The day has arrived. November 21st, 2024, a Thursday, the day of living donor kidney transplant. As my family and I arrived at Thomas Jefferson Hospital around 5am, we were ushered to the surgery prep room. Dana, my altruistic donor, was already there waiting for prep and alongside him Victoria, the family friend who introduced Dana to our kidney donation website, which sparked his interest in donating. He will go first as the donor always should. We exchange greetings and my wife and I thank him profusely for giving me an extended lease on life and to be able to be here for my family’s future. Dana shrugs it off like he was just giving a neighbor some sugar. His heart is incredible, and his altruism is through the roof. We were in side-by-side prep rooms as we undergo the typical pre-surgery interviews. Now we wait until we are called by the OR surgery team.
Call comes in for Dana at around 8am. As mentioned, the donor goes first, and the kidney gets put on ice until the recipient (me) can get it surgically implanted. We share an “air high fist” in solidarity with what we are both about to endure. I got the call around 10am to the pre-surgical area to prep me for anesthesia. I get the green light about an hour later to go to the operating room. I recall scooting myself over to the surgery table, anesthesia does their thing and ask me to take deep breaths from the oxygen mask. I take several deep breaths and I’m out.
I don’t recall if I dreamt of anything, but I get woken up by the surgical team calling out my name. It’s a bit of an out-of-body experience to hear people calling for you, but you are unsure where. You are in a void of darkness hearing the calls and head to the light, when you hit the lights your eyes slowly open. I see a bunch of smiling faces of doctors and nurses. Dr. Andreoni, the primary surgeon performing the transplant, informs me that all went well with zero complications. It is a joy to hear, but the pain from the surgical incisions keeps me grounded. My wife, Marissa, is there and holds my left hand. My right arm is loaded with IV holes…4 of them up to my neck to be exact. It feels good to hold my wife’s warm hand. She’s been my help mentally and physically at every step of the way since first renal failure diagnosis. I feel some relief as I think the major battle of kidney transplant has been won. New kidney in with no complication and donor is doing astonishingly great. Dana is now part of the Uno Kidney club and I’m in the Tres Kidney club. Things are looking brighter and as for now everyone lets me rest. Dosed up on oxycodone, I fall asleep easily but having a urethral catheter takes some getting used to.
Next morning is here. Dana is walking around the transplant floor and stops into my room. He’s doing a thousand times better than me as I hope he would be. I thank him again for his self-sacrifice and again he says he would do it again at any time. He went through a lot just to help me, a stranger who is now a lifetime friend that he met only 3 weeks ago. Dr. Andreoni stops by this time without the smiling face but a bit more serious. He lets me know that my numbers aren’t where they should be and that I’m retaining massive amounts of water weight, which in total was around 40 lbs. The new kidney should have taken care of the numbers and the water weight, so they are unsure what’s going on. To find out, Dr. Andreoni wants to open me back up and do exploratory surgery to check on the 3 vessels that were used to connect Dana’s transplanted kidney to me. In a kidney transplant most of the time they hook up to the iliac vein and artery along with a ureter vessel connected to the bladder. He’s suspecting some shortened vessel issues. Dr. Andreoni goes over the plan and I consent to the operation set for November 23rd 2024.
Exploratory operation day arrives and I’m in the prep room waiting for the OR call. I get called in and do my worm crawl over to the operating table. Oxygen mask on and I’m out again. From this point on all is told to me. I do not recall at all what happened, but my life was on the line. Below is an excerpt from Dr. Andreoni’s notes.
“Anesthesia team preoxygenated and started to perform their intubation sequence when HR became very low and it was difficult to feel a pulse. I was standing at patient’s left side, and when I was unsure if I could feel a carotid pulse, and Dr. Zemela could not feel a femoral pulse, I began CPR as the anesthesia team intubated and gave epinephrine and an OR code was called for optimal assistance. Heart rate and blood pressure were soon recovered.”
