Showing posts with label Toronto General Hospital. Show all posts
Showing posts with label Toronto General Hospital. Show all posts

Tuesday, February 16, 2010

Never expected this

This past weekend was a mixed bag of good and not so good. Martin and I enjoyed some time together with Scarlett and family and friends. Then yesterday I had a terrible day. Strange symptoms and pain, everything came crashing down. No idea what was going on. My Sats were 99%, my FEV1 that morning was really high 3.1L. So what was going on? I started to shake, and had cold sweats. No fever. Just agony. It got worse and worse. I ended up in bed, falling in and out of sleep.


It took me a while to figure out that I was having withdrawal from a pain killer that I am on, Oxycodone. What?! Are you serious? This is not happening? This is all I need!! I actually hate the drug. I don't like the way it makes me feel, but when I was in terrible pain, it helped me deal with it. The worst part of all this, is that I was never told that the dose that I am on could be so addictive. I had the understanding that it was such a low dose, that I could stop taking it when I thought it was time, and that would be that. So that's what I did. I stopped taking it, and this is what I got. Now, I have been in a lot of pain during the last 5 months, but I can safely say that this is some of the worst pain - withdrawal. Of course I read all about it, and figured out quite quickly that this could be a serious problem. This is why people can't get off them, the pain of doing so is unbearable to many people. Grrr....I don't need this!!


Anyhow, so as of now, I went back onto the dose that I was prescribed. As to alleviate the withdrawal. I don't want to do anything to harm myself, but I also want to get off these pills ASAP. I certainly feel like my team dropped the ball on this. That hospitals and clinics do not talk to their patients enough about the nature of these drugs. Again, I was always very careful when taking pain killers in the hospital since I did not want to become too sleepy and inactive. But I saw people that were on such high doses, for so long, that I think it hindered their tx recovery. And it seems like the doctors and staff do not pay any attention to the addiction that could result. But addiction never crossed my mind. I had no idea that the physical nature of addiction could be this powerful. I have NO emotional need for this drug. I don't like how it makes me feel, and only have used it when in extreme post operative pain, which I have experienced. Now all of a sudden I try to stop taking it, and my body goes nuts.

Needless to say I am frustrated to have this obstacle. I am also quite scared to start to come off the pain meds, now that I know how sick I can get. My body just seems so sensitive to everything after tx, its amazing. I try to stay focused and positive and recognize that this all takes time and it's all a process, but I also get down when things get set back like this. When I have little control and need to sit back and take it easy and wait until things settle down. I try very hard to think that this will pass, and it will be over, like all the other things that have happened since November 21st. But it's really hard sometimes. These seem to be some of the most extreme symptoms yet.

I have called my tx team and we'll see what the plan will be. I am sure I will have to go on smaller and smaller doses, and still experience withdrawal. I actually just want to make sure I can get off them, and then never take them again. It's not worth it! I feel like such a dummy that I took these pills in the first place. Certainly put myself in harms way, and set myself back.

As for other tx frustrations - since I seem to be on the topic - I am in the process of booking my 3 month assessment. The booking is all over the place, and it's giving me stress. Things like having my lung function done at 7am and seeing the clinic at 2pm. Those long days kill me, and keep me away from home. Obviously I am generally frustrated today and need to re-focus.

Monday, February 1, 2010

Q & A: The Answers 1 of 2

Thank you all so much for all those great questions. I had no idea there would be so many! But I love it, since I often wonder does everyone reading understands certain medical CF terms, or wants me to clarify something. This is such a great way for me to write a post. I will go by name and questions. And yes I do plan to answer all, unless they are the same question. So here goes.

Q: Carol: "Will you ever know who the donor was?"
Q: Julia: "Also wondering who your donor was"
A: I have not yet spoken about the donor family, and there is a reason for that. I have sent out my thank you letter, which will go out through the Trillium network, and that will confirm the donor family if they choose to respond. That's the politically correct answer. That's me playing by the rules of the hospital and Trillium donor network. But the fact is our story with the donor family is a very special one. The day after my transplant, the donor family contacted John (my brother) via email since our story was so public. Due to timing and many other circumstances, we are pretty sure this is the correct match. Of course this only happened since our story was all over the media and it was fairly easy to put things together. This is not something that the Trillium network is happy about, though I want to be clear that this was not us reaching out to get this information. I am happy that they did contact us. They are the most generous, wonderful family, and I will be thrilled to write a post in the future about them. Right now I want and need to play by the rules and wait for confirmation that this family gets my letter. But I can tell you that they lost a dear loved one, very suddenly, and their choice to donate came at the only time it could to save my life.

Q: Winter: "Is it true that you will never experience CF symptoms in your new lungs? And if CF affects other parts of your body, do you still have other concerns with having CF?"

Q: Taryn: "Are there any residual CF issues that you have to deal with post tx? Does it affect other parts of your body?"
A: This is a common and really good question. The CF will never 'come back' in my new lungs. These lungs are genetically different, which means they do not have the gene that is malfunctioning and creating that thick mucus that ruins lungs in CF. So this is the good news. This means that treating these lungs is totally different than those with CF, meaning that the lungs behave differently. I have to get used to what I felt was CF infection, and what could be transplant infection or rejection. There is a lot of education that comes with that, so that you do not confuse old CF body to new tx body. I am learning. As for my other organs. I do still have to deal with other issues but they are minor, and non life-threatening. At least for me and my history. Every CF patient is different. I have no kidney or liver problems. I am pancreatic insufficient but when I take my enzymes as I should (and I never miss them) I gain weight well and digest well. I don't see this as a problem per se. I am also a diabetic, which is of course a huge pain in the butt if nothing else. I have been a diabetic for years and years. Everyone post tx will have high blood sugars due to tx medications, so the fact that I already had a handle on it, was actually a blessing. I have little problems at this point controlling blood glucose levels. I do take it very seriously as I do not want organ damage due to high blood sugars. Again I don't see this as a huge problem, since I can manage it. Of course it would be nice not to take insulin, but I don't think about it any more, as taking my enzymes.


Q: Beth: "When you look at your scars what do you think, if anything?
A: Hmm. Good question. The truth is the scars are not an issue for me at all. I have long past the point of vanity in my life. Yes I love to have nice clothes, and dress up and I used to wear heels everywhere I went. Certainly enjoy girly delights. But I have also gained tons and tons of perspective after a life filled with CF, diabetes, PORTS, needles, bruises, and now the scars that I have. They are large, visible, and all over my body. I have my large cut, plus the drainage tubes. I have the Nova Lung scar near my groin which is massive and very ugly compared to the neat chest one. I have my trech scar on my throat which is healing and I think it will disappear eventually. But I also have little tiny ones from IV's all over me. I still discover them sometimes. When I look in the mirror I like them. I never worry about them that's for sure. I do have some sort of pride. They are battle wounds. They represent what I can't forget and somewhat don't want to.

