Posts Tagged ‘liver transplant’

Four years and still not dead

Sunday, August 8th, 2010

“A transplant patient with an autoimmune disease? That’s impossible!”

–from an episode of House

I just passed the fourth anniversary of my transplant, or as I prefer to spin it, my fourth new birthday. When the count of years starts getting out of hand, it’s nice to have an alternative, even if it costs an organ.

A scan of my not-so-new liver was tumor-free and the annual draining of the blood showed my various counts lingering near acceptable ranges – acceptable for me if for nobody else. It seems I’m good to go for a while longer.

My hepatologist is brilliant: I could not be in better hands. But even she’s a bit mystified at my continued presence. Oh, she’d probably deny it, but I’ve seen her expression during the bad times, I’ve parsed her careful choice of words. My continued presence is a continuing wonder.

(more…)

About all that health stuff…

Tuesday, February 23rd, 2010

I’ve got this deal going – in my head anyway – with the Three Fates. The Greeks called them Clotho, Lachesis and Atropos, and they spin out, measure, and in the end cut the thread of our lives. We are literally in their hands.

My deal is, I get to stay alive for some unspecified number of moments after the liver cancer and transplant. I get to be conscious, occasionally functional, and once in a while I even get to thrive. I also get to experience each and every sensation of a body running down its weave.

I’ve started and not finished a dozen posts on my health trials of the past year. One did refer to my struggle last summer just to learn that I’ve comedown two impossible–for-a-transplantee autoimmune diseases, but that’s it. I feel guilt for not having posted more. (more…)

Medical system FAIL

Wednesday, August 26th, 2009

This happened yesterday. The only info you need to make sense of it are a) I was in the hospital for a few days about two weeks ago due to high fevers following an endoscopy (a look down the throat), and b) when they were looking, the docs saw something that concerned them,  declaring it Must Be Removed. I agreed. Now if only I could get it done…

Rather than polish it up and risk losing the, er, spontaneity, here’s the eMail I wrote to my friends.

Went to ENT (Ear/Nose/Throat) clinic today to get the thingy in my throat removed. The following happened:

1. Doc saw me, said situation is exactly what the docs in the hospital had said two weeks ago: growth on pharynx, probably papilloma, needs to come out. Said he’ll do an excisional (right word?) biopsy removing the whole thing (unless it extends into my brain or some other inconvenient spot). I said hooray for that! (more…)

Happy 58th birthday! Uh… hold on… better make that “85th”

Friday, July 10th, 2009

There has got to be a maximum number of diseases and disasters, conditions and catastrophes that one human body can handle before it just gives up and dives for the worms.

Surely two life-killing viruses, cancer, a liver transplant and all their attending “issues” is enough for one existence. You think?

Guess not.

This past month I’ve entered the brave new world of autoimmune disease. A couple of choices present themselves: one is called dermatomyositis, which is tthe operative definition at the moment, and it is NOT your friend. If you must read up, here’s a link, but don’t go there if you’re the least bit susceptible to internet-based too-much-medical-info-itis. My other option is graft versus host disease – GVHD in the jargon. This happens when a bit of the donor’s immune system gets into the recipient’s during transplant, and apparently requires (in non-marrow transplants, anyway) the recipient to have a weak immune system. Congrats, me! I win again!

The next doc who says to me, “Oh, but the odds are so small that such a thing will happen!” gets taken down. (more…)

Three years and counting… count.

Tuesday, March 10th, 2009

Today I sat in the courtyard by the Nurses’ building at UCSF talking to someone whose partner lay in a room above us on Nine Long, the liver transplant floor of Moffitt Hospital, waiting, suffering, hoping for a new liver that might save his life. The man I was talking to was distraught, grasping at hope as loved ones and caregivers do coping with such suffering. I offered what I could, listening and answering his questions. 

He asked a lot of questions. As his partner in that hospital room had said a few minutes earlier, meeting someone who has actually been through the craziness of a transplant is more helpful than reading medical abstracts. (I felt an immediate bond when he said that: one wonk can always recognize another.)

As I answered questions about my experiences I realized it wasn’t approximately three years ago when I learned about the cancer in my liver and my own quest for a transplant began: it was exactly three years. To the day. 

