Thursday, December 25, 2014

Post Tx Christmas II

It's been quite awhile since I've posted here, so I want to thank you for continuing to check.

As I write this at my Dad's home on the mountain, the winter winds are howling and I hear distant church bells playing Christmas carols. It is the first hour of my second Christmas, post transplant, and I am still marveling at this gift of gifts that I've received. Since the major med change at my one year mark, I have been doing better physically than I've been in years. 
Now if a few other things fall into place, I'll be ready to take on anything.

On other fronts, here is a little feature that is currently on the Pinnacle website: Bob Story

I'll try to post just a bit more regularly, if for no other reason, just to let you know I appreciate you looking here.

Until next time....may life be good to you all!


" I wish you a hopeful Christmas
   I wish you a brave new year!"

Wednesday, October 29, 2014

Donate Life Act (SB 850) Update


Many of you have been asking and just this morning, 3.5 weeks later, I got this official communique from Gift of Life -
I'll be bugging you for support again early next year.
Thanks!




Donate Life Act (SB 850) Update

Dear Supporters of the Donate Life PA Act (SB 850),

Thank you for your work this year in support of SB 850.

YOUR LIFE SAVING MESSAGE WAS HEARD and THERE IS NOW A COMMITMENT TO ACTION!

Thanks to your repeated and vocal message regarding the importance of action on the Donate Life PA Act—the PA Senate strongly endorsed the bill with a vote of 47-3. However there were not enough session days left in the PA House though to bring the bill to a vote. BECAUSE OF YOUR VOICE, we did receive a commitment from House leadership to address this important issue when they return in January 2015. We will need your support in the coming months as we look forward to working with the legislators to honor their commitment. We will reach out to you early in 2015 as we prepare to move the Donate Life PA Act forward and save lives together.

Sincerely,
Gift of Life Donor Program
& the Save a Life Now PA Coalition
401 N. 3rd Street
Philadelphia, PA 19123
215-557-8090 ext.1132

www.donors1.org


Tuesday, October 14, 2014

Well....


Last Monday, I spent the day at the Pensylvania state capital in Harrisburg with approx. 100+ other folks from across the state in an effort to get the Donate Life PA Act on the books before the legislative session adjourned. 
Now I don't have a single bone of political activism in my body but as you probably realize, this legislation is very near and dear to me. If you follow this page at all, you've noticed that I've been trying to muster support for this law.

I arrived at the group meeting place on the Capital's steps and I was on scene for about 30 seconds when a friendly lady named Diane came over and struck up conversation, welcomed me, and gave me a Donate Life PA tee shirt. Diane wasn't one of the organizers, but rather a long time supporter and a huge advocate of organ transplantation. I learned later that she has been actively involved with Gift of Life and it's cause, since the death of her husband who was an organ donor. I also met Masha and Jen -  more quality people from northern PA whose lives have also been intertwined with the transplant process. ALL of these folks are so friendly, so helpful, so caring, that I'm beginning to believe that this is a beautiful side effect / gift from being touched by the transplant experience.
A sort of - "Let's not try to see through each other in this life......Let's try to see each other through" philosophy that this world could use a lot more of.
I aspire to be more like these people.

Once inside the Capital, we met with folks from Gift of Life, CORE, NKF, and others and were given information and directions on who we needed to petition to get this bill passed. I went to the offices of my state senator and my district representative and introduced myself, had extended conversations with their staff, and  expressed my thanks as both of them have been supportive of  Act 850.

All of this peace, love, and understanding had me feeling so good as I left the capital that day. I had met some wonderful people, it was a spectacular Kodachrome kind of day with bright sun, deep blue, cloudless skies, and crisp autumn air that warmed to a welcome 76ยบ by mid afternoon. The capital is an absolutely gorgeous building, steeped in history, and in some small way, maybe it was a tiny bit of history that we were all part of today.

That was last Monday. 
SB 850 needed to be passed by the House by Friday.

It didn't make it.

Now, when the legislature convenes, all the work to get the Donate Life PA Act passed will again, start from square one.
Now I know this is the way the game is played, the way legislation works, but there are lives in the balance here.
It's all very frustrating.

Thanks for your help, your support, and for checking in here.

Wednesday, October 1, 2014

Congratulations and THANK YOU!



Dear Supporters,

Thanks to your hard work and commitment to donation and transplantation, Senate Bill 850 was passed yesterday in the Senate by a vote of 47 to 3!

Now the bill will move to the House Judiciary Committee and then the full House for consideration and we still need your help. Please keep calling THIS WEEK – now to your state representatives. Please ask them to:

  • 1. Support Senate Bill 850


  • 3. Pass Senate Bill 850 AS SOON AS POSSIBLE

Please also pass this on to your friends and ask them to call as well. We need our representatives to hear from as many supporters as possible – family, friends and coworkers.

You can find your state representative at this website: Find your legislator



More information about the Donate Life PA Act can be found at: Join Us | Save a Life Now PA



Thank you again for all you have done. With your help, we can pass this law and save lives.


Kari Rowe
Volunteer Coordinator
Gift of Life Donor Program
401 N. 3rd Street
Philadelphia, PA 19123
215-557-8090 ext.1132

www.donors1.org



Just FYI Senator Scott Wagner, representing York, voted in support of this Bill.

I'd like to think that the emails and calls to his office may have influenced him to this end.
Now a folo-up email or call to his office @ 717.787.3817 would be in line to express our thanks and gratitude.

See how your State Senator voted:
Roll Calls For Senate Bill 850


Thanks so much for your help with this.
PLEASE don't stop until it's a done deal.
We've come too far!


Monday, September 22, 2014

Urgent - Donate Life PA Act - IN JEOPARDY

The following is a late afternoon, urgent email that I received from Gift of Life today.

PLEASE SUPPORT THIS BILL!
If you haven't already, please sign the petition and consider using the links previously listed to copy and paste a form letter and email it to your State Senator. This info is also listed by following the links.

THANK YOU!



