April 26, 2012

A more sober transplant seminar

Yesterday I attended another transplant seminar.  There was very little information in it that was new to me, though there were a few tidbits.  I don't think the first speaker, one of the post-tx nurses, was very into it, but the PA who followed her was very lively!  I remember him from before. (I can't conjure his name at the moment, sorry.)  He's the one who shows off the teddy bear and how you hug it to cough immediately after the surgery. 

Anyway, as enthusiastic as he was, I felt very sober in this meeting.  The morning before, I had been skimming through Facebook and saw a post by a CF friend that one of her CF friends, Savannah Wood, had passed away.  I followed the profile link.  There wasn't much on her wall, but there was enough to construct a story from.  She'd been transplanted in September of last year and was apparently doing pretty good, but had chronic rejection - and that ultimately got her.

We talked about rejection at the seminar.  Mostly, the professionals reviewed what the grades and kinds of rejection are and what biopsy results mean.  (An A0, B0 is great.)  They discussed what steps can be taken to treat rejection.  But they didn't mention that some rejection doesn't respond.  They didn't explicitly put it out there that sometimes, rejection gets the upper hand and you die.  (One could argue that given enough time, this is true in 100% of transplant cases, perhaps.)

At the same time, I was also thinking about my friend Jerry Cahill, who at this very moment is lying on the transplant floor, having gotten the call Thursday.  I presume he's doing well, as he is sporadically updating his Facebook.  Now Jerry and I are no longer in the same boat.  He's moved on to the next boat.  Still tricky, still many medical problems - perhaps more.

The PA put up a picture of another recently transplanted patient on the screen, or at least that guy's incision.  This, too, brought to mind Savannah, as one of the pictures still on her wall is of her incision and chest tube holes perhaps two weeks post-tx, replete with several dozen staples (88? like a baseball?) and freshly sutured chest tube wounds.

It's all very sobering.  This is going to actually happen!  Theory will, at some unspecified point in the future, become reality.  And most sobering is my knowledge that not all things end well for the patient.  I cannot forget Richard, who passed away about six years ago and whose funeral I attended in Oklahoma.  He got transplanted, but never left the hospital.  To be sure, there are many among my network who have done exceedingly well post-tx, such as Piper Beatty.  I pin my hopes on those success stories; but I am a realist.

Don't misunderstand me; I'm not afraid.  But the timing is crucial.  The doctors know that; I know that.  But chance, god, fate - whatever you want to call it - does not know that.

Goodbye, Savannah; you are missed. Breathe easy.  Good luck, Jerry; I'm hoping you'll be the textbook-perfect case.  Because I need that good example.

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