I’ll get in trouble for this, but Jay was not a very nice Valentine this morning. He eventually got around to apologizing and explaining that he was nervous about getting to our first appointment on time and about all that was scheduled to happen today. But once we were on the road and past the traffic, we were much more congenial to one another and both more fit to live with.
Our first stop was with the Nurse Practitioner. We were both a little surprised to see that we would be meeting with another couple at the same time, and I think we were both pretty surprised at how much information we gleaned from this meeting. This blessed woman was nothing if not thorough. We talked about what would be happening during the next week, what would happen while Jay was waiting for a liver, and what would happen after the transplant. Here’s some of the most interesting information:
- We will know by next Thursday (yes, February 23) whether Jay will be added to the list. The other options would be denial and deferral. The NP said that they rarely deny anyone, but if they did it would be because the candidate would likely not be able to survive the surgery. Deferral would occur if further testing was required, or if the candidate didn’t have sufficient social support. When the NP told us that we would know by next Thursday I felt sick to my stomach. It just all became very real very quickly.
- Once an organ is available, we will have about six hours to get to the hospital. The two things they’ll look for in making a match are blood type and donor size. Some folks have asked about tissue typing. There won’t be any tissue typing for a liver transplant. Once we get there and Jay is ready for surgery, there’s still a chance that the transplant won’t happen. If the procuring doctor sees that the liver is unhealthy, or if the liver biopsy (which is done on every donor liver) comes back showing problems, the whole shebang will be called off and Jay will resume his previous spot on the transplant list. In the business, this is called a “dry run.”
- The surgery will take about 4-8 hours, then Jay will spend a few days in SICU, and then a few more days in a step-down unit. After that, he’ll have to stay in Nashville for a few more weeks until the doctor tells him that he can return to Jackson. The reason he has to stay close by is that they will need to do labs several times per week, and they’ll have to be able to get those lab results in the same day.
- Even though organ rejection is a possibility, it can be treated with medication. This was a relief to us since we both assumed that rejection could only be treated with a repeat transplant.
- Jay’s place on the transplant list will be determined by his MELD score, NOT by time waiting on the list. The higher your score, the higher your place on the list. While it seems brutal, it ensures that the sickest people get livers first. When you’re sick, this is actually good news.
· Do we know how long he’ll have to wait? Nope. Could be the next day. Could be the next year.
And that was just one appointment! I’ll tell you about the rest later.