Wednesday, July 1, 2009

Unoffical report on bronchoscopy results from 6/26/09

“Halt! Who goes there?”

(A slightly nervous chuckle) “What?

“You heard me! Identify yourselves.”

“Who are you?”

“CIA, Central Immune Authority. Now answer my question!

“I…I’m left lung.”

“And I’m right.”

“What are you doing here?”

“Our jobs.”

“Which is?

“Ah…keeping everything else going?”

(Nodding, with a cynical downturn of the mouth) “Yeah, that’s what all the aliens say; bacteria, viruses, mold, tumors.”

“Wait. Where are you going?”

“Where do you think? Back to lymphoid headquarters. But don’t worry; I’ll be back with a wrecking crew.”

I hope everyone gets the point of that fun little drama. It’s simple: acute rejection doesn’t have to be dramatic.

The encounter described in the drama happened sometime in the middle of June and led to my first episode of acute rejection. The actual date and time is undoubted lost in the mists of bodily functions. How it took place we know. For some reason, my suppressed immune system suddenly recognized the lungs which had been transplanted 13 months earlier. But why is a question we’ll probably never answer. A number of things could be responsible, either wholly or in combination.

It could be because of a misunderstanding we had about a change in the level of Prograf, a key immunosuppressant, the doctors ordered. I could have picked up a bug which aroused the immune system; in the emergency ward of the hospital where I sat with my mother for several hours, in the nursing home we’ve moved her into, or just walking through the supermarket. It could be related to the high level of stress I’ve recently been under with Harriet having a kidney removed, and my mother’s situation. On the other hand, it could be just another one of the mysteries of organ transplantation waiting to be solved by science. The flappett melted into the dogget before the ramicin took effect.

So what happens now? That’s the other subject I want to cover here. Before someone else who’s worried about rejection freaks out, I think it may help if I detail what is happening to me. Here goes.

The acute rejection was confirmed this past Monday. Later that morning a transplant coordinator from Shands called me and gave me the news, answered my questions, and explained what was scheduled.

1) Three IV treatments of 1000 mgs of Solumedrol (methylpresdnisolone), one each day for three days.

2) A prednisone taper from 60 mgs to 5mgs over 11 days.

3) Return to Shands in a month for another bronchoscopy.

The medications were delivered Tuesday morning. A couple of hours later a home nurse arrived, put in the IV, and gave me the treatment which took under an hour. Then she smiled and was on her way.

This morning I smiled when my FEV1 which had fallen to 3.66 was already back up to 4.14. I’m not getting carried away, floating off into the clouds. The stuff I’m taking is prednisone on steroids. There are side effects. But I’ve been there before. I also know it’s going to take some time to get back to where I was. But I have every reason to believe I will. In fact, I’ve got a feeling that by the time that guy from CIA got back to headquarters he wasn’t quite sure why he was there.

Rejection is going to happen, but as I said, it doesn’t have to be dramatic.

P.S. For anyone wondering what Bernie thought of all of this, he looked at me all day on Tuesday with a cocked head as if he sensed something was wrong. Then Wednesday morning, setting an example as he is wont to do, he took me for our regular morning walk like nothing was amiss. Another day, another lizard.

No comments:

Post a Comment