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My Left Kidney

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Re: My Left Kidney

#191

Post by [deleted] »

fritzo wrote: post #166
mort96 wrote: post #117

This was an enjoyable read. The solution of giving people money to donate their kidneys is terrifying to me however. I do not like the thought of desperate people selling their internal organs to survive one bit. Of course, if inequality was dealt with and nobody was desperately poor, it would be a different question. If everyone had enough money to comfortably get by, and the extra $100,000 from a kidney donation wo…

What is it that makes "giving people money to donate their time " so much less repugnant? Is it that time is finely divisible, whereas kidneys come in twos?

[deleted]

Re: My Left Kidney

#192

Post by taylorius »

eru wrote: post #134
mort96 wrote: post #117

This was an enjoyable read. The solution of giving people money to donate their kidneys is terrifying to me however. I do not like the thought of desperate people selling their internal organs to survive one bit. Of course, if inequality was dealt with and nobody was desperately poor, it would be a different question. If everyone had enough money to comfortably get by, and the extra $100,000 from a kidney donation wo…

Iran allows paying compensation to kidney donors. You can study how they are doing. Hint: they don't have much of a wait list. > I do not like the thought of desperate people selling their internal organs to survive one bit. See https://en.wikipedia.org/wiki/Repugnant_market Do you prefer desperate people have fewer options? Especially, do you prefer taking options from people that they prefer to take?

You can justify anything with that argument, no matter how horrific. Why not permit people to allow themselves be killed in entertaining ways, for a pay per view audience, with their surviving family getting 80% of the proceeds? It's possible that that would be the most money they will ever "earn". Don't you want to give poor people as many options as possible?

Re: My Left Kidney

#193

Post by ryanbrunner »

DoreenMichele wrote: post #40

It's a good read. I enjoyed the data analysis and his snarky wit about a few things. I enjoyed him finding out he could apply to another hospital and doing it "out of spite." I know he wants to encourage you to donate a kidney. I still wish we tried harder to heal the "original equipment from the manufacturer" we are all born with. I have been on the record a long time with this opinion. I get a lot of hatred for it,…

We can do both. I don't think anyone who encourages kidney donation wouldn't also advocate for encouraging healthy lifestyles and slowing down the progression of acquired kidney disease.

I have a genetic disease that ends in kidney rejection 100% of the time, with no real way to prevent the progression of the disease. I'm healthy, exercise often, eat well. I've never been overweight or had the slightest whiff of hypertension, I run every day along with other exercise, and my kidneys still failed. Some percentage of kidney disease is going to be like me.

I will say one thing that absolutely should change is better screening for kidney disease. A lot of times it's discovered because blood testing from some other thing coincidentally found a low GFR or high creatinine levels, and even then something like a 60-70% GFR is often dismissed by doctors. Fortunately we discovered the gene that causes my family's disease, so in our case we can be screened via blood tests, but for kidney disease without such a simple genetic cause we shouldn't leave identification and diagnosis up to luck.

Re: My Left Kidney

#194

Post by sadtoot »

atleastoptimal wrote: post #159

Good for him. However I feel bad it seems like a misplaced sense of personal guilt over being an effective altruist compelled him to do this. Many empathetic people worry far much over the slight possibility they are a bad person even though they're miles away from one. Evil, psychopathic people never worry about being a bad person at all, and can sleep soundly even in perfect understanding of the deliberate sufferin…

there's a lot of suffering in the world, and it doesn't matter too much to me who's fault it is (in the case of kidney failure, is it anyone's fault?). for me, morality isn't about avoiding being evil, or being better than my peers, it's just about increasing the amount of good in the world; particularly doing so if it's not too costly or inconvenient to me

Re: My Left Kidney

#195

Post by taylorius »

fritzo wrote: post #166
mort96 wrote: post #117

This was an enjoyable read. The solution of giving people money to donate their kidneys is terrifying to me however. I do not like the thought of desperate people selling their internal organs to survive one bit. Of course, if inequality was dealt with and nobody was desperately poor, it would be a different question. If everyone had enough money to comfortably get by, and the extra $100,000 from a kidney donation wo…

What is it that makes "giving people money to donate their time " so much less repugnant? Is it that time is finely divisible, whereas kidneys come in twos?