Dear Supporters,

Over the past several months we have asked for your assistance in advocating for the Donate Life PA Act (Senate Bill 850). Today we need your help more than ever.

SB 850 is scheduled for a vote in the full Senate tomorrow. Today we learned that the lobbyist for the state coroners association has circulated an amendment that would eviscerate the bill, as well as strip Pennsylvanians of their rights and jeopardize criminal investigations.

The Solobay Amendment would completely eliminate any requirements for coroners. As is the case now, they will be able to deny organ donation over the phone without ever investigating a case. This means that, on average, about 50 transplantable organs will be lost and 10 or more families will be denied their right to determine their loved one’s legacy. 

Please call your senator to ask them to OPPOSE the Solobay Amendment while supporting SB 850 in its current form. The Solobay Amendment will hurt organ donation and ultimately more people will die waiting as a result.

Sincerely,

Kari Rowe
Volunteer Coordinator

Gift of Life Donor Program
401 N. 3rd Street
Philadelphia, PA 19123
215-557-8090 ext.1132

www.donors1.org

Thursday, September 18, 2014

Latest Update

This just in.......

Dear Volunteers and Donate Life Advocates,

Senate Bill 850 was successfully reported out of the Appropriations Committee on Monday and it is VITAL that it be passed by the full Senate next week.

To those of you who have already made calls and written to your senators, THANK YOU!—but we still need your help! We need you to keep calling! Please challenge 4 of your friends or family members to make a call as well.

In support of the upcoming vote, we are asking all of our volunteers who live or work in Pennsylvania to call (or write) their state senator:

• Ask them to VOTE YES and support SB 850 (if you’re told they support the bill, be sure to thank them!)

• Urge them to contact leadership to ensure that SB 850 gets a vote by the full Senate

• Remind them that the hospitals and the community support  and needs this bill

• Finally, let them know that you support the bill because it will save the lives of those on the waiting list



A list of telephone numbers for all Senate offices is attached and you can find your senator by entering your Pennsylvania address here: http://www.legis.state.pa.us/cfdocs/legis/home/findyourlegislator/

Finally, if you haven’t already done so, please sign the petition at http://www.savealifenowpa.org/join-us/ and share it with your friends and family.

Thank you for your continued support and hard work- keep us updated on your Senator calls and send any questions our way!

Kari Rowe

Volunteer Coordinator
Gift of Life Donor Program
401 N. 3rd Street
Philadelphia, PA 19123
215-557-8090 ext.1132
www.donors1.org

 




Please.......


OK now I don't ask for much but if any of you can appreciate my being here at all, (and I know it's hard some days) or anyone else that you know that has benefited from a transplant, could you please consider signing this online petition in support of The Donate Life in PA Act?  No money. No hassles. No hard time. Just your name on an email document.

The Donate Life in PA Act is summed up like this : 
Pennsylvania has long been a national leader in organ and tissue donation and transplantation. We are home to many of the finest transplant programs in the country, but with that comes the responsibility to advocate for those awaiting a second chance at life. There are more than 8,300 people waiting for an organ transplant in Pennsylvania. Over the past ten years, nearly 500 of those waiting in Pennsylvania have died annually—or about nine people each week. I came very close to being one of those nine.

The first step towards solving this public health crisis is passing the Donate Life PA Act. This legislation will ensure that more life-saving organs are actually donated by increasing public awareness about the issue. It accomplishes this by bringing education about donation and transplantation to high schools, nursing schools and medical schools. Pennsylvania lags far behind national leaders in donor designation on driver’s licenses. Education in schools and instruction of those being trained as medical professionals can help remedy this by dispelling myths about donation.

The Donate Life PA Act also strengthens regulatory oversight by ensuring that all anatomical donations are initially referred to a federally-designated and regulated organ procurement organization (OPO). It also specifically prevents the type of unregulated recovery of tissue that led to the Biomedical Tissue Services scandal involving the theft of body parts at Pennsylvania funeral homes.

The Donate Life PA Act will help save the lives of people awaiting transplant in Pennsylvania. We ask for your support in passing this important legislation as soon as possible. Every day of delay puts more lives at risk.
_________________________________________________________________________________


If you feel really zealous, those of you living in Pennsylvania could let your State Senator know your feelings on this.


Here are a few other links to help you along:

 

IF NOTHING ELSE......could you please sign this?  

I thank you, as do the 8,541 (as of this very minute) people in Pennsylvania that are waiting for a transplant.



Saturday, August 16, 2014

The past is never far....

It was a year ago today that I came home from the hospital, post-transplant, (for the first time) and I so fondly remember just how sweet it was to be here.....balloons, banners, cards, my couch, my guitar, my REFRIGERATOR, my bed!!!
Home. Home again. Ahhhhhhhh.
Though it was short-lived (I had to go back within 4 days) it's a lesson that's imprinted on my brain now not to ever take even the simplest things for granted. Some of you know that I have been reliving the events of last year day and night for the past twenty days and never taking things for granted seems to be the underlying theme.

Thursday I had my official " One Year Out" clinic appointment. I text a friend that as I was going into the appointment, Inside Job was playing on my Pandora. I thought this was a beautiful coincidence and definitely good karma. The one year marker is a bit of a milestone in the tx world and they are very happy with how my grafts are performing. Although I am having some other issues that are directly related to the aforementioned success, they've handed me off to "other issue doctors." and despite my very vocal protesting I have had to have some rather medieval tests done. What they originally believed was the result of CMV, the transplant surgeons now think (hope) that the trouble is coming from the combination of meds that I am currently on and will be consulting with the other doc to determine a course of action. On Thursday they ran a couple blood tests to check levels of  CMV, eGFR, RBC Morph, Abs Baso Ct, Abs Eos, Abs Immature Gran Ct, Abs Lymph Ct, Abs Mono Ct, Basophils, Eosinophil, Immature Gran, Lymphocytes, Mature Neutrophils, Monocyte, Cyclosporine Levels, Lipase Lvl, Amylase, Magnesium Level, Phosphorus Level, Anion Gap, BUN, Calcium, Chloride, CO2, Creatinine, Glucose Random, Potassium, Sodium, CBC with Diff - HCT, HGB, MCH, MCHC, MCV, MPV, Platelet, RBC, RDW-CV, RDW-SD, WBC, and some others.