After we parted I walked to my car, secreted in a relatively unrestricted area near Golden Gate Park about 10 minutes away. I kept walking, right into the park and all the way to the AIDS Memorial Grove. I wasn’t planning to go there. The grove is a quiet area in a small glen filled with beautiful plants. It has been there long enough that the young redwoods can now be called trees.  

I took some pictures – my own solace and serenity these days – then returned to my car and came home.

I’ve been fretting about the economy and my diminishing place in it the last few days. Who isn’t? Listening to that troubled man… meeting his stuggling partner in the uncomfortable bed on Nine Long… in a hospital room I’ve been in myself… remembering that telling phone call three exact years ago…

Three years count so much more than numbers on a financial spreadsheet.

Three Scenes from a surgery

Thursday, January 8th, 2009

I’m being silly. No, that’s too kind: I’m being stupid. I desperately want to write, want to update this blog and take it to new places because I’m sick and tired of thinking – and writing – about being sick and tired (and maybe I don’t have to for a while!) and I want to work on my plays again and write the essays kicking around my brain and I’ve got this idea for a novel and…

But I don’t.

What I have been doing is everything I can to avoid writing. Photographing. Having an operation (again). Reading. Walking the dog. Recovering from said operation. And… uh… did I say photographing? It’s all just surgery-excused writer’s block.

Oh, my new photography obsession is a fabulous mania. I’m having a blast learning all manner of photo techniques, how to visualize the shot, taking classes and reading books on the subject. And of course snapping pics, hundreds, anywhere and everything, to the bored distraction of my friends, family, and dog. Somehow all the trauma and medications of the last three years left the visual parts of my brain functioning better – certainly more willingly – than the language parts. But photography isn’t writing. I need to write.

Well, the surgery excuse is now officially old. The operation succeeded – mostly – I’ve recovered – mostly – the dreaded bubble‘s gone – mostly – and I even made it to the gym this week – mostly. Time to put fingers to the keyboard. Before I shoot at the other writing goals though, I need to exorcise the health stuff.

So here, as a sort of mopping-up exercise, are three scenes from a surgery, which took place November 5th.

1. Nooo! I don’ neeed a kidneeee!     

In which the joys of pain meds reveal their dark side.

2. “Do you know why you’re still here, Mr. B?”

In which I learn you can wander the halls too long.

3. Terror.

Yes… well… there’s no other word with quite the impact of “terror” these days, is there? Yet I have to use it: all the synonyms I can find really just tell a part of the whole… totality we call terror. This post will be along shortly. Nailing down what I’m trying to say isn’t easy.

There. Medical demons exercised with the exception of #3. When it is done, I get to move on. Next posts, already in the boiler, will be on hypnotherapy and surgery, and just how much is a cure worth? Stay tuned.

No belly-search by TSA!

Wednesday, October 22nd, 2008

Amazing but true, folks: I’m taking a quick pre-surgery trip to San Diego and I’m happy to report I – and my ever-expanding belly bubble – made it through airport security without being “examined!” And a big hooray for that!

OK, I took precautions: a baggy t-shirt covered by a ratty jacket, strict Victorian-standard corseting, and of course the trick all men of a certain belly size use to impress others with their physique, a serious sucking in of the gut.

Maybe none of it mattered, maybe it was just that the crowd pining to get to the Other Side was large and the TSA agents wanted to get  rid of us. Whatever, it was nice not to have to go through the “what is that? Ewwww… pull DOWN the shirt sir!” routine again.

Now, to the beach! (Shirt on, of course.)

Confidence

Saturday, October 11th, 2008

Funny thing about confidence: you don’t really know you’ve lost it until you start getting it back. Without an inner voice constantly whispering a “you can do it” nag, a hypercautious agony aunt takes over and plunges you into a fog of jitters. Auntie has excuses for everything. “No, no, no!” she hisses. “Be careful!” “Oh, you really shouldn’t go out tonight. You’re not quite recovered you know!” “Of course you shouldn’t feel guilty about not taking that bike ride! Look at what you’ve been through!” Eventually this irritating scold owns you so completely you cringe at the risks involved with everything. “Be careful of that tea now, it’s hot!” “Don’t trip on that step!”

