Probably the most often question asked of me is some variation of "How did this happen?" or "Why did you need a heart transplant?” Sadly the only answer I can really give is a shrug and a weak smile. The truth is I neither know why nor understand why this happened. Not long after I got out of the hospital asked my doctor about the pathology of my old heart. The answer he gave me was pretty vague and wishy-washy even for medical speak. The report described how disease ridden my heart was, how sick it was, how it showed signs of other heart attacks, but really came to no conclusions or how it got this way. My doctor grumbled something about genetics causing premature coronary disease, but really, I have no family history of such premature coronary disease, no risk factors at all. 'Bad luck', people say.
Honestly, I guess there is some comfort in knowing that there isn't really a reason for what happened to me, that there was nothing I could have done. But still, sometimes it feels like living under the sword of Damocles, not knowing what (almost) killed me. It is not an oppressive fear that hangs on me, but it is there. It is incredibly difficult not knowing, not understanding how I came to have such a ridiculous string of health challenges (heart attack, pneumonia, strokes, infections, ITP). It is a question that haunts me, the question that I can't escape. It is a question that is extraordinarily frustrating. Not knowing why this has happened to me, and not knowing why I am to I face these challenges. Among all my current challenges, the depression, the meds, the ITP, not knowing is the hardest part.
Friday, June 18, 2010
Friday, April 30, 2010
Tomorrow is the day
Tomorrow is the day. I will be running in the Donate Life 5k in Fullerton, CA to support organ donation awareness. Thanks to everyone who donated, I 've raised $1300 dollars so far. If you haven't donated, you can do so at
http://www.active.com/donate/DonateLife2010/MStrane1
http://www.active.com/donate/DonateLife2010/MStrane1
Wednesday, April 21, 2010
DonateLife Run/Walk 5k
This is the second year that I'm going to participate in the Donate Life 5k. Last year I walked the 5K with a wonderful group of friends. This year I plan to earnestly run the 5k and have already begun training to do so. I have some distance to go to get to running an entire 5K, however the course is flat and I'm looking forward to the challenge.
I would like to take this opportunity to thank everyone who donated last year. Thanks to your generosity I was able to raise nearly $3,000 and ended up being the #2 fundraiser of all individuals.
You can sponsor me here.
http://www.active.com/donate/DonateLife2010/MStrane1
There is a severe dearth of organ donors right now, so any bit you can give would be greatly appreciated. Also, please remember to register to be an organ donor. You can do that here:
http://www.donatelifecalifornia.org/
or here:
http://organdonor.gov/
If you do sign up, please remember to tell your loved ones of your wishes
I would like to take this opportunity to thank everyone who donated last year. Thanks to your generosity I was able to raise nearly $3,000 and ended up being the #2 fundraiser of all individuals.
You can sponsor me here.
http://www.active.com/donate/DonateLife2010/MStrane1
There is a severe dearth of organ donors right now, so any bit you can give would be greatly appreciated. Also, please remember to register to be an organ donor. You can do that here:
http://www.donatelifecalifornia.org/
or here:
http://organdonor.gov/
If you do sign up, please remember to tell your loved ones of your wishes
Monday, March 29, 2010
Strength and Luck
A few weeks ago I had a chat with an old friend. In fact I've known this person for about 32 years. We were never super close friends but we drifted in and out of acquaintance because of our history and the fact that her brother was an incredibly close friend for many years.
She was very aware of my heart attack and subsequent heart transplant but she didn't know that details. Providing that I'm terribly comfortable talking about my experience with people I know, she asked questions and I answered them honestly. It'd been a while since I'd gotten into this much detail about the nitty-gritty of what I went through, and I've found that it helps me to talk about it in detail every once in a while. As I watched her incredulity at all that I had gone through, physically and mentally, it finally dawned on me. It finally sunk in. Something that people, Wendy in particular, have been telling me for long time that I don' think I ever truly accepted until that moment.