Translation: Upon intubation attempt my heart gave out. Through all the operations and procedures this year, my heart said it had enough and just wanted to rest for a bit. I guess if one is to have a heart attack the best time is to have it in front of a bunch of doctors. After not feeling a pulse and my heart rate dropping below 50bpm, Dr. Andreoni started CPR as the anesthesia team provided some epinephrine while finishing the intubation to help keep me breathing. Dr. Andreoni performs CPR for around 3 minutes until my heart wakes up again. If another 2 minutes had passed, they would have called in the defibrillators to kickstart me back alive. Dr. Andreoni is relieved but cancels the rest of the procedure due to cardiac arrest.
I get woken up this time in the ICU and with intubation still in tack and my arms tied down. I heard the same name calling out but as I opened my eyes, no smiling face was seen. Dr. Andreoni let me know what has transpired and that the procedure was cancelled due to the cardiac arrest. I’m shocked and frustrated and just want this damn tube out of my throat. I can’t talk and am confused on what happened. Several hours later they did take the tube out and I can finally talk. My wife arrives bedside that night while having Victoria take care of our baby Seneca. They would not let a 1-year-old into the ICU. We discuss what happened…she asks if I’m okay. I told in a stoic tone as to not have her worry more, that I was okay and didn’t remember anything besides the intubation annoying me.
Later that night I’m alone with my thoughts. It’s in between the every 2 hours check-in from the ICU nurses. My brain drifts off to the information of having a heart attack. My dark subconscious takes over and says to myself, what if your heart didn’t come back??? Are you worth more dead than to be such a burden alive for your family??? A single tear drops from my left eye. Maybe my dark subconscious is right; Marissa would get a windfall from my death, money would pour in from family and friends knowing that Marissa is now a widow. My daughters wouldn’t have to go the hospital what seems like every week. I look back at all my battles and the weariness begins to let myself believe it. Have I reached that stage of giving up and entertaining the thought of calling it done as my heart tried to do? Another single tear drops from my right eye. As I was wallowing in my own self-pity, my subconscious echoed a laughter, a little giggle more like it. As the sound comes into focus, it’s my darling baby Seneca, laughing and giggling. I start crying with both eyes. As the tears stream down, I’m ashamed that I thought death was a solution. What if I never heard that giggle again…that would be my hell. My subconscious pulls back from Seneca giggling and it shows Isadora playing with her little sister and getting her to giggle so much. It zooms out once again and shows Marissa looking over our two daughters so affectionately. It then zooms into framing Isadora and Marissa. Isadora asks: “I thought once Papa gets his new kidney all will be better but he’s still in the hospital, I just don’t get it.” Me too kiddo, me too. Marissa replies, “We have to have patience and let the doctors do their work and help your Papa keep on fighting. He will NEVER give up on his girls!” I’m full out ugly crying this time, ashamed that I thought of death as a solution but thinking that I can still fight, especially for my family. I realized money will never replace their father and husband for my wife. Money will not replace their biggest champion in whatever they want to do in life. Money will not replace the love I have for my family! Money will never replace me! I have renewed vigor to keep on fighting. I will make it through this, I will be here for my girls and wife! If I ever felt down again, I would just internally listen to Seneca’s giggle and the scene with Isadora and Marissa would push the darkness away. My family, even though they didn’t know it, have saved my life once again.
Days in the ICU pass as my heart has stabilized but the edema is increasing, and the kidney function is still not as it should be. Doctors change the regiment up a bit and add a new diuretic. I’m happy with that choice as I felt Lasik was jammed down my path to healing. ‘Patient not responding? MORE Lasik!’ seemed to be the consensus. At one point I even asked for a dialysis session to lessen the edema. Doctors said no and wanted it to naturally happen through diuretics.
It’s Monday November 25th, 2024, and Dana is on his way home to New Hampshire with Victoria driving him. I’m happy his recovery is going better than mine, and he seems in good spirits. He does check in daily with Marissa and he is concerned formy recovery. Most special, I am told, Dana and Victoria did get to meet my parents and older sister Oanh on Sunday before his homebound. My parents wanted to meet the man who saved their baby boy from ultimate kidney failure.
