Guest Blog by Jason: Month 12...Surgery Time!

The year began with Niem and I having ramen together with the mutual hope that we would be a match for an improbable miracle. We’re now less than a week away from what then, seemed like a dream and now, could give him a new lease on life. It’s been touching and inspiring to see the support that our community has generated behind us and our families through this amazing journey.

I’ll admit that as the date draws near, nerves start to play a larger role than they did back in the “hopeful miracle days” of this process. Unannounced pangs of nausea shoot up and down my body simultaneously reaching my cranium and belly at the thought of being cut open and sewed back together.
I’ve always been a nervous wreck when I think of pain or hear stories of other’s painful experiences. It’s odd to be in a profession and reach a level in it that works to resolve some of the worst discomforts out there and yet, be so averse to hearing about them. It’s an irony that never escapes me.

I’ve come to reason, recently, that there’s no real way to prepare for pain that’s forecasted to take place in your body. You can’t exactly practice being in it and expect to get better at enduring it when its inflicted on you. Every time I bump my elbow on a drawer or get an oven burn, it hurts just as much as it has every previous time before that! I just don’t see a day that stubbing my toe on the fireplace bricks will be something I just smirk at and walk away from without nearly doubling over.

The dilemma I face is the unnecessary pain to my otherwise pain-free self. Not a choice I often opt for but Niem is one of my best friends and he means the world to me. When it comes to those I know and love, I feel obligated and blessed to contribute positively to their lives.

That doesn’t mean I haven’t taken a few trips down ‘sudden panic town.’ It’s happened on more than one occasion and the most helpful exercise, it turns out, has been to talk to others about the upcoming surgery and be open about my feelings. Everyone responds so well to the surprising news when I initially tell them and, after seeing my own enthusiasm for it, gives me warm-hearted support. The barista at Philz coffee will ask about the upcoming date as much as my co-workers will provide words of encouragement.

Melanie and I have loved involving our three daughters through this process and their welcome positive responses have been one of the most wonderful miracles we’ve experienced. The most challenging part is still on the horizon with the support they’ll need to handle the emotions of their papa being down and out for a little while. We’re doing our best to prepare them. I hope they can learn, as I have, that a miracle worth seeing through can start over sharing ramen with a friend.


Guest Post by Jason Garcia, Month 6

Six months of hospital visits, medical exams and many, many blood draws later and I’ve been 100% cleared to donate a kidney to my best friend, Niem! My hope for procuring him one was no further than an arm’s reach away all along :-)

The medical exams I passed these last few month were a chest X-ray, a psych eval and an MRI to decide which kidney they’re going to choose and map out a route to get to it. As it turns out, my lung water content is in balance, mental faculties are up to snuff and we’re going with the right one. After having my body’s health and inner workings scrutinized in more ways than I thought were possible these last six months, it’s satisfying to know it’s primed for the task of having a major organ removed from it to donate to a friend.

With over twenty-five years of friendship behind us and having shared in some of life’s greatest moments, I feel blessed to have the opportunity to be there for Niem. He is one of the most amazing human beings I know. There’s nothing more enjoyable than going to a concert with him, attending one of his family BBQ’s or just having dinner together. The fact that we’re a direct physiological match raises the question on whether friendship is tied to biology at a degree we have yet to fully understand.

Coincidentally, John Oliver covered a story on the history of dialysis in the US recently that details how Richard Nixon’s signing of a bill into law in 1972 committed our government to bear the expense of dialysis and kidney transplant surgeries that’s quite intriguing. As Oliver put it, “Essentially, we have universal health care in this country for one organ in the body!”

It’s because of this that our pre-examinations are paid for by Niem’s insurance as much as yours would be, which also covers the cost of the surgeries and follow-up visits. What’s not covered are my family’s expenses from the 4 - 6 weeks off of work I have to take to recover from the surgical procedure. Being the sole provider for a family that consists of three adorable little girls and a wife who started nurse practitioner school this year puts me in a position that I have to raise those funds on my own. I’m reaching out to my friends, family, and community to please show your support by donating to my fundraising campaign in order to cover those expenses.

Our surgery date is set for December 20th of this year, and outside of securing my family’s financial needs, all I’ll have remaining is to prepare my body for the physical undertaking ahead of me. As my nurse coordinator simply put it “the less there is to cut through, the easier it’s going to be for you.” Thank you for your support, thoughts, and prayers!