I am strong.
I finally accepted, realized, the incredible strength it took for me to get through and survive the physical challenges I faced. I survived a massive heart attack. I survived strokes, and infections, pneumonia, loss of circulation, having my chest open for 11 days, and three major three surgeries. I survived all of that and I am walking and talking today. I am strong. More over, while I was in a coma, I battled nightmares of torture, kidnapping, drugging, terrorism, and many other terrifying circumstances, and through every nightmare, I fought. I fought to stay alive, I fought to escape, I fought to get home, I fought to save my self and many of my loved ones, through fear and pain and never ending dark I fought, and I can honestly say that I never gave up. I am strong. In fact, I have no doubt that had I ever given up, in those dark places, I would not be here typing this today.
I am strong.
To this day, I have people tell that I am lucky. To be honest, I chaff at this, probably more than anything anyone tells me about my experience. True, at times I do not feel very lucky for what happened to me. Even now, how I came to go through this seems extraordinarily unlucky. But I think I know what people mean when they tell me I'm lucky, and that is really what bothers me. It wasn't luck that got me through. It wasn't luck that I survived. It was passionate doctors and nurses who never gave up on me. It was a mother and girlfriend who never left my side. It was the dozens of cards and messages I received from friends and family, old and new. It was because of these that I survived It was because I am strong, and calling it lucky not only does a disservice to me, but all of the people who worked and prayed to help me live. It was not luck. I am strong
It is foolish of me to deny luck in this though. I am lucky that I live during the time that I do, when medicine can bring me back from death. I am lucky that lived where I did so that I would end up with the nurses and doctors that took care of me. Some may think that me receiving my new heart merely 8 hours after I was placed on the transplant list is luck, but I say, no, it was love. Love of a grieving family who had it in their heart to donate their loved ones organs so that others may live, in their darkest time.
It is taking me time to process this experience that I have been through, and am going through. It is still one I'm going through, and I have far to go, but I can now tell you this:
I am strong.
She was very aware of my heart attack and subsequent heart transplant but she didn't know that details. Providing that I'm terribly comfortable talking about my experience with people I know, she asked questions and I answered them honestly. It'd been a while since I'd gotten into this much detail about the nitty-gritty of what I went through, and I've found that it helps me to talk about it in detail every once in a while. As I watched her incredulity at all that I had gone through, physically and mentally, it finally dawned on me. It finally sunk in. Something that people, Wendy in particular, have been telling me for long time that I don' think I ever truly accepted until that moment.
I am strong.
I finally accepted, realized, the incredible strength it took for me to get through and survive the physical challenges I faced. I survived a massive heart attack. I survived strokes, and infections, pneumonia, loss of circulation, having my chest open for 11 days, and three major three surgeries. I survived all of that and I am walking and talking today. I am strong. More over, while I was in a coma, I battled nightmares of torture, kidnapping, drugging, terrorism, and many other terrifying circumstances, and through every nightmare, I fought. I fought to stay alive, I fought to escape, I fought to get home, I fought to save my self and many of my loved ones, through fear and pain and never ending dark I fought, and I can honestly say that I never gave up. I am strong. In fact, I have no doubt that had I ever given up, in those dark places, I would not be here typing this today.
I am strong.
To this day, I have people tell that I am lucky. To be honest, I chaff at this, probably more than anything anyone tells me about my experience. True, at times I do not feel very lucky for what happened to me. Even now, how I came to go through this seems extraordinarily unlucky. But I think I know what people mean when they tell me I'm lucky, and that is really what bothers me. It wasn't luck that got me through. It wasn't luck that I survived. It was passionate doctors and nurses who never gave up on me. It was a mother and girlfriend who never left my side. It was the dozens of cards and messages I received from friends and family, old and new. It was because of these that I survived It was because I am strong, and calling it lucky not only does a disservice to me, but all of the people who worked and prayed to help me live. It was not luck. I am strong
It is foolish of me to deny luck in this though. I am lucky that I live during the time that I do, when medicine can bring me back from death. I am lucky that lived where I did so that I would end up with the nurses and doctors that took care of me. Some may think that me receiving my new heart merely 8 hours after I was placed on the transplant list is luck, but I say, no, it was love. Love of a grieving family who had it in their heart to donate their loved ones organs so that others may live, in their darkest time.
