Up The Farway Tree

The Dress Rehearsal - Part 2

The words filtered through the haze of anaesthetic drugs and in my confusion my first thought was 'are you joking, because that's not very funny'. As he carefully repeated the words "You have NOT had a transplant" the words slowly sunk in and I realised that this was no joke. My eyes opened wide in utter disbelief, and tears began to silently fall. I was still intubated so could not speak, and instead lay in the silence that followed. My mum was wiping my tears, and Andrew was holding my hand. At that moment in time it was little comfort.

Unable to think clearly, or to communicate, I then became fixated on having the tube removed from my throat and tried to desperately convey this. As I tried to point at the tube, the nurse kept thinking I was trying to pull it out and would push my hands back onto the bed. I became increasingly irritated as she said repeatedly "in a minute" and "when you are awake" - I felt pretty much awake and could watch the minutes ticking by on the clock. I think the most distressing thing about the situation was that I still had my old lungs, so was coughing every few minutes, which meant she had to use suction to clear my airways. At least after the real transplant I will be waking up with healthy lungs and this should not be a problem. With the realisation that the transplant had not taken place, understandably, the pain also seemed to get worse - probably because it now felt so pointless and unncessary. I couldn't tell anyone it was hurting so instead tried writing out letters on the bed covers. Seeing that I was tying to write something out, Andrew told me to draw the letters on his hand and I was able to spell S-O-R-E and he could tell the nurse I was in pain. It wasn't long after this that the nurse finally decided I was awake enough and asked my family to leave so she could extubate me. She seemed to spend forever collecting pieces of equipment and fiddling with my tubes, before she finally asked me to cough hard and pulled out the tube. It was a blessed relief.

My family were allowed back into the room, and although I could now speak I suddenly had nothing to say. I did however have one rather unhelpful remark for my mum. To understand I have to explain that the day I got the phone call my mum had been telling me about a lady called Margaret Sinclair (who is soon to be made a Saint) that she had started praying to that day. So when I got the call my mum had said 'Oh, Margaret Sinclair was listening'. On finally finding my voice in ITU I pulled mum in close before muttering "Your Mary Sinclair is rubbish!" to which she quickly responded "Her name is Margaret, and she is not rubbish!" It was not one of my most mature moments, although I think we can safely blame the drugs in this instance ;-)

Soon after the extubation the transplant coordinator returned to see me again and offer more explanation now that I was more awake. He explained that the initial inspection of the lungs had been unremarkable - they had looked good and nothing unusual had been reported. At the point they clamp the donor lungs, a call is made to the coordinator to tell them to start surgery on the recipient (me). Around 35 minutes into the surgery the coordinator received a second phone call, which he expected was to tell him the lungs were on their way but it was instead to say there was something wrong with the donor lungs. After clamping, they perfuse the donor lungs with a preservative solution, during which time the blood will drain from the lungs. On performing this procedure the lower lobes of the lungs unexpectedly took on a patchy appearance - something similar to what can be seem in the victim of a road traffic accident (but this donor was not in this category) or in someone with a blood clot in their lungs (but this was also not the case). There was no clear explanation for this appearance and the surgeon had never seen anything like it appear at this stage before, but there was clearly some problem with perfusion in the lungs. He took the very brave decision to report the lungs as being unsuitable at this late stage. Much discussion took place within my own team, who decided that it would be much safer to stop the surgery now and leave me with my own lungs for a while longer, than it would be to continue and risk the transplanted lungs failing - possibly even that same day. It was very fortunate at this stage that the surgeon had only made an incision involving skin, fat tissue and some muscle layers - but he had not touched the bones or entered the chest cavity. If the call had come much later in the proceeding they may have reached a point of no return. On hearing this explanation I felt absolutely no anger or regret that they did not continue, but only relief that a problem showed itself in time, and not after the surgery when it would have been too late. Maybe mum's Margaret Sinclair was watching after all

More to follow..