Duke Transplant Evaluation Day 2

Note to readers: these transplant evaluation recaps are delayed a week because I was just to darn exhausted to blog during that week. Enjoy.

Day 2 - Tuesday August 3rd

Day 2 started out fairly easy with a full pulmonary function study and arterial blood gas draw. Keep in mind that these are easy relative to some of the other tests. My FEV1 result was 25% to which the technician said "oh that's good they will like that number". Looking perplexed I asked what good meant. She said that number is in the range they want you in to be listed. Once again I'm hit full force with the reality that this transplant thing might be getting closer than I anticipated. The sense of the inevitable is mixed with a blend of sadness, relief, and excitement. When the time comes I'll be sad in admitting that my lungs have finally failed and there is nothing more I can do to keep them going. But on the flipside I'll be relieved and excited to have some other option that will allow me to live a life full of breath.

The ABG blood draw hurt a bit but otherwise was uneventful. Only a small bit of torture compared to my next test.

Then I went to have a pH/Manometry test. For the Manometry the techs numbed my right nostril and the back of my throat. Then they snaked a tube the width of a straw up my nose and down my throat. This part was not painful but made me gag like crazy. Of all the procedures I've ever had this was in the top 5 for most difficult. And no sedation :( While the tube is down you are not to swallow for 30 seconds (not easy after you've been gagging right before this and have a mouth full of saliva). Then they have you take a series of swallows of water. The purpose of all this is to measure how well the muscles in your esophogus work. Then they removed the large tube and snaked another much smaller tube down. This one is about the width of a coffee stirrer and will stay in for 24 hours. It's attached to a monitor that will measure the pH levels in the portion of my esophogus just above my stomach. During the test I have to keep a log of when I start and stop eating or drinking and also every time I cough. Recording every cough will be a challenge since it's so second nature to me.

Next we met with the transplant surgeons. I'm really not that scared about the actual surgical part of transplant. The surgeons seemed to think this meant I thought transplant was not big deal and let's just go for it. I'm highly aware of how difficult and uncertain transplant can be and want to keep my lungs as possible. But my biggest concerns are what happens after the surgery not in the OR. Drug side effects, rejection, other related issues like diabetes, and the poor long term survival rates are WAY more daunting in my opinion. But maybe it's just because I've had so many operations, have witness a neurosurgery, have a mother as a nurse etc. that make me a bit desensitized.

The final meeting of the day was my most highly anticipated...infectious disease. The doctor assigned to me changed at the last minute and we got Dr. Cameron Wolfe instead. Dr. Wolfe is a wonderfully funny & cute Aussie doc. Thankfully he seems highly competent as well. We got to share stories about our six week trip down under back in 2002 and really felt at ease with him. The best part of the appointment was finding out that my resistant pseudomonas would be something they could handle post transplant. Although I'm still a bit concerned that really eased my fears quite a bit.

Another day filled with some good, some bad, and some in between. This is really a mentally and physically exhausting process. And that nose tube thing is a real pain!!!