11

What Every Kidney Recipient Should Know

Sunday, September 11, 2011

Lee Chen HoeDeceased Donor Transplant Recipient

Kuala Lumpur Hospital

July 27, 1996

22

My loving twin girls

33

Coping with CAPD

-Took me 4 months to finally accept the fated illness

- A supportive family and my loving twin girls

-I was reassigned to desk job in charge of Material

Control from Technical Service

-Had to stop once or twice in the North South

Highway to take a cat nap before continuing my

journey of 60 km to work

-To put up with unfriendly and hostile remarks

-A strong determination to pull through

44

Wai Tan Kung Exercise

55

My Preparation for Transplant Operation

-Signing up for the Waiting List

-A Positive mind set

-Walking exercise

-Practice of Wai-tan-kung tai chi exercise to stay healthy

-Closely followed my dedicated CAPD nurse’s advice

-Had my teeth checked by the dentist to prevent infection

-Resourceful on pre and post transplant care

-Emotionally, mentally, physically and psychologically

prepared for the transplant operation

66

Post Transplant Operation

The success rate of transplant operation in

Malaysia is 90+ %, compatible to any part of the

world

-You will be back to normal

-No need to stick to Haemodialysis /CAPD schedule

-Sexual life

Can start 3 or 4 weeks post transplant operation

when the site of the wound is alright

77

Post Transplant Operation

-You will be placed in the Intensive Care Unit

-Transfer to a Single Occupant Quarantine Room for about

two weeks

-Follow closely to the heavy dosage of anti rejection

immunosuppressive drugs

e.g. Cyclosporine, Tacrolimus, Mycophenolate,

Prednisolone, Azathioprine (Imuran) Twice daily

-Hypertensive drugs e.g. amlodipine, Atenolol,

-Cholesterol drugs e.g. lovastatin

-Store medicine in cool and dry place away from children

- Be wary of the expiry date of the drugs

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Post Transplantation Operation

Medical Follow up with Kuala Lumpur Hospital

-Ultrasound or Computerized Topography (CT)

Scan

-Nuclear Magnetic Resonance (NMR), if necessary

Doctor will prescribe 2 to 3 months of medical leave

for you to recuperate after the transplant operation

99

Post Transplantation Operation

Medical Follow up with Kuala Lumpur Hospital

Blood Test

-Urea (1.7-8.3 mmol/l)

-Sodium (125-145 mmol/l)

-Potassium (3.5-5.0 mmol/l)

-Creatinine Level (65-122 mmol/l)

-Uric Acid ( Male 202-416 µmol/l)

Female 142-239 µmol/l)

-Urine Test ( Free of albumin)

(Source: Nephrology Department of Kuala Lumpur Hospital)

1010

Post Transplantation Operation

-Meet the Dietician

-Stay in touch with the Transplant Coordinator

-Observant of any bodily changes for the first six (6) months

caused by the immunosuppressive drugs

e.g. Cyclosporine will cause

-Moon Face

-Hairy body/ Ladies will start to grow moustache

-Pimples

-Will put on for a few kilos of bodily weight

-Temperamental/Emotional caused by Prednisolone

-Drink at least 3-5 litres of water during the initial

1111

Post Transplant Operation

Signs of graft rejection

-Fever

-Pain or swelling in the graft area

-Less urine output

-Report immediately to our “Holiday Resort”

-Creatinine level will increase from the normal

level to ≥ 200 mmol/l

1212

Post Transplant Operation

Three types of graft rejection

-Hyperacute rejection occurs within first 24

hours of transplantation

-Acute Rejections occurs first few weeks or

months after transplantation

-Chronic Rejection

1313

Post Transplant Operation

Administer of Medication for rejection

-Intravenous Methylprednisolone

-Change anti rejection drugs

e.g. FK506

-ATGAM/Thymoglobilin-Very costly drugs

10 – 14 injections

1414

Post Transplant Operation

Precautionary Measures to take

-Wear a face mask during the initial first 3 to 4 weeks

when going out

- Do not go to crowded places

-Keep away from pets

--Keep away from people who have a cough or fever

--Keep away from family members who have

chickenpox or measles

-No taking of herbs or direct sales stuff

-Don’t be your own doctor, i.e. subtracting the drugs

1515

How I look before and after Kidney Transplant OperationHow I look before and after Kidney Transplant Operation

