Tuesday April 19

After weeks of flirting and flip-flopping, transplant and I are hand-in-hand: It's official. Today I signed the dotted line and, following a few inappropriate jokes about diseased lungs and death, was listed. Let the wait begin!

It was quite the day of build-up, we arrived at Toronto General around 11:30 and didn't see my Coordinator until around 12:30. We briefly chatted about where to go once I receive the call, travel restrictions (I cannot travel more than 2.5 hours away) and activated my pager. I then briefly saw a man about drawing my blood (they always seem to get you!) and hurried along to meet the surgeon, then we waited... and waited... and waited... and apparently set a new record for longest wait time to meet with the surgeon (2 hours, yay us?). I ended up reading through my entire chart by the time my name was called. P.S. Mildly fatty liver? Fatty pancreas? Pfffft! I'm deeply offended.

Once seated in another waiting room disguised as a doctor's office, I was handed a stack of papers to read through: 1. General Surgery consent. 2. Blood transfusion consent. 3. Bilateral lung transplant consent (which was worded very bluntly, but I guess there is no sugar-coating 'high risk' surgery) 4. Stem Cell/Bone Marrow study. 5. Lung Biopsy study. 6. Ex-Vivo Lung study 7. Organ and Tissue sample consent. I'll fan out the details later, but the bottom line is there was a lot of signatures to be had--my shaky signature will surely have them double-checking my age.

The surgeon finally appeared in what should have been a curtain-rising moment, the whole day, heck month, had been leading up to this. I was warned that some surgeons tend to be graphic while describing the surgery and was perched at the edge of my seat with excitement (yup, still a medical freak), but this calm, methodical French man, kept it simple and clean. He described the surgery nonchalantly: They will cut across my chest, break my sternum, then remove the weakest lung first (in my case, this is my right lung). Meanwhile, my left lung will continue to ventilate while my new right lung is being placed. In some, rare cases, a heart-lung machine will need to be used during the transplant, but that is generally avoided. Once both lungs have been transplanted, I'll be stitched up and sent to the ICU with a lovely array of chest tubes, ventilator, and a bunch of other goodies, and from there we wait and see how quickly I progress. The entire surgery can take anywhere between 6 and 12 hours.

What else did I learn today?

Well for starters, my lungs are huge. Sure, I'm a hobbit through and through, but my lungs are 4.7 L which is actually above average for females (average is 4.2 L). Years of diseased and hyper inflated lungs have, apparently, served me well.

Secondly, I am now positive for the Epstein-Barr virus, which sounds bad, but it's actually a GOOD thing. Two years ago I was negative (only about 5% of the population is negative), which meant that I was at increased risk for post-transplant lymphoma. Obviously my quest to hang around people with mono paid off--cheers to that! On the other hand I'm still CMV negative, which is fantastic (only 20% of the population is CMV negative) but it doesn't really matter that much since it is likely my donor lungs will be CMV positive, unless I hit some sort of CMV-less jackpot.

Thirdly, all my shots that I suffered through last year seem to have worked. No chicken pox for me! Or hepatitis A and B! My use of exclamation marks is not just a formality.

And so, as the ink dries over at Toronto General, I will climb into bed at Bond for (hopefully) my last night. Yes, I was supposed to go home yesterday, but my white blood cell count decided to throw a fit once last time and jump to 14.7... but we stopped the IVs anyway and I agreed to stick around for observation--I guess I can't object to the ongoing admiration.

Reporting from the recently settled snow globe,
Goodnight.