The next day my niece Savannah (who lives in south Philly) stops into Jefferson to care for Seneca as Marissa diligently visits me in the ICU. I’m sure she’s concerned but doesn’t show it. She shares pictures of their time at the hotel next to the hospital. Seneca is a darling wherever she goes, people are enamored with her big eyes, smiling disposition, and with the ability to say Hi and Bye with the cutest hand wave to everyone she meets. The following day Marissa’s cousin Gregory takes care of Seneca during my ICU stay. I forgot to mention that Isadora is staying at my brother Duy’s house and loves that she can play with her cousins for the week. Thank you Duy and Emily for taking such good care of Isadora that she almost didn’t want to leave.
On November 27th, 2024, the doctors decide to do an angiogram to make sure the vessels from the kidney transplant and in good order. Although not as conclusive as the previously attempted procedure, it’s safer and won’t induce a heart attack. They go through the procedure without issue. There is some pain from the insertional sight on the right side of my groin. My groin has gone through so much, just another hole and pain it must contend with. This angiogram was used to view the vessels instead of the ‘open me back up’ procedure. They find nothing of issue and share that the vessels and blood pressures are adequate. I’m left in a state of content that nothing is wrong but also with frustration that they didn’t find anything diagnostic. Something that could point out the issue instead of just constantly adjusting the diuretics.
Another day passes and I find myself still in the ICU on Thanksgiving Day. Good news is that they deem me well enough to move back to the transplant recovery area as my heart and vitals have stabilized. Weight (from 196 to 180) has come down a bit but I’m still suffering from edema in my legs, feet, and abdomen. An amazing ICU nurse, Holly, promised me some T-day food with the nurse’s potluck for people working at the hospital that day. I eagerly accepted, wanting something other than hospital food for once. I got moved before Holly could get the food ready, but she promised me she would make me a plate and bring it to my room at transplant recovery. It was around 8pm but Holly kept her promise. The plate had a little bit of all Thanksgiving goodies. Turkey, stuffing, mac and cheese, gravy, green beans, and a glob of cranberry sauce. It was all there and made me think of my family, my parents, and my siblings. It made me remember what home and normality was like.
Yet more days have passed, and I complain about my foley (urethral catheter) not functioning as needed. It seems to take forever for the doctors to approve removal, but they give the nurse the go ahead. They basically just deflate the “ballon” and yank it out. There’s a lingering shock and burn of where the foley used to be. I feel free to pee now but into a mobile urinal which the nurses constantly measure for liquid output. My physical mobility is still hampered by IVs, and leg pressure bags tie me to the hospital bed. I’m slowly losing weight again as I had ballooned back and between 190 and 180lbs. I was 156lbs the day before transplant. All the extra weight was water retention and displaying itself as edema throughout my body.
December 5th, 2024, arrives and all doctors are in consensus that I’m good to go home and recover from there. It’s been a total of two weeks in the hospital. It only took me 11 days to get discharged from the hospital for my open-heart surgery in March. Either way I’m excited and ready to get out of there and regain a sleeping schedule, eat some real food, and have the mobility to walk around my house. I get a full regiment of medication including immunosuppressors, heartbeat regulation and many others. It will take some time in getting to know them, but I’m a fast learner and taking pills is second nature to me now. I can down a mouthful without water.
Home time is short lived as we are back in Jefferson for my twice a week clinic on Friday December 6th, 2024. There we meet Dr. Gulati and he’s concerned with the weight fluctuation and present edema. I’m now bouncing between 180 and 185lbs. It’s better than it was but still a good 30lbs above my pre-transplant weight. He prescribes reduce fluid intake and guess what? MORE Lasik. I shake my head slightly but still adhere to what Gulati asks of me. He’s a well-seasoned Nephrologist and has gone through 10’s of thousands of kidney transplants. He’s not overly concerned about things and believes the kidney is just slow to respond stating that some transplanted kidneys take time to recover from “cold storage”. He’s expecting once that turns, I will have my numbers normalize and kidney functioning as it should. We go home for the weekend to double up on the Lasik and reduce water intake, and hope for the best.