Q: Barbaram55: "How are you finding the post transplant drug regimen?"
A: I am on a lot of drugs. Mostly new. I have a few cross overs from the CF regimen, but those are things like vitamins, and enzymes that I still take for digestion. Basically I got one of those huge pill boxes, have a chart that they set up for me that tells me when to take what, and I follow that. It's only pills, and it's really no big deal. The only side effect that I have is the shaking, which is getting better every day. The Prednisone (steroid) makes you eat more and makes you slightly puffy, but I don't really see that too much, and the appetite is amazing. I love being able to eat like this, and of course it's helping me gain weight, and fast! I am told that within the next few months, to a year, I will take less and less of the supplements that I am on now. When my nutrition gets better and I am back to a normal weight, like I was pre-tx.

Q: Sarah and Brielle: "...do you think you and I could meet up for a play date..."
A: Sarah and Brielle, I have been waiting to hang out since we met all that time ago!! I can't wait. Let's wait until spring is closer and that flu season is over, and we will have that play date. I can't wait to meet Brielle, and have you meet Scarlett. It will be a hoot!! Thanks for all your support Sarah!!

Q: Marti: "What was it like to be home after being in the hospital for so long, and what are your days like now. And what is your favourite thing to do with Scarlett?"
A: Okay, well where do I start with this. I was technically in and out of the hospital (first St.Mike's and then TGH) for most of 2009. It was a terrible year for that. In October I went in, not to come home until January 2010. That's 4 months, 4 long and difficult months. At first I did not want to come home. Even though I hated being there, I felt safe there, and was so scared and weak. But that feeling went away within a few days, and then I began to re-discover life. Home food, my bed, Martin, my family, and of course my Scarlett. Please don't think I'm nuts for wanting to stay there, but I think after so long and after being so sick, home is scary. I have heard this from many people post surgery. Anyhow, now things are so amazing. Every day I do more around the house and with my baby. My mom and I are enjoying the time I think. I hope she feels the same way. I still take lots of breaks and am told by the TGH staff to rest and not do too much too soon. And I generally follow these instructions, but the better I feel the more I want to do, naturally. These days I make sure to do all my meds and record my temperature and FEV1 level every day. I really take care of all that first, it's a family effort to make sure that comes first above all else. I exercise a lot, both at TGH and at home. I am working very hard to get better and better, and more and more fit. I of course do as much with Scarlett as I can, but right now I still can't lift her. So my mom and Martin do that. I feed her often, watch as Martin bathes her (which is very cute), cuddle with her, and sing to her. My favourite thing by far is when we hang out in bed together, she stares at me and touches my face and I sing to her. We just love each other. She reaches out for me and my heart melts and I love her more and more. Each day I can't believe I can love her more.

Q: Shirley: "Are you doing any advocacy for CF or Organ Donation"
A: Right now I don't have any more energy for advocacy. I liked the press that we got, and the fact that as a result of the media coverage organ donation was talked about. That's such a great thing. In the future I will do more, probably for organ donation more than for CF. I know my family, especially John, will always be involved, as well as Barb that did such an amazing job for the Toronto Star. But right now, I need to work on myself, and to get myself back physically. After 6 months or a year, I am sure I will advocate in some sort of way. I feel like it's such a blessing, organ donation, that can give people their lives back, that I need to always spread the word so that people donate. For me it seems like a simple problem to solve, getting more donors. It's all about education, and I think we're going to make leaps over the next generations.

Q: Lisa: "Why don't you have a feeding tube like most cf'ers do?"
A: My experience is that most adults with CF don't have a feeding tube. I don't know what the stats are on this, but I don't know many that do as adults. As for me, I was always a good BMI. I always ate well, and had a BMI of 21 or above. A feeding tube was never mentioned to me as an option or necessity. The last year I lost weight, and we knew we were going into transplant. I kept a great BMI until about September/October. At which point I got lipids (feeding through IV) and I gained tons of weight quickly, and then it was lights out for me. Next thing I knew I was post tx at TGH. I did lose SO much weight after, as you know. It's hard to be this thin, but I am gaining so quickly and eating so well, a feeding tube is the last thing they would recommend. Feeding tubes after transplant are just not commonly used. Many people have the opposite problem due to the prednisone, and of course your organs working so well. I am gaining about 2 lbs per week now, and that's a good pace. Hopefully within the next few months I will be back to my 120-130 lbs.

Q: Mark: "What are you feeding Scarlett?"
A: Haha! I love this question!! Well she was and is a formula baby! She started on solids at about 4 and a half months. She loves her baby rice, all sorts of flavours. My mom makes her everything fresh. Carrot soup, rice, apple sauce with pear or other fruit. She loves yogurt, and banana, and of course still has her formula bottles. I love that she eats only fresh home made food. She has not been sick yet, and we think at 6 months that's pretty darn good. She had the sniffles once (I think from me after I came back from TGH) and she fought it off quickly. We hope to start her on organic chicken between 6 to 7 months. That's the next step. She seems to be the same weight now but growing longer and longer (taller and taller I should say). So there you go Mark, I'm not sure you were interested in all these Scarlett facts, but I love writing about her!!

Q: Toni: waiting for tx and scared that the call will not come
A: Toni, I wish I could tell you not to worry, but I know it's so hard. But you have to stay positive and take it one day at a time. No matter what happens, or how lousy you feel, find something to laugh at each day. Find a happy moment, no matter what. Focus on your family, friends, things you love to do. For me it was my baby. It was my husband and the love on my mom, dad, and John. It was the unconditional support of friends, and strangers. It was my blog that I wrote in and let myself get distracted from the scary situation that I was in. Toni, I know it's scary. Waiting is so hard, but it's worth it. Try to deep breathe, close your eyes and visualize how amazing it will be, and how your pain and suffering (all that work) will pay off. It will. Be strong and brave, and marvel in how brave you are. Be selfish, this is hard. Harder than anyone who has not been through it can imagine, that makes you special and brave. Write me anytime, and I will try to say something to comfort you. I wish you nothing but luck, and I cannot wait for you to experience the other side of this.

Q: Angie "How do you get over or come to grips with the fear of rejection?"
A: The truth is I just don't think about it. I work hard every day to do all that I can to stay well. I eat very well - healthy whole food, no junk, I drink lots of water to keep hydrated. I work out, and do my meds religiously. That puts my mind at ease. I feel in full control. I do all that I can, and that is all I need. Rejection is a negative thought that can overwhelm you, same goes for infection. My advice is instead of wasting time worrying and thinking about it, do something! Get on your bike, go for a walk, eat a good meal, kiss your baby (if you don't have a baby, kiss your spouse, mom, dad, sibling, or your best friend.....) Good luck with being listed. I hope you have a very uncomplicated wait, surgery, and recovery. You can do it!! It is so worth it. Stay enthusiastic and positive Angie!! I wish you nothing but the best, and please email me if you need anything. I can try to answer your questions, and hopefully give you some sort of comfort!

