There is nothing more exhilarating than to be shot at without result.-- Winston Churchill

Twelve weeks downrange from the transplant operation, June 8, 2013.  Despite some setbacks, things are progressing well. The HeartMate II, left ventricular assist device, was my 24/7 life support for 38 months and served me well, but having a heart transplant was and is the ultimate solution for end stage congestive heart failure.  I am one fortunate fellow.

Rejection speed bump encountered and passed.  No one knows what the future will bring: the key is to live in the moment.  Easier said than done, when you don't feel well and are in uncharted territory.  I keep telling myself that the only easy day was yesterday.  It has become a kind of mantra, quietly repeated, but it helps.

Hence the Churchill quote in the working title of this post.

I've had a week off from hospital duty but go back again Tuesday for another right heart biopsy to check the rejection factor.  Even though all heart transplant patients take a number of anti-rejection drugs, the body's immune system can still rear it's head and cause havoc with the new organ.

Meanwhile, I've applied to LifeSource, the organ transplant procurement agent put in place by the federal government, to be a volunteer speaker to high school students and others encouraging them to be organ donors.

Many balk at the notion of sharing their organs and tissues. But without donors there would be no transplant programs. It is not that you are sharing an organ or tissue with a stranger but that part of you continues on and selflessly supports a life in one who truly needed it.  What a gift.  

Being a donor is courageous, in my view.

Be a donor. Visit: http://www.thenationalnetworkoforgandonors.org

You've gotta have heart, all you really need is heart

I learned that my new heart was showing the first signs of rejection this week but all is not lost. Not by a longshot.  These things happen and more frequently than not are a new heart speed bump.

I traveled Monday last to the U of MN for what I thought was a routine biopsy of the new heart.  There have been about 10 of those biopsies through the right Jugular vein so far and each was negative for rejection.  

That changed Monday afternoon when my transplant coordinator called as I traveled back to Fargo (actually more than halfway home). After a minute's hesitation, I returned to Minneapolis.

It developed that my new heart was being attacked by my body's immune system but it apparently wasn't something to be too concerned about, because the cardio team caught it early.  The counter attack by the docs involves a three day course of heavier doses of anti-rejection drugs and close monitoring of vital signs.  So I'm back in the U of MN hospital for observation and care.

Looks like a week long stay.

The strains of "Heart" from the musical Damn Yankees have been running around in my head: 

You've gotta have heart 
All you really need is heart
When the odds are sayin' you'll never win
That's when the grin should start
You've gotta have hope
Mustn't sit around and mope,
Nothin's half as bad as it may appear
Wait'll next year and hope
When your luck is battin' zero
Get your chin up off the floor
Mister you can be a hero
You can open any for, there's nothin' to it but to do it
You've gotta have heart
Miles 'n miles n' miles of heart
Oh, it's fine to be a genius of course 
But keep that old horse
Before the cart
First you've gotta have heart

I particularly like the line "when the odds are sayin' you'll never win/ that's when the grin should start..."

Grinning is good.

What does "and beyond" mean in the working title of this blog?

After 38 months of carrying a heart pump, a left ventricular assist device, around in my chest, keeping me alive, I was fortunate to receive a donor heart in early June. I was listed as a heart transplant candidate in October, 2011, so my actual wait for a heart was about 20 months.

The LVAD was implanted in April, 2010, at Mayo Clinic, after the sudden onset of end stage congestive heart failure.  Without the LVAD, my days were numbered.

When I received the call that I donor heart had been found, what was left of my heart leaped out of my body.  Talk about excitement.  But knowing that it might be another dry run (I had three by June 8, 2013) I tried to contain myself: anxious, frightened, and a lot of other things that have descriptions in the same vein.  As I've commented in the last post, the air ambulance ride from Detroit Lakes, MN, to Minneapolis was a blur.

But that is only the beginning of the odyssey.  It has been reported to me that the surgeon suspected "acute rejection" of the donor heart by my immune system. There were two potential outcomes:  either the heart "woke up" and functioned or it didn't. Sounds detached an clinical.  I didn't know what was happening because I was asleep.

My surgical team at the University of Minnesota Medical Center, sedated me and kept me breathing with life support machines.  I was in medical limbo for many hours.  As I said, it could have gone either way.  Such are the fortunes of war.  Once the first shot is fired, the best plans are usually worthless.  No outcome is predictable until the last shot is fired.

In my case,  my new heart awakened and began to function.  My breathing was not quite so quick to return to normal. It took 8 and 1/2 days for me to be able to breath unassisted.  Meanwhile, any muscle tone I had was gone.  I couldn't open my hands and couldn't swallow very well.  I couldn't stand let alone walk.  Balance was shot.  I dropped 25 pounds.

Meanwhile, the anti-rejection drugs were taking a toll.  Some of these immune suppressing drugs will be a lifelong proposition.  I took 10 or more daily medications with my LVAD.  I now take about three times that number.  Some I will gradually be weaned from.  Others remain for the duration.

So the focus of these postings will shift to what is happening after a heart transplant and that's where the"Life at 9200 rpms and beyond."  The LVAD is gone and the fixed speed of 9200 rpms is history.  I am no longer bionic.  Now I'm self-contained and waterproof again.  

If I count my original heart, the LVAD, and now this fantastic gift of a donated heart, I'm gaining on the proverbial cat's nine lives.  This is chance number three and so a Third Chance at Life.

All who are interested, welcome to an evolving life blog with emphasis on beyond the HeartMate II.