I also had the joyous revelation the other day that it's been more than a year now since an event of hypoglycemia has almost killed me. With the deteriorating kidneys and the diabetes, this was becoming an all too often occurrence back then and so this alone is worth any inconvenience or symptoms that I have now.

Since I've now cleared the one year hurdle, I am not scheduled to return to clinic for six months (analogous to birds being kicked out of the nest) and my twice-a-week blood draws now are cut back to once every two weeks. Woooooo Hoooooo!!!

That's the word from here for now.

Sign me......Forever Thankful.


Thursday, August 7, 2014

Blog Maintenance

Alright, as much as I really hate to do this, I have to bother the people that I appreciate the most on this blog - those that leave comments.

Because the web is full of jerks, miscreants, and those just out to make life a drag for everyone else, I get about 50 pieces of email a day from web-bots "commenting" on my blog. Now I have the screening set up that their comments don't show, but I still get their emails in my inbox and it's really becoming bothersome.

Most of these look something like the following.
(The third party links have been disabled to protect you all.)
________________________________________________________________________________
  • Anonymous has left a new comment on your post "Ten": 
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Posted by Anonymous to Bob's Inside Job at August 3, 2014 at 12:34 PM 

____________________________________________________________________________________________
  • Anonymous has left a new comment on your post "Ten": 
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Posted by Anonymous to Bob's Inside Job at August 7, 2014 at 12:54 AM 

___________________________________________________________________________________________
What's up, this weekend is good in support of me,
as this moment i am reading this enormous educational paragraph here at my residence.

My site: protein shake diet

Posted by Anonymous to Bob's Inside Job at August 7, 2014 at 9:25 AM 

____________________________________________________________________________________________

Ridiculous, sad, sometimes funny, but always a pain in the butt.
So as you can see it's a bit of a drag to deal with 50 of these everyday and so I've had to add a "Captcha" or  "Word Verification" when you want to add a comment. I sincerely hope that this doesn't discourage ANYbody from leaving their thoughts. If it does, please let me know and I will remove it and just put up with the spam.

Thanks for your cooperation with this.

Saturday, August 2, 2014


III




This is a beautiful day!

Thanks to all of you for the great wishes, texts, and remembrances.

Sign me....

"Darn Glad To Be Here"





Evening of August 2, 2013




 Evening of August 2, 2014

Friday, August 1, 2014

My Frame of Mind.......................If I could frame my mind, where would I hang it?


II

Today, a year ago, just about mid-day was when I got "the call." 

The number on my phone came up as UNKNOWN - that's how the tx center always shows up, but it couldn't have been more fitting as there was no way to have known what exactly lay ahead. It's been a heck of a year, time that I almost surely would not have had, an incredible experience, and isn't that what life is all about.....the experience?

Sorry about replaying all of this for you again but it is like a movie about a life that's like a movie that is just on continuous replay this weekend. Even the weather today mimics that of last August 1 to a tee.

Enjoy this beautiful day!

Thursday, July 31, 2014

Triduum

I

Ok, for those of you that know me close-up, you know that last year at this time things were kinda bleak. July was coming to an end and I hadn't had a prospective call from the tx center in like.......ohhhh a hundred years or so.

Unawares to me.......that began to change on this very day July 31st, 2013.

Today begins my forever-on own personal triduum.

At about 12:30 this afternoon, a year ago today, my donor lost his life and shared the one he had with me so that I could keep mine.




It is a beautiful morning here in South Central today, just as it was a year ago this morning. I can not even begin to tell you the thoughts, scenenarios, and emotions that are all part of the circus inside my head today.
It is all so very bittersweet. I am forever grateful.

This is the ever-constant thread that is running through my thoughts for the next few days.

If you get a chance about mid-day today, give a pause, a smile, a prayer, or a shout-out to my donor.
I know I will.

Thanks so much.

Wednesday, July 2, 2014

Eleven

Coming into the homestretch.....

It's been .92 years, 
or 11 months,  
or 47 weeks and 5 days, 
or 334 days .....
(I will spare you the hours and the minutes.)

... how ever you count it - What a long strange trip it's been.

I remember the wise and wonderful Dr. Ottman telling me as I laid in the ICU last August not to fret the short-term stuff but to look six months down the road.

Well it's been six months almost twice over and I'm still dealing with some things that I thought would be long gone by now. 

I was so psyched to declare that I was CMV free last post and it looked as though I could look forward to feeling better this summer than I have in years.

But it seems that the universe has other plans. 

Now the  higher levels of CMV are back. I can not tell you what a drag this is to be dealing with again.
Argh.

On the flip side....
My talk at the Transplant Consortium went well. I met a lady from the NKF that recognized me from a photo shoot that I did for them more than 20 years ago. Crazy.

The panel that I was on was put together by The Gift of Life Donor Program.
We each told our stories in detail and then afterwards we took questions from the audience. It was very well received by the crowd of critical care nurses and other hospital personnel that take care of both donors and recipients.
I was personally thanked by a lot of them after the program was over for sharing my story.

And so...... As I slide quickly toward the 1st year anniversary My new goal is to have all of these problems wrapped up by August 2. That may be a lofty goal but that's what I'm shooting for.

Thanks for checking in here.....this time....and for all the past months.

The story continues.

