Saturday, July 15, 2017

- Transplant Update

It was a bit of synchronicity, that my "Irish Twin" brother and two of my closest friends all underwent transplant procedures in the same couple of weeks near the end of 2016. I was thinking about them a bit, and thought I'd pop off a little status update for those of you who know these guys and might be wondering how they're doing.

The short answer is amazingly well across the board. I know the most about my brother's situation of course, since I was his donor, and because he's my brother. My friends are important to me but that doesn't quite rise to the level of family. So let's run through his stuff first.

My donorship was by far the least invasive, but for some reason known only to science and defying intuition, my brother's recovery plan was the longest of the three. It will be roughly a year before he's considered 'fully' recovered, but his numbers are putting him near the top of the curve in terms of side effects and external issues. One interesting thing about receiving a donation of what is essentially an immune system, is that it sometimes includes something called Graft vs Host syndrome, which is an interesting phenomenon.

Transplanted tissue like lungs or kidneys are sometimes recognized by the recipient's immune system as being 'foreign', so recipients of those transplants are given immunosuppressants to keep their immune system from rejecting them. Well GVH is when the transplanted immune system recognizes the rest of the body as being foreign to it, and attacks the rest of the recipient's tissue as foreign. It's potentially one of the more serious side effects, and can pose a real and ongoing problem for some Bone Marrow recipients.

The doctors told both my brother and I that a small amount of GVH is to be expected and 'preferred' to no symptoms at all. And my bro has hit that mark perfectly. He has a persistent itch, but no rash, and no other symptoms. But for his complaints (the whiner) his symptoms don't technically rise to a diagnosis of GVH at all, which is precisely where the doctors hope all their patients would land.

In fact, they monitor all manner of biochemical numbers for him and he is consistently at the top of the curve for all of them. We figure this is because he and I are so similar and have such similar histories. Not only were we a perfect match for the genetic markers they monitor, but we are also less than a year apart in age, caught chicken pox within a few weeks of each other, we were exposed to the same environments etc.

His two daughters (ages 21 and 20) were in the city yesterday and came by my place for a few minutes. The older one lives at college, but the younger one is living at home until she leaves for school in a few more weeks. When I asked her how she thought he was doing she said "he has his routine." "really?" I said, "REALLY" she replied with an eye roll.

If your teenage daughter is rolling her eyes when describing you, I think it's a generally good sign.

I talk to RP [pictured above - three to my left] (or text message anyway), usually a couple of times a week. He's here in New York slaving away at his gig at [great big huge money management firm] with no complaints. He donated a Kidney for his dad, and when I ask about how things are, all I get is reports on his father.

My recovery from Bone Marrow donation only involved avoiding all alcohol for a few weeks afterward, which since it was christmas, I elected not to do. The only symptom this created were extremely bloodshot eyes, which only Mrs Derb ever commented on, while I was keeping her company at the Vdare Christmas party.

But it's major surgery to remove a kidney so RP's recovery took weeks longer than my own. He was hospitalized for a bit, worked from home for a bit afterward, and was told to 'take it easy' for an extended time after that. I texted him two weeks ago on a Saturday, and discovered he was out in California partying it up with some work friends, so that's clearly all behind him. He reports that his father is taking the responsibility of carrying around his son's Kidney VERY seriously, has lost weight and is following doctor's advice with regard to exercise and diet - an area where the senior Mr. P had sometimes lapsed in the past.

I met the senior Mr. P a few years ago when I helped them both build a fence around the house where RP and the family P was living. The fence was engineered like a tank trap and will no doubt be standing for generations after the house it surrounds has tumbled to dust. My contribution to the project consisted of holding my thumb up at eye level in line with the fence and saying things like 'looks pretty good to me." But I did have a few minutes between supervisory contributions to get to know the Senior P and I'm genuinely glad he's doing so well.

Finally there is RB [pictured above to my immediate right]. He received what to the most of us would seem to be the most serious of the transplants, but ironically, had the shortest recovery time, coming very close to my own symptoms as a donor. RB received a lovely pair of human lungs, slightly used, at a moment when he was days from death. His donor clearly has the most serious consequences, and though I'd like to make a joke about it, I think it comes off as a little too callous. I find it helps to remember that the tragedy leading to the donation preceded RB's receipt, and would have had the same consequences for the donor whether he also saved my friend's life or not, so the donation itself was only a plus. I think it's best just to move on, and not think too deeply about it.

I spoke to RB on the phone about 3 weeks after his procedure. Amazingly, he was stuck in San Diego traffic, complaining about how late he was going to be, and bouncing a blockchain startup idea off me. At the time my brother was so laid up with post chemo side effects that he could barely pull himself together well enough to raise his head off the pillow and text me about how lousy he felt. But here was RB changing lanes, relishing his renewed ability to climb a flight of stairs on his own, and ranting about the Democrats. For all intents and purposes back to his old self, only without the persistent cough.

RB referred me to a friend of his who is deeply involved with an Angel funding group here in NY, and my partner and I met with them a few weeks later. The first 10 minutes of our pitch meeting was about the two of us sharing our amazement that a man can be (potentially) hours from death, go through such an amazingly intrusive procedure, and be back in traffic cursing social justice warriors, what felt to the two of us like the next day.

His is a life renewed. He has no complaints, no side effects (none he's reporting to me anyway) and a future much brighter, and considerably longer, than he would have had otherwise.

So, three donations, three successes. I do think it's worth mentioning that the more severe the symptoms for the donor, the less severe they seemed to be overall for the recipient and vice versa. I don't think you can extrapolate that but if you could, then I would imagine the first ever brain transplant will one day occur with a patient who is awake, and who hops off the table and walks to the recovery room.

Say what you want about how medical care is paid for in this country. But no one is telling me we have 'bad healthcare' in the US. The reality is that it's so good, that 3 lives I know of were saved, and 6 months later, we all think it's just another day.

Be well all.

1 comment:

MikeCLT said...

I am glad to hear that your brother and friends are doing so well.I hope they all continue to have strong recoveries.