If you’re interested in donating to Jason Garcia’s fundraising campaign, please visit his Gofundme page at to make a contribution. Your generosity is appreciated and will go a long way in making this miracle a reality! If you want to read about Jason’s journey through the testing you can visit his posts on my blog at


Guest Post by Jason Garcia, Month 3

In many ways, it is the job of the kidney donation nurse coordinator to try to rule you out as a candidate. Enduring major surgery under general anesthesia to remove a major organ requires that the medical staff test your health and suitability in every possible way. Being supremely healthy is an absolute requirement.

So far, I’ve had to be a blood type match, have my glucose levels, blood pressure and cholesterol checked, pass an ultrasound screening of my kidneys and bladder, share enough antigens and be a cellular match with Niem to get to my big test day at Stanford. This is a medical evaluation which includes a 24-hour urine collection, blood draw, second urine sample, meetings with the nurse coordinator, doctor, social worker, and EKG and chest x-rays.

The big test day was scheduled for a Wednesday, but in reality, it started a day earlier. I had to collect all of my urine into a medical-grade container for 24 hours. It was also recommended that I drink at least eight glasses of water during the collection period, so I had to make sure to be extra hydrated.

The least conspicuous bag to carry the urine container turned out to be our kid-friendly pink and gray cold-insulated tote bag. Besides that challenge, it wasn't too difficult to manage collecting my day's output. That is, until I realized I had already filled 3/4 of the jug after just six hours.

What doubles as a medical-grade container when in the middle of your workday? A large water bottle of course, but should it be a liter or a gallon? I went with my most doctor-y hunch and opted for the latter, so as not to have to repeat the procedure. Somehow, I managed to also squeeze it into the tote bag, along with the three ice packs I kept in there. In case you’re wondering, I have a deep love for Niem and as much as you might be cringing at hearing this story, I can tell you that it takes the sort of commitment you’d have for a close family member to get through this whole process.

I was at Stanford’s medical facility by 9AM and went right in to drop off the jugs. I got a little smile when the nurse looked at my makeshift medi-vessel and she commented that it was a good choice. First, I had to pee into a cup and then I had a record twelve vials of blood drawn! I did surprisingly well and even chatted with the phlebotomist, but I felt a little woozy as soon as she put the gauze and tape on my arm. A deep, sharp, but short-lived pain panged at the bend of my elbow. It cleared up pretty quickly but felt like a rather ominous start to my test day.

Melanie arrived just in time for our meeting with the nurse coordinator at 10AM with Lily, our five-year-old, following close behind. After putting on a movie for Lily, we dove right into all of the details that a surgical candidate must sign off on. Marilyn, my nurse coordinator, covered everything there is to know about the pre-op prep, surgery, post-op, follow-up appointments, possible risks, probable outcomes, long-term effects, and answered every question we had. It was reassuring to see that every detail was discussed openly and professionally, while all along making it clear that I could walk away from the whole thing at any time.

As we wrapped up that first meeting with Marilyn, I started feeling those two bananas I had after my blood draw were probably not enough to hold me over. It was all I had eaten since my dinner eighteen hours ago when I started my fast for the blood draw. I tried eating a few bites of a ham and cheese croissant sandwich I brought before the doctor walked in, but it wasn’t too tasty. I asked Melanie if she had some ibuprofen because I was starting to get a mild headache, and managed to pop them in before the nephrologist came in.

He said he usually only met with the patient, but was okay with my wife and daughter being there for a few minutes. I could sense his discomfort. But, as soon as Melanie asked some questions, he answered them to her satisfaction. Unbeknownst to everyone, I had told Mel, who’s been a physical therapy assistant in hospitals and recently was accepted into UCSF’s nurse practitioner program, the doctors would have to pass her litmus test, or this donation was a no-go for me.

Once Mel and Lily left, the doctor seemed more in his comfort zone and covered more details about the surgical procedure. He said he didn’t anticipate any issues with my health that needed managing. He did recommend that I get my BMI (Body Mass Index) below 30%. Marilyn had already made that clear when she told me I was at 30.9% and said, “The less there is to cut through, the easier it’ll be for you and the surgeon.” That was just about the nicest way I’ve been asked to lose weight, I must say.

After the doctor left, the social worker came in. She focused on the more social/psychological/practical part of the donation. She asked questions like: “If after you donated the kidney, you were to experience kidney failure, how would that make you feel?” She was a breath of fresh air from all the medical talk and really seemed to hone in on the more important day-to-day things involved in recovering from major surgery. Melanie had a chance to come in and ask plenty of questions. By the end, I really felt the social worker had my family’s best interest at heart.