Friday, June 6, 2014

Preterit


I had clinic yesterday and they gave me some very good news. I am currently considered CMV Free!
Hopefully I am all done with the nasty Cytomegalovirus but they will continue to check me for it in the coming weeks as the virus can return when the super dosage of drugs that I am currently on is adjusted back to more of a "maintenance" level.
Dr. Waybill told me yesterday that she believes it's possible that I have had CMV since the transplant but it is often difficult to get a positive test result and so it went undetected for a good 6+ months. They all said how much better I look relative to past months (they really don't tell you when you look like hell) and almost all of my blood levels are much better. My white blood count is back to normal, and my red blood count is also back in the normal range for the first time in ohhhhh.....seven or twelve years. Joy!
As I've mentioned, other than a few persistent issues that I'm dealing with, I've felt better lately than I have for quite some time.

I wasn't officially attended to by Dr. Yang yesterday but before I left, I asked one of the nurses if he was in and she asked if I needed to see him. I told her I didn't "need" to, but that he would be disappointed if I didn't say hello. She summoned him and when he came down the hall to see me - he had the biggest smile I've ever seen him wear. We talked at length about my progress and he told me how they have discussed my case at meetings both at Harrisburg and in Philadelphia concerning the CMV, sharing details, implications,and results. We had a very nice conversation and I think that perhaps the dynamics of our doctor / patient relationship have improved. 

It's kinda nutty but I had  posted, a year ago tomorrow, that I was having an up-tick in blood numbers and now things are light-years better. It seems June has been a good month for me.

I hope the summer is off to a good start for all of you as well!







Tuesday, June 3, 2014

Ten


Among the verses of Faust of Goethe, there are:

If nine is one

Ten is none

Here is all the mystery



Ten is the symbol of the matter in harmony - 4 + 6.

Ten represents the Creator and the creation, 3 + 7, the Trinity resting in the expressed universe.

For Pythagoras, 10 was the symbol of the universe and it also the whole of human knowledge.

The sum of 5 + 5, the number 10 represents the two opposite current directions of the conscience:
involution and evolution.

The number ten is regarded as the most perfect of numbers, because it contains the Unit that did it all and
the zero, symbol of the matter and the Chaos, of which all came out; it then includes in it's figure the created
and the non-created, the beginning and the end, the power and the force, the life and the nothing.

According to Agrippa, "ten is called the number of all or universal, and the complete number marking the full course of life." He also attributes to it a sense of totality, the achievement, the return to the unit after the development of the cycle of the first nine numbers.

For the Mayans, it represents the end of a cycle and the beginning of another. The ten was regarded as being the number of the life and the death.

In China, the cross represents the number 10 - as the totality of the numbers.

For Pearl Jam - Ten was a legendary first release.

For Christians, ten signifies Completion - The Holy Spirit descended on the apostles ten days after the Ascension of Jesus.

And 10 was also the Pythagorean symbol of completeness.

In Bob World.......while the Ten month mark doesn't mean perfection or completeness, it does signify another month of progress. I had another CMV test the other day and hope to find out the results when I go to clinic later this week.
Although I still have some persisting abdominal issues, and I'm still working to get pre-op strength back, I've come a long way in just the last two months (since they finally discovered and began treatment of the CMV,)
and one heck of a long way since this night ten months ago.


Thanks for checking in here.
Here's to ten more. 


Friday, May 30, 2014

In My Eyes.....



So.....This past Memorial Day weekend I went to a few cemeteries, visited with loved ones that have gone on, I talked with my mom awhile, I payed respects to others......and it was a very beautiful sunny, spring day. The kind of day that I have a new-found, deep appreciation for in lieu of all of the events of the past year.
A REAL appreciation deep inside as I continually thought of how damn lucky I was not to be currently residing among these stones. As I was winding up my visit, a marker, (above) on the back of one stone caught my eye and when I read it.......I got a lump in my chest roughly the size of a Kennebec potato.
I mentioned to a friend that I was glad it had been a sunny day and that I had my shades on.

OK, before you all go off thinking that Bob has gotten as mushy as a rotten potato, you have to understand that even beyond the side effects of some of the drugs that I'm on that can really wreak havoc with your emotions, this whole donor / recipient,..... souls united in the cosmic dust thing,..... really can't be completely appreciated from the the back seat of the theater. But when it's close.......when it's YOU.....or someone you love, be it the donor ....or the recipient.....it is on a much, much deeper, uber-intense level.

Now I have to be clear here, this was not my donor, but now that doesn't matter....we are all intertwined.

Words escape me right now and eloquence has never really been my friend, but the parents of the lad that rests under this marker (he was only 16,) who saw to it that his young, effervescent spirit could live on through organ donation and gave that gift of life to others, these people are super human to me.
Beyond the human vice of selfishness, beyond the overwhelming grief that they had to have been suffering, and possessed with a power bigger than the pain - they chose to do this. These are the saints among us.

May God forever bless them and their son.

Friday, May 2, 2014

Comes a Time....



Number Nine...Number Nine...Number Nine...


Today marks the nine month bench mark of my transplant. 
Only nine months? Really?!?!?!?? 
The road has seemed longer than that. We've covered so many different scenarios.
Jumped through so many crazy hoops. Overcome so many arduous obstacles.
Now with the hope that the tx recovery gestation period is over - I am ready to move on.

The latest nutty impediment has been the CMV virus, but I found out yesterday at clinic that I am winning the battle. My CMV levels, when they were officially recognized several weeks ago, were 64,000 and now with the help of some darn powerful drugs and plenty of clean living, those levels have dropped to below 200 which the tx center considers "negative." They tell me that once I've tested negative three times in a row (over the coming months) - they will consider me victorious over the active infection.
This is such a welcome change as some of the issues that have bugged me for the past 9 months have been alleviated here lately and now can be directly blamed on the CMV.
The doctor told me that although they had given me the prophylactic IV's in the fall, kept me on meds to deter CMV, and had tested for it regularly, he suspects that somehow it had been "disguising itself" in my system and this has them baffled. He said he has even brought my case up at a conference at Penn recently to discuss this and alternate ways to detect the infection sooner.
Again, a CMV infection to most people is not a big deal, but to those with transplanted organs, it can really spell trouble so I am glad this is moving into the rearview.