Pre Kidney Transplant-1994

Hb 7+gm/dl

Post Kidney Transplant – 1999

Hb 13+gm/dl

1616

2142644519411900Creatinine

Jul 31Jul 30Jul 29Jul 28Jul 27Year 1996

1900

941

451

264214

0

200

400

600

800

1000

1200

1400

1600

1800

2000

'Jul 27 'Jul 28 'Jul 29 'Jul30 'Jul 31

My Creatinine Level Pre and Post Transplant Operation

1717

My Twin Brother-Mohd Azizi

Sharing the same organ donor (July 27, 1996)

June 10, 2000 May 27, 2009

1818

CONTROL YOUR DIET!!!

1919

My Twin Brother-Mohd Azizi

Sharing the same organ donor (July 27, 1996)

June 28, 2011

2020

My Post Transplantation Self CareMy Post Transplantation Self Care

2121

My Post Transplantation Self CareMy Post Transplantation Self Care

1. Regular medical follow up in Kuala Lumpur

Hospital

2. Look at life differently and positively

3. Consume more fibrous diets-lots of fresh fruits,

vegetables, and less meat

4. Exercise-brisk walking, badminton, wai-tan-

kung tai exercise

5. Drink about 3.0 liters of water daily

6. Non smoking or drinking

7. Leading an absolutely normal quality of life

2222

MBA GraduationMBA Graduation-- August 2, 1999August 2, 1999

Continue education to

enhance your market

values by returning to

university

With my mother at the

Universiti Putra

Malaysia

2323

Or…

-Start your own business so that you are

financially independent

e.g. Insurance agent, unit trust, will writing

-Start your own family

-Ladies need to discuss with the doctors should

they decide to conceive a child

2424

I am Grateful:

-Thankful to the donor family

-The doctors and medical staffs of

Kuala Lumpur Hospital

-My parents, my wife, my twins and

siblings

-Involve in Organ donation awareness

campaign

2525

Many organ recipients take things for

granted and never say a word of thanks

to the DONOR family !

The Transplant Coordinator got to

purchase a Thank You card as if it was

from the recipient and send to the donor

family as appreciative of their noble and

altruistic act of organ donation, the Gift

of Life!

2626

Don’t ever forget that….

No Donor=No Organ=No Transplant

2727

“You must give something to your fellow

men even if it’s a little thing, something

for which you get no pay but the privilege

of doing it”

Albert Schweitzer

2828

Chen Hoe Lee:

I'm so glad to see how healthy you two

are looking! Thanks for keeping me up to

date on your progress and on all the work

you do for transplant issues. My family is

so happy that my husband's kidneys have

served you so well!

Best wishes, Madge Bender

(May 28, 2009)

2929

Dear Chen:

I'm so pleased that we were able to make

your life and your "twin's" life longer

and happier. Your efforts to make

transplants more common and acceptable

in your country and your region are

commendable. Keep up the good work

and good luck with it!

Best, Madge Bender

(May 29, 2009)