Yes, I think it is that. Any such "time for cash" arrangement will have an end date, and can be terminated or renewed regularly. Whereas selling a kidney - once it's gone, it's gone. The transaction can't be repeated.

Re: My Left Kidney

#196

Post by ryanbrunner »

DoreenMichele wrote: post #180
bawolff wrote: post #179

Earlier quoted context omitted.

> I still wish we tried harder to heal the "original equipment from the manufacturer" we are all born with I mean, i don't think its for lack of trying.

I was bluntly told "People like you don't get well. Symptom management is the name of the game." I replied "It may be true that I will always be infected with something but this particular infection has to go as it's killing me." My doctor physically took a step back as if I had slapped him. I'm quite confident it's due to lack of trying. If you have zero goal of actually getting me better, please don't blame my cond…

You're both sort of wrong.

Solely symptom management should not be the recommended course of action for anything short of stage 5, and there is a ton you can do to slow or stop progression in the early stages, perhaps even avoiding the need for dialysis / tranplant altogether.

But as much as you say kidney disease "has to go", it won't. Reduced kidney function from chronic kidney disease is permanent, and no matter how hard you try, you're not getting to the point where your kidneys get better. You can only pause progression.

Re: My Left Kidney

#197

Post by ryanbrunner »

Waterluvian wrote: post #47

> The vast majority of donors, 98 to 99 percent, don’t have kidney failure later on. And those who do get bumped up to the top of the waiting list due to their donation. Can’t help but picture a roller coaster queue wrapping around the back of a hospital, and some guy is cutting the “Singles” line, defending himself from scowls with, “I’m not cutting! I’m just getting my kidney back!”

They're just making sure everyone has 2 kidneys before they give anyone a third. :)

Re: My Left Kidney

#198

Post by hcks »

The whole benefits of kidney donation to a stranger comes down to an effective donation of $10,000 using the same logic.

How is it effective when he could have probably raised 2 times that amount by working in place

Re: My Left Kidney

#199

Post by ryanbrunner »

caust1c wrote: post #53
Waterluvian wrote: post #47

> The vast majority of donors, 98 to 99 percent, don’t have kidney failure later on. And those who do get bumped up to the top of the waiting list due to their donation. Can’t help but picture a roller coaster queue wrapping around the back of a hospital, and some guy is cutting the “Singles” line, defending himself from scowls with, “I’m not cutting! I’m just getting my kidney back!”

Just imagining a surgery gone sideways situation and they just decide to trade the one still in with the one they just took out. (Not even sure this is an option, orientation and all, just imaging)

Transplanted kidneys generally go lower in your belly than your "native" kidneys and they aren't swapped, the original kidneys are left in and they add another. Anyone who's had a transplant most likely has 3 or even 4 kidneys inside them.

Re: My Left Kidney

#200

Post by JacobDotVI »

ryanbrunner wrote: post #181
matisseverduyn wrote: post #23

"But looking more closely at the increased deaths, they were mostly from autoimmune diseases that couldn’t plausibly be related to their donations." Kidneys make calcitriol. One kidney means you'll make less, and if you don't supplement, you'll become deficient. Deficiency would (possibly) lead to autoimmune diseases. Also EPO (erythropoietin). One kidney means less, and less (possibly) means fewer new red blood cell…

One small advantage of kidney donation is that it comes with lifetime screening without some of the gatekeeping normally attached to that. I dunno exactly how it works in the US, but here in Canada you can't just really demand blood tests purely for screening reasons, there needs to be a reason for it. But if you're a donor, your transplant clinic will insist on periodic screening both to monitor for GFR dropping as…

Some screenings have gone direct to consumer in the US. Fairly easy to purchase online, make an appointment, then show up for a quick collection.

https://www.ondemand.labcorp.com/

https://www.questhealth.com/sale

Quest is even running a sale right now on some tests!

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