Q: Shannysnewlungs: "Visitors? How are you handling friends wanting to visit?"
A: I know we spoke today at clinic, but I will give my answer here again. I am really really careful with having friends even family over right now. Flu season is scary for us right now, so generally I have had only a few people over. I have not seen most friends in months and months. Even some family for the past few weeks due to illness. It's terrible. I miss everyone SO SO SO much, but there are phones, and email and text. And that's the way it's going to be until spring comes and/or my meds go down a bit. And since I was always this cautious when I had my CF lungs, this is nothing new to people that know me well. They all understand and I love them for that. People that don't understand need to be explained that what can be a common cold for them, could be hospitalization, or worse for a transplant patient, especially so fresh out of surgery. But again, most people are more than understanding and often cancel dates since they feel slightly unwell and want to make sure they don't get me sick. I always appreciate those people.

Q: Lauren Grace: "They say that sometimes you take on traits of the person whose organ you have received. Do you have any new traits or likes?"
A: As far as know, not really. Nothing new. I used to love sugar, now I don't. But as far as I know my donor loved sweets. So as much as I would love to have some cool similarities and differences, I don't. May be I will notice things in time, but not now =) I too have heard people having radically different tastes.

Q: Angie: "What is a Nova Lung?"
A: The novalung helped me exchange gases during the time when I was on the ventilator and had severe problems with CO2 retention. When you retain CO2, just like when you don't have enough O2, damages to the brain and other organs can occur. I was put on it to help my body when I was on the ventilator. The novalung basically re-oxygenated my blood when my lungs were not able to do it any more. It's a small box that sits outside of your body, that your blood passes through. It is connected to a major artery. Mine was located at my groin (where the right leg ends). I have quite the scar to show for it, but it did keep me alive for those few extra days that I needed. It's a great machine, but a person cannot be on it for ever, so time is of the essence. It is certainly a last result life support measure.

Kathy - can you send me your email. I would love to write you personally, or may be call you? I know how you feel in so many ways. Hang on, fight hard. This is such a hard time, 2 weeks after, but you have to be strong and fight and be brave. I hope you trust me enough to give me your contact info, and we can chat. When I read your email I really felt for you. I know the pain and the fear, and the last thing you need is to feel alone. You are not. I am thinking of you, and wishing you a better day each day. My email is nataliaritchie@rogers.com You are NOT crazy! I look forward to hearing from you!! We can email, or Skype, or text, or msn....we'll figure out a way.

Q: Brian Michaels: "One or two things you want to do once you've recovered."
A: I tend to take things days by day now. I feel like I do things that I have wanted to do every day now. Small things, first, like taking care of my Scarlett and being with my husband in my house. This is so great for me! I took Scarlett for a walk in her pram the other day. It was something like a dream, since I never knew I would be able to so soon after the surgery. For the future I want to play tennis with my husband, with my friends, take some lessons. I want to run in the future too. So badly. It is the ultimate freedom for me. With that comes running after my baby once she starts to walk and run, I want to ski, to swim in the waves of the ocean....Oh sorry you asked for 1 or 2. My life has a lot ahead, I can't wait!!

Jessicajv: I will answer your question, and all the rest in the next post. I hope I did justice to the questions everyone! xoxo

Wednesday, January 27, 2010

The first month

As I mentioned previously, I do not remember a lot about the first little while after my lung transplant. I do think about it a lot, and certainly I have heard many stories from family and friends and even seen segments from the media that have allowed me to 'remember' more. The truth is I don't remember how sick I got before. When I was still at my CF ward at St.Mike's and was put on the ventilator. As if it never happened. From there I was transferred to the Toronto General Hospital ICU where I waited for my lungs.

(Nearly 10 weeks post lung transplant, January 27th, 2009 - today!)
It was during this time that my family started to notice my rapid decline and the fact that I had little time left to live. I was sedated, and not breathing on my own. My lungs failed, I was hemorrhaging blood when I coughed into the ventilator and when I was suctioned. Martin was unlucky enough to have witnessed one of the the times that I was suctioned in the ICU and he said it was horrific. I was convulsing and bleeding a lot. So, my family decided to push for a living donor scenario. There was just less and less hope in those lungs coming. The first step was for everyone to get tested for their blood type. To every ones surprise both my mom and dad, as well as John were all B+ (same rare type as me) and Martin was O, also able to donate. Everyone was ready to donate a lobe, including my husband. Not a thought went through their minds not to, in fact they were all joking about who would be lucky enough to do it. We also got calls from my aunt in Chicago who is also a B+ and my uncle in Poland that was ready to fly in right away. When I think about all these people willing to go through this surgery to save my life, it makes me feel like the luckiest woman in the world. Their fight was just as strong as mine. I would do the same for each and every one of them in a split second.

November 21, 2009 came around, and my dad said he felt that I only had a few days to live with my lungs. He saw the doctors getting worried, running out of options after the Nova Lung started to cause problems. Martin said that he knew one way or another we were going to operate that weekend, but everyone thought it would be from family live donors. Martin was sitting in his office at work, ironically fixing up our Will, getting ready to be called into the OR when he got the call. It was not him going into the OR, I was, the lungs had arrived. At first he thought it was a joke, after so many ups and downs, it was hard to believe that now, truly in the 11th hour, a donor had been found. It was the best news he had ever heard he said. The news got around quickly. He called my mom right away, who has heading to church with Scarlett at that very moment to continue to pray for our miracle. When my mom called my dad, he cried on the phone, the lungs are here, her lungs are here!

My mom, John, Angie, and baby Sophie (who was only 8 days old at the time) stayed at our house during the operation. I always told my mom, no matter what, not to drag Scarlett to the hospitals. She needed to continue her schedule, and so that's what my mom did. Always respecting all my wishes regarding my baby. I trusted she would be a perfect babcia and caregiver along with Martin. So the 4 of them spent the next night at our house. Comfort in numbers at the most critical time. Martin and my dad were at the hospital.

My dad never left my side. He slept in the chairs, in the waiting rooms, even though others told him to sleep, go home, rest, he rarely did. He just could not leave, even though I was unconscious and in the impressive hands of the ICU at TGH. Those people kept me alive. I have a lot of people to thank before I even went into the OR.

