Matthew’s transplant T + 4

It is incredible to think that 50 years ago, a surgeon with a huge desire to help someone, a donor and a recipient and every person involved, made history and as a consequence many, many people’s lives have been saved. As we sat down to write this blog the news agencies were celebrating 50 years since Chris Barnard did the first heart transplant, and as a consequence of this many, many people’s lives have since been saved.

We were excited on day T+4 as we arrived at Busamed Gateway Private Hospital – we were told that the doctors wanted to extubate Matthew that morning. We knew this meant a further step forward and that he could then talk to us! At the same time, however, we were filled with trepidation, as we also knew from past experience, that this could be a traumatic time. Matthew had in previous surgeries given his doctors some hairy times around extubation. Everyone was expecting this to happen relatively early in the day as the doctors like to monitor the condition for a few hours to see how it goes, but the doctors ended up in surgery later than expected. As 3pm approached we grew a little glum as we knew that if it wasn’t done soon, it wouldn’t happen that day.

In the meantime, Matthew being a right determined Legemaate and with his agitation with the ventilator tubes, had figured out that he could almost reach the pipe by bending his head to the side, manoeuvring his body and lifting his left leg. He almost got there, but the sisters quickly stopped him and a stern word or two was spoken. By now the Airvo, which would continue to support Matthew’s breathing, had arrived. This was to be used once Matthew was extubated, but it was already 3pm.

We went for a cup of tea, and when we got back we were told that Matthew had been extubated (was off the ventilator) and was taking HUGE breaths. We were elated and couldn’t wait to see him. At least with the Airvo on (it delivers supporting pressurised airflow into the lungs), if Matthew pulled it off, it was easy to refit. Matthew’s breathing was doing incredibility well – if fact just before coming off the ventilator he was taking 1 litre breaths! (Normal folk take breaths between 500 and 800 ml!!!) From a volume point of view, the lungs were working well. With the big breathes Matthew told them that his chest was sore, he was given a strong pain killer and he seemed to relax more and eventually drift off to an early sleep. We were also then able to have a relatively early night.

Matthew’s transplant T + 5

Having experienced some scary moments with Matthew post extubation in the past, I admit that I called in to the ICU a couple of times from our hospital room during the night. It was so encouraging to hear that he was having a good night. Unfortunately, as the pain killer wore off, the side effects of the medication again set in and he got extremely agitated. It also seemed that the swelling of the organs expected for T+2 happened during T+4 (including the brain), which had resulted in the difficult night for Matthew and the sisters on duty. I know it is their job, but to watch the sisters just take everything in their stride makes me value their contribution to the process so much. The calmness and diligence with which they dealt with any situation certainly helped us to be confident in the care Matthew was receiving. And as a further encouragement , we were assured that there will still be a number of these battles over the next while which would lead to a trying time for him (and us) but that they would be there to support us. Organ Transplantation certainly isn’t for the feint hearted!

For various reasons this day was a very emotional day for Janet, but once again the support we received from the SICU Unit Manager, Vanessa, Theatre Manager, Chantel, and Marketing Manager, Sue, was incredible.

Matthew slept a lot on T + 5 and everyone was so surprised at how well he tolerated the Airvo which is rather uncomfortable. But then again, Matthew had been on oxygen for 7 years so he was used to dealing with something different to the norm. All in all it worked out to be a great day for Matthew even though he now began planning for a change in venue. He was adamant that he needed a room with a view … of the rest of the ICU! The transplant cubicle is stuck to one side with little visibility once you are inside, and of course now that Matthew could talk, he had lots to talk about.

Matthew’s Transplant T + 6

What a joy it was to walk into the ICU on the morning of T+ 6 to see Matthew eating a peeled apple! Of course there is another story here! Those who know Matthew know that he has always had a peculiar pallet. Matthew does not eat ANY vegetables or fruit AT ALL except for small sweet baby carrots and light green apples – peeled. He was told he could have fruit to eat – so he order a green apple peeled. The kitchen sent him a pear! That went back with an instruction for a GREEN APPLE and a knife to peel it. Back came a green apple with a bread knife. Anyway, the apple got peeled and Matthew was munching on it.

He was being so funny about his food – all of which was medication induced. Firstly he had told everyone that he only ate peeled, green apples – in fact anyone who doesn’t eat them needed to leave his room. We laughed so much when we heard this as it so out of character for Matthew. With his limited pallet and taste range it also didn’t surprise us to hear that he had told the sister that he wanted ONLY Chocolate Ensure (no Strawberry Ensure) WITH Milo added in it too! And by the way, he had also flattened the chocolate mousse that had been brought for him earlier. He had been given a little taster of Chocolate Mousse on his tongue whilst still intubated as an incentive to comply with the instruction to get him extubated. As soon as the tubes were out he had asked for it!

As we looked back over the last few days, we were relieved that everything now seemed to be going really well – even his lungs were looking slightly better as they had started to clear. His body and legs were still swollen with fluid but this had also begun to reduce. The sisters said he was being very compliant doing exactly what they asked him to do.

It was during this time that we once again were reminded that people were praying for Matthew. His extubation had gone off without a hitch and he appeared to just be progressing well. It was so good to be able to sit at his door and chat to him about all sorts of things. Of course in true Matthew style his first words of the day were “When can I go home?” This was very quickly followed by things like “They need an interior decorator, the room is so bleak….”

Matthew was still on a lot of medications which were helping to manage his body and rejection issues, and he will still need to be weaned of some of these and new anti-rejection drugs added, so we expected to see a few more bad days in ICU over the next two weeks or so, but we were very pleased with his progress.