Not long ago, a week in the life of Clara Fiorini would include three days of kidney dialysis, trying to read the newspaper with failing eyesight, and a lot of sleep.
Fiorini, 60, of the community of Fork in northeast Baltimore County, knew something was terribly wrong.
"I knew I needed a transplant," she said this week.
Once doctors confirmed that Fiorini needed a kidney transplant because one of her kidneys was shriveled and the other was barely working, her husband, John, volunteered to give her one of his.
"Mr. Fiorini was determined from the get-go," said Jessica Wilson, transplant coordinator at the University of Maryland Medical Center. "Once he said that he was going to do it, no one could stop him."
To John Fiorini, 62, it just made sense. "I didn't think that it was fair for someone to wait eight or nine years on the list," he said. "It didn't bother me to take a kidney out."
But even with a willing donor, complications continued to haunt Clara Fiorini. "We were ready for a while for the transplant, but she kept getting sick," her husband said.
"We had some pulmonary concerns," said Dr. Stephen Bartlett, head of the medical center's division of transplantation. "She had a fair amount of fluid in her lungs, and it was difficult for her to lie flat, so we were kind of nervous about transplanting."
Doctors were able to drain some of the fluid. That helped with one hurdle, but the most serious one was still to come.
Despite taking powerful anti-rejection drugs, Fiorini had formed antibodies that would cause her body to reject her husband's kidney.
To control the condition, she underwent plasmapheresis, an experimental procedure that cleanses the blood of reactive antibodies.
The transplant took place July 6. John Fiorini went through a laparoscopic kidney removal. The laparoscope contains a miniature camera that allows surgeons to watch what they are doing on a video monitor. When the kidney is disconnected, they use their instruments to wrap it in a plastic bag and slide it out of the 2 1/2 -inch incision.
This surgery usually allows the donor to leave the hospital within two days and resume normal activities within two weeks.
Once John Fiorini, a retired bricklayer and hardware store owner, emerged from surgery, his only concern was for his wife of 41 years.
Karen Fiorini, one of the couple's three children, said that all her father could say was "I'm tickled pink" in a groggy voice.
A week after the surgery, the once pale, physically drained Clara Fiorini was smiling in her hospital room, marveling at how much better she felt.
"It doesn't seem real," she said. "It's a lot different than before."
"It's amazing to see the color in her face," her daughter added.
Now, thanks to her husband and the surgery, Fiorini can see better and can fill her days doing the things she enjoys most: needlepoint and reading the paper.
"I don't feel any different," John Fiorini said. "It was just something I had to do."