Comfort Zones

We all have them. Those places and people that we know we can trust with our lives. They know us there. They support us and often literally keep us alive.

This is extremely true for transplant recipients. Our Transplant Centers are our Comfort Zones. for many of us, this is where we found the physicians that have ever been able to answer our questions about our diagnosis.  I remember my first trip to University of Pittsburgh. I searched 28 years for answers to what my diagnosis actually was, and the cause.  Then as if by magic, I was overwhelmed with answers ! And the Coordinators- oh my ! if all health care staff could be just like them.  They were caring , positive, and so friendly.

Great flash back... and you know, even now at a different transplant center, this remains true.  We as patients literally put our lives and well being into their hands. No other doctors office runs like these do.  We talk to a live person, we get call backs, we get answers AND we do not have to wait 48 hours!  Many times I have said, "I wish all offices could be like my center."

I am currently in a concerning dilemma.
I sense the chronic rejection/infection from my right lung has sneakily taken up residence in my left lung.  Now this devious organ has tried this before, many times.  We try to catch it early and make it move back home.  Let me give you a little history here. The right lung is from a double lung transplant almost 26 years ago (I know, Yay me !) while the left lung was re-transplanted at Shands Hospital almost 15 years ago (again Go Me !!). I am known for doing all possible to stay away from hospital admissions.

Through the years my transplant coordinator has always known that if I call and say there is an issue, we jump right on it.  We've shared many hospital admissions that took me years to get my strength and endurance back, and neither of us want a repeat.  Bette, happy and medically managed healthy is a wondrous thing to be !

I've noticed my cough ( part of right lung chronic rejection, and as Heddi would say "A real Bugger") has gotten more prominent. Pain in my right side tells me it's on the move. Pain on my left side screams "Get it out !"  My cough can be loose (preferably) or tight to the point of choking me (not fun). When you are woken up at 3AM choking and cannot get air in to make ANYTHING move- it is NOT a good thing. Both sides ache from muscles being strained to unbelievable levels. Been there. done that. Sadly it will happen again many times in my life.  My friends know, my biggest fear is suffocating, alone and no help.

This is where I am now.  Plus temperatures off and on  for the last 3 weeks.  Now comes the inevitable, walking across the room and I am struggling to breathe. This is NOT the Bette, who was walking and climbing in Maine just a few months ago ! This is NOT the Bette I want to be !
I coughed/ choked so long and hard on Sunday morning I went into A-Fib- today is Tuesday and I am still trying to get my heart rate back to normal.  I will, if not my cardiologist will bring me in and there is an IV that works - just an annoyance is all.

Now the real concern... There is not one physician or coordinator who remembers my past history. They are all NEW !  I was called in a prescription for Levacquin, 1 tablet a day for 7 days. Ha ! I laughed hysterically.. I know it has to be knocked out and fast. This infection will shore up the tower, bring out the seige enginges and merely enjoy the little attack on it's defenses. Plus, I cannot take it. Levacquin causes a prolonged QT wave in your heart. I already have that, plus it does not play nice with my heart medication Multaq. I had open heart surgery with the double lung transplant instead of a heart transplant as well.

I called up Monday and asked if there was availability for a Wednesday visit.  They were full & overbooked. Now, under different circumstances, this infection would have been long moved back to it's home with me being treated like we normally do.  Heavy duty antibiotics called in & if I don't feel better within 14 days, a visit to start IV meds.  I have repeated my history multiple times. I wonder if they are tired of hearing  "This is what Dr. Baz always did for me and it worked ?"  Maybe I should change it to Dr. Baz, Dr. Akindipe & Dr. Salgado ? In my defense, my previous physicians proved to me time and time again- they would keep me alive.  Those transplant coordinators deserve a universe of praise as well ! I admit, when I'm sick, I want to get well NOW.  I had all these transplants to embrace life and this is merely an interference with me getting on with life.
I guess what I'm saying is, after trial and error we found what works for me. I don't really want to go through trial and error again. Is it too much to ask, to have a physician who KNOWS me and a coordinator as well.

During this phone call, I spoke with Rita the transplant assistant. When I mentioned coming up, her response was, "You're one of our strongest patients, when you call we know you are serious." My response: "I know! right! You're the only one there who remotely remembers my history."  I did get an appointment, with a promise that I will be given nothing unless in conjunction with my Cardiologist approval. As long as he knows, and we are proactive, I'm OK with it.

