Dynamist Blog

Another Kidney Experience

From Groundhog Day blogger Dave Rogers, who wasn't quite as lucky as I was with the kidney donation:

Kidney donation is a safe procedure, and it's different, I understand, today than it was when I gave one of mine to my brother on 2 June 1997. He and his bean are still going strong, as am I.

I recall watching CNN in the hospital room right around the day of the surgery when Johns Hopkins announced a new method for removing a donor kidney using a laparoscopic procedure, requiring a much smaller incision with a shorter recovery period (and much smaller scar) for the donor. As usual, my timing was a little off.

These days, all a donor actually has to have is a matching blood type; although the better the match, the easier it is for the recipient in terms of managing against tissue rejection.

If you're in good health, under 60, and actually have two kidneys (How do you know? Has anyone ever checked? Some people only have one!), you're a donor candidate. At the time of my donation, all medical costs of the transplant were borne by the government, because transplanted kidneys are orders of magnitude cheaper than ongoing dialysis and managing the health-related issues attendant to dialysis. I believe that remains the case today. I donated mine on active duty while I was a member of the Board of Inspection and Survey, (kind of like the Spanish Inquisition, but not really), and since my surgery was scheduled over our normal two-week summer break, I think I missed only three weeks of work, and a week of that was for the travel and prep work prior to the surgery. I think the recovery time for donors today is even shorter.

Kidney donation is not without risks, and you'll sign a dozen waivers that will scare the hell out of you. Driving a car is not without risk, and will often scare the hell out of you. There are few things in life anyone can ever do that will make as much of a positive difference to someone else, so it's worth the risk, in my opinion. If you know of someone who needs a kidney, consider becoming a donor.

I heartily second that sentiment. While I appreciate all the flattering emails, donating a kidney is not, in fact, an act of supreme courage or sacrifice. People do harder, more dangerous things every day. Thanks to laparoscopic surgery, my biggest incision is a mere two inches long. I'm not 100% better, but I'm at 85-90%, and that's after barely more than a week. Of course, it's a lot easier if you're self-employed, have a spouse with flexible hours, and have no kids to take care of.

The Dems' Stealth Candidate

He has an appealing personality--including a sense of humor--and a centrist message, along with a lot of experience. The experience makes him vulnerable, of course, but in a general election I think he'd pull more votes than Hillary. Isn't it time the Democrats nominated someone likable for a change?

Better (Replacement) Bones

Gretchen Cuda of Wired News reports that researchers at Lawrence Berkeley Labs have found an ingenious way to mimic some of nature's strongest structures, promising better artificial joints.

A team of researchers in the Materials Science Division at Lawrence Berkeley National Laboratory has managed to imitate the complex structures found in ice and mollusk shells, and the ultra-strong material could lead to everything from stronger artificial bone to airplane parts.

The scientists used the physics of ice formation to develop ceramic composites four times stronger than current technology. "Because we can control the freezing of ice we could get very sophisticated structures," says Eduardo Saiz, a physicist at Lawrence Berkeley and one of the authors on a paper published in January in Science....

Ceramic has been the material of choice in joint-replacement surgeries for years because it lasts longer and produces fewer immune reactions than metal or plastic. It also contain millions of tiny pores that the patient's own bone cells can bind to, strengthening the new joint. But the spongelike structure of conventional ceramic is weak, and can fracture....

The breakthrough came after the Berkeley team realized that similar layered structures formed when mineral-rich water froze. So they tried freezing a mixture of water and hydroxyapotite, the mineral component of bone. As the ice formed, the minerals became trapped between the layers of ice crystals. They freeze-dried the material to remove the ice, leaving behind hydroxyapotite layers similar to nacre's. By increasing the speed of the freezing process, they could decrease the layers' thickness to just 1 micron -- nearly reproducing the scale found in nature.

A Note from Sally

Sally is home from the hospital, doing well, and adding Diet Dr. Pepper to her repertoire of drinks. (She also looks a lot prettier than she does in that picture below.) She asked me to post this note to readers:

A number of dynamist fans and bloggers have sent me good wishes and praised Virginia -- the Goddess of Renal Fortitude -- for her supreme generosity. When I could answer individually, I did, but for those whose e-mail addresses were elusive, I want to thank you so deeply for your heartfelt encouragement and for, indirectly, calling attention to the desperate organ shortage issue. I will be turning my attention to that for the next big project....Fondly, Sally Satel

You have been a wonderful community of support for both of us. Thank you all very much.

Kidney Transplant Update

Steve and I went to see Sally today, our first in-person visit since I left the hospital Tuesday morning. She's back to her old self and is supposed to leave the hospital tomorrow. I am very, very happy--happy that she's doing so well, happy that I could give her a kidney, and happy to have her as a friend.