(Holding my favourite Christmas gift from friends Kelly and JR - my new lungs in plush blue)

It was my dad and Martin that walked with me as they wheeled me into the OR. Martin and my dad remember the dramatic unplugging of all my tubes and devices, and that being a very scary and emotional moment. And the the doors closed, at that was that. It was all in the hands of Shaf Keshavjee and Tom Waddell, my surgeons, and the many other staff involved. I wish I could know them each by name and person. They are all so valuable to me, and all so committed to saving peoples lives. I don't remember really waking up and the days that followed in any logical order. I remember one time waking up, I think I was still in the ICU but I am not sure, and my dad's face and Marty's and them saying to me over and over, you got your lungs, it's all over. Big smiles all around. On my end I felt nothing but discomfort, confusion, and distress. I was unable to move, and had tubes coming into my nose, throat, hands, everywhere. I was confused as to how I got in that room. I could not speak due to the trach, and I found that difficult and I panicked a lot as a result. I remember the horror of the panic of not being able to move. I had pain medication that was used liberally, so I was not in terrible pain. It was more a tension and stillness of my body that I found unbearable. I was soon sedated again since I could not calm down. It took me a long time to discover that I had had my operation, I was alive, and that I had been very very sick. This took the longest for me to realize since I did not remember a thing.

(Seeing Scarlett again on Christmas day)

Over the next month the recovery was the hardest part of my life thus far. Before I turned the corner, both mentally and physically, I went through a dreadful time. My brother said that I looked constantly in shock, ready to die, cry, ask and beg for help, even though there was not much anyone could do. Time had to pass, meds had to work, medicine had to do its thing. But after dealing with CF for 30 years, one comes to think of lung transplant as the easy part. At least that's what I thought. I heard stories of people leaving the ICU in 2 days, then out the door and home in 10 days or 2 weeks. That is what I expected for years and years. I did not expect for me to get so sick, so fast and to have to fight like I did.

By far the hardest part was not being able to move. I began to get sore, and agitated. Lifting my arm over my head was impossible so I started with physio by just lifting my leg a few inches, my arm a few inches, stretching my toes up and down, and trying to sit up in a big chair for an hour or so a day before getting back into bed with the help of a lift. It was devastating for me to have to go through that. I felt very sorry for myself and really believed for the first few weeks that I would never walk or move again. A silly thought when I think where I am now 2 months later. But when you expect something so different and wake up one day, and this is what you have to deal with, your mind plays tricks on you.

Martin had a lot to do with my rehab. He took time off work and worked with me for weeks, until I was walking with him down the hall. Large walker, small walker, holding his arm, then on my own. We did a full weights program, Martin pushing me all the way. Even when I did not want to move from bed. He would make sure I got my pain meds, that I ate, and that I got out of bed. It was the hardest part. Sleeping was easier since it was so much work to move. But things got better and better. Every day a better step, stronger legs, small changes. My body began to respond.

(Arriving in the TGH Atrium December 26th, 2009 - 1 month post transplant)

There were set backs along the way. Since I was so weak, I was in bed longer, and unable to get to the bathroom for nearly 5 weeks. This is so difficult as an adult. I had to wear a catheter that was removed quite early as to prevent infection, at which point I wore adult diapers and used bed pens. No one really talks about such things, but the challenges of that are huge. I was also on Lasics at the time, which is a medication that makes you get rid of the extra fluid that your body is holding, which meant that I was urinating all the time. And when I say all the time, I don't think I can even describe how much that was. At times I would wake up to a bed soaking from top to bottom. Needless to say, the doctors soon evaluated me and noticed that what was happening was unusual. My bladder had stopped contracting and letting me hold urine. So I went back on the catheter to make my life, and those poor nurses that were in and out of my room 24/7 lives easier. That time was so hard for me. I had bladder pain from not being able to empty in time. I had bowel pain. It was insane. There were nights that I prayed for relief in any form. Most of the time I got good drugs to help me sleep and get relief.

So I know that was too much information, but I said I would be open. After that when I got stronger, the doctors told me the catheter had to go. I had all my tubes removed and it was the last to go. I was so horrified that I would have no bladder control again, but this time they took it out and everything worked as it should. The muscles had come back, like everything else in my body. It was just time, strength, and it felt great to feel that much more in control of things. Let's say that I will never ever take for granted such simple things again.

So that was my first month. The second was wildly different. I moved ahead faster and faster. I spent more time alone, without as many frets about being alone. I started to gain confidence in myself and in my new lungs. I reached a new plateau those last few weeks.
The second month...To be continued....

Monday, January 25, 2010

Amazing things.

Today I was at my TGH clinic. Another super long day. It started off a little bumpy, literally!! When heading out this morning to the car, with my mom Scarlett in tow (since I can't drive yet, I have to rely on my mom with Scarlett to drive me) I fell on the road. I did not slip, there was no ice or snow. I just stepped off the curb and my knees just gave in. Ouch! I forget still that my knees and legs are so skinny and there is so little muscle! Yikes. It was not the nicest thing to have happen at that early in the morning, especially since I knew I had a long day ahead of tests. As far as I can tell all is okay, one sore and bruised knee.

So I had my PFT's first, followed by treadmill room (basically physio - treadmill, bike, weights, and legs....I have to continue until 3 months post-op) then blood work, xray, and finally clinic. My day started to my pft's, which are the tests that require the patient to breathe in to a machine and find out lung function. I know that not all my blog readers out there know all the CF and transplant lingo and tests, so I am going to explain as I go along. Anyhow, today we saw another incredible number. My new lung function is 76% (or 2.65L for those that follow those more accurate numbers).. I was in shock. About a week ago I was at 63%! My family and I are so happy, we're thrilled. It's all like a dream.



Clinic went really well. The doctors are thrilled with everything, and hope that it all keeps on track like this. My drug doses were changed, so that I am not on such high steroid doses, and that's always great news. My xray is pretty, clear, and when the doctor looked at it today, she was thrilled that after 2 months and all that I endured waiting for my lungs, they were able to achieve such positive results. I can tell from the staff, everyone in surprised. To be honest, I am too. I believe in science and medicine, but really it all just feels miraculous to me. From what was a bad dream, so just plainly a dream come true.



I am very tired, and am off to bed. Scarlett is long asleep, the good baby that she is. Mommy's little helper I think of her. Being to sweet as mommy goes to her clinics and tests - and it seems like she understands it all. That we need to stay strong together, not only her and I, but her daddy, and grandparents. Stay strong and keep going as we have being. Together, no matter what, how hard it got. And it got so hard, and now the clouds are parting, and 2010 has emerged, again like a dream.


Myslef and Martin with our little Scarlett - who loves to hold on to daddy's hair!!

Monday, January 11, 2010

Home

January 6th, 2009 I finally got discharged from TGH. Home after all this time.

For the past 4 days I have used this time to settle in at home, and spend time with Martin, Scarlett, and the rest of the family. The first day was very hard, as I just learned to walk the stairs and was not sure if I would be able to do so at home. But things got better each day, and these past few days have been strong, and quite amazing.

Today my Scarlett reached out for me, for the first time, and though I still can't lift her due to rib and chest pain from the surgery, it was such an incredible thing to experience. My daughter and I seem to fit like mother and daughter, and no amount of time, and illness, and hospital time will change that.