The weekend passes and we are back at Jefferson on Monday December 9th, 2024. Numbers aren’t good, especially my Creatinine increasing which is the opposite of what we want. Edema is still severe, and it seems that I just can’t shake the weight. The recovery team wants to do 2 things: Echo cardiogram as well as a biopsy of the new kidney. Marissa advocates and gets a scheduled echo from our local cardiologist office for Tuesday, and Jefferson is expecting the biopsy to happen on Friday. Best laid plans of mice and men…. After reviewing the echo, the Jefferson transplant team recommends immediate kidney biopsy to ensure that it’s not failing nor any rejection. There’s water retention in the heart and causing some pulmonary hypertension. The fight continues as Jefferson wants me to come in Wednesday December 11th, 2024, for this stat kidney biopsy.
Back in the hospital for the scheduled outpatient procedure and they prescribe IV Lasik to help the edema. I’m on deck for the transplanted kidney biopsy. Dr. Rivera, who I know from my previous stay in the ICU, is the fellow who will perform the kidney biopsy. He assures me that it will be much less painful than when I had my own native kidney biopsied in November of 2023. He says not only is the new kidney in the front and direct access easier, but the nerves were also never connected to the transplanted kidney making pain more about the tissue surrounding the kidney than the kidney itself. He performs the procedure with me under twilight anesthesia and takes two samples. Dr. Rivera was correct, it was tender but far from painful. He used a single band-aid to cover up the insertion hole. He used ultrasound to avoid any vessels that would bring pain. It was a quick procedure, and he sent the samples off to the pathologist for examination. As I was in the recovery room, Marissa and our daughters joined me. Marissa lets me know that, per the Echo, the Jefferson transplant team wants to admit me to the hospital so they can try to maintain the edema and hopefully reduce the water retention in my heart as well. They say they probably want me in for 2 days, but I know better. It will take them more than 2 days to dial in the diuretics. Still frustrated, but I am prepared to do what I need to do to get better. I do bounce back on some of the edema and the high dose IV Lasik does seem to be working albeit slowly. They changed my diuretics to include Bumetanide and Metolazone. Success! I drop nearly 4 lbs. on the 17th and another 4lbs on the 18th. Edema is reducing and I’m feeling much better. I’m just happy they gave up on the ‘MORE Lasik’ approach.
| Date/ Time | Weight | Height | BMI (Calculated) |
| 12/18/24 0535 | 78.4 kg (172 lb 14.4 oz) | —– | 27.1 |
| 12/17/24 0540 | 80.1 kg (176 lb 9.6 oz) | —– | 27.7 |
| 12/16/24 0553 | 81.7 kg (180 lb 3.2 oz) | —– | 28.2 |
| 12/15/24 0300 | 82.2 kg (181 lb 3.2 oz) | —– | 28.4 |
Days pass again and they keep me admitted because edema and creatinine have improved but not by much. The biopsy analysis came back that there’s no rejection detected, and the donor kidney is in working order. Good news is that no rejection exists but they still don’t know why my numbers are so off. They want to confirm what’s going on with my heart and set an angiogram for December 18th. They go through my neck for the angiogram due to the multiple IV holes in my right arm. The cardiologist, Dr. Storoznsky, sees that there is still water overload and recommends continued diuretics to help reduce this. With my change in diuretics and progressing weight reduction, he believes that it will work itself out.
