Monty Kleiman
(Heart Transplant 1993)

I had been an ‘in and out’ coronary care patient since 1976, at the Moorabbin Hospital. In 1991 the cardiologist diagnosed me as terminally ill.  He said that he had exhausted his knowledge, and resources, and could do no more for me.

                 

We decided to get a second opinion. An appointment was made with another cardiologist,  He gave me a thorough examnation, studied my medical history. As a result he made an appointment for me with the director of the Transplant Unit at the Alfred Hospital.

 

At the consultation with Prof. Don Esmore, the director of the Transplant Unit, reviewed my case and gave me a thorough examination. As a result he informed me that I was sufficiently incapacitated to go through the assessment program to establish my overall suitability, but to secure placement on the waiting list, I would have to have one hundred per cent consensus of the transplant team.

 

I underwent many intensive tests, medical procedures, physical examinations, and psychological tests, plus various interviews, some involving all my family.

 

The results and consequence being that I was placed on the heart transplant waiting list and given a pager so that they could contact me at any time of the day or night. We were overjoyed. We could now hope for an answer to our prayers.

 

Being placed on the waiting list is no guarantee that one will survive the wait.  The object now was to keep as fit as possible and to outlive the waiting list.

 

Every thing possible was done to support me at home. Special handrails and a portable ramp were fitted to the house.  Moorabbin Hospital provided special aids to help me to be partially self-reliant. During my wait for a donor heart the Moorabbin Hospital was merged with the Monash Medical Centre, resulting in the closure of the Emergency Department and the Coronary Care ward.  I was the last patient to be moved out of the Coronary Care Unit on the day of closure.  I also had the undesirable record of having the most admissions! I was then transferred to the Alfred Hospital.

 

The pager went with me everywhere and the alarm went off a number of times, the initial excitement followed by despondency when the calls turned out to be false alarms. It was very stressful and detrimental to my disposition, temporary affecting my self-esteem and morale. I became so weak I could no longer stand and had graduated to a wheel chair.

 

I recall vividly one incident when I was at home, I was in the bathroom alone trying to clean my teeth.  I started slipping to the floor but some how managed to sit partially on the side of the bath, I was unable to control myself and slipped further, bottom first down into the bath. Try to imagine me doubled up with my feet splayed pointing at the ceiling.  I was completely helpless. I yelled for Leila my wife. You should have seen her face, the horror, and disbelief that simultaneously projected her anxiety and concern. I thought it was impossible for her to pull me out, but she tried very hard.

 

Leila assessed the situation and with her ingenuity and rational, tied two dressing gown cords round my waist with the other end tied to the wheel chair and, slowly inched me up and out. It was a tremendous feat and a great relief to us both.

 

I developed a most bizarre habit: I perused the papers and watched the TV looking for reports of any fatal accidents.  Speculating as to the outcome, thinking, is that a potential donor and how was the bereaved coping with the tragic trauma of losing a loved one and making the decision to donate the organs?

 

I was unable to sleep at night and listened regularly to radio 3AW and the program the “Overnighters”, a nighttime talk back show. I called the station most nights, whether at home, or in hospital, and related on air various stories about my life. I even received some fan mail from the listeners! Many listeners called the station offering me hope and support during my long wait for the “CALL”. Station 3AW sent me a pile of easy reading books.

 

On one occasion during the night in the Coronary Care ward, the nursing staff joined me on the talk back session, and it was suggested in fun that the radio station should send Pizza's for the night staff.  It was 4 am. We did not anticipate any consequences.  Surprise!!! The pizzas did come, and were enjoyed by all!!

I had been nineteen months on the waiting list and my health was deteriorating rapidly.  I was still in the coronary ward. I needed to get away from this environment and to be with my family and friends

Most Saturday nights our friends dine out. This particular night the heavens opened up. I asked Leila if she would like to take me in the wheel chair to the restaurant. I think Leila realised that I wanted one last fling. Hiding behind her brave face she got me into wheelchair then into the car. Stacked the wheelchair in the boot, getting drenched at the same time. We then joined then our friends in the restaurant.