I feel like now I am ready to start to tell my side of the story. It seems like when I was far gone, the paper and the news told their version and my family's. But where was I during all that time? I have lots to say both pre and post operation, and I am going to start to write. I want to be truthful, and tell it how it is, and though the outcome is such a miracle, the ups and downs of transplant (how it was for me) is something I want and need to share. It make take me 5 posts, it might take me 20. but there is lots to write, and I can't wait to share.

I want to thank everyone, again and again for the support on the blog, the house, the hospital. For the cards, well wishes, presents for the whole family, the food made, the emails, the texts, the calls....and on and on. I cannot thank everyone in person, even personally, but here I thank everyone. I feel like it was not just me in that operating room, it was the hearts, and prayers of so many people, and my great city Toronto. I am immensly flattered, as my lung transplant is one of 100 last year. Including many people that I know, that are just amazing.

Thursday, December 31, 2009

2009 all in a year for the Ritchies

What can I say about 2009. Never in my wildest dreams did I ever think things would go as they did, but at the same time, now things are perfect, as they should be. I have my husband, my daughter, and my new lungs. Somehow, 2009 accomplished what we wanted, but it was a battle in every way.

On July 17th, we finally met our little girl Scarlett after a lot of hard work getting her here. But it was more than worth it as we met the most amazing family on the way. Scarlett came into our lives and changed everything for the better. She is now 5 months and amazes all of us, and is a true blessing in all of the pain that we have all had to endure otherwise. We just love our Scarlett Anna more than anything. I cannot wait to back home with her very soon taking care of her, being her mom.

Health. 2009 was the year of bad and good health. In January 2009 I was already very unwell and on IV antibiotics. In fact I was on IV's most of 2009, until this miracle came and I got the lungs I needed. It began to be incredibly difficult in the summer, when I had to use oxygen 24 hours a day and life just had no quality left to it. It was then that all we could do was wait. No one expected me to get that sick. It happened so fast. From lungs that still somewhat worked for me, to ones that were no longer working in a matter of a week. Then came the ventilator, sedation, ICU, TGH, Novalung, and finally before there were no more options, a donor. Lungs. That miracle. How it all unfolded, is a story I am yet to tell. It is uncanny. Due to the media coverage, the story was much more than a regular transplant. But I will leave that for another time. There is too much to say, too much to write about. Much of it is just pure miracle.

On the family side of things, we once again proved that together we are stronger than when we are apart. There was a wedding, John and Angie's. And their little girl born November 13th, Sophie. All such amazing news.

So, we welcome 2010. It will be amazing. A new chapter, and a new beginning of sorts, but really a continuation of my life. Good or bad. With all it's up and downs. My life.

Wednesday, December 23, 2009

Mother and Daughter Reunite (+ Toronto Star)

Hi Everyone,
A lot has happened since the last blog update - and you'll be happy to hear that all of it is good news : )

Natalia is right back to full-steam-ahead recovery and progress, back to the second stage Step Down Unit after last week's setback, starting to eat food in mass quantities (she's currently only 88lbs from trials, tribulations & transplant with an ideal weight of 125-135lbs [I know, I'm sorry Nat, I just told them your weight:], gaining more strength every day, walking further and further, in better and better spirits, and continued monitoring of her new lungs have doctors concluding that they are a particularly strong set...and Natalia is adjusting to them superbly.

Natalia and baby Scarlett were reunited yesterday via a covert, undercover visit (children under the age of 11 aren't allowed in this part of Toronto General Hospital so Scarlett was snuck in - for any/all medical staff currently reading this thanks in advance for turning a blind eye). It was quite a sight to behold (see video link below).

The key components to Natalia's next steps are continued patience combined with food. Lots and lots of both (Natalia is busting to get home), but food in particular for critical weight and additional strength.

So, Natalia won't be home for Christmas, but she will be home soon. Exact date is yet to be determined because every day is a little bit different...sometimes 5 steps forward, other days a few steps back, but overall progress to the goal line which is the most important part.

Her hands are still shaking (cause cannot be determined....likely due to how under weight she currently is and not related to immunosuppressive drugs as mentioned in a previous post) which has been preventing her from getting online to start writing in her blog again, but her emotional and psychological healing from her too-close-to-death ordeal has been particularly tremendous in the last few days which has encouraged her to fight through the shaking and personally type a Holiday/Christmas message to all of you very soon so keep your eyes peeled....

All the Best and Happy Holidays To All,
And continued thanks on behalf of Natalia, Martin, Scarlett and family for your incredible interest, support, thoughts, prayers, love, offers, wishes.

Myles Slocombe
PS: FRONT PAGE COVERAGE WITH UPDATE ON NATALIA&FAMILY's JOURNEY in the TORONTO STAR:
http://www.thestar.com/living/christmas/article/742570--a-breath-of-life-for-christmas?bn=1
Special and ongoing thanks to Reporter and friend Barbara Turnbull

Friday, December 18, 2009

Recovery Setback

Hi Everyone,
Since the last update on Wednesday morning Natalia has encountered an unexpected bump in her progress.

It's not entirely known yet what has happened, but her body may have had a reaction to one or a combination of the medications she's on that may have created an adverse reaction and/or medical staff may not have provided her with the amount of food her body required via feeding tube after she had another bronchoscopy (Natalia is also Type-1 diabetic so food intake is critical).

The last 3 days have been unsettling for her - she may have had a seizure, lost a lot of weight rapidly, was at times feeling paralyzed and numb, had to be taken back up to the Step Down Unit on the 10th floor where she is right now and has experienced a few other things that have all been a physical, emotional and psychological blow for her and shock to Martin and family.

The GOOD NEWS is she's starting to feel better. And has been sleeping alot. And eating alot. Current theory in the Ritchie household is that her current recovery is due in large part to her mom Hanna's polish soup recipes... (Nat has just started to be able to eat actual food again)

The last few days have certainly been a confirmation of the nature of cystic fibrosis, organ transplants and Natalia's journey. And proof positive of why it's important to not get too far ahead of one's sense of relief and excitement when progress is being made due to the nature of the beast. There can often be unexpected turns for the worse. But as you know there can also be expected and unexpected turns for the better as well and that's what's being focused on right now.

Thank you in advance for an increased infusion of thoughts and prayers at this time.

We'll update you again when we have a better sense of things...and as Natalia gets back on her road to recovery full steam ahead which she'll undoubtedly do.


Myles

Saturday, December 12, 2009

The LEAP to Speech + Online Resources

Hi Everyone,
She speaks!
With her new tracheostomy tube, you'll be happy to hear that Natalia can speak again!

In her typical style, Natalia has leapt right over the hurdle of potentially needing a speech pathologist after a month of not being able to say a single word and weeks of tubes pushing past her vocal chords. It's a bit whispy at the moment, but Natalia's voice is back.

So she's now walking (in longer and longer stints, with a bit of assistance, down the hallways of the Step Down Unit) and talking.

Small steps are turning into longer strides.

