Category: Pre-Transplant Clinic Visits

Every month, I go to the Methodist University Transplant Clinic to have my p.r.a. (percent reactive antibody) blood test performed.  I go the first week of every month and this month my beautiful gingersnap joined me at the clinic.  Every time I have my blood drawn for this test, I distract myself from the the needle by singing the oh so appropriate song “Match Maker” from Fiddler On The Roof in my head.

The purpose of the p.r.a. blood test is to ascertain if I have been exposed to new foreign tissues and if I have developed antibodies to them.  If I have, then the donor organ must match those antibodies.  As these antibodies can change frequently, the test must be performed monthly as well as immediately prior to the transplant surgery.

Along with the p.r.a. test, many other factors must match before a donor organ can be matched and hopefully a successful transplant performed.  Our blood types must match and the donor’s height and weight must be approximately the same as mine.  After those are matched,  our tissues must match.  This can vary greatly depending upon if the transplant recipient has had miscarriages, pregnancies, blood transfusions, previous surgeries or previous transplants.  If the recipient has had any or all of these things, they are what is called “sensitized” and can be difficult to match.

Unfortunately for me, I am sensitized.  From what I understand, I am a hard one to match.  Sometimes being unique isn’t good.  Ha Ha!  When it comes to medical conditions, you just want to be a middle of the pack, run of the mill kind of case.  Because of the difficulty in matching a suitable organ to me, I could possibly be on the pancreas transplant waiting list quite a long time…or I could get the call tomorrow.  Who knows?

 

 

Today was a very busy day.  Richard and I got the kiddos to school by 8:15 and then scurried home out of the rain for a hurriedly consumed breakfast. We bolted from home (more like lurched) at 8:45 to make a 9:00a.m. routine follow-up with my gastroenterologist to discuss how my cystic fibrosis is doing.  Richard and I left their East Memphis office, had a quick bite to eat, and then zoomed across town to Methodist University Hospital Transplant Clinic for a 1:00p.m. appointment with an early 12:30p.m. check-in.

We met the surgical fellow, surgeon, nurse coordinator, social worker, and dietitian and of course the phlebotomist vampires had to have their 7 vials of blood.  Over the next 3 hours (yes, I said hours) we discussed at length the actual logistics and mechanics of how the pancreas transplant would be performed.  It is really quite fascinating if you look at it from an engineering standpoint.  The surgeon was extremely kind, compassionate, and went to great lengths to answer any questions that Richard and I had.  He said from his point of view, that he is an advocate for me and for the pancreas transplantation.  He assured me that he would argue on my behalf at the upcoming Transplant Board of Doctors meeting this Friday morning at 8:00a.m.

All in all, it was a reassuring clinic visit and my last one before I am officially listed for a pancreas transplant on Friday, March 2.  Watch for updates!

It just so happens that on the day that the entire world is sharing love and hearts, my heart received some much needed love and approval from the cardiologist.

Let me back up a bit. I checked into Methodist University Hospital on Monday morning to have some cardiology diagnostic tests performed for the transplant. The transplant doctors need to be sure that my heart and cardiovascular system are healthy enough for the surgery. I got to the hospital at about 8:00a.m. after having fasted since the previous evening. I spent the next 6 and 1/2 hours going through one grueling test after another. They wouldn’t have been so bad if I had been allowed to eat or at least drink water, but that would have marred the results.

My first test was to be a stress test performed in Nuclear Medicine with radioactive isotope thalium tracer injected into an i.v. in my arm but that had to be postponed until late morning. The tech could not get an i.v. into my arm because my veins are too small and extremely scarred from years of hospitalizations. He sent me to radiology so that the tech in the CT Scan lab could use doppler to find a deeper vein for an i.v. The radiology tech was able to get an i.v. placed and successfully performed a ct scan with contrast.

I then was shuttled off for a chest x-ray. I left radiology with my still functioning i.v. and headed back to nuclear medicine. I was able to have my stress test performed. I finally went to the transplant clinic lab where 13 vials of blood were sucked out of my veins like Dracula after a Lenten fast. Seriously, who knew that much blood could be taken? Don’t forget, by this time it was 2:30 in the afternoon, and I hadn’t eaten or drunk anything since about 11:00p.m. the previous night.

Armed with all of those test results from Monday, I met with the cardiologist to review the results today. We did the do-si-do and he cleared me for surgery. I have no pancreas at all, but a healthy heart. Happy Valentine’s Day to me!!!

Also, don’t forget it is National Organ Donor Day!

The transplant board of doctors said, “Yes!” I had been waiting for 2 weeks on pins and needles, anxiously awaiting the green light from my transplant nurse coordinator at Methodist University Hospital.  Let me just say, the wait was made more nerve-racking by  dealing with three 8 year old stir-crazy kids.  The inclement weather had also brought an unexpected vacation for the bambinos by way of 6 consecutive snow days.  I was to receive word of the decision on Friday, January 12, but the snow and ice Memphis received delayed the decision until the 19th.

The board meets every Friday morning and reviews all of the patients that have completed the medical evaluation portion of the transplant process.  They review the test results and vote approved, deferred, or denied.  The board decided to review my case before medical evaluation to decide if my medical conditions would bar me from having a pancreas transplant and save me the trouble of further testing if their answer was to be a denial.

I am happy to say that they agreed with my nephrologist’s conclusion that I am in urgent need of a pancreas transplant and that I am a good candidate as well.  Yay!

I am so thrilled and terrified at the same time. My stomach is churning. Yikes!

My husband and I attended the transplant education seminar today.  We learned some pretty interesting information about what to expect during the transplant process.  The transplant team did a great job of detailing how the potential transplant recipients would be evaluated for an organ transplant to determine if we are physically capable of having the surgery and whether the potential recipient was actually in need of a transplant.

We learned about how we would be placed on the organ waiting list and the various lists that we could activate once initially listed.  We were educated on the protocol of how we will be notified of a donor match and organ availability.

We heard from a nutritionist regarding the importance of maintaining a healthy lifestyle both prior and post transplant.  A quick aside, I cannot stress enough the absolute high priority importance of eating well and excercise. We have to take care of the bodily functions and organs that we still have. We also must take care of the precious gift of life, this incredible organ that we have been given.  We cannot treat it as a renewable resource and be careless with it.

We listened intently to the pharmacist as she went over the medications that we would take, the reasons for the medications, and the absolute Golden Rule – Do Not Stop Taking Your Medications!!!  Message received pharmacist with the voice like Minnie Mouse.

Finally, we were educated on the costs of our new lives. We gravely nodded and diligently noted just what this gift would demand from us financially.  It is a sobering and macabre experience to learn exactly what your life is worth.