It was about 1:15PM when we ended our meeting with the staff and I was to go upstairs for the EKG and chest x-ray. I said goodbye to Mel and Lily and felt like we really had things going for us. That is, until I made my way up to the second floor.That mild headache started turning into a medium one. Then, as soon as I checked in and walked into the testing room, I started to break out into a cold sweat. The nurse asked if I was okay and I said I felt nauseated and just started getting a headache. She connected the electrodes quickly, as I began to perspire all over. I thought I was going to pass out, but the test was quick and she had me up and drinking water before you knew it.

She connected me to a couple of monitors and said “Your vitals are fine.” We concluded rather quickly that it was my lack of food that was probably to blame. I had two bananas in twenty hours, had to hydrate extra which probably lowered my electrolytes, had twelve vials of blood drawn and had taken ibuprofen on an empty stomach. As soon as I made it out of the EKG lab, I booked it to the bathroom and puked. It was puppies and rainbows an hour ago and now it felt like the sky had been parted by a hail of thunder and rain.

I didn’t know what to do because I couldn’t think straight while I was lying on the floor of the bathroom trying to prop myself up. The headache was head splitting at this point and I managed to make my way down to Marilyn’s office. The social worker happen to be walking by at that moment and could tell I wasn’t well. Marilyn was not in so she grabbed another nurse. I tried to eat some crackers, but couldn’t manage to open the wrapper.

The nurse took me back and brought me some apple juice. The same nephrologist came in to see me and also concluded it was the lack of fuel. I then asked where I could vomit and he pointed to the sink next to him. I only barely made it there, as he pulled the curtain to cover himself.

Ten minutes after lying on the bed, I went out to the lobby where I began to feel a little better. All I wanted to do was sleep and/or be out in the sun which was beaming through the windows.

The nurse didn't advise it, but said she couldn’t stop me. I went out and immediately started feeling better. The color started to come back into my face and I could actually sit and think about what to do next. I decided to text my friend Omar, who worked nearby, to come and pick me up so that I wouldn’t have to be alone for this. A different nurse called me to see if I was alright, and I said I was doing much better. I was afraid this would somehow affect my candidacy as a donor and was going to go back for the chest x-ray, but she said that it was no big deal and I could do it at another time.

I drove with Omar and spent the night at his place. We had a great evening catching up and looking at amazing photos of his trip to Cuba. I called and left a message with Marilyn at 7 the next morning and she left me one, too, saying that these things happen and that they had enough info on me to make a final decision on my candidacy the next Tuesday.

That Tuesday couldn’t come soon enough. I got a call from her while I was at my daughters' school picking them up. She told me I passed all of the exams and I qualified to be a direct donor to Niem! All that remained was to go in for the chest x-ray and a mandatory psych eval for non-blood relatives. A pre-op MRI is required to map out how they’re going to remove my kidney, but all looks good for a December surgery date.

Tears quietly streamed down my cheeks and I thank her for everything she’s done. I immediately called Niem and didn’t care that it’s the middle of his workday or that I’m surrounded by parents and kids going about their business, because after I shared the news with him, for a moment, time stood still for us and we could feel we were part of something bigger than ourselves.

There have been two times in my life I’ve been so sure about something that I decided all I could do was record its unfolding. The day after I went on my first date with Melanie, I went out and bought a journal to document our first twenty-five dates. Likewise, when I started on this kidney donation journey with Niem, I started to journal it in this blog, because when there’s no question something is meant to happen, all you can do is embrace it and be grateful you’re a part of it.

Guest Post by Jason Garcia, Week 8

Yes, I know Week 8 doesn’t come after Week 5, but it took a few extra weeks to get those lab results from my last blood draw to determine if Niem and I match antigens to move on to one of the final tests, the Crossmatch test. It’s been a challenging waiting period because we had picked up so much momentum early on with each passing week. In between, however, Melanie and I celebrated Lily’s fifth birthday and Amelia’s seventh as well as seeing Kylie perform a song in front of the whole school. Ironically, Melanie is also playing the waiting game after interviewing for UCSF’s nurse practitioner master’s degree program.

Recently, I’ve researched and run multiple scenarios in my head on all the possibilities that being a kidney donor would bring. The information is out there with things like the 1% risk of mild bleeding as a result of the surgery, adhesion build up sensitivity, high blood pressure, protein in my urine, hernias, organ impairment and stitches coming apart. All are possible outcomes that I don’t think anyone would willingly volunteer to put themselves at risk if they had the choice.

I know the others in our close group of friends wouldn’t want to put themselves at risk either but a couple have already been ruled out as candidates for one of the many, many reasons you can be and one is in the middle of testing now. We’re just like that with each other. When I asked Niem to help me with some artwork I needed done some months back, he didn’t quote me a price. He asked what I needed, when I needed it and how it is he could best help and he did. Our group of friends wants to know the What, When and How on ways to be there for each other, not the Why.

