The Sober Widow

Chapter 13

OK, let’s talk about the transplant itself. I wanted to title this “third time’s the charm” because that’s actually what happened to me. To begin, I’m sure I don’t have to tell you that transplant of any organ is most definitely not an exact science. With a few exceptions (like a living donor can give a kidney or even a partial liver, blood and bone marrow, plasma, etc.), most organ donors are deceased. That’s a terrible burden for the organ recipient to accept. I struggled with the guilt that in order for me to live, someone else had died. Then a kindly doctor told me that that person would have already tragically died anyway, but was generous enough to become a donor while he/she was alive. I felt much better after that, but it was still a tough pill to swallow (along with all the other pills, ha ha).

I’ve told you about the hoops I had to jump through to get to this point, and I briefly mentioned the MELD score. MELD stands for “Model for End Stage Liver Disease.” Think about that. “End Stage.” Meaning I was pretty close to death (and in fact, they called the crash cart on me in the days just prior to transplant, because my blood pressure was so low I had passed out).

The purpose of the MELD score is to evaluate where a patient should fall on the transplant list. The higher the score, the higher you are placed on the list. Below is a chart showing your life expectancy chances based on your score, which can change on a daily basis:

MELD SCORE                   MORTALITY RATE

40 or more                          71.3%

30-39                                     52.6%

20-29                                     19.6%

10-19                                     6.0%

<9                                           1.9%

My score fluctuated between 32-36 on a daily basis. That’s obviously a pretty high score. My doctor told me that once it hits 40, you’re no longer considered a candidate for transplant because your liver is too far gone, and surgery would essentially be wasted on you because your body probably wouldn’t accept the new liver. Diseased livers affect all the other organs in some way, and they become damaged, too. That’s why I needed a kidney as well.

About two weeks before Thanksgiving, I was at the tippy top of the list, along with another patient who I had met in our initial orientation meeting in July. I remember a few weeks after that, Lucia and I had gone into Boston for the final evaluation before they admitted me, and we saw him in the hallway. He looked so, so sick that we were really worried he might not make it, and I would have done my best to check on his progress, if it weren’t for the HIPAA law.

And of course, with the holidays approaching, here I am asking my doctors daily, “when, when, wheeeennnnnn????” and they kept reminding me that they can’t predict when someone is going to die! But of course, the sicker you are, the more you are anxious for it to be done so you can feel better. And every time I turned around, someone was telling me how much better it would be after the transplant surgery was over. Great, dangle the carrot that I can never get on my own.

So one day, around 5 a.m. a doctor comes into my room. I’m in the ICU at this point getting the 22/7 dialysis. And he said “Lisa, we are pretty sure we have organs for you.” I was shocked and burst into tears. Then he told me they had to put me on “NPO.” I don’t know how they come up with these acronyms but it means “take nothing by mouth.” Therefore, starting at 5 a.m. I can no longer eat or drink anything for at least 8 hours or longer depending on when they wheel me into surgery. I learned later that that’s why they tell you even before they know for sure whether you’ll be getting the organs, so that there’s no lapse in time to delay surgery as those organs are most likely on ice, having been flown in by helicopter. Sidebar – one of my rooms at the hospital was near the helicopter pad and they would go right above my room at all hours of the day, and each time I’d pray that there was cooler in there with my name on it).

Here I am, fasting away with only some ice chips to relieve the thirst, and I’ve called everyone in my posse to tell them “the transplant is happening!!” when at 9:00ish someone comes into my room to apologize profusely. Seems that the organs were supposed to go to someone else, and there was a major miscommunication somewhere. Then I learned that in addition to the liver team, the kidney team and the transplant team, which I saw every day, there is also a surgical team and the ICU team. Among those five teams, communication was apparently lacking that day.

Now I have to make some very difficult calls to say “psych! Not today!” And to say I felt gut-punched is putting it mildly. When I heard how the mix-up occurred, I let them have it but good. And remember, I was not a nice person at that time! I didn’t even feel bad about it, and they were completely contrite.

It was right then that I determined never to tell anyone except my brother, who did need to know, when it happened again, just in case the rug was pulled out from under me like this time.

It wasn’t long before that did occur. A new doctor I didn’t know (on the surgical team) came to see me and said “today’s the day!” again. I’m sure you can understand my skepticism. I called my brother and swore him to secrecy. This is the part where I should tell you that weeks before, he had started a text chain with my closest friends and family and as word spread, people kept asking to join the chain. And folks started conversing in one-off discussions who really didn’t know each other before all this. And if you know my brother, he was sure to entertain everyone while giving them updates. People still tell me today how much they enjoyed his texts and how funny they were, even when the news wasn’t so great.

So now I’m on NPO again and dutifully sipping on my ice chips. Hours go by and I’m getting more nervous and anxious. As much as I wanted this surgery, it’s still a pretty major event, and I could certainly die during the operation and never wake up (not actually a bad way to go, I guess). Then, that same surgeon came back and said “psych!” again. This time I was glad, because after they tell the patient, they conduct major examinations of the organs to make absolutely sure they are good to go, including doing biopsies for undisclosed things. I guess the reason they rejected the organs was because the donor was a hard partier and they were already showing signs of serious wear and tear. No organs for me!

Now I’m getting really, REALLY depressed. There was a PA on the liver team who I came to know and love, who seemed to always be talking me off the ledge. She was comforting and encouraging and promised me that I would get my organs, I just had to be patient (and I joked that hey, I am already A patient, ha ha ha). Sigh. It was so hard, and I’m getting sicker every day and feeling a tad more miserable each day.

FINALLY on December 9, 2024, I got the call. The one that stuck. Stop eating! Stop drinking! We found organs, and this time we really like them!

I am asked all the time what I know about my donor. The answer: hardly anything. This is what I know: It was a woman, she was very young, and she died in an accident (I’m thinking car, but sometimes I make up something very heroic for her, like saving a baby from a burning building). Either way, the organs were perfect. The doctors were giddy with just how perfect they were. But I was completely doubtful until I knew for SURE that surgery was happening. Which for me, meant being wheeled into the OR.

Again, only my brother knew. I had asked the OR nurse to call him for me when it was definite that surgery was going ahead. I had called him when they came to get me, but it would be at least an hour from that point to “scalpel down.” I think the nurse forgot. She did eventually call him, but it was already a few hours in, and he was a wreck. Then he could call everyone and tell them, so I had my cheerleaders in place even though I didn’t know that.

I remember waiting to go into surgery and wondering what was taking so long. Turns out that they are still testing the organs, basically doing a “once over” before they are completely satisfied that they are acceptable. Then they wheeled me in, put the cuff over my face and told me to count down from 100. I made it to 96.

Part 2: I woke up! I survived! Keep reading!