Although my red blood count, and my H & H, aren't where they should be yet, most of my other bloodlevels are coming along nicely and my new organs ("grafts" as they are known in the business) are performing wonderfully. To be quite honest, although I still feel that I have a few things to be worked out medically, this past week has probably been the best that I have felt physically since my transplant.

Both the transplant nurse and then later the doctor told me that I "looked good" yesterday (?) and when I asked the nurse about this she said "Bob, there was a time, before your transplant, when you really weren't doing well. You were really pretty sick."
Funny, I don't recall them saying as much at the time but these people are all so positively optimistic that I probably shouldn't be surprised.
But all of that is now downstream. Life is upstream.
That's where I'm headed.

Thanks for the past nine.
Thanks for checking in here.

Tuesday, April 8, 2014

YO YO MAhn

I got a call from the Transplant center yesterday with the results of last Thursday's bloodwork and it seems that things have significantly improved. When they initially discovered the CMV present in my blood, the IgG titer levels were at 64,000  ("normal" is between 250-500) and so they were a just little bit concerned.
As of last Thursday my level had dropped to 1000. 
My white blood cell count was back up to 3.6 (normal is 4-11.)

So the decision to treat this problem with the large dose of oral meds was indeed a brilliant move.    Ahem.

They are having me come back to clinic again this Thursday for more major testing.
As I've told some of you - the tx center folks are always telling me that my white blood count is low....
my red count is low.....my H&H is low....
I told them:  "I'm just down about a quart! 
If we could ease up on all of these blood tests things would surely rebound!"

It might be awhile until they let me prove this theory to them.

Thanks for checking here.

Wednesday, April 2, 2014

Eight Is Great


Eight months ago tonight I was living with new organs.

It's been quite the road this post transplant road to recovery. As mentioned in my last post I am currently doing my best to beat the Cytomegalovirus. I am doing this in a way that will come as no surprise to most of you - and that is - on my own terms. I was instructed at the time of the last post that I would need daily IVs for the foreseeable future. I could either carry an IV pump with me 24/7 for the infusion or I could sit down for approx. 1.5 hours twice a day and administer the IVs to myself. This was to be done via a PICC line that they would put in my upper right arm, snake through my shoulder, my chest, and into an area of my heart.
 Like this -
OK This over exaggerated, highly distorted, and complete  misrepresentation is Bob's idea of the proposed PICC line.


-taking the long way home as opposed to using my left arm because of the fistula that I have in my left arm. This is the same reason they must give me all IVs and take all my blood draws and  blood pressures  from my right arm. Darn fistula.
So after being told all of the ins and outs of such an undertaking, I politely said "No." and said I was willing to take the high doses of the potent oral meds and see where that got us. Though this required  quite the concession by Dr. Yang, he decided to let me try it and one week later, the CMV rate, which a post tx coordinator told me was the highest she'd ever seen, had come down a bit. Tomorrow I go for another measure and if the meds have continued to do the trick, then we will continue with current drug therapy.

Although I have a few other issues that I'm dealing with concurrently, this has been the biggest and most dangerous pest. I'll complain more on the others later. For now, I'm happy to be here and happy to be winning the CMV battle.

Hard to believe it was only eight months ago tonight that I was laying in ICU astonished to be alive. 
Sooooo much has happened and we've been through sooooo much since then. 
Thanks for sticking this out with me and for continuing to check in here.

Eight is Great and more soon.

Wednesday, March 19, 2014

Someday an answer will find me....

It has been a long winter.

Lately I've been having a couple of blood problems. Too high of this. Too low of that. I still have blood labs done twice a week and generally although I check the results online, I don't hear much from the transplant center unless something is way wrong.

I heard from them last week and they ordered several extra blood tests for me to have done this past Monday. I heard from them again this morning with the news that I have an active blood virus that they are a bit concerned about.
Concerned to the point of quadrupling my medicine and restarting the IVs that I had received once a month for three months in the fall. Now they want those IVs to be done everyday for the foreseeable future. They briefly told me that they will put a long-term use IV line into my arm and then I will have the fun of giving myself the IV each day.

My next clinic appointment wasn't suppose to be until April, now they want me to come up in two weeks for a "major" blood work-up and consultation to see where things stand. 

That's all I know for now. I'm sure more will follow.

It has been a long winter.

Saturday, March 8, 2014

Done Vida


A beautiful painting of the Gift of Life symbol that Kara made for me for Christmas.


              March is National Donate Life Month.

                                               Read up on it.           Think about it.

Gift of Life Donor Program                                            United Network for Organ Sharing

                                                    Facts About Organ Donation



                                                             Blurring the Lines...

This is a repost of an interview of  the March 19, 2012 episode of NPR's Fresh Air program with Terry Gross.
It is incredibly thought provoking and extremely informative. 
To give equal opportunity to all sides be sure to listen to the whole episode.

And check out this Pinnacle video on the right side of the page here: 
http://www.pinnaclehealth.org/transplant.aspx



Countless thanks to any persons who have donated or intend to donate life saving organs.

Sunday, March 2, 2014

Seven


SEVEN months ago today, at this moment, I was in surgery with machines doing my breathing for me, machines pumping and cleaning my blood, machines monitoring my heart, my lungs and my brain activity.
Machines making sure I was alive and some damn fine doctors doing their best to keep me that way.
Now seven months later, by their genius hands and by the grace of God, I remain that way.

Although no one knows exactly which day has their name on it, I've been advised by the same doctors that I most likely wouldn't be here this day without that day seven months ago.

And so......I remain v e r y  thankful. 
'Seventy times seven times' thankful.

The incisional hernia fix was a month ago tomorrow and although things are still not feeling all copacetic in that region, Dr. Yang assures me it's "all fixed."  Time will tell. 

It's been a crazy, rocky road but as of  late things have settled down into a post transplant groove that will serve as my "normal" for the future. The sudden changes, unexpected events, and all the daring drama seem to have faded for now or perhaps it's just the excitability of the patient that has calmed.