My suggestion for hiring coordinators. Let's not look at qualifications, but more at longevity. My coordinator in Pittsburgh is still there 26 years later. How comforting that is. My original coordinator  at Shands, I had for many years & was heartbroken to lose her as well as my physician (happily married with gorgeous kids), but there was a long period of transition to Sonja. Sonja was moved to pre-transplant after a few years and I got Chad who after 2 visits took a promotion and I got Sherrie. I just barely knew her and she left. After a few talks with Ashley-Marie my new coordinator, she is trying her best to know me and be my advocate. I only hope she stays for a long time.. The foundation of my comfort zone has shaken just like out recent Hurricane. This appointment will be stressful as I fight for what I know I need from years of experience, as well as try to not bring up physicians of the past.

Safe to say, I will get through this. I am not ready to check out yet, even with continual coughing for 5 years and lack of sleep from said coughing.. This is still my life and I intend to check out when I am ready. My goal to be back in Maine next summer and walking those inclines again !  Oh, and the lobster and Haddock are a great enticement too   :)

Be safe... Be a Donor.... Lives depend on you .

October 23,1991

       It hardly seems that nineteen years have passed since one anonymous, caring family changed my life.
So many years have passed and I've experienced so many things I never thought possible, yet I remember this day as if it were yesterday......
       It was just past midnight on October 23,1991 when my mother woke me for a phone call. I should have known by the excitement in her eyes who the caller was. It was my pre-transplant coordinator from the University of Pittsburgh Medical Center (UPMC) telling me there were lungs available and I was # 1 to receive. I also knew that I could get there, and it be a "no go" meaning the lungs deteriorated too much in transport or were too damaged to transplant.
     It is because of this one day, I learned to  have more patience than the normal person should need, and survival. The survival part will be explained to you soon.
      I contacted my Air Ambulance company who had ben contracted to fly me to Pittsburgh from Jacksonville, Florida. They were under contract to have a plane waiting in Alabama for just such an emergency. They returned my call with the grim news that a plane would be arriving from Houston, TX. Now being an airline ops agent I knew this would not get me to UPMC in my allotted 4 hours.  I mentioned that after the pilots got there, fueled, checked the weather, did a pre-flight and a 2 hour trip to JAX I would not make the 4 hour window necessary. I could feel my chances slowly slipping away. I mentioned I would call UPMC for the OK.
      Upon calling and speaking with my coordinator he mentioned they had a plane sitting in Tampa that had just taken a patient back to the US Virgin Islands and it would be sent to me. Hurray!!!! I called the air ambulance back with the news and he was visibly upset. When he started asking when the arrival was and the tail number alarm bells began going off and I asked why he needed this info since he was no longer in the equasion. "Merely making sure all goes well for you." Yeah right. I advised him I was in aviation ops and all was fine but thanks anyway.
       We headed out for the private section (FBO) of the airport to await my "chariot". While we were sitting in the lobby 3 customs agents walked in and glanced my way. "alarm bells again" I mentioned : "They better not be looking for my plane!" Well it turns out, they were.  The plane landed and the medical staff came looking for me and customs reared it's ugly head. Seems they had a tip (did I mention those alarm bells from the air ambulance) that a medical plane was landing that had not cleared customs prior to arrival. The Captain told them he was in the US Virgin Islands, then West Palm Beach and finally Tampa before flying to JAX to get me. He even showed them the log book. Well those lovely customs officials demanded to take apart all the medical equipment onboard and inspect it. No way said the DR. onboard, 'These are needed to keep her alive prior to transplant." The pilot offered to let them fly to Pittsburgh -take apart all the equipment upon landing and then he would fly them back to JAX-no way.
         I was slowly watching my chance at life slip away.... I made a snap decision and asked for a quarter. "Why?" I'm calling channel four news, they'll get my plane in the air. Without being noticed I walked to a pay phone and called the news station. I explained that customs was holding up a "life flight" air ambulance on a bogus tip. When I was asked why I was calling, my reponse was "This is truly a matter of life and death-and it happens to be MINE!"  Within seconds a loud voice boomed over the customs walkie talkie "Who the hell called channel four!!!!" They all looked at me as I politely smiled and held up the phone receiver. walkie-talkie "Get that damned plane in the air!" Our plane was released (not without dirty looks) and I was finally on my way.
         The medical staff onboard were fantastic. Any need was immediately seen to and I was told to relax and enjoy the trip. Flying through those clouds on a dark night felt like I was flying to a new life and new adventure. That feeling is still with me today. Each day is a new adventure to be enjoyed with absolute relish and abandon.
         Due to the delays we got to Pittsburgh airport late. I was rushed to UPMC where the Dr's said they were cutting the time very close. I should have been on the table, old lungs out and waiting for my new ones by 5AM. I didn't arrive until 5AM.... As I lay on a gurney in the ER telling the staff jokes one of the Dr's. looked at me and said :"Well are you ready to go?" My eyes got as big as saucers, I smiled and asked, "So, it's a go?" "Yep, hurry up with that punch line before we put you under."