Given where she was just 3 weeks ago - deteriorating quickly and getting far too close to death's door - thanks to hope and determination and science and medical skill and the incredible generosity of someone who gave the gift of life and his/her incredible family that helped make it happen, Nat is walking and talking and smiling and getting closer and closer to continuing her recovery at home where she can return to being a Mom and Wife and Daughter and Sister and Aunt and Friend on a bigger scale and more consistent basis than ever; moving forward with her new lease on life and getting busier as she gets stronger to catch up on lost time and experiences (I think it's starting to make Martin a little nervous - early morning runs, visits to markets, long walks, trips....he's going to be quite busy)

As I'm sure you'll agree, it's all really quite incredible. Miraculous even.

The power of determination, patience, will, spirit, love, family, support, generosity, medicine, technology....and serendipitous timing.

Your unfaltering support of Natalia and her family's journey has, is and will always be something that they appreciate and thank you for on a scale that can't be expressed.

Nat's original hope and goal of sharing her personal story to help people understand the trials and tribulations of a terminal disease....to leave a journal and lessons for her daughter Scarlett....and to help humanize a national issue by helping to put a face and personal story to the importance of organ donation with the hope of helping bring some greater good for other Canadians that are currently on a transplant waiting list (approx 4000) and to help future Canadians in need of an organ transplant has been working: there is strong evidence from many of you that a difference is indeed being made.

Victories on two fronts.

For those that may not have had an opportunity yet, please consider your choice and wishes about organ donation, discuss them with your family, and see below for more information.

For Natalia, a final bronchoscopy was conducted yesterday and all was clear, the trach should be completely out in a couple of days allowing her to breathe entirely on her own all the time, to start eating food again, and to continue the count down to getting home with her family which doctors currently estimate to be approx 2 weeks.

We'll keep you posted as the victories and remarkable journey continues...

All the best,
Myles Slocombe

ORGAN DONATION:
By making your wishes known, you have the opportunity to save up to 8 people’s lives and enhance the lives of up to 75 more should, God forbid, something happen to you. In many cases, when families lose a loved one, the gift of life their loved ones were able to provide is the one tangible silver lining that brings a degree of comfort at a time of loss. Don’t just discuss it with loved ones: sign your donor cards and add your name to applicable provincial registries in the provinces that have them. Even more powerful is to state your wishes in a living will. All of the above will let your next-of-kin know your intentions, having your name in a registry can save important time, and a living will with a health care directive carries the most amount of weight.


For more information and to register your wishes now:

->Alberta, Nunavut, Northwest Territories:
No registries at this time – sign the back of your health card
->British Columbia:
http://www.transplant.bc.ca/index.asp
->Manitoba:
http://www.gov.mb.ca/health/donor.html
->New Brunswick:
http://www.snb.ca/e/0001e.asp
->Nova Scotia:
http://www.legacyoflife.ns.ca/
->Newfoundland & Labrador:
Donor Card/Driver’s Licence
->Ontario:
http://www.giftoflife.on.ca/page.cfm?id=3F79E442-F7FD-4057-AA63-7B0279A17EF1
->Prince Edward Island:
Place sticker on your health card renewal form onto your health card and/or have red heart engraved into your driver’s license at time of renewal
->Quebec:
Obtain donation sticker from local hospitals and pharmacies and attach it to your health card
->Saskatchewan:
http://www.health.gov.sk.ca/organ-and-tissue-donor-information
->Yukon: Donor Card

ADDITIONAL RESOURCES:
http://www.organ-donation-works.org
http://www.recycleme.org (Ontario only, but a very effective & informative website)

Thank you.

Monday, December 7, 2009

One Step & Victory At A Time

Hi Everyone,
Natalia continues to recover at a good and steady pace: all drainage tubes that were connected to her chest cavity have now been removed, continued bronchoscopies are doing their job, infection remains but is being effectively managed by new antibiotics, white blood cell count is down and in a better range, physiotherapy is progressing, she continues to gain strength and alertness and is, one step at a time, getting closer and closer to getting home.

She hasn't been able to start speaking quite yet, but that step is very close and very soon.


Exact date for her victorious return to baby Scarlett and the elated smiles of Martin and family is to be determined, but Operation Home For Christmas is still in the cards, and, as a fallback position, Operation Home in the Very Early New Year is a guarantee.

Martin & Natalia's mom Hanna are particularly busy getting things prepped on the home front, including Martin having the approx 50 foot fir tree on their front lawn covered with white Christmas lights to greet Nat on her return (professionally installed with assistance of a cherry picker, he's pulling out all the stops). Scarlett is busy getting chubbier and cuter for her Mom (now 4.5 months old, a whopping 20lbs, 3 months ahead of eating schedule & already eating solid food...look out Xmas cake...).


In recent days Natalia has been able to start getting online which is another great step forward. When she's a bit more ready, she'll be logging in to say hello to all of you - a particularly large and symbolic stride forward no doubt : )

Very Best To You All, and continued thanks for all of your support of Natalia, Martin & family's journey,
Myles

Thursday, December 3, 2009

Slower & Steadier Wins The Race

Hi Everyone,
On behalf of Natalia, Martin and family, thank you for your continued support while Natalia continues to recover at Toronto General Hospital. Since the last update on Monday progress has been made for her on some fronts, less so on others, with the key theme being slower and steadier wins the race.


Natalia’s awareness and overall strength continues to improve which is key. After a few tries, she has been able to stand up and walk a short distance on several occassions with assistance. Intensive physiotherapy continues and is helping her body and movement improve.

She hasn’t been able to speak yet, but a new tracheostomy tube is going to be used tomorrow which should allow her to start talking and will be a large step forward (the trach itself likely won’t be required much longer).

Medical staff performed a bronchoscopy today (described in an earlier post: a bronchoscope is a flexible metal tube with a camera and suction that is inserted down into the lungs) and have detected quite a few secretions. Additionally, her white blood cell count has increased since the last update and is higher than ideal. This doesn’t suggest organ rejection as much as it strongly indicates an infection, so doctors will be putting her on a new course of antibiotics which will hopefully take care of it in short order.

Unfortunately, there are indications that Natalia may have to remain at TGH for all of December, but that hasn’t been completely determined yet. As you’ve likely detected over the course of following Natalia’s journey, variables change all the time which can be for the good and sometimes for the bad. The most important thing is she is on an upward trend of improvement...there are just a few bumps which, all things considered, were to be expected.

As you know, where Natalia has been battling back from is a place that hopefully none of us will ever have to experience and a place from which most people, quite frankly, wouldn’t have survived. Natalia has a spirit and will and determination to live and be a loving daughter, and sister, and friend, and aunt, and wife, and Mom to baby Scarlett that really does defy description. It’s inspiring. It’s motivating. And it puts everything we tend to complain about and take for granted into perspective. As much as I’ve tried to put recent weeks into words on her behalf...a lot of what she’s been through...and the totality of what she’s been through...well...there just aren’t.

