November 1, 2009

| March 9, 2010 | 0 Comments

Posted by Hiland on March 1, 2010

When Tampa General Hospital transplant coordinator Ann called at 11:32 p.m. November 1st, 2009,  I was lucky to hear my cell phone.

Her declaration that “we have your new heart,” stimulated a host of emotions, including an unexpected tinge of hesitation.  In my 25 months on the list, I had been called once before, to Columbia Presbyterian.  As I did not receive that heart, I knew that this time there was also the possibility that this heart was not for me.

I wanted to believe this was for real, but did not want to set myself up for another disappointment.  As my family was spread around the country, I certainly did not want them to start jumping through hoops without knowing this was going to happen.

“Can you check-in at the hospital in about an hour?  The surgery is scheduled for 3:00 a.m. The ER personnel will process you in and direct you to 8-K.”  Ann said.

“I’ll be there, Ann.  Thank you!”

Ann was serious.  The realization that Tampa General Hospital had procured an organ for my heart transplantation sparked so many physical, psychological and spiritual responses that I literally sat for ten minutes spinning through my preconceived “to do” list.

  • Bing  – for a ride?
  • Adrienne – for a ride?
  • Shower, shave
  • Pack reading materials, cell charger, reading glasses, underwear
  • Pack shaving materials
  • Call Suzy
  • Call Herb
  • Call Cari
  • Call John
  • Kids – not yet

It was a start.  It seemed prudent to know this was for real before pulling the trigger and setting in motion a chain reaction of airline tickets, lost work and vacated housing.  After all, the cavity size would have to be a match and there would be other considerations.

The staff would have to evaluate my mental and physical state.  The stakes are high.  Organs do not go to unfit, unwilling or non-compliant recipients.  A surprising number of waiting transplant patients change their minds at the last moment.  As a result, more than one recipient is usually summoned for the same organ.  To my surprise, this was not the case on November 1.

I busied myself psyching for a letdown.

I began to work my way through my punch list.  Despite the midnight hour, I called Bing for a ride.  No answer.  Adrienne, likewise.  The real world was bracing for the hard reality of Monday morning.  I decided to walk to the hospital.

So, to shower and shave.  That went pretty well, but the nerves were beginning to show.

I put on my lucky white shirt, some low cut socks, underwear and tried to decide between olive or beige shorts.  After packing, I decided it was time to put Suzanne on red alert.  She would not be able to catch the direct flight from Albany to Tampa before 12:30 p.m. November 2, 2009.

The important thing for Suzanne was to know the call had come.  There was a good chance and that I would call as soon as I knew it was a go. I suggested that she not notify all the kids until we knew for sure.

As always, Suzanne received the news with a rewarding hopefulness.  Since relocating, our time together had been sparse but tough decisions are part of the transplant commitment.

We were sure the good people at Southwest would make an accommodation for a late ticket.  Their direct flight from Albany would leave at 12:30 and arrive in Tampa at 3:30.  If the procedure took place, I would still be under the anesthesia.

I called my friends Annie and Herb, who boldly announced, “This is great!  Keep the faith, Doo!”  Herb does not leave a lot of room for indecision.  My spirits were lifted.

So, on with the sandals and away I charged to the elevator.  Arriving in the lobby, I checked my appearance only to discover I had not chosen either the olive or the beige shorts.  Back at my room, I donned the beige.

The hospital was close, but I had been in the hospital for five days the week before and I was experiencing some difficulty walking.   The adrenaline seemed to surge me through the ER doors.

On the way to the hospital, I called the consummate healer, my stepdaughter, Cari, who was resting along with grandson Matthew.  Next I called my friend and the first Albany cardiologist to save my life, John, who had overseen my open-heart surgery in 2000.  John did not blink.  He took the late night call with enthusiasm.  John has a calm way of rising to the occasion and boosting one’s spirits.

The ER people seemed puzzled that I had walked to the hospital.  They were also surprised that I did not have an intravenous feed.  We worked our way through the obstacles, but I had an uneasy feeling that a mistake had been made.  I had been on an intravenous feed for five days previously but had been discharged late on a Friday night..  In any case, I was soon away to 8-K via wheelchair.

On 8-k, Rose introduced herself as my nurse.  She conducted a preliminary check, took all the vitals, drew some blood, conducted a quick interview then asked about my mental state.  By this time, the activities had sparked a fair amount of nervous energy.

Rose seemed puzzled that I did not have a Primacor intravenous feed, from which I had been removed when I was discharged from the hospital on Friday.  The intravenous feed affected my wait list status.

Primacor is an inotrope and vasodilator that works by increasing the force with which the heart pumps blood through the body while widening the blood vessels and further facilitating the blood flow.  After my last three cauterizations, I had to stay for a few days to receive infusions and had realized almost immediate relief that eased the heart failure symptoms for a few weeks.

After meeting with Rose, I had the sinking feeling that a clerical error had been made.  I thought I was about to be sent home.  I called Suzanne.  She was calm but puzzled.  We both knew there was a possibility this heart would not be for me, but Rose asked if I was prepared to proceed.  I told her that I had waited a year and a half at Columbia before coming to Tampa more than six months ago.  Rose understood my readiness.

Rose inquired about my support network.  I explained that Suzanne would arrive Monday afternoon and stay until I was in a safe place and that Hiland, jr. was in Fort Myers, where he and Liz were expecting the arrival of Lily Doolittle any day.  Rose was satisfied that the wheels were turning.

The missing intravenous port seemed the only problem.  Without the Primacor, I was no longer a status 1B.  Rose informed Ann, the coordinator, of the confusion.

“Will I be going home?”  I asked.

“We’ll see.  Not if I can help it.  You are still scheduled for a 3:00 a.m. transplant.”  My hardworking heart was pumping away.

It was two hours before surgery.  I called Suzanne explaining the tenuous position.  Once again, the irony of the transplant process made it difficult to get mentally prepared for what I knew might be a tough journey.

That mental preparation is as important as the physical preparation.  As my heart had deteriorated, I was more able to control my mental state than my physical state.

Rose came back.  She was calm and oozing of confidence.  Her strength was reassuring.  She located a good vein, sank the IV anchor and tied it down.

When Ann arrived she notified us that she would have to call UNOS to notify them of my status change.  It was clear that UNOS would determine whether I would be going home or not.

Before Rose followed Ann to a landline, she instructed me to rest and assured me that the right thing would happen.  “You have waited a long time,” she said.

It was 2:00 a.m. November 2nd, 2009.  Surgery was scheduled in one hour and the organ needed to find a home pretty quickly.  I thought there was a time deadline and it was drawing near.  I was at the hospital and ready, catheter or not.

At 2:40, I called Suzanne again.  “I may be going home.  I’ll keep you posted.”  Before I hung up. Rose burst through the door.

“You are on for 3:00 a.m.  Lie down, go to whatever hiding place your mind goes and breathe.  This is real.”

I handed Rose the phone.  “Explain what’s happening to my wife, please.”

I lay down on the bed, crossed my hands across my lap, closed my eyes and gave the Lord’s Prayer one more chant.  I immediately fell asleep, at peace and quiet.

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