I made her pose with her first post-operative dose of our favorite beverage. (The secret to our tissue compatibility is that our real blood type is Diet Coke.)

sally.jpg

Her case manager says Sally has gotten more flowers than any other transplant recipient. She has a lot of friends.

If It's Not Regulated, It's Forbidden

The NYT's Dana Bowen reports that health inspectors have launched a campaign to shut down a popular new cooking technique that doesn't fit into existing regulatory guidelines. The campaign comes in response not to an outbreak of food poisoning--no problems have been reported--but to a New York Times Magazine story on the popularity of sous vide cooking.

The New York City Department of Health and Mental Hygiene has quelled the sous vide revolution, for the moment. In the past few weeks inspectors have told some chefs to throw out shrink-wrapped food, forbidden them to use the equipment used to make it and told them to stop cooking and storing food sous vide until they have a government-approved plan for it.

In some cases, inspectors are handing out fines, which start at $300 per offense. The department's actions seem to represent the first time a city agency has singled out the technique, and how chefs use it.

The city health code, which governs the way chefs cook, does not specifically address the way a restaurant should vacuum-pack food. While no health problem has ever been tied to sous vide in restaurant kitchens in New York, officials say they are concerned that food could breed botulism and listeria if it is vacuum-wrapped improperly. [Emphasis added.]

Side note: The one good thing about Times Select is that it gives NYT subscribers free access to the Times archives, including articles like the magazine piece linked above.

Adam Smith in Arabic

Given recent distractions, I'm a little late on this, but if you haven't read Jonathan Rauch's latest column, on translating classical-liberal works into Arabic, by all means do so now. With the help of a brave Iraqi translator, Cato's Tom Palmer is spearheading this inspirational effort. Here's the connclusion of Jonathan's piece:

The Internet, in contrast, makes possible worldwide, instant distribution, at a nearly negligible cost. MisbahAlHurriyya.org relies heavily on volunteers and donated Web services; its budget, says Palmer, is in the five figures. Thanks to e-mail, conferring and passing manuscripts between Washington, Baghdad, and Amman -- a logistical nightmare in the days of mail and fax -- is a cinch. The site, entirely in Arabic, advertises on the popular Arabic Web sites Albawaba.com and Aljazeera.net. The whole enterprise was impossible a decade ago.

Firmly establishing liberal ideas took centuries in the West, and may yet take decades in the Arab world. Authoritarian and sectarian and tribalist notions are easier to explain than liberal ones, and it is inherently harder to build trust in mercurial markets and flowing democratic coalitions than in charismatic leaders, visionary clerics, and esteemed elders. The liberal world's intellectual underpinnings are as difficult to grasp as its cultural reach is difficult to escape. Thus the disjunction within which Baathism, Islamism, and Arab tribalism have festered.

Yet few who are genuinely intellectually curious can read J.S. Mill or Adam Smith and come away entirely unchanged. The suffocating Arab duopoly of state-controlled media and Islamist pulpits is cracking -- only a little bit so far, but keep watching. In the Arab world, the Enlightenment is going online.

While we're on the subject, let me once again plug Liberty Fund's Library of Economics and Liberty, which offers searchable, full-text editions of classic works in English. The online versions mirror Liberty Fund's authoritative printed texts.

Kidney Transplant Update

before.jpg

Here are Sally and I on Saturday morning before the kidney transplant. My operation went extremely smoothly. Hers took longer than expected, because a little bit of the kidney was spasming, making it hard for the surgeons to attach the blood vessels. Worse, a couple hours after surgery she started hemorrhaging and had to go back into surgery--an unusual and dangerous complication. Fortunately, she came through OK and is gradually recovering.

I am now out of the hospital and doing fine, recuperating at a friend's nice DC crash pad. I'm a bit weak and not as mobile as usual, but I'm off pain medication and more normal than not. Here I am:

after.jpg

A Medical Adventure

Unless people like Leon Kass get their way, someday patients with failing kidneys will be able to get made-to-order replacements that are exact genetic matches, either through therapeutic cloning or some now-unknown future technology. Now, however, if your kidneys stop working, you have three options: die, go on dialysis (regularly described as "living hell" by dialysis patients and their loved ones), or find a donor kidney. And donor kidneys are in short supply, made shorter by legal restrictions and social taboos.

Last fall, my friend Sally Satel wrote about the issue in general and her own search for a kidney donor. Between the time she wrote the article and the time it appeared in the NYT, I heard about her situation and volunteered as a donor. Our tissues turned out to be unusually compatible for nonrelatives and, when her Internet donor dropped out, I moved from backup to actual donor. We have our surgeries tomorrow morning.

As surgeries go, the procedure is safe and straightforward--far more so than people think. A donor can live a completely normal life with one kidney. The recipientis not so lucky, since a foreign organ requires a lifetime of immunosuppressant drugs. But that's a lot better than the alternative.

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