The intention of this particular blog update isn’t to have a negative tone, but as mentioned in my first blog post, Natalia wants to provide candidness without any sugar coating.

This is still a hard time for her. A different kind of hard, because she is of course on the other side of the transplant now so it’s all about the pace at which she gets better, rather than before when it was all about the speed at which she was getting worse.

Progress will continue to be made. The course of events and the lifeline that became available when the call came with her new lungs just 12 days ago is astounding. But it is still a hard road.


The aforementioned “totality” and culmination of what she has been through takes a toll physically and psychologically. But, as we all know, Natagladiator is an Olympic fighter and be it for Christmas or just into the New Year, she will be home soon where her new chapter and lease on life awaits.

Myles

Monday, November 30, 2009

Home in Time for Christmas (?)

Hi Everyone,

Natalia’s journey continues to make great progress from the depths of where she was just before her transplant last w/end – she continues to fight, to heal, to improve and get closer and closer to being able to return home; indeed, if all goes well, there is optimism that she will be home in time for Christmas(!).

Natalia’s progress, though steady, hasn’t been without a setback of sorts.....the setback seeming relatively “minor” in the context of recent weeks for Nat and all she has been through. Under more normal circumstances, the setback and even more so the remedy would have seemed a lot more significant.

Natalia had to have a tracheotomy.

Going off the ventilator last week proved too early as mentioned in last update, so for a more phased approach doctors had to give Natalia a “trach” so that when she needs the assistance of a ventilator, it's already connected to her via intubation via her throat (vs. having to re-insert all the tubes through her mouth, down her throat and into her lungs like previous ventilator setup) and all the medical staff have had to do is turn the ventilator back on for instant mechanical ventilation when required. This method has allowed Natalia to breathe by herself for growing periods of time, starting with short periods at first and now, at current stage, she’s pretty much breathing entirely by herself all day and, very soon, all night.


Natalia’s sedation has continued to be reduced. She’s no longer sedated for the purposes of actual sedation, but due to heavy pain medications, is still groggy.

Her awareness of everything is there though.

The only thing that’s preventing her from being able to speak at the present moment is the tracheotomy (which will likely be closed up in the next couple of days). So she’ll be able to start communicating properly very soon.

Swelling is down almost entirely now.

Physiotherapy began a few days ago, and there is optimism that medical staff will be able to get Natalia up and walking for short periods of time as soon as today.


2 out of 5 drainage tubes that are connected to her chest cavity to drain excess fluids and blood have now been removed.

The blood infection is still there but continues to be managed.

Her vitals remain strong. And her white blood cell count which spiked up to 29 late last week has trended down to 13, which suggests that the immunosuppressive drugs are working and preventing her body from rejecting her lungs.

Natalia will be moved out of the ICU in the next couple of days which will be a huge milestone - down to the 7th floor where TGH has a “Step Down Unit" where extensive physiotherapy and rehabilitation will take place as they prepare Natalia for her return home.

So some amazing progress has been and continues to be made.

Martin and family are doing very well and are of course more and more relieved. Their happiness quotient continues to grow as Natalia gets stronger. Due to the rollercoaster ride they’ve been on in recent weeks and the overall ride they’ve been on due to the nature of Cystic Fibrosis, they do have some inherent caution as a preemptive coping mechanism so-to-speak because they do know things can change. They haven’t been jumping up and down with blind elation, but their smiles are defininitely getting wider and wider. And their excitement grows about the very real prospect of Natalia getting home in time for Christmas – something that, as you well know, was beginning to seem like an impossibility up until her new lungs came.

It's all a continual testament to the power and life saving & life changing importance of organ donation. As John stated so well in the last CBC installment, if there is a moral to this story, let that be it. The difference it makes cannot be put into words.


Thank you to everyone for your sustained concern, thoughts, prayers, hope and optimism for Natalia, her family, their journey, and her upcoming return home.

What a day that will be.


And although the walk in the park with Scarlett and Martin may have to be a snowshoe or cross-country ski, that day will come as well.

We’ll continue to keep you updated as Natalia’s victories continue - and it won't be long now before Nat will be online, typing, and sharing her journey again with all of you.


Myles

Monday, November 23, 2009

On The Comeback Tour, How You Can Help + Online Resources

Hi Everyone,

It gives Martin and team great pleasure to let you know that Natalia is doing very well since last night’s blog post. In her typical fashion, she’s fighting, fighting, fighting, starting to make progress in her recovery sooner than anticipated, and is currently exceeding expectations. The bleeding which was an issue has completely stopped. And all of her vitals are at normal levels. She does have a bit of a blood infection but it's being managed. The sedation has been reduced enough for her to start to wake up and open her eyes. As of right now, she can communicate by blinking & nodding yes/no and is cognisant of the battle she’s making strides towards winning. As Martin updated her and explained the gravity of what she's been through, her tears started to flow. Whether she will remember today once she gets past this next phase is to be determined.

As an aside, to help raise awareness about the trials of terminal illness and the incredible importance and benefits of organ donation, as most of you know, Natalia and family’s journey has been followed in the media --- to the chagrin of some and gratitude of others.

They made the choice to make their private story a lot less so in the hope that it would bring a greater good.

The outpouring of support for this choice has been overwhelming. The number of people who have written to say they have been inspired by Natalia’s story....inspired by Natalia and her family....inspired and motivated to make that important decision about their organ donation wishes should anything ever happen....to discuss their wishes with their loved ones (even better is to also make wishes known via signing organ donation card and even more importantly registering with provincial organ donation agency as a matter of record [see links below])....well....it has been equally inspiring and rewarding for Martin and all.



Countless people have also reached out and offered help in Natalia's time of need. Everything from babysitting Scarlett, to dropping off food, to coming by the hospital, to sending out emails to raise additional awareness. Martin and family can never thank you enough. Right now there's enough support to babysit Scarlett until she's well into her 30's (hopefully that won't be necessary:), feed an army, and keep a signficant part of the Toronto population awake with vats of tea and coffee.

Here is what you can do to really really help:

Consider making the very personal choice about organ donation, and take time tonight to make your organ donation wishes known.


On behalf of Natalia, her family, the approximately 4000 Canadians currently on transplant waiting lists; and of course on behalf of future Canadians who will need the gift of life, to those that have already done so: thank you, thank you, thank you.

Hopefully events over the last few days will inspire even more of you to do the same, because it really does save lives and makes the most profound difference for entire families and many many others.

On the media coverage front, tune into CBC’s “Connect with Mark Kelley” tonight for an update on Natalia and visual account of the last few days.