It is taking me time to process this experience that I have been through, and am going through. It is still one I'm going through, and I have far to go, but I can now tell you this:
I am strong.
Wednesday, February 10, 2010
It's the little things, ain't it?
I do think that at some point I should stop looking back, however, this morning, I started thinking about all the little things. What little things am I referring to? When someone has a long hospital stay and devastating health crisis like I had, the focus is on the major health issues and not on all the little annoyances that go along with a long hospital stay and being on high doses of dozens of medicines, things that I may not have mentioned previously.
Being in a coma, obviously, much of your normal hygiene routine falls by the wayside, and for various reasons, does not get taken care of. When I was very sick, my heart had trouble keeping my blood pressure high enough, to help it, I was on blood thinners. Because of that, it was important that I did not get bleeds. This meant they couldn't brush my teeth properly. Instead of a normal tooth brush, it was an essentially a piece of foam on a plastic stick. I remember this because they were still using these "brushes" after I woke up. The problem with these things is that they don't really clean your teeth of plaque and tartar, so when I woke up my teeth were encased in plaque and tartar. Maybe not that big of a deal, but all the gaps between my teeth had filled in - so much so that my teeth actually kind of hurt - it was uncomfortable. So uncomfortable in fact that I used to fantasized, in my delirium, about them having a dentist come in and clean my teeth.
After my transplant, I finally convinced my mother to bring in the sonic toothbrush and after a couple of days of using that I was able to free my teeth from their tartar imprisonment.
In addition, to not being able to properly brush my teeth, they also refused to properly cut my toe nails, for fear of cutting the cuticle. This wouldn't be such a big deal, except for the fact that I have a couple of minor hangnails that need attention. The nurses at the hospital had no idea how to deal with them, and thus refused to cut my nails, nor would the let me (not that I could, but I'll get to that later). I wasn't able to cut my nails until I left the hospital, and by that time my nail, while not that long, again my mother had actually managed to trim them for me a bit, had reached a thickness that I didn't think was possible for nails- I would say 1mm, but it sounds like an exaggeration. I'm not sure, but I do know that I had to cut my nails with big scissors because nail clippers wouldn't cut it, literally. Anyway, after a month or so trimming my toe nails were back to "normal". I suspect that the medications change the biology of my body in some way and caused my nails to grow in this weird way.
This brings me to my hair. When I left the hospital, I noticed that my hair had taken on a straw like quality that no amount of washing would relieve. Only the strongest of conditioners would seem to soften it up for a bit. Again, I suspect it's from the medications. Eventually my hair went back to normal (albeit with a few more gray hairs), but really don't think it really recovered until it had all grown out.
Speaking of hair, one thing that I did not like about being in the hospital, aside from having to go to the bathroom in a bed pan and be helped by someone, was the sponge baths. In addition, to it being humiliating to have some one else, including men, clean you with a sponge, it was cold. Sure they would use warm water, but you are still open to the air, the only good things about it was 1)being clean afterward, 2)the pre-warmed blankets they would put on you afterward. One good thing about being in the hospital though was how they cleaned my hair (on occasion, since they only did this a couple times). One way to clean your hair was to put this shower cap sort of thing on your head, which fit pretty tight. They (the nurse) would break something in the cap and it would be filled with shampoo and warm water. It felt so good. I loved it, though some crazy nurse told me that it would make me lose my hair - not a very nice thing to say to a psychotic hospital patient.