On Tuesday, I noticed I missed a voicemail from a nurse I hadn’t talked to before in the process of transferring over to a new phone. I called her back the next morning while I was at work and she tells me we’re a good antigen match! If that wasn’t good news enough, she also says they conducted the crossmatch test which is a stronger determining factor on whether we’re actually a match or not. It’s negative! That’s a good thing in medical crossmatching lingo. It turns out my kidney can go directly into NIem because his cells didn’t reject mine under the microscope.

I was at a loss for words and the reality of what she was telling me took a second to sink in. Maybe I shouldn’t have called in the middle of my workday while I’m waiting for a client was my next immediate thought. Tears began welling up and I didn’t know what to say. “So, what’s the next step” I ask, but inside I’m also thinking they just saved me from having to have my blood drawn one last time by doing the crossmatch test at the same time as the antigen test. Yay!

She then tells me about the next step, which includes meeting with the surgeon, transplant coordinator, nurse and social worker. Also, a few more tests like an EKG, chest x-ray, a quite unique sounding test that I pee into a cup at some interval time for a whole day. Fortunately, my client walked in as she was explaining that last test to me. Only one big news a day is my general rule.

I did manage to schedule that appointment for March 8th before we ended the call. I agreed to call her in the next few days to find out more details about what’s involved for that half day of testing and any preparatory steps I need to take as is occasionally the case. I squeeze in a text to Niem that I’ll be calling him at 9:50 and go greet my client. I call him at 9:48 and relay the news. We’re both speechless, but still attempt to form sentences yet, inside, we know what the other is feeling.

What can you say? The chances of my kidney being able to go into Niem’s body was in the low single digits but to me it was signed, sealed and delivered. We agree to call each other later because it’s the middle of the workday and blessings like this should only be conversed about after work hours. I call my wife and close friends and give them the good news. Collectively, we all breath a sigh of relief knowing there are still a few hurdles to get through.

Hours after all of this, Melanie tells me the amazing news that she got into UCSF’s nurse practitioner program! Blessings all around and reasons to celebrate which for our family means ice cream parlor visits. An NP specializing in geriatric care is what she’ll be going to study. Looks like I’m building my own post-op health team from the ground up here.

The next day, I ask Niem if I can call his mom and dad which I’ve known for twenty-five years and have a high respect and love for. He texts me their number and I call them. His mom picks up and knows the news of course. We share a few tears and connect the way parents do. I learned a lot from the little things I saw her do and the big sacrifices they made for Niem and his siblings. Not many words are exchanged but our feelings are expressed well.

There are many steps and hurdles that we still have to get through to make this happen but for now NIem and I will be going through this together with our friends and family. I mean, isn’t that the way things are suppose to be?

Guest Post by Jason Garcia - Week 5

After an ultrasound revealed that I have two kidneys and that they’re in relatively good health last week, the testing to see if I’m a match to donate one to Niem seems to have gotten more specific to see if I match his physiology. As a matter of fact, the next test is known as the tissue typing/compatibility test and will give us a clearer insight into whether my particular cellular make-up matches Niem’s enough to be accepted by his body, and not reject the organ.

Before scheduling the test, I had an opportunity to attend an informational meeting with Niem and Linda, Niem’s girlfriend, on kidney donation sponsored by UCSF with a surgeon as a guest speaker. I was excited to be able to ask questions Melanie and I had been wondering about and to hear more details about the actual surgery.

It was great to be there to support Niem and try and be a well-informed donor, but these meetings are not a joyous affair. Niem didn’t look like most of the people attending because many were visibly ill or quite compromised in their health. I wondered if it was because of their need for a kidney. It felt like Niem, Linda and I were in our own little bubble of hope because we had each other.

As the surgeon spoke, he detailed much of what I already knew, but it was nice to hear how routine the surgeries were. They’ve done thousands of these with success and he showed us some great statistics on it. The thing he stressed most in his presentation is how everyone should make their best effort to find a living donor. It gives you an immediate access to a kidney without being on a waitlist, and the percentage of surgical success as well as the lifetime of the kidney are much higher with living donors than cadaver donations.

The other members of his staff included a living donor and transplant coordinator. They shared a few stories of random people who stepped forward and donated one. There was someone’s mailman who did, and a teacher who did for their student, for no other reason than because they could. Most of the questions from attendees revolved around how they could move themselves up their donor list, or go to one that had a shorter waitlist. It was heartbreaking to hear their stories.