Either way, this blog is obviously starting to wind down as it has successfully served the purpose for which I intended it. I've been asked to speak on a transplant panel in June and I hope to see if this blog could continue to help anyone else and so I will keep it going for the time being and post when I have something new to report.

Thank you for continuing to check in here.


Monday, February 3, 2014

Like a Phoenix......


Well.....got through yet another one.

All went as planned and now CaseID 321918 is back in his comfy home this snowy evening.
It was questionable early this morning if we would even be able to get to the hospital with the ice and snowy weather. Dr. Yang's office even called to see if I would be there, as north bound route 83 was completely shut down for a while. (Thanks to several of you for the ride offers.) But we left with plenty of time and Nick got me there and we were even early.

2/3/1014 - 2:23 pm

FRM:orstatus@pinnaclehealth.org
MSG:CaseId: 321918, Patient has arrived in the Operating or Procedure Room
________________________

FRM:orstatus@pinnaclehealth.org
MSG:CaseId: 321918, Surgery or procedure has started
________________________

FRM:orstatus@pinnaclehealth.org
MSG:CaseId: 321918, Surgery complete; preparing patient to leave the room
________________________

FRM:orstatus@pinnaclehealth.org
MSG:CaseId: 321918, Patient is in the Post Anesthesia Care/Recovery Unit
________________________

FRM:orstatus@pinnaclehealth.org
MSG:CaseId: 321918, Patient has been discharged from the surgical area

The doctor continued my pancreas incision making it a bit longer. Which, although a little more than uncomfortable, I guess is better than a brand new cut because with all the surgeries I've had over the years I'm really beginning to look like some kind of thingamajigsawpuzzle.

                                                                          Dr. Yang

Things are true to what the doc said - 
I'm pretty sore this evening and he's collared me with several limitations (grrrr) like:
NO snow shoveling, No lifting any weight at all, and No driving for a while.

So if you see me thumbing along the road of recovery stop and give me a lift. Will ya?
I've got good stories. 
I promise it wouldn't be a boring ride.

Thanks to all of you for all your support and for checking in here.

Sunday, February 2, 2014

This is Worth My Attention......

Today, it has been six months since my surgery. This is kind of a milestone in the transplant world.
I was reminded by a very good friend last night, as I was watching the Penguins game, that six months ago I was in a very different place, thinking very different thoughts. I fell asleep last night reliving those moments.
All in all, it's great to be here.
Six months ago, at this moment, I was just about half-way through my transplant surgery.
Tomorrow at this time they should just be finishing up my incisional hernia surgery and then it's back to the now familiar road of recovery.

I certainly appreciate all the good wishes and offers of help, and to the people who observed this 6 month date with me. It brings a big 'ole smile to my face. Thank You!
I'll post tomorrow after-the-fact to let you know how it all goes.
Thanks for checking in here.

Monday, January 20, 2014

Another step on the road.....



The hernia fix is scheduled for February 3. 
Before that happens I need to have a new EKG and another chest X-ray. 
Evidently the ones I had done five months ago aren't valid anymore.
I had all the preliminary bloodwork done today.
Although I've had hernia surgery before, and would prefer to have that doctor do it again,  Dr. Yang wants to do it himself at Harrisburg just so no one is messing around so close to the project that he has been overseeing for almost six months now.

The doc seemed happy with my overall progress but made no real mention of  me hitting what he termed earlier as "a major benchmark" of 6 months post-op.
As I've said once or twice before, if you want info from Dr. Yang you have to really be extremely assertive with questions. Then you have to be particularly cautious that he knows you are not questioning him but rather asking questions for the want of information.
The subtle nuances of dealing with transplant specialists.

Thanks for looking here.

Sunday, January 19, 2014

Next....

So, since this incisional hernia is the big pressing problem that I'm dealing with physically right now, the tx staff have moved my six month post-transplant clinic up 14 days to tomorrow.
I hope to find out how they are going to handle this and more importantly how soon.
Details to follow.

Wednesday, January 8, 2014

And the boat continues to rock....


At clinic last week I made mention of a few things to Dr. Narins and after he checked me over he told me he wanted me to have a CT scan done and so I had that yesterday.
Not just a CT scan but a CT scan with "oral contrast."
Yeah.



As delightful as this might sound, it involves sitting in the radiology department drinking a concoction every twenty minutes for two hours. Then waiting a while for everything to settle and then off to the tube to be scanned which takes all of about five minutes.












Today my post-tx coordinator Steph called to give me the results and it seems that I have two issues to deal with.
First, I have a large volume of "fluid" around my new pancreas. (The major contributing factor to the belly that I am working so hard to lose.) Dr. Yang says (again) that this will be re-absorbed by my body but it may take another six months or so.
Grrrr.
He tells me he could insert a needle and drain it but he really doesn't want to pursue that venue unless it's really an emergency. Messing around so close to the new organ can bring all kinds of trouble so that's going to be a wait and see deal for now.

Secondly, I also have an incisional hernia.
When they transplanted my new pancreas they needed to cut a hole in my peritoneal cavity to do the hook-up of assorted things inside and now it seems that some of the inside things are pushing to get out.

This notable and highly scientific medical definition is brought to you by.....me.
I'm sure Dr. Narins or Dr. Yang would have a much more eloquent explanation.

The hernia is a bit more of a continual discomfort and so the plan of dealing with that will be discussed at my next clinic appointment on January 30th. These surgeons will do anything to push any more invasive procedures off until, at the very least, six months post tx surgery.

So I'm sure about now the people at Pinnacle are hating the day they ever decided to take my case on, seems I've been a burr under their saddle right from the get-go.

Anyways........this isn't how I wanted to start off the new year with a post like this but, all in all, I am here and able to post so that's a plus.

Seriously, thanks for checking in here.


Thursday, January 2, 2014

2013 in the Rearview Mirror




January

At the end of recent years I've developed a bit of a personal custom of writing down some of the highlights of my life in the past year, some of my biggest shortcomings, the things that really sucked, and what I can do to make life better in the new twelve months to come. In recent years the big black cloud of end stage renal disease had been hovering over my head and never far from my conscious thoughts.
Below is a synopsis of how that portion of 2013 played out in my life.

