August 15, 2024 - Liver Offer
I was anxious, didn’t really sleep and was ready to go home! I was on the phone with my mom first thing in the morning trying to make plans for her to come and get me. Keep in mind she was still in Spokane; Tim was still in California and the dogs still needed to be taken care of. Thankfully we have amazing neighbors who were willing and ready to step in at a moment notice. But I still had no word on when I was going to be discharged!
Hepatology had already done their daily round first thing this morning and nutrition was in for a reassessment, but no one seemed to know anything about me being discharged. I was frustrated and very tearful because I just wanted to be home. By no means was I giving up my fight, but I was struggling mentally and emotionally living in the hospital.
My mom decided to come regardless of whether I would be discharged and that we would just figure out the details of our trip home when she got here. So, I got on the computer and booked her a one-way flight to Seattle, leaving in a couple hours. I was hoping that by the time she got here, I would be ready for discharge, and we could head to the airport to make our way to Spokane. When I hung up the phone, those plans changed in an instant!
During her daily rounds, one of my doctors (whom I haven’t seen for several days) came in to see how I was doing and to discuss my case with the resident doctor assigned to her. During our discussion, I had mentioned to her that I was excited to go home today and that I had just gotten off the phone with my mom and booked her a flight to come get me. She looked at me in a state of confusion and then said, “You might want to call her back because you’re not going anywhere, you’re getting a liver!”
This is the first time that I have heard this news and quite honestly, I didn’t know if I should believe her because during my time here, she had known history of speaking too soon. Claiming something is going to happen prematurely and then it never comes to fruition. But the more I think about it, this makes total sense. I have been trying to get my FMLA paperwork signed for the past 3 days with very slow response from the doctor and now getting discharge paperwork is next to impossible. I continued to ask her repeatedly, “are you sure? Am I really getting a liver?”
She couldn’t 100% guarantee it because of course, the transplant surgeon had to determine that the liver was a match and acceptable for transplant and to confirm that I was willing to accept the offer, but my transplant coordinator had officially received an offer from the organ procurement organization. Now rather than planning for discharge, we began planning for transplant. I immediately called my mom and the conversation went along these lines:
Me: Mom, you might want to pack more than an overnight bag.
Mom: Why, are you not getting discharged today?
Me (crying): No, I GOT A LIVER!!
Mom (frantically crying): Oh my gosh! Are you serious? Oh my gosh, what do I need to bring? I need to catch my flight. Oh my gosh! Don’t let them take you to surgery until I get there.
Me: Calm down, you have time. Surgery isn’t until tomorrow. See you soon, love you!
For the remainder of the evening, it was prep time. My mom made it to Seattle a couple hours after I got off the phone with her and was able to be there as part of the discussion with my transplant team and ask questions. They discussed the difference in the type of donors. The first being Donation after Brain Death (DBD) in which the organ is recovered while the blood is still circulating with optimal organ function and the other being Donation after Cardiac/Circulatory Death (DCD) in which the organ is recovered after the heart has stopped beating and blood is no longer circulating with impaired organ function. The organ I was receiving was recovered via Donation after Brain Death.
They also discussed the possibility that there is always a chance that it was an Increased Social Risk Donor which may occur with donors that are brain dead (DCD), donors that had IV drug abuse, experienced jail time or had no medical history and are therefore at increased risk for spreading HIV, HCV and HBV. Fortunately, in my case there were no indications of social risk factors.
Repeat labs, chest x-ray and EKG were performed to ensure that it was safe to proceed with the transplant, and I signed my life away, literally! The plan was to operate by using a Mercedes Scar stretching across the entire top of my abdomen since it is the largest solid organ transplanted. A breathing tube would be intubated for the surgery and blood products would be given throughout. The entire surgery was expected to take approximately 5-6 hours in which I would be in ICU immediately afterward with the goal of removing the breathing tube within 24 hours after surgery.
I was scheduled for surgery at 1:00 p.m., August 16, 2024 and was encouraged to spend the evening relaxing as much as possible and enjoy my favorite meal or treat that I hadn’t been able to have while admitted, my last meal in a sense. All I remember wanting was a Dragonfruit Lemonade from Starbucks, not because it was my favorite, but more so because my mom got in trouble on a couple of occasions for sneaking one in for me.
I spent the rest of the evening full of nerves, but I tried to stay positive and pray, A LOT!! I made phone calls and texts to my friends and family, made sure my mom had everyone’s phone number so she could provide them with updates throughout and enjoyed all the goodies my mom was able to round up (limited with choices in the hospital). Nurses, doctors and my favorite student intern who had been special parts of my journey thus far even stopped in for a good luck wish and/or a prayer. It was finally happening!!
MELD 3.0: 28 (female), 27 (male) at 8/15/2024 7:10 AM
MELD-Na: 25 at 8/15/2024 7:10 AM
Calculated from:
Serum Creatinine: 1.14 mg/dL at 8/15/2024 7:10 AM
Serum Sodium: 139 mmol/L at 8/15/2024 7:10 AM
Total Bilirubin: 17.4 mg/dL at 8/15/2024 7:10 AM
Serum Albumin: 2.7 g/dL at 8/15/2024 7:10 AM
INR(ratio): 1.8 at 8/15/2024 7:10 AM
Vital Signs:
Temp: 37.1°C (98.8 °F) BP: 127/90 Pulse: 95 Resp: 18
SpO2: 100 % on 1 L/min room air