Other things I think people don't think about for those in a coma. You lose your voice from having a tube down it for weeks. You lose you appetite because they kept your stomach full through a feeding tube. Your hearing becomes very sensitive...because I don't why, but to this day I have ringing in my rings whenever I hear a cracking noise, like for example, every time I hear a carabineer shut closed.
You get amazing knots in your back from lying in med some much- when I got out the hospital I had walnut-sized knots in my back -it was impressive.
Still, all of these were minor annoyances, yet somehow, I remember them almost as vividly as the actual horrible things that happened to me.
Being in a coma, obviously, much of your normal hygiene routine falls by the wayside, and for various reasons, does not get taken care of. When I was very sick, my heart had trouble keeping my blood pressure high enough, to help it, I was on blood thinners. Because of that, it was important that I did not get bleeds. This meant they couldn't brush my teeth properly. Instead of a normal tooth brush, it was an essentially a piece of foam on a plastic stick. I remember this because they were still using these "brushes" after I woke up. The problem with these things is that they don't really clean your teeth of plaque and tartar, so when I woke up my teeth were encased in plaque and tartar. Maybe not that big of a deal, but all the gaps between my teeth had filled in - so much so that my teeth actually kind of hurt - it was uncomfortable. So uncomfortable in fact that I used to fantasized, in my delirium, about them having a dentist come in and clean my teeth.
After my transplant, I finally convinced my mother to bring in the sonic toothbrush and after a couple of days of using that I was able to free my teeth from their tartar imprisonment.
In addition, to not being able to properly brush my teeth, they also refused to properly cut my toe nails, for fear of cutting the cuticle. This wouldn't be such a big deal, except for the fact that I have a couple of minor hangnails that need attention. The nurses at the hospital had no idea how to deal with them, and thus refused to cut my nails, nor would the let me (not that I could, but I'll get to that later). I wasn't able to cut my nails until I left the hospital, and by that time my nail, while not that long, again my mother had actually managed to trim them for me a bit, had reached a thickness that I didn't think was possible for nails- I would say 1mm, but it sounds like an exaggeration. I'm not sure, but I do know that I had to cut my nails with big scissors because nail clippers wouldn't cut it, literally. Anyway, after a month or so trimming my toe nails were back to "normal". I suspect that the medications change the biology of my body in some way and caused my nails to grow in this weird way.
This brings me to my hair. When I left the hospital, I noticed that my hair had taken on a straw like quality that no amount of washing would relieve. Only the strongest of conditioners would seem to soften it up for a bit. Again, I suspect it's from the medications. Eventually my hair went back to normal (albeit with a few more gray hairs), but really don't think it really recovered until it had all grown out.
Speaking of hair, one thing that I did not like about being in the hospital, aside from having to go to the bathroom in a bed pan and be helped by someone, was the sponge baths. In addition, to it being humiliating to have some one else, including men, clean you with a sponge, it was cold. Sure they would use warm water, but you are still open to the air, the only good things about it was 1)being clean afterward, 2)the pre-warmed blankets they would put on you afterward. One good thing about being in the hospital though was how they cleaned my hair (on occasion, since they only did this a couple times). One way to clean your hair was to put this shower cap sort of thing on your head, which fit pretty tight. They (the nurse) would break something in the cap and it would be filled with shampoo and warm water. It felt so good. I loved it, though some crazy nurse told me that it would make me lose my hair - not a very nice thing to say to a psychotic hospital patient.
Other things I think people don't think about for those in a coma. You lose your voice from having a tube down it for weeks. You lose you appetite because they kept your stomach full through a feeding tube. Your hearing becomes very sensitive...because I don't why, but to this day I have ringing in my rings whenever I hear a cracking noise, like for example, every time I hear a carabineer shut closed.
You get amazing knots in your back from lying in med some much- when I got out the hospital I had walnut-sized knots in my back -it was impressive.
Still, all of these were minor annoyances, yet somehow, I remember them almost as vividly as the actual horrible things that happened to me.