2013 
...started off with my usual yearly appointment at the transplant center and this year my biggest question was why I hadn't been called with any kp offers in like forever.
I had not even been put on the Possible. Maybe. 10 Steps Down. or Maybe, But Probably Not lists.
It had only been 2 1/2 years since I was put on the transplant list but time waits for no one and as my GFR and other blood numbers continued to slide I became a bit more anxious. 
AND I was headed toward a surgery to install a fistula that I had no intent of ever using.


And so on January 24, I had my left arm's blood lines rearranged a bit to accommodate a new  
"vascular access" otherwise known as a arteriovenous fistula
This was only to be used in case I may need it to facilitate an organ transplant as toxins were building up in my blood at a rate that may soon nix my chances at any transplant.

And so we went from this :



To this:


A "fine vascular access."

BTW this has grown to about 5x this size now.
Since this has been put into my left arm, and my circulatory system was rearranged, all injections, all blood pressures, all blood labs, and all IV's have to be done to my right arm.
After almost a year of this my right arm is definitely showing signs of wear and tear.


February

After doing two stress tests and more bloodwork in February, I was okay'd by the tx center to be back on the active transplant list again. So after all the hoops and loops I'd been made to jump through - this was good. My arm was healing well. The surgeon was happy at how it looked at the post-op appointment. My nephrologist was like a kid at Christmas when I showed him that I had it done but he also knows that I was still not into anything that remotely had to deal with dialysis and so he assured me that he hoped to never have to use this new access.


March
The month of March was pretty quiet with the exception of getting approval of the fistula and being 
"cleared to use it." The only other news was that my Glomerular Filtration Rate (GFR), a test used to determine how well the kidneys are functioning, had fallen to 8. Nornal is greater than 60.
Not so good.





April
In April I made it a point to mention that it was National Donate Life Month.
Someday a generous person may save your life, the life of one of your family members, or the life of someone you know (like me) through organ donation.
You have a higher chance of needing an organ in your lifetime than you do of ever becoming a donor.
Think about that and then please sign up to be an organ donor. Tens of thousands of people are waiting for a transplant. You have the power to change someone's life so much for the better 
and they will be forever grateful.

I know.
I am one of them.


Gift of Life is my area's organization that is part of the nationwide organ and tissue sharing network run by the United Network for Organ Sharing (UNOS). They offer support programs to the family and friends of donors who gave the gift of life after death to help cope with the sudden loss of their loved one. These programs are offered free of charge in recognition of those who made the gifts possible. The donor program is also responsible for all aspects of educating the community about organ and tissue donation.

Although the Gift of Life program serves my geographical area, through this link: organdonor.gov you can register with any organ donor network in the U.S.




May

It was a very quiet month. I was really becoming a bit disheartened as it had been almost a year since I had any kind of call from the transplant center at all. The spring air was warm and wonderful, the world was full of new life but at the same time, in the quietest moments, when I wanted to be honest with myself.....
I could feel it slipping away.
My friends, who were checking on me, continually asked me how I was feeling and it was the same story each day to varying degrees so on the blog I posted a link that described the cruddy feelings listed here.




June


GFR up two points to TEN!

In what I called a "Summer Rally", my GFR had actually rebounded a slight bit to 10.
Other blood numbers were a little less desirable.

Still all quiet on the Pinnacle front so I gave my pre-transplant coordinator Becca a call just to see what was up. She advised me that I had not been forgotten, that there had been no appropriate organs,
 and she assured me that good things would happen for me soon.



July

I got out camping with some great friends, Glenn and Big A, 
and I did my best to enjoy the beautiful summer weather.
Otherwise, another quiet medical month. 
Friends keep checking on me, and I did my best to accent the positive but time keeps slipping...


August


August 1st, and an "Unknown" caller, an Unknown message, an Unknown future.
How crazily appropriate this was. I think it should be the cover of my next book.
So...Into the Great Unknown.

At midday, as I was about to have lunch (the last real food I would have in a week), I received a call from Becca at the transplant center with a potential kidney / pancreas offer. As she explained the ins and outs of what was going on, I swear I could hear a smile in her voice and I had the distinct feeling that she was as happy as I was (although at the time, my happiness was shrouded by a  tsunami of nervous reactions.)

Now you do your best to try not to get too excited because many things can happen, many things are apt to go wrong, and I had been here before. 
Still, your mind races, your heart races, you find yourself rushing around in a very automatic, almost robotic mode doing the silliest stuff before you head to the hospital - paying bills, making sure the house is presentable, taking care of mail.....

Then off to the hospital to sit and wait...
But it wasn't that way at the hospital this time. From the moment I arrived things were in full swing, happening at a crazy pace, even though it was still just a "potential" chance at the organs there seemed to be a different feel this time.

And different it was. The afternoon of August 1st I had the customary bloodwork, typing / cross-matching, chest ex-rays, ekg's, and a sit down discussion with my pre-transplant coordinator Becca, and Dr. Seth Narins one of the transplant surgeons. They went over the entire procedure again, explained risks, fielded my questions and did their best to set me at ease. This was SO helpful to me. Just to have these people sit down with me and explain everything again, to see their faces, and to be able to look into their eyes, gave me a good read that I was in very competent hands. Becca, who had been on this trip with me since the very beginning, had an air of reassuring confidence that meant more to me than she probably knew.
 Dr. Narins told me that the donor was 19 years old and so, if everything worked out, I would be getting some absolutely wonderful organs.
As for the big question..... Dr. Narins said he wouldn't be able to tell me if my transplant would be a certainty until he recovered, inspected, and had the organs in hand, only then he would say for certain that the surgery would happen.

August 2nd, at 8:30am, the hospital received a call from Dr. Narins and Dr. Ottman the surgeons who traveled 3 hours to the donor's hospital saying they were on their way back with two pristine organs, that the organs looked great, and to get me prepped for surgery at 11:30am .



