Wakonda father will give precious gift Tom Logue of Wakonda enjoys a lighter moment with his daughters (from left) Alexis, 8; Alison, nearly 3; and Abby,1. Tom will give a kidney to Abby in what was an incredibly quick location of a compatible donor. by Randy Dockendorf While most children ask for a bedtime story or glass of water, Abby Logue has a different bedtime ritual.
Tom and Angie Logue of Wakonda don't just tuck in their year-old daughter � they also hook her up to a dialysis machine.
Abby suffers from renal failure, and doctors at Mayo Clinic in Rochester, MN, have determined she needs an immediate kidney transplant.
The search for a donor can be long and excruciating, and face incredible odds. But unlike many patients who must wait months or years, Abby found her match immediately � and right in her own house. After two days of extensive testing at Mayo Clinic, physicians determined Oct. 13 that Tom � a 39-year-old farmer � was a compatible kidney donor for his tiny daughter.
Tom said the news meant Abby became much closer to sustaining her life.
"I always hoped it would be me. I always hoped she would get one of (my kidneys)," Tom said. "I was relieved when I heard the news. Our search was over."
Abby must weigh 18 pounds before the doctors will perform the transplant. In mid-November, she weighed 17 pounds, and the Logues continue to monitor her weight daily. "Along with increased feedings, nutritionists have added a carbohydrate/fat supplement to Abby's formula to help her put on weight," Angie said. "We hope, by late December or early January, Abby will have gained enough weight to have the kidney transplant."
A routine ultrasound during Angie's 32nd week of pregnancy showed Abby had fused kidneys, resulting in one horseshoe-shaped kidney. However, the Logues remained hopeful Abby would enjoy the normal health of older daughters Alexis, now 8, and Alison, now nearly 3 years old.
"But we saw changes in December and January," Angie said. "Then we went to Mayo Clinic at Rochester, MN, in February to see a pediatric nephrologist, who is a kidney specialist for children."
The Logues learned their baby would likely need a kidney transplant some day. But when?
"The doctor said Abby might be 4 years old or 84 years old when she needs a transplant," Angie said.
Abby's condition worsened earlier this year when she contracted Rotovirus, a viral infection which causes diarrhea. The family noticed she was not regaining her normal appetite. "She was weak. She didn't have the energy to do anything," Angie said.
On April 23, Abby received a feeding tube in her nose. The Logues monitored her daily intake and weight, finding little success stimulating her appetite. Last summer, the Logues were surprised to learn the reason for Abby's problems. Mayo Clinic physicians diagnosed June 24 that renal failure was causing Abby's lack of appetite, and she needed a kidney transplant.
Tom stepped forward for testing as a possible donor. He underwent a battery of tests, including blood type and tissue match.
"I never realized all the things that the kidney does for you, besides removing waste," Tom said. The other kidney functions include fluid control, regulation of blood pressure, control of the body's water and chemical balance, and filtering waste products from the blood.
The transplant will be complicated by the location of Tom and Abby in separate Rochester hospitals. Tom will undergo laproscopic removal of his kidney at Methodist Hospital. The kidney will be transported by ambulance to St. Mary's Children's Hospital, where Abby will be prepared for surgery and receive the kidney.
"They usually don't remove
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the recipient's kidney, but they will take out Abby's kidney and replace it with mine," Tom said. "The doctors said my kidney will shrink to fit Abby's body, then will grow to normal size as she becomes an adult."
After the surgery, Tom will remain in the hospital for two or three days, while Abby will remain hospitalized for five to eight days. The Logues will then remain in Rochester for four to six weeks of daily lab work. The family plans to stay at the Ronald McDonald House, if possible.
"There is always a chance that Abby will reject the kidney. She will be on anti-rejection drugs for the rest of her life," Angie said.
As she waits for the transplant, Abby undergoes peritoneal dialysis every day for 10 hours.
"Abby usually gets overnight dialysis, from 8 p.m. to 6 or 7 a.m.," Angie said. "I can take her off the machine before I go to work at the University of South Dakota in Vermillion. My mom, Eleanor Knutson, comes to our house during the day to watch Abby because she can't go to daycare."
In addition to dialysis, Abby had a porta cath put completely under the skin. A tube leads to a major vein, which protects the vein and is less painful because it results in fewer, smaller needle sticks, Angie said. Abby continues to be fed with the nasogastric (NG) tube but takes about 6 to 8 ounces from a bottle during the day. She also receives dressing changes every other day.
The daily ritual includes weighing Abby and taking her blood pressure and temperature. Those who handle Abby during her dialysis and other health procedures must practice extensive scrubbing as part of the hygiene measures. One inadvertent touch of a surface means washing all over again. Abby continues to receive tender loving care from all members of the family, including her young sisters. In fact, Alexis and Alison dogpiled onto Tom and Abby when they posed for a picture. Abby's illness has apparently given Alexis a dose of maturity far beyond her years, Angie said.
"Alexis is older, so she knows what is going on and wants to help whenever she can," her mother said. Despite the daily struggles, Abby has not lost her ability to have fun. During this visit, Abby played with her ducks, toys and Barney. She showed particular enjoyment biting her pink toy bunny.
"It stinks that this had to happen, but life goes on," Angie said. "A kidney transplant is a big deal, but it could be a lot worse. We take life for granted. It shows how lucky you are." The Logues have received a tremendous outpouring of support, from Angie's colleagues at USD to neighbors who help Tom with hay, crops and livestock.
"People have been really wonderful, and we appreciate that support," Angie said.
The Logues prefer to focus on the future, particularly the arrival of springtime.
"Hopefully, by Jan. 15, we will be all done with recovery. Tom will be ready for spring planting and hay work," Angie said.
The Logues said they realize the transplant will not provide a lifetime solution.
"The longest living kidney donation lasted 39 years, and the average is 15 to 18 years. We want Abby to get through high school (before her next transplant)," Tom said. Tom said the transplant has already created a stronger bond with his daughter. "We are very close already, and I feel this makes us even closer," he said.
While the future remains uncertain, Angie said she remains grateful for each day. "Together, Tom and I made a life," she said. "I carried Abby nine months and then delivered her. Now, her dad has given her life."