Tuesday, January 26, 2010
all I wanted was a Pepsi
"all I wanted was a Pepsi, just one Pepsi, and she wouldn't give to me..."
- Suicidal Tendencies, "Institutionalized" (1983)
2009 has come to a close and I find myself in much that same position I was in a year ago. I risk this becoming a whine-fest, but my life is what it is, and I've been pretty honest so far, so I see no reason to change at this point. The year ended with a good trip back east to visit family, it was somewhat crazy, driving (well, riding for me) back and forth from
Here it is almost the end of January and I have yet, to review 2009 or look much forward to 2010. I guess I’ll start with my goals for 2009. I know I went through this back in March, but I think it bears going through again.
1. Touch real rock by March - I actually already did this on Dec. 27th - I climbed a 5.7 and 5.8 at
2. Run a 5k (specifically the Donate Life Run/Walk on April 25th. Want to sponsor me? http://www.donatelifeoc.org/ - I walked the 5k this tear, but it is the end of January and I am going to start training to RUN it this year, again, I would love it if you would sponsor me - http://www.donatelifeoc.org/, though I have not yet registered
3. Finally, finally finish publishing my work on the Lenwood fault. Ummm, Keeping up with my regular job has been enough.
4. On July 30th, 1 year from my heart attack, I want to ride the Chumash Trail, the ride I did that same evening. http://tinyurl.com/8hgk4f - I did this with the Pasadena Mountain Bike Club, I did not make it to the top, but I still had fun.
5. With much luck, stabilize my meds enough by May so that I can go to
6. Not miss phoning or sending a card for one single relative or friend’s birthday. - I tried, but I did not do so well with this :-(
7. Do everything I can to take care of my new heart. - I did well with this until November when feeling not so good from my ITP treatments lead me to not do so well with my diet, between the steroids and my diet I've put on some weight. I'm feeling better now, and exercising more than I have in about 5 months.
8. Personally thank, as many of the people who phoned, emailed, wrote on my care page or visited me in the hospital as possible. - I created a personalized card, and was able to thank everyone at the hospital.
I would love to say that I'm doing better than the last entry and, honestly I am, at least than I was doing several months ago. I'm still battling ITP, I'm trying to be optimistic about the whole thing - my platelets have stabilized, though at a level that is not really satisfactory (40k at last check). The BK virus has been cleared from my blood but is being stubborn in getting out of my bladder, luckily I'm still asymptomatic. I'm feeling well enough to get back to exercising again, unfortunately to some degree I feel like I'm back to where I was at last January, basically at zero. Honestly, I'm not that out of shape, but certainly worse than I was in August, when I could actually see a glimmer of normalcy.
I know that recently I mentioned that I'd begun taking Lexapro to deal with some depression, and honestly, it's worsened. I'm not entirely sure why, though I guess that is the nature of depression. Some of it may be some difficulty at work, some of it may be due to my lack of activity, not being able to bike or climb recently, some of it may be unresolved issues from the transplant, and some of it may just be. I honestly don't know. I'm fighting it I guess, but I'm not sure I really know what that means. I understand, those who think I should just snap out of it, and be happy that I'm alive, like I said, I don't know why I can't. But hey, at this point I'm still trying, I get up everyday and go work, I try, I take care of dogs, I try to get exercise when I can, I try. I sometimes do feel like I should just run away from it all.
Anyway, it’s another year and I can't believe it's been so long since I left the hospital. My doctors appointment ARE getting less and less, and despite everything, I am expecting a good 2010 - and why not, it is the year of the Tiger (starting Feb 15).
Friday, November 20, 2009
Take Another little Piece of My Heart
Rather than post up another entry bemoaning my on going trials (and trust me they are ongoing), I decided to write something up about trials past. Namely the procedure known as a heart biopsy. A myocardial heart biopsy is the definitive procedure used to determine if a transplanted heart is showing any sign of rejection.