December 19th, 2024, arrives…Marissa’s 40th birthday. The only thing I have for her is that I will be discharged today from the hospital. I look forward to it immensely. My weight is now down to 166lbs. It’s great progress in 3 days of the water shedding. One last thing remains and it’s the ureter stent removal. During transplant surgery they installed a stent from the donor kidney through the ureter and into my bladder. It was to help urine pass through without vessel collapse. Marissa is now in my room with Seneca waiting to take me home. Urologist shows up and preps me for stent removal. Senior Urologist oversees the procedure. They do use some numbing agents, but you still feel it, especially during extraction. Yes, they go through your penis with a fiber optic cable via the urethra and into the bladder where they hook onto the stent and yank it out. Reminded me of the foley removal but deeper. I was leaking blood clots for several days at home. I had to create a ‘manipad’ of toilet tissue paper to catch the clots as they slipped through. Luckily that was done in 4 days but it’s always disturbing to see blood coming out of your ‘manhood’.
I’m at home and things are getting better. It seems the diuretic change is what turned the corner and I’m losing weight and creatinine number is dropping closer to acceptable rates. As of writing this, I’m down to 155lbs which is below what I weighed pre-transplant. I expect to lose at least 5 more pounds as there are still some lingering edemas in my calves. It will be an ongoing battle as I’m now on immunosuppressants for the rest of my life. I will have to be careful around crowds and even extended family and friends. I’m still trying to get my energy back and the immunosuppressants leave me with trembling in my hands and muscle spasm in my legs and arms. It’s a bizarre feeling when your appendages just take off on their own. I haven’t hit anyone yet so that’s a good thing. My family is in full support of me and I’m still prescribed bed rest and no strenuous exercise. It will be a slow climb back but being home and getting better is more than I can ask for.
The battle is far from over. If it’s not kidneys, it’s my heart. Upon an additional Echo review my Jefferson cardiologist, Dr. Eisen, recommends a trans-esophageal echo cardiogram of the heart to see if I will need mitral clips for a leaky heart valve. That will be scheduled later this month of January 2025. I return twice weekly to clinic with my wife to ensure medications are optimized and to continue to monitor my post-transplant progress.
I guess (and hope) this is it for this website regarding new content. It was successful in procuring a donor (thanks Dana!) and it has kept my friends and extended family up to date on what my family and I have gone through. I will leave it up for several months in hopes it will inspire anyone going through the same issues and for any friends and family that just haven’t gotten to read it yet.
Thank you to the friends and family who have donated funds to my family through Venmo/PayPal. It will come in handy once my healthcare resets in the new year and out of pocket cost will quickly add up.
Thank you for those of have donated to our 529 accounts for Isadora and Seneca. My girls are my world, and you have helped them ensure an educated future even if I’m not around.
Thank you who have read through my journey with me. I hope I can impart what a struggle it is to have failing health and the fight it needs to overcome it. I hope it can inspire anyone else who may be going through renal failure as well.
Thank you, Singer Equipment, for sticking by me and offering so much support to see me through. It’s endearing to see how much my co-workers are truly concerned about my health and recovery. Due to the complications, I will probably be available to get back to work in early March. I’m eager to get to that point.
Thank you, Adam Vozzo, for always helping and updating the website for us. Your involvement was imperative to the success of communication.
Thank you to my parents and siblings who have provided their support financially, their time, and in babysitting Isadora. You have provided support to Marissa when she felt all alone in this battle. You were the key in helping us continue fighting.
And last but not ever least, thank you to Dana and Victoria, without you the kidney transplant would not have occurred. You ended my battle with dialysis and have extended my life expectancy so I can be around with my family and whatever the future holds for us. You both will forever be considered friends and confidants to this small but mighty Phamily.
In reading this, if you still wish to donate to the girls’ 529 Accounts, please see below. Any donation is state tax deductible for those who live in Pennsylvania.
For Isadora: Ugift code: 532-A7U https://ugift529.com/readysave529/532-A7U.html
For Seneca: Ugift code: N35-S67 https://ugift529.com/readysave529/N35-S67.html
If you still want to donate to the Phamily you can use my Venmo and/or PayPal accounts: @Phamist