The Detour
Before the kidney, the plumbing needs attention first
I got a call on Wednesday, a follow-up on a small hematoma at the incision point on my wrist from the coronary angiogram. In the middle of that call, I learned that the transplant team had met that same day to discuss the results of the test. The conclusion was that I would not be eligible for a kidney transplant until the issues with my coronary artery blockage get resolved first.
That’s not exactly the news I was expecting, but it isn’t entirely bad news either. It is a detour.
I’ve written before about living with diabetes for most of my adult life, about the slow decline of my kidneys, and about what it’s meant to start the transplant evaluation process. This is the next chapter, not a new one.
Here’s the short version, for anyone catching up. My kidneys have been declining for a while now, a long-term consequence of having type 2 diabetes for over twenty years, most of those years before the medicine caught up to people like me. I’m on the transplant waitlist, and we’re investigating the possibility of a living donor, which means skipping the years-long wait for a deceased donor organ entirely. I feel positive about that part of the story, and I’ll get to that part more in a bit.
But before any of that can happen, the transplant team needs my heart and its plumbing to be cleared for the surgery itself. As part of the medical evaluation for transplant, they found blocked arteries. I’ve been told the heart muscle itself is fine. My pumping function tested completely normal, so this isn’t a heart problem so much as a plumbing problem. From what my cardiologist has explained, stenting may not be a great option given where the blockages are and how extensive they are, which is why a bypass is the path being set up as the likely fix. Nothing is on paper yet, but it’s clearly the direction things are leaning. If it does come to that, it’s open chest surgery, the real thing.
So that’s the detour, or at least the shape it’s taking. It is most likely looking like a bypass, then months of healing, and then, hopefully, the transplant.
Why I’m not panicking
I’ll admit my first instinct, hearing “open heart surgery” mentioned as a real possibility, was to think of my dad. He had a bypass in his seventies, and while he survived it, he came out the other side with vascular dementia. He was never quite himself again. That memory sat in the back of my mind for about a day.
But I’m not 72. I’m about to turn 59, and I’ve been told the difference matters more than I would have guessed, that a younger body and brain tend to recover differently, with more cellular reserve and better resilience to the stress of surgery. I’ve also stayed physically active for years, and apparently that’s not just good for the body. I’ve been told consistent activity can have a real protective effect on the brain too. I’m certainly not invincible, but I’m also not starting from where my dad started either.
I’ve also lived through a case of diabetes that wasn’t so forgiving. Chronically high blood sugars, constant management, and no real safety net did the damage to my kidneys back in that era. I’m not in that era anymore though. Ozempic has made my blood sugar control about as stable as it’s ever been, and I’ve been told that stability gives me a real shot at sailing through this without things spiraling. It’s old damage, but I’m working with new tools now.
The part that’s actually moving me
What’s been catching me off guard isn’t the surgery. It has been the response.
When I started expressing that I needed a kidney, several people closest to me didn’t hesitate. There’s been testing, conversations, and real willingness, more of it than I expected, and I don’t think I’ll ever stop appreciating the support. Marsha and I have been doing both individual and couples therapy to work through what it means for her to potentially be a donor, too. That whole process is on pause for now, until my vascular issues are sorted out, but it hasn’t gone away. It’s just waiting.
I’ve also learned that compatibility is its own small lottery. Blood types, antibodies, and tissue matches are things I never thought much about until I had to. Some people who offered to help weren’t able to. That’s part of why I hold the people who tried so close, since the willingness mattered every bit as much as the outcome. Whatever happens next, I already feel so supported.
I’m staying vague here on purpose. Nothing is finalized, and this is other people’s story to tell too, not just mine. But I want everyone who has raised a hand, tested, or simply asked how they could help to know I see it, and I’m not taking it lightly.
What’s next
I’m waiting on a scheduling call for my next consultation, where I expect to get more clarity on whether the bypass is really the path forward or if there’s still something else on the table. My transplant advocate is almost certainly working through insurance and logistics behind the scenes right now, the way she has been doing before each step of the process. If the bypass does turn out to be the next step, I’m looking at three to six months of healing before the transplant itself can happen, time for my chest and my heart to settle.
It’s a long way around. But it’s a way through, not a dead end, and that’s the part I keep holding onto. So, for now, I’ll be 59, active, and with people who have volunteered to help. That’s not a bad place to be standing when a detour shows up.
AI disclosure: I used AI tools during the drafting and editing process to help clarify structure and language. All ideas, judgments, and final wording are my own.