A heart biopsy is a test in which small pieces of tissue are taken from the heart muscle, and examined under a microscope. Now a heart biopsy is not for the faint of heart (no pun intended) generally it supposed to be a relatively pain free procedure, but I know of several people who have to be sedated to deal with it.
When many hear the word biopsy, most think of long needles pushed into the body by a radiologist to retrieve tissue, a heart biopsy is a bit more complicated and invasive.
The Procedure:
• Prior to the biopsy, you asked to NPO, meaning no eating, no drinking. I had a ironically heart breaking experience in the hospital involving being NPO for a biopsy. Much of my time in the hospital I was nauseous an not hungry at all, one morning, however, my appetite came back, for once I was looking forward to breakfast. I waited almost excitedly for them to deliver my cheerios, only to have the nurse come in and announce that I was NPO - I didn't get to eat for another 3 hours.
• At USC the procedure itself happens in one of the fanciest procedure rooms I have ever scene. It involves fluoroscopy, or real-time Xray, thus there is a rather sizeable X-ray machine. The doctor has one of the monitors hooked up the PC, which he typically uses to listen to music on Pandora, which he unfortunately likes to tune to the Coldplay station. I fucking had Coldplay with a passion and I think Chris Martin has to be the douchiest douchebag to ever pick up a guitar outside of Dave Matthews. Luckily Dr. Barr began letting me pick the music after a while - and no I didn't complain.
• For me the procedure is always performed by my cardiothoracic surgeon and post-transplant care provider, Dr. Mark Barr.
• Before they, dig in so to speak, they clean the entry site, which has ad sometimes lead to partial shave, and usually leaves me with a big yellow splotch on my neck from the antiseptic.
• So now the question is, if they not get the tissue with a long-ass needle, then how do they get it. In most cases, a large vein on the right side of my neck (jugular vein) is used. That's right, the go in through the jugular to get to the heart.
• OK so they are going in through the jugular. They ain't doing this without some sort local anesthesia. They started me with straight Novocaine. Well, guess what, after 3 months in the hospital on everything from Vicodin, Morphine and more potent things, they might as well be injecting me with saline. The first couple biopsies were incredibly painful, the second bringing me to tears, all the while, Dr. Barr telling me, this shouldn't hurt, at all. Finally, one of the technologists suggested a drug cocktail using Lidocaine and Sensorcaine. The sensorcaine, seems to make the most difference, someone penetrating to the deeper nerve endings, and subsequent biopsies have been much less painful.
• After the area is numb, a catheter or tube is inserted into my vein. Which is where I get the most discomfort, Dr, Barr is essentially jamming a big plastic tube into my neck and he jams pretty hard.
• A special instrument, called a bioptome, is inserted through the tube and threaded into the heart with the help of fluroscopy. The bioptome is an instrument with small jaws on the end that open and close around small pieces of heart tissue. Once the bioptome secures a piece of tissue the instrument along with the piece of tissue is removed. I usually feel a few extra beats of my heart when the tissue is removed, but last time I could actually feel the bioptome being removed through the heart and vein. It doesn't hurt, per se, but it is surely one of the funkiest sensations I have every had.
• Once the heart tissue is removed, it is sent to the laboratory for study. If there is any evidence for white blood cells attacking the heart muscle, then BINGO, rejection. But guess what, I've had 9 biopsies and not any indication of rejection, and while rejection is possible at anytime, Dr. Barr doubts that I will have issues with it from now on. That's good, I've got enough issues at this point.
Philosophies differ greatly across the country on the number and frequency of heart biopsy, at UCLA a heart transplant will have up to 14 biopsies in the first year and routinely there after. At USC, where I had my heart transplant, however, the heart transplant patients generally get 8 in the first 6-8 months and then none ever again unless you show other signs of rejection. As I said, I've had 9 because a bout of dehydration made them concerned that I was rejecting.