I asked about the histocompatibility process for a donor and they explained that there were ten antigens, not six as I had previously thought, that we each possess. After I find out how many I match to Niem, if any, there’s one last test that would remain. We have to literally take a drop of blood from each of us and put them in a slide and see if his cells reject any of mine under a microscope. To think that after everything's said and done that it comes down to whether Niem’s cells and mine get along is incredible. If our friendship is any indication, I think they will.

Everyone had a chance to ask them questions after the presentation and I made sure to cover my bases on the things I was curious about. I was especially interested in speaking to the living donor coordinator. It turns out that I qualify for disability for the surgery recovery period of 4 - 6 weeks! Melanie was brilliant enough to suggest I ask. This one detail sets a lot into place for us not having to worry as much on the financial end of it, because this would cover half of it.

After the weekend’s presentation, I learn that it’s kosher to talk to my coordinator on timelines since there was a story or two on the subject. I tell Rachel that if Melanie gets into UCSF’s nurse practitioner school, I’ll need to have fully recovered from the surgery by June to take over full care of my daughters. She responds positively and says she will inform the nursing team so that they can try and quicken the testing pace once they receive the package back that they’re going to FedEx to me. I’m happy to hear the news.

After getting off the phone, I think to myself, “Did she just say she was going to FedEx me a package?” Two days later that package arrives and the box in the envelope reads “Donor Tissue Typing Kit.” Okay, this just got turned up a notch...was I going to have to draw my own blood here? As I opened the styrofoam package, six empty glass vials lay inside. Fortunately, the letter said to take it to a LabCorp near me to draw the blood. Phew...but six vials of blood is twice as many as I’ve ever had taken out of me at one time! Time for a new PR.

I decide not to make an appointment this time and just to show up to a location I haven’t been to before since walk-ins are welcome. I’m there when they open at 7:00, and I’m the fifth one in line. When they call my name, I hand over the box and the receptionist smiles at how well organized everything is. “Stanford really makes it easy for us to do the testing since they provide everything for us.” It turns out the vials have a anticoagulant to keep it intact on its Fedex trip back.

The blood draw is a breeze, but does take an extra minute to fill all of those vials. The lab handles the package and gives it to the FedEx folks and I’m done. The letter I received from Rachel said it would be 2 - 4 weeks to get the results on this one, but I’m hoping my call will shorten that time. After talking to Niem, I find out they already have his antigens. That night I have a dream of Niem and I dancing like we did when we were in high school. I hope it’s a sign of how our cells will do once they’re on that petri dish dancefloor.

Guest Post by Jason Garcia - Week 4

After a month of being in the process of looking to donate a kidney, I’d have to say the most important thing is to be patient. Everyone has been amazing thus far and things have moved as they should, but there’s nothing like that feeling of wanting to help now. Since the great relief of last week’s revelation that my glucose levels aren’t off and that I’m not pre-diabetic, I was able to visit Stanford to have my kidneys looked at more closely.


It’s actually the first time I’ve been to Stanford. Their name is on the insurance provider for this, and not a third-party clinic for my testing. If you haven’t been there before, you’re in for a treat. First off, the scheduling was easy and I got the exact time I was hoping for. This test is an ultrasound designed to confirm that I, (A) have two kidneys, and (B) they’re healthy enough to run things on their own.


I remember attending at least one ultrasound with my wife when we were pregnant with each of our daughters. It was a little odd trying to connect to the image on the screen when it’s tough to know what you’re even looking at. I recall having to force a smile, because you’re supposed to say they look cute and all, but I wasn’t feeling it, since it looked more like a Rorschach blotch than a human baby.


I’ve got to say, you know you’re somewhere special when there’s valet parking. I arrived a little early to the surprise of someone parking my car for me! I checked myself in and only waited fifteen minutes before being called in. I had to wear the standard patient garb with the open back, but I only had to loosen my pants and not go full birthday suit which I appreciated. It was funny being on this end of the ultrasound where Melanie was during our visits to the hospital.


The image specialist squirted the warm gel on my lower abdomen, and started pressing a wand that looked like a store checkout handheld scanner below my belly button. I didn’t have to fast for this test, but I did have to drink three glasses of water an hour before. It felt like she zeroed in on my bladder, because I was feeling the pressure begin to make me clench. She actually was looking for my bladder and said it looked good, and the water was designed to expand it to see inside. She then mercifully suggested I go to the bathroom, because the kidneys didn’t require a full bladder to examine.


The day before the exam, I was able to sit down and read a great comic book on chronic kidney disease with my nine year old daughter that explained the kidney’s function extremely well. Niem had given it to me and I thought it would be a good way to get her to understand what he’s going through and why I’m looking into being a donor. It was amazing and really did a great job explaining it in a way that she could understand and connect to. Medikids, which is written by doctors, is a must if you have children, and you want to find an easy way to talk to them about CKD.