3030

The Visionary Leader and Nephrologist

Dato Dr. Zaki Morad

Mohd Zaher

Senior Consultant

Nephrologist

Head of Nephrology

Department

Kuala Lumpur Hospital

1985 to 2006

NKF Kidney Walk-March 15, 2008

3131

Nephrologist

Dr. CC Tan

Consultant

Nephrologist

Head of Nephrology

Department

Hospital Tengku Ampuan

Rahimah

Klang

NKF Kidney Walk-March 15,2008

3232

July 24, 2010

3333

Had it not due my twins in giving me the

motivational inspiration to courageously drive

on plus a shower of medical care and touch

from Dato Dr. Zaki Morad, his team of

doctors and medical staff from the Nephrology

and Urology Department of Kuala Lumpur

Hospital to remain healthy to this day, it

would have been difficult to persevere for 19

years in seeing them through their education,

was the proudest moment and achievement of

my mission in life

3434

10th Anniversary

July 27, 2006

3535

Celebrating my 10Celebrating my 10thth Anniversary of Anniversary of

successful transplant operation with successful transplant operation with

medical staff and organ recipients of medical staff and organ recipients of

Kuala Lumpur HospitalKuala Lumpur Hospital

3636

15th Anniversary

June 28, 2011

With Datuk Dr. Ghazali-Consultant Nephrologist and

Head of Nephrology Department, Kuala Lumpur Hospital

3737

Dialyzing Nurses, Post Transplant Coordinators and Nephrologist

3838

NASA Kennedy Space CentreNASA Kennedy Space Centre

Epcot Centre FloridaEpcot Centre Florida--July 27, 2000July 27, 2000

3939

1. Carry more than enough medication that you need

during long distance travel or holidays

2. Carry your medicine prescription booklet with you

or a doctor’s letter stating your dosage in the event

there is immigration or custom checks

3. Carry two (2) sets of medicine - one set kept in the

check in luggage and another in hand luggage, or

ask travel partner to carry one (1) set

4. A list of Healthcare providers and contact nos.

5. Ask the doctors for a short supply of antibiotics,

e.g. diarrhea, nausea, giddiness

(Reference: Roche Pharmaceuticals)

4040

6. Drink your own boiled water and lots of it

7. Keep your watch at home time if you are traveling

to countries of different time zones

8. Carry your insurance card with you

9. Have your blood test check one (1) week or so before

your travel

10. Upon return, take a rest for a few days before

going for a blood test because you would be

dehydrated during travel.

11.Use sun block for out doors activities

- Our risks of contracting cancer is 5 x higher than

that of a normal person

4141

Green Ribbon Support AssociationGreen Ribbon Support Association

1. To promote and provide support, care

and counselling to patients who

have undergone transplant of organs

to return to lead normal life again in

the society.

2. To create awareness of major health

diseases leading to end stage organ

failure.

3. To improve donor rates in the country.

4242

Be There for the newly diagnosed patients-

Prof. Masuri Othman of UKM-Feb. 27, 2003

Ms Marzianna wanted to donate a kidney

to her 8 years old daughter-

December 5, 2009

4343

4th Malaysian Transplant Games-June 25, 2006

4444

4545

KAS-NKF-Rotary Dialysis Unit-

Kuching May 25, 2009

Bintulu Rotary Club-

October 31, 2008

March 11, 2011

Kota Kinabalu

4646

4747

4848

I always have these PICTURES in me whenever I

am out for Organ Donation Awareness Campaign

P-A burning passion and love for the job

I-Taking the initiative to strike a conversation on

Organ DonationC-Communicate in the simplest possible language

on the topic

T-Take time off from my appointments or work

U-Understand from the viewpoint of the other person

R-Research on the topic and responsible for my work

E-Enjoy the work and ever grateful being given a

chance in this noble act. Expect nothing in returnS-A sincere and supportive family and derive the

greatest satisfaction for the work done as it saves lives

4949

World Transplant Games-

Gold medalist in Badminton

1997-Sydney, Australia

1999-Budapest, Hungary

2001- Kobe, Japan

2003-Nancy, France

2005-City of London, Canada

Silver medal

2007-Bangkok

2009-Gold Coast, Australia

5050

What are the Financial Assistance?

1. SOCSO

• Must have made at least 24 contributions to SOCSO

• Below 55 years old

• Claimable for Invalidity Pension Scheme

• Claimable up to 50 to 65% of your maximum income

of RM 2,000 per month

• Dialysis is taken care of by SOCSO

2. Social Welfare Department

• Claimable up to RM 300 /month