room. Jim is under. Let the transplant begin! Finally eat lunch in the cafeteria.

1:30: Parents arrive.

2:30:  Mandi calls from the operating room. Nearly finished. Smooth sailing, no transfusions needed.  Flooded with relief. Reality starts to dawn.

3:00: Our pastor, Tony Caffey, his lovely wife, Sanja, and their ridiculously darling son, Alastair, join us from Arthur, Ill. Alastair and I play Angry Birds with a vengeance. This sweet boy distracts me as time passes slowly.

3:30: Dr. Wellen, the transplant surgeon, calls. Jim McFarlin has a perfect little kidney inside him. Going into post-op. Much rejoicing. Many tears. Prayers of thanksgiving. More Angry Birds.

4:30: BUZZ! McFarlin, party of two – Your husband is ready. Tony and I visit with Jim for five glorious minutes! Unbridled joy.

4:35: Return to surgery waiting room. Circle of prayer. Wrapped the donor’s family in prayer and cried for their loss.

5:45:  BUZZ! Mom and I get five more minutes with Jim.

6:30: Quick dinner in cafeteria with Mom and Dad while we wait for Jim to arrive on the 16th floor.

7:45: HALLELUJAH! Jim is settled into his room and is groggy, but lucid. No pain! We spend the rest of the evening pretty much just looking at Jim. My parents eventually leave to enjoy the gracious hospitality of dear friends Eric and Cheryl Schweitzer. I spend the night with Jim, watching him and offering prayers of thanksgiving.

Conclusion: Our new day has dawned and we cannot wait to dash off to parts unknown at a moment’s notice, unfettered by a cycler, heavy solution bags and all the dialysis accoutrements. One day in the future, we hope to have contact with the family of our donor. But today, we want to thank all our friends and family – and many unknown, yet interested strangers – for the prayers, love and support. We could literally feel your arms around us. We love you all.

Psalm 27:13-14 says: I would have lost heart, unless I had believed that I would see the goodness of the LORD in the land of the living. Wait on the LORD; Be of good courage, and He shall strengthen your heart; wait, I say, on the LORD!

Promise fulfilled.

P.S: Goldfish total unknown.