Once I came back from the most relieving relieving I’ve ever had, we looked into my kidneys. I had to prop myself at an angle while laying down, so she could wave the wand at an angle, since they’re in the back of your mid-section. At first, I thought I was pregnant, because I thought I saw a face, but it turned out to be my liver. We confirmed I had two kidneys and that they looked healthy. Unlike the previous tests, the results are immediate and I can walk away satisfied knowing I passed. In total, I’m there no more than forty minutes and I walk over to the valet and I’m in my car heading over to Philz coffee to meet Niem for dinner at Coconuts Caribbean.


I update him on the great news of the health of my kidneys. I then share with him that I’ve learned from Rachel about the order of the testing that’s remaining. This is after first giving blood to find out my blood type and overall health, which revealed possible elevated glucose levels. Then giving blood twice in the Fasting Blood Glucose test which revealed they were normal and belongs in the category of the asterisk you see at the bottom in case you were wondering.

1.      Psychosocial phone screening

2.      Histocompatibility

3.      Donor Evaluation (meet with MD, SW and RN, and routine labs/urine including 24 hour urine collection, CXR, EKG)

4.      Psychiatry Consultation

5.      MR Abdomen

6.      Surgical Evaluation


*However, if any of the above is abnormal, further testing or evaluation may be necessary prior to proceeding with the next step.


As you can see, there are still a few steps to go. As Niem and I look at the list, we see that they’re of course designed to make sure that all of the factors that can be controlled are looked into deeply. This is not brain surgery, but it is organ surgery, so I need to feel reassured that the pace of the process is by design. Everything must be evaluated, checked in on and tested twice if need be because surgery is an involved thing.

I look forward to Rachel’s phone call next week on the next step.

Guest Post by Jason Garcia - Week 3

Well, here I am three weeks into my search for whether I can donate a kidney to Niem and things quickly turned a corner when I found out that I might be pre-diabetic last week. Nice to be finding out before it’s actual diabetes, but I certainly don’t want this to turn into a pre-diabetes blog here anytime soon.

As before, the third-party test center made it easy to schedule a convenient appointment time near me. This more official Fasting Blood Glucose test required a twelve-hour fast, so that my system would be free of any calories or sugar for the test that would determine if I’m pre-diabetic, or only have glucose levels on the higher side of normal. If I’m pre-diabetic, then the kidney donation is a no-go and if I’m not, then I just need to take some time to improve my health and I could move onto the kidney health and tissue typing stage. Neither is good news for making my kidney available to Niem now, but the former is more troubling because I know enough about diabetes to know it’s not good news.

I had my four-year-old daughter, Lily, with me for this test, so we loaded up on toys and activities for the two-hour test. The clinic was in a nice residential neighborhood and seemed out-of-place yet serene somehow. Checking in was a breeze and they got me in quickly. Lily was by my side the whole time and provided me with good support for the needle I was about to endure. It wasn’t so difficult this time and they only needed one small vial. I then had five minutes to finish a sweet, orangey drink that went down easily, albeit with some jitters from the sugar rush.

We had to wait in the lobby and not leave the clinic, so as to not spend any of that glucose. That might lead to a false reading from burning the sugar. Unlike the previous glucose test, also known as a random or casual glucose test, this one is pretty damn accurate. In two hours, they would take out another small vial of blood to see what the spike in glucose levels is like, and determine which of the two I am. It would also set a PR for the amount of needles I’ve had inserted into me in a two-hour period.

As I played Shopkins line-up with Lily, I looked at her and wondered about her own health and unforeseen medical situations that could come up like this for her or my other two girls. She might be one of the many people who lives a perfectly healthy life with only one kidney. People can go with only one and never even know it. Our overall anatomy and the conditions we come down with can often be so random that you almost want to say you luck out not to be in a situation where you’re in need of an organ or come down with some fatal illness.

Lily, herself, was in a situation when she was seven weeks old in which she came down with double pneumonia in which her life hung by a thread. The care of some amazing doctors, nurses and many small miracles came together to get her through her near two weeks in the PICU. Melanie and I truly learned the humility that random illness can bring and our own friends and family were there when we needed them most. Blessings come in many shapes and sizes and the one Niem is in need of is in the shape of a ginormous bean.

The more I read about the safety of living as a kidney donor, the more I am reassured that this is a safe option for me and my family. Minor risks are present and the actual surgery is a big deal, but I know there will be caring people that would be there for me if this ever became a reality.

Once I’m in the back office awaiting the phlebotomist, I’m not so worried about the needle and tell Lily she can wait outside if wants. She came in to support me anyways.