And thus my new life began.....

        It was not all cakes and punch, don't let me kid you. After being taken off the respirator I had to be placed back on due to fluid build up in my lungs. That is a story in itself if anyone cares for a laugh. I know a nurse who certainly isn't laughing to this day. When I woke up and realized I was back on the respirator (the bane of my existence) it had to be the most depressing day of my life! "Why did I do this?" Alarms started going off! Staff rushing around and entering the cubicle next  to me. The recipient next to me turned critical! Talk about an attitude adjustment. "I opened my eyes. looked to heaven, and said "Thank you God, I never meant to think that way!" "Just please don't let me have to be shocked with all these (49) staples in my chest".

     I was extubated in a few days and transferred to the lung transplant wing. Whew.... Getting closer to home.  I did suffer a severe rejection, but came out of it with my sat levels at 100% not to shabby for a girl who lived on 46% room air for most of her life. I was told that the new lungs were severely damaged in the accident, and I may have to be placed back on a respirator to wait for another "good" set of lungs. I thought,"no way-YOU don't now me very well."

       Yes I have learned alot and organ transplantation has made me the character I am today. But would I trade one single minute good or bad? Not at all.
So today please take a moment, look up to the sky and thank my anonymous donor for giving me a life I never dreamed possible. She was only 34 and from Lancaster, PA.
And if you aren't an organ/tissue donor please consider it. Don't wait until it affects you or your family personally. There is a family out there just like yours watching the life slowly ebb out of a loved one with a terminal diagnosis.


Share your life....Share your decision... Become an Organ Donor

A Blessed Weekend

   Well we are in the last day of National Donor Sabbath Weekend. I am also celebrating 7 years with my second lung transplant today. It was 7 years ago on a Friday morning when  my call came in. I had just returned from a trip to Shands in Gainesville and discussed my Advanced Directive, knowing I had minimal time left to live. The phone rang in the middle of the night.  You always get an ominous feeling when the phone rings at night. Something has happened, or a loved one is sick. 
     Somehow I knew this was my call. I was the one sick, but with Gods' blessing and Shands hospital this might change. I remember waking my parents who were visiting at the time and everyone seemed to launch into hyper-drive. Everyone that is, except me. I didn't have the energy, stamina or strength to try. As I watched my parents rush around to get ready for the 2.5 hour drive I began to have doubts. I knew my physical strength was gone, it'd been the longest 2 years of my life, and I wasn't sure I would make the surgery. I also didn't want to waste a precious lung on someone who might not make it, when the lung could go to someone with a better chance than me. As Mom came in to give me a hug (somehow she knew I was having doubts), I asked her if she thought I could make it. This was probably the first time but most definitely the last time my parents would see my resolve falter. I remember she looked at me with all the love in her eyes and said " You can make it through anything, you're strong".  Of course she'd say this, after all she's a mother. But , she was referring to my mental strength, while I was worried about my physical strength.
    I'd been through this before, but this time my endurance was nowhere near what it was in 1991. Chronic rejection is much worse than Pulmonary Hypertension could ever be. Chronic rejection  is tough to endure. It was the biggest test of life I have ever had to endure, and pray to never endure again. Though I know I will endure it at some point. I hope to make it as far in the future as humanly possible.
     While I was questioning myself, I remembered it was the start of National Donor Sabbath Weekend. Surely, this is a sign that this transplant was meant to be. With all my doubts I had to at least give it my best shot at success. So off to Gainesville we band of merry men started.
     The holding area was a beehive of activity. I was introduced to my surgeon Dr. Staples. Yes, this is his real name. I made the off the wall comment, " and you use staples right?" This was my way of releiving some tension. I then met his wife, so I now had Staples & Staples MD... Sounds kinda cool huh?  It was during the wait process I discovered he was concerned with doing my transplant because I had lost down to 90lbs.! Wow, and my scale said I was at 100 lbs. it had been difficult to keep weight on at this point, since I was using all my calories to breathe. I had long ago consciously made the choice between eating or breathing. breathing was mandatory- eating optional. Thankfully the decision was to go ahead with the transplant.
    So today, as they say 7 years later- the rest is history.

Remember : Be a Miracle in someone's life, Become an organ or tissue donor.