Almost Two Years Post-Transplant and Counting

Walking in the desert for several weeks gave me a better appreciation for what matters most: being healthy and enjoying life.

On June 8,2015, I will pass the two year mile stone for survival after a heart transplant.  Amazing.  My second "heartaversary."

My cardiologist has changed twice since June, 2013, and, as would be expected, there have been the predictable and some unpredictable troughs and triumphs.  Stay in the game as best you can, is the advice I give, if asked. 

A day at a time. That means take care of what you have and try to live in the moment.  It is harder than it sounds since so many of us are driven by our calendared future events.  The track of the past is only a history of where we have been and is no predictor of any future plans or promises.  

That is not to say that I do not make plans because I do.  But planning guarantees nothing.  You can plan the plan but not the outcome. Times, conditions and things change.  I am not prone to philosophical thinking.  These are not pearls of certitude.

I am pleased to be here to see another birthday, another heartaversary, and another cardiologist.

Some words to leave you with that are powerful to me:

     Without the organ donor, there is no story, no hope,
no transplant.
     But when there is an organ donor, life springs from death, sorrow turns to hope, and a terrible loss becomes a gift. 

                                       --United Network of Organ Sharing.

Greetings from Arizona's Sonoran Desert

First of all, I'm grateful to be here to enjoy life in the desert. It has been nearly five years since heart failure literally stopped me cold. 

A HeartMate II left ventricular assist device, a battery powered internal heart pump, kept me going for 1,161 days as I waited for a suitable heart for transplant. When you're on a transplant waiting list, there are no guarantees.  The wait for me was just over three years but I am most fortunate.  I am heart recipient number 788 in the University of Minnesota Heart Center's continuing transplant program, having received the gift of life June 8, 2013.  But back to the desert. I've been hiking in the desert almost daily for the last several weeks.

The desert landscape is fascinatingly beautiful and potentially dangerous as well.  The transplant team at the U of MN cleared me to travel out here and enjoy some warm weather.  Warm at this time of year is in the 60s during the day.  That's 60 degrees above Zero. 

The desert is unique for a person more accustomed to leafy trees, flowing water, still water, flat land and rolling hills, and growing grass. 

Here, east of Phoenix, the mountains rise all around forming a valley. You can see a pollution film, a haze hanging over parts of the valley. It's common most days and causes breathing alerts.

Breathing is actually a large part of the potential danger of the desert. For those with suppressed immune systems, airborne fungus spores are the menace. It's not the scorpions, poisonous snakes or gila monsters that pose the problem, but simple airborne spores. 

The spores are in the ground but after a rain the wind stirs them up. Farming, road construction, general construction activities disturb the soil and fungal spores, too tiny to be caught by the average surgical mask, come to the surface and can be carried hundreds of miles through the air. Therein hangs the tale. 

It's called Valley Fever and you never see it coming. The federal Center for Disease Control calls it a "silent epidemic." Persons affected often get a bronchitis or pneumonia-like condition. There is no proven vaccine. The disease usually clears up  on its own but it can recur or be permanent and is sometimes deadly, especially for those with compromised immune systems.

Oral anti-fungal medications for humans have proven effective in serious cases. But dogs and cats as well as all mammals in zoos and in the wild are susceptible.

The endemic areas where the infection is present includes the southwestern United States: Arizona, New Mexico, Utah, Nevada and California.

Two state prisons in Southern California on the western edge of the San Joaquin Valley recorded 3,000 cases per 100,000 people in 2005-06. A lawsuit against the state for permitting inmates to be subjected to Valley Fever conditions. A receiver appointed to oversee the prisons ordered susceptible inmates to be moved out of danger.

The incidence of Valley Fever varies widely.  Here in Maricopa County Arizona around Phoenix there were 3,450 cases reported in 2007, which converts to 1 case per 100,000 persons in an estimated population of 3.8 million.

By contrast in New Mexico there were 35 cases reported in 2008 and 23 cases in 2007. Those figures are for the entire state and converts to 1 case in 56,685 persons.  The estimated population of New Mexico was 1.9 million.

Valley Fever incidence is on the rise nationally. In 2011 the reported number of cases nationally was 42.6 per 100,000 persons.
That was an increase from 1998 of 5.3 per 100,000 people. That's a significant almost explosive increase.

As for prevention, that is a difficult question in a Valley Fever endemic area.  If you're here, you are potentially exposed.  So stay out of blowing dust and dust storms.  You can see the serious dust storms--haboobs--coming from 20 to 30 miles away. They don't happen often, fortunately.  Since you cannot see the micro sized spores, stay out of high wind situations.