G'Day

              … The Biggest events in the last two years have of course been the birth of our daughter Emma Claire and the matter of my small and trifling lifesaving operation.

Bloody Hell! A Transplant!

The fact that with my Condition I could one day require a lung transplant was not news to me, however the fact that I was eligible there and then was. This was quite a shock to Jo and I, and indeed to my UK Consulting team too (Again, that I had a Consulting team in the UK might be a surprise to some; such subterfuge! Explains my penchant for flu jabs and keeping warm etc. eh?).

Now I had noticed whilst climbing mountains in Scotland earlier in 2000 that such an activity was a tad challenging, but hardly cause for major surgery. It would seem that presented with me, without knowing my history in detail, the chap from Sydney leapt to the conclusion that I had suffered a catastrophic decline; not really the case, rather that I had been able to cope extremely well with such a low lung function, though there probably had been a significant drop in the twelve months  before coming to Australia.

 Anyway, we didn't like him much, and when we moved to Melbourne we got on with the team much better; which was a good thing really because we would come to rely on them very heavily.

We spent fifteen months in Sydney, were there for the Olympics, and, although I love the City … , we were glad to be moving. Melbourne is great place to live, better than Sydney in my opinion; except for the lack of icons such as the Harbour, the Opera House and the Bridge, though the "G" might come close. Melbournians have an envious sibling relationship with Sydneysiders in much the same was as Mancunians and Londoners; each "knowing" that their city is better. Melbourne has the Grand Prix, the International Comedy Festival, the Yarra Valley, decent roads, the MCG, decent climate… I could go on, just plonk in something like the Opera House and it would win.

The Saga of the Visa

The next big issue was for me to becopme properly eligible for the operation. Though I had yet to reconcile myself that I was ready for it I would have to change my visa status. ...

… It wasn't until May the next year that, after supplementary evidence, much worrying and the help of a federal MP, that I was granted provisional permanent residence.

A nice young nurse shaved my chest and gave me my first doses of immunosuppressant medication. The registrar arrived checked me out; I asked her if I'd be able to play the flute after the operation, she said she didn't see why not and I said that was great because I couldn't before (Ho Ho!). Jo's family arrived around midday having flown at short notice from Queensland. … (my mother-in-law) asked that as I'd be under for some time had I considered asking for some cosmetic surgery as well.

Much hilarity! Unbeknown to me there were some last minute checks on the donor that were causing some concern to the team; organs are not dished out on a first come first served basis, rather blood types and tissue types are matched (these must be correct for major rejection to be avoided) and antibodies present are analysed; mismatches here can cause infection problems. It is not uncommon for people to be called in, going through all the emotions of that time, only for one or other factor to result in someone else receiving the organs.

We had been warned that there may be several false alarms. The op' was scheduled to begin at 2pm, but was delayed and it was not until half three that I was wheeled to theatre with Jo and Emma at my side. I still maintain that I had the east part, and always had (and will have). Jo had to watch my steady decline, was aware of all the stats on my life expectancy with and without the op, and for the next 6 to 8 hours would have to endure the torture of complete and utter helplessness. All I had to do was lie back and drift off to sleep

There was more prep in theatre. I had an epidural put in, I was rather keen that it would be a good one given the size of the cut I was about to obtain. Apparently my back was more gristly than most with the anesthetist all but putting his knee into my back as my shoulders were held to give purchase from the front.

For the medically interested the epidural was beefed up by the addition of adrenaline, a new technique apparently. I had several “lines” inserted (two arterial in my wrists, six venal in my neck, put in for sampling blood gasses, administering drugs etc. There were others but I forget the detail), and electrodes on my chest for monitoring heartbeat etc.

My normal social worker, a fantastic lady, was unfortunately on holiday and her reserve decided to pay a visit. Nice thought but she was rather embarrassing, lord knows what the theatre staff thought, as she asked if’d like to try some relaxation techniques; frankly I was perfectly relaxed and was far more interested in the asking the surgical team about what was going on than joining in calming mantras. I

I thanked her for her concern, she left and I could get on with asking about the most expensive machine in the hospital (in case the administrator came round) or the one that goes ping ( the team were familiar with Monty Python and knew to what I was referring). Seriously, talking to the team was interesting and probably my way of dealing with the situation. I talked with one of the doctors, who was a Brit … offered some tax advice (get some) and chatted about the Old Country until just after 4pm when I was put under full antithesis

                         For the squeamish; skip this paragraph!

The incision, contrary to populat belief, is not up and down the sternum as it is for a heart, but stretches from one armpit to another under each pectoral and is known as a “clamshell”. The arms were tied as on a rack, literally, and pulled, hinging on the spine the opening is clamped open. One lung was clamped off, deflated and removed. A new one was inserted, sewn in and partially inflated and began to breath for me. The other one was then deflated and removed, the second new one sewn into place and it was partially inflated and began breathing for me. All surgical tools are accounted for and I was closed up and stapled together (82 held the wound together to be removed a few days later, permanent wires held together my sternum where it had been severed). Apparently the op’ finished at half 11 in the evening I am told and I was wheeled to ICU.

Recovery 

Jo came and visited at about midnight to be presented with what looked like a dead body, yellowish grey from the iodine and cold as body temp was reduced to control bleeding. I first came to at about 6am. Intubated, communication was difficult, and I had to use a pen and paper which was challenging. The tube would be removed once it was certain that I could breath on my own having been taken off the respirator earlier in the morning. From this first moment of consciousness on I can truly say that my recovery has been nothing short of miraculous.

 The tube came out later in the morning and I could speak. I could also look down and see my new trophy etched across my chest. I could also breath. By 4pm in the afternoon I was sitting NEXT to my bed supping chicken soup. Incredible. The ICU team joked that I was an imposter as I was alert, doing well, my sats were 97% and heartbeat 90. My visitors told me that my lips were pink again and not blue; I could see the difference in my nails which were now a healthy pink too. I spent 48 hours in ICU before I was moved to ward 5E.

This was very good going, I would have been out earlier but for some adverse liver function indicators. The lungs take time to inflate fully and where some notice a difference instantly I didn’t. It was on day 3 that I noticed that I could talk for more than short bursts without gasping for breath. In fact I could talk and talk and talk!

Over the next week or so my progress was again excellent. My medication regime was impressive, about 80 tablets a day to start with, including some pretty strong pain relief. I was lucky to avoid major hallucinogenic side effects, though I did have the odd nightmare about falling asleep and stopping breathing, as if my new lungs needed my conscious thoughts to keep them breathing.

Going Home

After two weeks I was well enough to go home. Hospitals are all very well but they are full of sick people and are not the best place for an immunosuppressed person. The feeling of elation on the way home is something I will never forget, all the thoughts of what would now be possible, all the things that we would be able to do. To sleep in my own bed was fabulous too. The next morning Emma woke at 6:30,

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