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The Transplant Experience

“You are about three days from dead” said Dr Laurence Mc Bride as he helped me back in bed after my journey of three feeble steps across the hospital room.

Mayo Clinic in Jacksonville Florida was to be the venue for my subsequent journey of nine months. A journey back to health with a change of heart.

Having experiencing a variety of cardiac difficulties since my early 20's, I had had the good fortune to be in the right place and medical science had evolved apace of my needs. Most of the help I received involved some form of sharp stainless steel, physical therapy and medication. The skills of physicians and advances in treatments afforded me a generally normal lifestyle.

And then there came failure. A bungled attempt at a second multi vessel bypass left me in worse condition than at any previous time. Congestive Heart Failure (CHF as termed) is a condition where the muscle of the heart is incapable of pumping a sufficient blood supply for one to maintain normal activity. There are various degrees of this affliction, but it is a progressively wasting disease that evinces mortality in generally 2 to 5 years.

Well I spent about a year in and out of the hospital on almost a monthly basis, receiving treatment for increasingly aggressive circulation failures.

My last remembered ambulance trip to the local ER featured a gurney ride down a long corridor as I heard the PA speaker call out a code blue. I wondered who it was and then realized it was probably me.

“PERCHANCE he for whom this bell tolls may be so ill as that he knows not it tolls for him.. ...and therefore never send to know for whom the bell tolls; it tolls for thee.” J.Donne It is strange the things that come to mind under duress, perhaps it is a defense. However in the treatment room with all the medical people, machinery and monitors, I watched with a semi conscious interest. I watched till one of the monitors went very flat, the cardiologist broke into a sweat and came at me with a very long needle, syringe and paddles. I decided to go to sleep. I woke several days later in Mayo Clinic and met the good Dr. McBride and the above cited dialog.

McBride continued by stating that he could offer me a heart transplant, I was presently not strong enough to survive that operation but they would affix to my exterior chest wall something called a Bi-Vad or a bilateral ventricular assist device, (a mechanical heart). With proper exercise and therapy I might regain enough strength to survive the transplant process. He continued that this would be the hardest experience of my previous or subsequent life. Did I want to continue? And. Why did I want to do that? Good tough questions presented in a concerned but firm manner, and directed as a screening process to evaluate candidates likely to cooperate and succeed.

My response to those questions came with difficulty and emotion. My thoughts ran to ….everyone wants to continue, the survival instinct, there are things done that probably be better redone, things undone that needed attention. I am as tough as the task. I am too young to die. why me? It's not fair!

My only spoken and remembered response was to point to a recent snapshot on the bedside table. “Those are my grandsons fishing. I was suppose to be there. I want to be there next time.” He smiled and said OK.

So I cooperated during the next day's twelve hour operation which succeeded in implanting and attaching the Bi-Vad. When I awoke I noticed that this intimate device was accompanied by a 600 pound, not so intimate control machine about the size of a refrigerator. We were all roommates for about a week when a smaller unit, disguised as a roll about suitcase was substituted. That constant companion accompanied me in all events. From the four times daily walks and machine exercises provided by the occupational and physical therapists through semi sleepless nights, the little poka-poka machine was always there and though somewhat inconvenient was my lifeline.

After three in patient and impatient months, on December 12^th 2002 to be exact, I received a letter from Dr. Daniel Yip, who was my attending medical cardiologist. I had been deemed by the transplant team to be of sufficient strength to undergo the rigors of cardiac transplant.

I was thereby placed in category A on the national registry transplant waiting list or UNOS.

United Network for Organ Sharing (UNOS) is the private, non-profit organization that manages the nation's organ transplant system under contract with the federal government. Currently they list about 110,000 people waiting for transplants and 12,000 Donors. (January through October 2010). So if you please, donate life. See http://www.unos.org/

While the waiting time can be lengthly, I was policy prioritized due to being on essential life support. The priority for any recipient is also affected by the particular geographic region, the population dynamics, donor commitments and the activity of local civic donor procurement organizations. Jacksonville, Florida is uniquely fortunate in benefiting from the best ranking in all these areas.

My wait was short. Doctor Yip called me late on the evening of January 7, 2003. “We have a heart for you. Will you accept it?” Well that was apparently a required formality. Of course I accepted.

After midnight another 12 hour surgery was started. I woke a day later with the poka-poka machine gone and a 21 year old heart was beating in my 64 year old body. Life was back, life was good.

The transplant was a success, the patient thankful, the doctors pleased and proud. The long road of recovery began. Most transplant patients recover swiftly, I however somehow managed to be different. I remember waking one morning and counting the tubes and wires going in out of my body. Thirteen, was that an ominous number? Unfortunately one of those tubes carried a fungal infection into my system and populated a large region of my thoracic area. This was an extremely critical condition. Well the good Doctors at Mayo, consulted, investigated and came up with a treatment plan. It was to me a strange and somewhat desperate plan, with what I found out later, had little statistical chance of success.

Every second morning for three weeks I was returned to the operating theater to be opened up and washed out to remove the fungal infection and attempt to prevent regrowth. Additionally a recently developed anti-fungal medication, specific for my type of infection had been released. This added feature provided the healing victory. As the medical literature indicates, I was the first known person with that particular post cardiac form of infection to survive. Once again everyone was pleased, thankful and proud.

I was and am so thankful for the help of my wife during all these trials. She lived in local lodging and maintained all the tasks of our normal lives while being the caregiver to my needs. She endured the wait and watching during many critical periods. She kept the faith and kept my spirits alive. My daughter helped with her visits and support. She was mother to our faithful dog who suddenly had his life dislocated. The many friends and relatives who provided support were also an important part of the healing process.

For myself, I am still, after many years in a state of wonderment.

I am now entering my ninth year of wonderment. Why did I survive, why did that young man sign a donor card, why did I get to Mayo Clinic, which in my experience is a most unique place? Why was I taken care of by such a wonderful group of caring nurses, physicians and therapists?

Why did Doctor Laurence McBride, the surgeon who invented the Bi-Vad, started three transplant centers, save my life and hundreds of others, die the day before this past Thanksgiving. Why did he die of sudden cardiac arrest, in the presence of other physicians who were unable to save him?

Why did I survive? Perhaps to tell you this story, perhaps to encourage you to sign a donor card.

Perhaps, to try to tell you of the possibility of hope, perhaps to encourage you to “Look the Tiger in the Eye” in times of pain fear and discontent. Perhaps to remind you to have hope. Hope Floats.

Peter