Unless you had the misfortune to be raised wary (or had a very difficult childhood, the same thing), auntie’s isn’t the default human condition. (more…)

Every time I start a post…

Saturday, September 13th, 2008

…Bang! I slam into another concrete wall pretending to be a speed bump.

  Twilight, Shelter Cove, CA

In January after surgery took me down, I was miserable enough to ask myself – for the first time ever – the big question: Should I stay or should I go? Just hang it up and dance down the tunnel of light? And for the first time, I was indifferent to the answer. But as I recovered my stubbornness kicked in – late, but much to my relief – and so here I am.

Five months later I found myself trying to cope with a bout of confidence of all things, struggling to really believe I’d regained something of a semi-functional life for the first time in two years. I even got to take a road trip. Then I was knocked flat by a simple endoscopy (tubes and cameras down the throat for a veinal lookie-loo) which re-triggered my ever-hovering hepatitis C and left me on the couch panting and deranged for two weeks.

  King's Range, CA

Recovering from that would-be-funny-if-it-didn’t-suck experience, I’ve spent the last month plus agonizing over whether to have yet more surgery to fix the ever-enlarging bubble on my abdomen, the result of last winter’s hernia repair that didn’t go so well. The bubble’s spawning now, with two tiny new bubbles popping up. I swear Alien’s in there doing something evil. (The surgery decision: No! NO! NO KNIVES! Not ’til I have to! [Which may be sooner than I'm telling everybody.])

And through all this, my new liver, which had actually taken to behaving itself, decided to do some sulking again. And so now I’m back in this gray area where some things work, sort of, other things not so much, not knowing day to day what it’ll be like and wondering just what the $#^% “health” is, anyway?

I suppose the biggest epiphany I’ve had from all this is something I already knew: There’s this line running through my life. Stay on one side of it, and the deities smile benignly and permit me to muddle along. Cross that line, and bang! (there’s that ‘bang’ again) those same gods set the hounds from Dante’s circles on me. This line is as thin as a new-bought razor blade.

  Otto taking a beach nap

Anyway, I’ve decided to post the various fragments I’ve been working on, plus a few off-topic bits (a poem, anyone?) just so I can make some sort of break with the last six months – writing-wise, anyway – and start anew. Consider these posts – they’ll be showing up over the next week – a mashup of fragments from my muse and detrius from my mental garbage collector. Oh, and there’ll be pictures: I’m obsessed these days with photography. These are from a drive to California’s Lost Coast last week.

Bolting from the ER

Monday, May 5th, 2008

I am not proud of this.

Friday morning I awoke with my right eye desert-dry, red, lumpy and painful. It hurt a lot, every blink an agony. What moisture it managed to produce was pink in color, tears mixed with blood. I could hardly see and it was impossible to read. Sentencing me to a life without reading would be crueler than marching me down a long hall to a gas chamber with a noose around my neck and a cocktail of lethal injections in my arm. I was not happy.

This isn’t the first time an eye’s gone bonko lately. My eyes have been chronically dry for years and the meds making up the small mountain of pills I take daily thanks to the liver transplant and my other ailments have only made them more so.

Worse, a few months ago, after my latest near-death experience and the rise of my belly-bubble, the docs put me on a heavy dose of diuretics, two flavors, in an attempt to keep said bubble under control. Besides the obvious side-effect of making it impossible to pass by a bathroom without saying hello, diuretics have wreaked havoc on every moist membrane in my body. Especially my eyes.

More than once I thought I’d have to go to a doc or the ER to have an eye checked out for the symptoms I describe above, but I always found an excuse to avoid it. It’s late, I’d rationalize; sleep and see how it looks in the morning. Those tears aren’t really pink they just look pink. Or I’d dither so long on what to do the pain would lessen and I could see again, if tearfully.

Friday however the full set of symptoms were present when I woke up and only got worse as the morning went on. The ache was awful. My friend Jeff – Saint Jeff of the Infinite Patience I should call him, at least when it comes to helping me with my health “issues” – called at just the right/wrong time. I told him what was going on. “I’m coming over,” he said. And so he did and we agreed I should go to the ER and have the eye checked out. All my usual contacts at the UCSF Liver Clinic were away – it was Friday – I had no other option.