They took me to the OR at 11:20 and started the 6 hour and 37 minute operation.
Dr. Narins told me later that when he grafted the new kidney into my body it began working almost immediately. He said generally it takes around 12 hours for the new organ and the new host body to meet, shake hands, and start working together, however he said my body was so full of toxic poisons that the kidney began working right away.

Later that evening I was in ICU surrounded by family.





August 3rd....Back to life.


The next two weeks were a constant mix of good news (that my new organs were working wonderfully) and the downer that I was constantly bleeding internally from the area where my new pancreas was attached to the rest of the system. A junction the docs refer to as the anastomosis. The surgical joining of two structures that are not typically connected.
They were doing their best to treat the problem "medically" (rather than "surgically.) So they hooked me back up to blood machines, several more IV's, gave me more plasma, more platelets, something known as cryoprecipitate and a very heavy dose of albumin, a protein compound, to help keep blood nutrients running through the blood stream and prevents these nutrients from leaking out through the tissues (via the bleeding.)

At the end of what seemed like a forever stay in ICU and forever and a day in the hospital....
I was cleared to go home. 
After saying goodbye to all my caregivers I left on a warm August day and everything on the ride home looked so darn good. I'd felt like I had been away for years rather than weeks.
This home-spun euphoria lasted all of 3.5 days when I woke up with a fever and feelings of ill being. The tx center sent me to the local ER who ran all sorts of tests and when the results were forwarded to Dr. Yang, he wanted me back in the Harrisburg hospital A.S.A.P.. I found out later that this was a bout of rejection, and rejection is one word that transplant patients do NOT want to hear.

All totaled,- it was 27 out of  the 31 days of August 2013 in the hospital.
18 of those in ICU.
31 units of blood, plasma, platelets, and the other aforementioned blood products.
But I got to go home with 2 new organs that were functioning wonderfully and I got to go home with a new outlook on life.


September

 The beautiful month of September started off with an inherently impatient guy trying to learn patience as I was not allowed to go out very much at all thus no big groups....no fairs....no farm markets....no stores....   no church....no lollapalooza gigs.....nuthin.
This took a bit of getting used to, but as I said many times, I did NOT want to risk getting put back into the slammer (hospital) or worse yet, endanger my new kidney and pancreas. All of this lo-key living, with not much physical activity, combined with the steroids and the umpteen other pills I was on didn't make for much quality sleep. And believe it or not during these everlong awake hours of the night, my mind would inevitably wander and wonder about my donor, about their family, who in the darkest days of their family's life, selflessly gave these gifts to whoever could use them.
These are truly special people. I hope God abundantly blesses them in the future.



Also making the scene at about this time were the "nasty tremors" (sounds like a punk rock band) that haunted me until my meds were changed in early December.

On September 17th, I had my first of three Cytogam IV's at home that went pretty well for all the hype.
Clinic visits every week or at the most two, and bloodlabs done twice a week make up my new schedule.
You see? I had to be on the mend in September because I was finding things to gripe about!


October

October was full of changes and tweaking (not twerking). 
Fine adjustments in medications...adding this one....subtracting that one....replacing this with that....four of these for one of those....  My transplant coach Jan had told me it would be this way. There's a lot to this transplant business. You really do have to live in the moment with a hope for the future.
The fine tuning of meds is a most subjective aspect to each individual transplant recipient. Although the powers that be know what drugs are needed - just how differently each individual can react to such medicines and dosages  may vary greatly. This is where the art of the science of medicine comes in.
At the end of the month came my second Cytogam infusion, this one was complicated a bit by a sudden onset of some major teeth-rattling chills and a real drop in blood pressure. My nurse Barb, was on top of it all and after shutting the IV down for 45 mins or so and restarting it at a very reduced rate, all ended well with no lingering effects. Two down. One to go.
The road to recovery post transplant may not be the smoothest road to walk, but it's sure worth walking nonetheless.


November

The Thanksgiving month started off with Dr. Yang agreeing to switch some major medicines on me in an attempt to stop the tremors. This was a big concession for him as you may remember just a month ago he shut me down cold saying that maybe we'd look at doing that after the new year. And so now he switched  one of my major immunosuppressants from Prograf to Neoral (or Cyclosporine). I can't say it was an overnight  success, (few things in this business are) but over the past two moths the tremors have reduced to practically nothing and I am so grateful because the Vibration Reduction mode on my Nikon lenses was no match for these shakes.
Midway through the month, I had my last installment of the Cytomegalovirus Immune Globulin IV. The nurse was aware of the trouble that I had last time so she slowed down the rate of infusion and it all went smoothly.


December

Even with frantic Christmas shopping, the maddening crowds (that I wasn't suppose to be in) and the battle to keep my white blood count above the red line, December was a great month.
Tremors were all but gone, the IV's were done, my WBC kept slipping but with a few shots of Neupogen and some of my own self-production the count as of today is back in the normal range. Christmas with my family was beautiful, and over the holidays I got to spend some time with a few friends that mean an awful lot to me. Others, that I really wanted to see but didn't get the chance to, or who were sick and didn't want to take the chance of polluting their low white blood count friend, are on my New Year's resolution list to get to see SOON.
This year I feel comfortable setting such a goal for myself and the coming year and I've told several of you how not only my health but also my demeanor and my mindset have changed greatly from last Christmas.
All for the good.
I am blessed.
It was a heck of a year.
Thank you for checking in here.
Thank you all for being such great friends.
And most of all, my greatest thanks to God, my donor, and his selfless, caring, and wonderful family.

May 2014 be good to all of us.



Post-Script.



I am finishing this epic post on the evening of my 5 month out mark.
Five months ago at this moment, the surgeons had just finished up and I was being taken to post-op.
Today, I had clinic and the doctors and nurses are extremely happy with my progress, my blood results (WBC is back in check), my appearance and my post transplant demeanor.

As always, thanks so much for continuing to check here.