I get a call from Rachel on Friday, which happens to be the day of Lily’s fifth birthday and the day Melanie has her interview for UCSF’s Nurse Practitioner Master’s program. She says I’m not pre-diabetic! She also adds that this more accurate glucose test revealed that I’m within the normal healthy range and can move on to the next phase of testing!

I’m beside myself and immediately call Niem with the great news. We rejoice for a moment on being able to continue on our path and no sooner do I get off the phone with him then I get a text from Melanie telling me her interview went really well. On this day that our new president is sworn into office, it seems that some things can still go right.

Guest Post by Jason Garcia - Week 2

I’m not a big fan of needles. After moving on to the blood and urine test phase to check in on my overall health for Niem’s possible kidney donation, I knew one would be involved. I’ve learned to look the other way and not think about it, which usually works for me.

It was easy to set up my appointment online by clicking the link Rachel sent me for a convenient appointment time right near my work. The place had a health-clinic-meets-a-nice-office-space feel to it and they first asked for my insurance. I wasn’t sure how to answer since it wasn’t my own that was covering this. After the receptionist got my order number from the computer, she said, “Oh, don’t worry about it, Mr. Garcia. It looks like everything is paid for and being taken care of.” There’s something special about involving others in the process, so I told her I was doing it to see if I could be a kidney donor. She was very sweet in her response and then handed me a cup to pee in.

As I sat and waited for the phlebotomist/nurse, I thought about Niem and what he’s going through. As I’ve looked into being a donor, a lot of emotions have run through my mind ranging from joy over the possibility that this could help extend his life, and sadness over the reality of what it means. It’s gotten me more in touch with a part of life I’ve never had to face much in my forty years. The illness of a close friend.

Dialysis is deceiving because there’s not much that tells you someone’s even on it. There’s the obvious tube that comes out of their abdomen, but that’s usually under their clothes. In this last year since Niem started receiving daily home treatments, outside of questions of whether overnight trips will have a power source for his portable dialysis unit, there have been no outward signs he’s got much of anything going on.

Once they call me in for the inevitable stabbing and extraction, I hang on to the thought of why I’m doing this, which eases my nerves. I tell the phlebotomist-nurse-possessor-of-the-needle I’m not a big fan of them and that I just survived my blood being drawn at Kaiser recently. He says they suck at drawing blood there, and he’d rather do it himself than go there. I laugh and feel a little more relaxed. I look the other way as he does a little wiggly move with his finger that distracts me from the initial poke. I notice that he takes a little longer than at Kaiser, so with the added time I decide to brave it and look at the needle in my arm! My heart starts racing and I get a little warm, but I don’t pass out.

After he puts the customary gauze and tape on me, I see he’s holding three vials of blood. I ask if those are all mine. He says yes. I’m shocked because they had only taken one at Kaiser, and he didn’t take that much longer than they did, but they only took one vial! I ask if he had to attach each tube separately into the needle because I didn’t feel a thing. He nods yes. I compliment him and feel satisfied in having worked with someone with samurai needle skills.

Four days later, I receive the news from Rachel that my glucose levels came in slightly elevated and that they need to do another test to see if I’m pre-diabetic or if it’s just that I have elevated glucose levels. After the heartbreak set in of potentially not qualifying to be a donor, the fear of possibly being pre-diabetic quickly set in. I’ve had blood drawn from my own health insurance provider twice in the last year and never once did I even get an email telling me I should come in and take another test. The best they did is tell me I had glucose levels on the higher side of normal, but that they still were within normal range. Well thank goodness I’m looking to donate a kidney or else I might never look to find this out.

Rachel informs me of the next step, which is to set up a glucose stress test that would take two hours to determine if I’m pre-diabetic, or have glucose levels on the higher side of normal. If I’m pre-diabetic, I can’t be a donor because diabetes can lead to kidney failure. If it’s the latter, then I’d have to lose some weight and regulate my glucose levels to qualify to be a donor.

I call and schedule it for next week and, oh yeah, Niem’s Cigna Health Insurance is covering this, too.

I call Niem and we decide to meet for dinner in a couple days. It’s actually the first time I have face-to-face time with him since I started this process. I’m immediately reminded of why I’m so happy to be doing it. I know some people say that donating a kidney is a selfless act, but as I sit there laughing with my friend and enjoying life for what it’s meant to be enjoyed for, I can’t help but think that it’s actually a little selfish. I want to live my old days with him and talk about how we got through this hurdle and the next one that comes our way. In life, we need friends, and if it’s selfish to want to keep them around as long as possible, then so be it.