So I get to the ER which is mercifully quiet at 1 in the afternoon. The morning day-care rush of uninsured sneezing children are gone and the gunshot wounds and overdoses haven’t clocked in yet. It’s just me and a few others, all in one form of medical misery or other. I do the insurance intake blotting my eye, taking note of the continuing pink of my tears. Another short wait and a nurse calls me in, does the blood pressure-temperature bit, tries not to gasp as my medical records pop up on her screen (“Uh, which organ did you have transplanted, Mr. Brownson?”) then asks me to wait in a nearby hall for a visual acuity test. “I can see,” I tell her. “It’s the bleeding and the pain I want to check.” I give my best pleading look. “I don’t want to lose an eye.” She nods in that ER “we’re on it” kind of way.

A few minutes later – it really is quiet here – another nurse points me at an eye chart. As predicted I can see ok between the painful pink blinks if I have to. I repeat my plea. “I just want to know if it’s damaged and if I can get some of those numbing drops to control the pain.” Another concerned ER nod and I am led to a “room.” Now, unless you’re having a heart attack or are full of gunshot wounds, a “room” in the ER is usually just a niche in a hall with lots of tech equipment and medical supplies jammed around a bed. If you’re lucky, a curtain closes you off from everybody else. You couldn’t squeeze three ER techs in these spaces if they had to save your life.

The nurse points to the bed, on which is a hospital gown. “You can…” but I bolt to a chair that is half in and half out of the niche. No way am I putting on the gown and getting into that bed. “OK.” The nurse shrugs. “You can sit there if you like. Your charge nurse will be with you shortly.” She gives me another ER smile, curtains me in and disappears.

And so I sit in the gray light blotting my eye. Five minutes, ten… The medical equipment and tubes and rubber gloves lean in on me; the hospital gown, neatly folded and placed at a cocky angle on the edge of the bed, fills my aching eyes. Since I cannot read I cannot distract myself from my ever-active mind. Dangerous.

What am I doing here? Every time I blot my eye I check for signs of lessening pink. The pain is receding and the post-diuretic headache is kicking in – a sign the process that caused the eye problem is cycling through. Why am I here? This is an ER! I am NOT sick! Up goes my anxiety.

The main reason I haven’t written much in this blog lately is that over the last dozen or so weeks I’ve experienced my longest period of “functional” in two plus years. Yes, I’m still anemic. Yes, the Hepatitis C is still in my liver and my blood, muttering and plotting like a madman in the shadows. I still get dizzy and achy and tired and at times befuddled and blah and blah and blah. But I’ve also traveled: two trips to the Tahoe area, one driving and the other on the train over Donner Pass. I made it to the gym last week, first time in five months. Twenty minutes’ exercise takes everything out of me, but it’s a start. I’m planing to visit my sister in Wyoming at the end of the month. I even have hopes of getting back on my bicycle soon.

Sitting in this ER “room” throws me right back into the miseries of December and January and my post-hernia surgery metabolic collapse. Three ER visits over “the holidays,” serial hospitalizations, the worst pain I’ve ever experienced – hell, ever imagined – the weeks and weeks of recovery that still isn’t complete… these things are still too too vivid in my memory. But most of all sitting here reminds me of the devastating hit my very being took from that whole miserable michegas, a hit that left more damage than the liver cancer and transplant ever did.

The niche is dim with the curtains pulled but the lights on the equipment are bright. I blot my eye again. There is less pink. I blink, the pain is down. I hear a woman in the room next to mine on a phone telling someone she’s ready to go but is waiting to be discharged. Eventually I see her through the gaps in the curtain; middle aged and in a red dress, she leans out in the hall anxiously looking for someone, anyone, to come and set her free.

What AM I doing here? It’s becoming an obsession. I won’t give up the life I’ve pulled together, however hobbled, these last twelve weeks. I just won’t. They cannot take it away from me. No! The ER only leads in one direction: to more procedures, more doctors, more exams, more endless nights and days in the hospital – that horrible wonderful hospital that saved my life only to put me through groundhog days of torture. WHY am I in the ER? WHY did I come?

The charge nurse doesn’t appear. The woman in red makes another call and haunts the hallway. My eye hurts less and less, my anxiety hurts more and more. The pink tears stop. I fantasize about walking out, just getting up and leaving. The more I think about this the more urgent the idea becomes. I argue with myself: Stay and they will steal my twelve weeks. I’ll be imprisoned again in perpetual “unwellness” and this time I might never escape. I have to go, I have to go.