 

I cannot remember what meal I ordered but I know I drank a lot of wine. Without taste buds I did not appreciate the meal, even though it was in lieu of ‘Sustagen’ which was my staple diet.  Nor did the wine have any effect on me!! Leila then drove me home on flooded roads. The rain did not ease up all evening. At least I’d had my fling.

 

The following Sunday the twelfth of September 1993 the phone rang at 5.45 p.m. We had finished our evening meal some thirty minutes earlier. Leila answered the call. It was the transplant Coordinator, and Leila assumed that she was just checking up on me.

 

The Coordinator wanted to know how I was, and how long it was since I had eaten.  Leila told her about half an hour ago. The reply was “..can you bring Monty to the Emergency Department by 7 p.m., we think we may have a heart for him?" 

 

For the first time in all the time since I have known her Leila was lost for words, and just a mite hysterical; also very jubilant! We had been waiting nineteen months for this moment, and yet it was a total surprise.

 

My adrenalin raced to fever pitch, and my heart was beating so fast, I thought I would have a heart attack, or that I would be too ill to have the transplant operation. I was thrilled, yet very worried.

 

The normal procedure to select a recipient, is to bring two waiting patients to the hospital, and into the preparation ward. The final choice is then dependent on the best match, degree of the severity of the illness, and the length of waiting time, and this was all subject to the heart being vetted. There was only a 50/50 chance that I would be selected.

 

Leila phoned our two daughters. They raced to our home, and we all went to the Alfred Hospital The coordinator met us at Emergency, and conducted us to the preparation room, but until the heart was approved we would be on standby.

Luckily, I was the only candidate this time, and was prepared irrespective of whether the operation went ahead or not, and I was taken to the operating theatre. 

At 11 pm. the go ahead was given. The three girls were offered blankets, etc, to stay in the waiting room, but Prof. Esmore advised them to go home, and that he would phone them as soon as the operation was over. This they did, and sat and talked all night in front of the TV. It was on, but they neither saw nor heard it.

 

Being understandably anxious and impatient they phoned Prof. Esmore at 6 am. He had just finished, and was about to phone them to say that I was in the recovery ward, and that they could visit me right away.

 

The most amazing experience was when I left the intensive care ward, and the machinery etc was disconnected, I was breathing normally and unassisted. Moreover I had no pain from the chest wall incision. It was unbelievably fantastic.

 

To combat any early rejection, the first large dose of the immuno-suppressants is administered with your pre-med. Post operation, a period of trial and error is the norm in ascertaining the strength of the anti rejection medication, which is relative to your body weight. Regular biopsies to check for rejection are made by taking snippets from the heart (or lung!) and analysing them. A not too uncomfortable procedure.

 

I had to learn to walk again, with the support of a walking frame and with aid of the physiotherapist. I commenced an exercise program almost immediately, as I was determined to walk out of the hospital unaided, which I did six weeks later. The euphoria I experienced walking out of the hospital and being in the land of the living with my family was ecstatic beyond words. The hand of man had resurrected me, all be it at the traumatic demise of my donor's bereaved family.  Did I have the right to rejoice?

I

 wrote a letter to the donor's family expressing my condolences and my gratitude (a weird contradiction) and letting them know of my near one hundred per cent return to the way of life I had prior to my prolonged illness.  With the hope that it gave the donor-family some consolation. The letter was anonymously written and was forwarded per the transplant coordinator as per the organ donor/transplant protocol.

 

My welcome home was straight into the bosom of all my family and friends. Without the support of my wife, children, and grandchildren throughout the many years of my illness, I would not be who and what I am today.

 

Also the fantastic support and care of all the staff of The Alfred Hospital Transplant Clinic, then and ongoing, is phenomenal. I now live a "normal" life. Life is for the living, and living my life now is one massive bonus!!!

(Written by Monty Klieman, with just a few ‘edits’ by yours truly!!)               to page 2

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