I look forward to next week’s test. Whatever the news, I will be grateful to have found out now and taken the measures to lead a healthier life. Ironically, in my efforts to help Niem, he’s already helped me more than I could have imagined..


Guest Post by Jason Garcia - Week 1

I'm a week into my journey of finding out if I'm a possible kidney donor candidate and so far, I'm still in the running. I figured the first thing we needed to know is if my blood type is a match to Niem’s B positive, so I called Kaiser and it turns out they don't have a record of it! Isn't this basic, important information my medical provider should have? God forbid I'm in a terrible life threatening situation where I'm in need of a blood transfusion because they're going to need to take four hours to find that out.

I went to get blood drawn and it turns out I’m O positive and a possible match! After this great news, I decide to get started with the official donor application process. Niem sends me a link to fill out a standard info and health history questionnaire which takes just twenty minutes. At the end, I check off the times I’m available to talk to a representative who’s suppose to call me.

Monday 11:00 am rolls around and I get a call from Rachel, a living donor intake coordinator with Stanford Health Care, confirming they received my information. Wow, that's the exact time I checked off on the application! These people are really on top of their stuff. She sends me a thirty minute video to watch with a husband and wife that’s going through the process of donating a kidney for his brother. I decide to ask Rachel about the chances of being a match and she tells me that most donors aren’t usually a complete match. Hmmm, I don’t know what that means but that's kind of encouraging to hear.

IgA Nephropathy is the name of the condition and the video does a great job in answering a lot of my questions. You know, like what the surgery entails, the recovery, the chances of dying and stuff like that. I hate to be so blunt, but the number one question on anyone’s mind looking to donate an organ must be what the chances of dying are, aren’t they? I’m relieved to hear that it’s as safe as standard appendix removal surgery and other possible risks are there, too, but are quite low. Phew, thank goodness!

After the video, more questions come to mind like time off of work from the 4 - 6 week recovery period after the surgery. This brings up the fact that this could be a financial burden on the welfare of my family with that much time off of work. It’s the more real side of trying to gift an organ to extend someone’s life which seems mundane, yet poses a greater risk to not making this a possibility for someone in need of a kidney. I’m happy to learn that the entire cost of everything involved is taken up by the insurance of the organ recipient. I’ve got to imagine it’s what makes this whole thing possible for donors looking to make this a reality for someone they love.

Rachel called me at the end of the week and said I passed the initial screening questionnaire! I can move on to have my blood drawn and urine sample to check in on my overall health and the health of my kidneys. I’m crossing my fingers that all those salmon dinners and arugula salads the last many years really did keep me as healthy as I'd hoped they would.

Guest Post by Jason Garcia - Week 0

Happy New Year, everyone! My friend Jason has kindly written about his experiences looking into being a possible living donor candidate. I am blessed to have him explore this for me, and wanted to share his thoughts with you.

Earlier this year, Niem started nightly dialysis treatments because his kidneys are failing. I've been a massage therapist for the past twenty years dedicating my life to helping those around me and the truth is I don't even know what the name of his condition is because I'm afraid. All these years he's been dealing with it I felt he'd find a way to solve it or slow it down enough that it wouldn't come to this but that never happened. Now that he's almost a year into his routine of receiving truck sized deliveries of dialysis fluid and we've all become accustomed to seeing him leave our get togethers early so he can be home for the nine plus hour blood cleansing, I've decided it's time I look into what I can do to help my friend.

I've known kidney donation is that magic bullet that can turn someone's life around because I've seen those movies that usually star Ryan Gosling or Julia Roberts. The truth is that it can be 4 - 5 years of being on a wait list to even move up the list to possibly get lucky at finding a donor that matches you. I'm not too encouraged by hearing that and movies don't usually go on that long for us to see that happy ending.

For years I've thought that matching a donor’s kidney to someone in need of one is like matching a tri-states lottery numbers but I decided to look into it anyways just in case I'm holding that golden ticket. For someone whose favorite movies usually star zombies or Bruce Campbell, I'm quite squeamish about real blood, surgeries or anything involving someone being in pain. Maybe that's why I'm in the business of helping others get out of it and as I think about the possibility of being a donor, I can't help to think about this prospect.

Niem and the other five of my core friends that I met while I was a sophomore in high school are uncles to my three daughters and they mean the world to me. I don't know what this journey of finding out if I'm a donor candidate will entail but I feel blessed to be starting. When I look back a few years from now, I want to know that I did everything I could to extend his life. It's amazing that we live in a time where this is even possible. After asking a few medical professionals I work with, I've come to find out curiously that there aren't any other organs you can look to donate like the kidney. This is looking a little more promising...