I look at the gown on the bed, the lights on the equipment, hear the woman in red call for someone, anyone, in the hall. I dab my eye one more time, still no pink. Without consciously deciding to I grab my backpack, jacket and hat, stuff the hat in the pack and back out through the curtain into the hall. I look for an escape but can’t see one, just halls leading to halls.

“Can I help you?” A young nurse carrying sheets and gowns appears.

“No, no, thanks. I’m fine. I have to go.” I stumble all over my words and flash a panicked smile.

“I’m your charge nurse,” she says. “What do you need? Here, come on in…” she indicates the little room. “Lets see how your eye…” The woman in red watches and I am aware enough of what I am doing to be know I am telegraphing panic.

“No, no… everything’s fine, really. I’ve got to go. Really. Got to.” I hurry down the hall and take the first turn. I see doors to the world but they are marked “Ambulance Intake Only.” The charge nurse rounds the corner. “You can’t go out that way that’s for ambulances.” I’m trapped. She sees the panic on my face. “You have to go out the way you came in,” she adds gently.

“Thanks,” I say, my face redder than my eye ever was. I pass her by, back into the main hallway to the next left but it’s a dead end. Finally I find a hallway that leads to the intake area.

“Everything all right?” asks the intake nurse. “You’ll be right back.” It is a statement not a question.

“Fine, fine, thanks.” I’m shrivelling into a pit of chagrin. “I just… my eye is fine, fine. I just have to go. Thanks. Thanks so much.” And I bolt through the double-gated security-guarded entrance onto the street.

I’m both enormously relieved and hugely ashamed to be standing outside again. I am liberated and I have also let these people down, the same people – sort of, anyway – that saved my life two years ago. And now I’m running from them as if they are evil incarnate, each one intent on sucking out what is left of my life.

I go far enough to be out of sight of the ER and call Jeff. “Please, please don’t yell at me,” I start, then tell him what happened. He pauses, but does not yell. He does understand, at least on some level. “I’ll pick you up,” he says. “We’re not far.”

As I cross the street to the elevators that will take me to the rendezvous point – UCSF is on a San Francisco hillside and is vertical not horizontal – I’m overwhelmed with shame. I pull out the cell phone again and dial the hospital general number. Yes, I have it memorized. They connect me with intake at ER.

“This is Ed Brownson,” I say. “I just came in, but I had to leave. My eye is fine. I really really apologize for taking up your time. Everything is fine. I’m very very sorry.” The person on the other end asks a couple of questions then thanks me for calling. “Please tell the staff I’m sorry for taking up their time,” I repeat. “Oh, and tell them I didn’t touch anything in the room.” As if that makes it all better. I get in the elevator and go down to Irving Street to wait for Jeff.

As I said, I’m not proud of this. Truth is, the whole bloody experience was devastating. I panicked and I don’t panic easily. Or proudly.

Oh, there are excuses if I want one, no problem. The awful experiences of December and January. The fact that ERs never listen to what you say or to what you need but always go for their procedures and protocols no matter how irrelevant. That I should not have to go to an ER just to have an irritated eye looked at but should be able to go to a drop-in clinic – same with all those kids with colds – if only this damned country had an intelligent health system. Or I can evoke the most honest and easiest excuse of all: after two years of all this, I. Have. Had. Enough.

But as we learn when we are kids, excuses change nothing. I bolted. I panicked and bolted from the ER. And I found out another limitation on my once unchallenged carpe diem “nothing gets to me” attitude to life.

In January I found my limit to pain; I didn’t know where it was before. Now I’m learning just how many trips to the hospital, how many medical procedures, I can take before I crash and burn in red-faced madness. Two years ago, when I sailed through the liver cancer and the transplant, the lesson seemed to be “I can survive anything.” Now I see how thin that illusion is. I guess 2008 is my year of learning limitations.

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It’s been too long between posts. I’ve decided to add less edited, more frequent comments and experiences to the mix. Oh, I’ll still be doing the essays, I seem incapable of not writing them. But they take longer to think through and there is so much more going on in the life of a professional transplantee and lab rat… Stay tuned.