A heart biopsy is a test in which small pieces of tissue are taken from the heart muscle, and examined under a microscope. Now a heart biopsy is not for the faint of heart (no pun intended) generally it supposed to be a relatively pain free procedure, but I know of several people who have to be sedated to deal with it.
When many hear the word biopsy, most think of long needles pushed into the body by a radiologist to retrieve tissue, a heart biopsy is a bit more complicated and invasive.
The Procedure:
• Prior to the biopsy, you asked to NPO, meaning no eating, no drinking. I had a ironically heart breaking experience in the hospital involving being NPO for a biopsy. Much of my time in the hospital I was nauseous an not hungry at all, one morning, however, my appetite came back, for once I was looking forward to breakfast. I waited almost excitedly for them to deliver my cheerios, only to have the nurse come in and announce that I was NPO - I didn't get to eat for another 3 hours.
• At USC the procedure itself happens in one of the fanciest procedure rooms I have ever scene. It involves fluoroscopy, or real-time Xray, thus there is a rather sizeable X-ray machine. The doctor has one of the monitors hooked up the PC, which he typically uses to listen to music on Pandora, which he unfortunately likes to tune to the Coldplay station. I fucking had Coldplay with a passion and I think Chris Martin has to be the douchiest douchebag to ever pick up a guitar outside of Dave Matthews. Luckily Dr. Barr began letting me pick the music after a while - and no I didn't complain.
• For me the procedure is always performed by my cardiothoracic surgeon and post-transplant care provider, Dr. Mark Barr.
• Before they, dig in so to speak, they clean the entry site, which has ad sometimes lead to partial shave, and usually leaves me with a big yellow splotch on my neck from the antiseptic.
• So now the question is, if they not get the tissue with a long-ass needle, then how do they get it. In most cases, a large vein on the right side of my neck (jugular vein) is used. That's right, the go in through the jugular to get to the heart.
• OK so they are going in through the jugular. They ain't doing this without some sort local anesthesia. They started me with straight Novocaine. Well, guess what, after 3 months in the hospital on everything from Vicodin, Morphine and more potent things, they might as well be injecting me with saline. The first couple biopsies were incredibly painful, the second bringing me to tears, all the while, Dr. Barr telling me, this shouldn't hurt, at all. Finally, one of the technologists suggested a drug cocktail using Lidocaine and Sensorcaine. The sensorcaine, seems to make the most difference, someone penetrating to the deeper nerve endings, and subsequent biopsies have been much less painful.
• After the area is numb, a catheter or tube is inserted into my vein. Which is where I get the most discomfort, Dr, Barr is essentially jamming a big plastic tube into my neck and he jams pretty hard.
• A special instrument, called a bioptome, is inserted through the tube and threaded into the heart with the help of fluroscopy. The bioptome is an instrument with small jaws on the end that open and close around small pieces of heart tissue. Once the bioptome secures a piece of tissue the instrument along with the piece of tissue is removed. I usually feel a few extra beats of my heart when the tissue is removed, but last time I could actually feel the bioptome being removed through the heart and vein. It doesn't hurt, per se, but it is surely one of the funkiest sensations I have every had.
• Once the heart tissue is removed, it is sent to the laboratory for study. If there is any evidence for white blood cells attacking the heart muscle, then BINGO, rejection. But guess what, I've had 9 biopsies and not any indication of rejection, and while rejection is possible at anytime, Dr. Barr doubts that I will have issues with it from now on. That's good, I've got enough issues at this point.
Philosophies differ greatly across the country on the number and frequency of heart biopsy, at UCLA a heart transplant will have up to 14 biopsies in the first year and routinely there after. At USC, where I had my heart transplant, however, the heart transplant patients generally get 8 in the first 6-8 months and then none ever again unless you show other signs of rejection. As I said, I've had 9 because a bout of dehydration made them concerned that I was rejecting.
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