Also, here is some recent coverage by our Team Get Nat Lungs supporters at the Toronto Star:

Today:

http://www.healthzone.ca/health/newsfeatures/article/729390--new-mother-well-after-double-lung-transplant
Yesterday:
http://www.healthzone.ca/health/newsfeatures/article/729154--surprise-lung-transplant-gives-mom-renewed-hope

CBC Coverage from last week as promised:
http://www.cbc.ca/connect/2009/11/on-a-mission-update-on-natalias-health.html

Very best to you all,
And here’s to Natalia’s continued recovery,

Myles Slocombe

It’s never too late to register your organ donation wishes. By making your wishes known, you have the opportunity to save up to 8 people’s lives and enhance the lives of up to 75 more should, God forbid, something happen to you. In many cases, when families lose a loved one, the gift of life their loved ones were able to provide is the one tangible silver lining that brings a degree of comfort at a time of loss. Don’t just discuss it with loved ones: sign your donor cards and add your name to applicable provincial registries in the provinces that have them. Even more powerful is to state your wishes in a living will. All of the above will let your next-of-kin know your intentions, having your name in a registry can save important time, and a living will with a health care directive carries the most amount of weight.

For more information and to register your wishes now:

->Alberta, Nunavut, Northwest Territories:
No registries at this time – sign the back of your health card
->British Columbia:
http://www.transplant.bc.ca/index.asp
->Manitoba:
http://www.gov.mb.ca/health/donor.html
->New Brunswick:
http://www.snb.ca/e/0001e.asp

->Nova Scotia:
http://www.legacyoflife.ns.ca/

->Newfoundland & Labrador:
Donor Card/Driver’s Licence
->Ontario:
http://www.giftoflife.on.ca/page.cfm?id=3F79E442-F7FD-4057-AA63-7B0279A17EF1
->Prince Edward Island:
Place sticker on your health card renewal form onto your health card and/or have red heart engraved into your driver’s license at time of renewal
->Quebec:
Obtain donation sticker from local hospitals and pharmacies and attach it to your health card
->Saskatchewan:
http://www.health.gov.sk.ca/organ-and-tissue-donor-information
->Yukon:
Donor Card

ADDITIONAL RESOURCES:
http://www.organ-donation-works.org

http://www.recycleme.org (Ontario only, but a very effective & informative website)

Sunday, November 22, 2009

11:59 Of The 11th Hour

Hi Everyone,

At no time was hope ever completely lost but I must admit things did reach a stage for Natalia and the decline of her health in the last few days (CO2 levels came down w/ the Novalung but getting enough oxygen into her blood was starting to prove an insurmountable challenge plus she was going septic) that makes writing the following 3 words a rather surreal and hard-to-believe experience:

NATALIA GOT LUNGS!!!

Yes....you read it correctly....

NATALIA GOT LUNGS!!!

After a successful transplant she is back in the ICU where she is stabilized and doing well considering the battle she has been through.

There was some initial concern about post-operative blood loss but that is being controlled, her blood pressure has become normal again, her C02 levels are currently 39 vs 120+, she is now receiving 40% oxygen on a ventilator vs. 100%, her oxygen saturation is 98, her temperature is up at 38.3 degrees C but white blood cell count is down to 13 (which suggests her immune system isn’t creating white blood cells to fight against her new organs). Her O type lungs are healthy and working.

Apparently Natalia will likely be kept completely sedated for several more days and it’s unlikely that she will be coming off the ventilator for the next 2 weeks or so (when she does come off it will be done in stages) because she is currently too weak to breathe on her own.

How close things came for Natalia is hard to fathom and harder to convey.

It has been discussed and agreed by Martin and family that the timing was quite literally a miracle.

To give you a sense of how close things were, when I spoke with Martin less than an hour before the call came out-of-the-blue he was literally at his office preparing his last will and testament and putting his business affairs in order as a precautionary measure in preparation for the possibility and hope of going into surgery as a live donor to try and save her life.

Indeed, Martin, John and Chris were fully and equally prepared to hear the results of a meeting with doctors scheduled for yesterday afternoon that either A) Natalia was no longer a candidate for any form of transplant due to her deterioration or, in their hope and estimation more likely B) the living donor option would be moving forward and likely moving forward almost immediately with 2 of the 3 of them before it was deemed too late to be viable, her candidacy removed, and all options and hope lost.

And then, the lungs came.

During what must be a profound period of mourning for another family right now, the ultimate gift was bestowed upon Natalia. The most generous gift a human could ever possibly receive has been provided by complete strangers and the gratitude of Natalia’s family cannot be expressed in words.

There’s actually quite a lot about the last while that can’t really be expressed in words.

Natalia’s journey - her battle, her will, her spirit, her determination, the love she has for her family and the love her family has for her - defies measurement and defies description.

It's a story that couldn't have had many more twists, many more turns; any more ups, any more downs - and any more at stake.

Martin and family are doing really well. They’ve been on the rollercoaster ride of rollercoaster rides as you know, and currently have what I think is a sense of cautious relief with elements of residual disbelief. The reality and extent of the recent course of events hasn't had a chance to settle in for them yet, plus they are fully aware of the fact that Natalia is still in a fragile and vulnerable state. So they’re optimistically realistic or realistically optimistic, one of the two.

Natalia's battle has been one of unbelievable proportions where human will, science and the skill of incredible doctors and medical staff all came together to beat what was quickly becoming a certain path - but as she sleeps and rests and recovers right now she is not out of the danger zone yet.

But she is on the other side now. A new battle has begun. And also another chapter.

A humble and continued thank you on behalf of Natalia and her family for the concern, thoughts, love, prayers and support of all of you, and to the donor and donor family who gave so much.

We’ll continue to keep you posted as things progress for Natalia. There will be more obstacles. But there will also be more victories.

And Natalia is a giant leap closer to that walk in the park.

Myles

Friday, November 20, 2009

Just Around the Corner

Hi Everyone,
So far things are going well with Natalia's new phase on the Novalung. Her CO2 levels have been substantially reduced from 120's down into the 50's which is a safe zone (we hover in the 40's), and there has been no indication of bleeding on the blood thinners so things are very stable which is excellent. With some additional research it's my understanding that the Novalung was invented in Germany back in 1996 and since then there have been approx 1200 uses of it in Europe with a 95% success rate. In Canada or North America it's been used 13 times to date, and in every single case it has enabled recipients to make it until lungs became available. If things remain stable for Natalia, there's every reason why the 100% success rate will remain exactly the same. She has some time (approx 1 month) and due to highest status for next set of B+ or O lungs that are the right size, they're just around the corner. Plus we still have the living donor option - Hanna and Maria have been removed from the list of potential candidates due to age and size, but Chris, John and Martin remain in contention and are busy undergoing a battery of tests.
Keep up the positive thoughts, keep up the positive prayers...let's get this done!
Myles

Thursday, November 19, 2009

CBC Coverage

CBC will be airing a third installment on Natalia and her family tomorrow night (Friday) on their primetime show "Connect with Mark Kelley" during their 7:00-8:00pm and 8:00-9:00pm (Eastern Standard Time) cycles, covering aspects of the current stage of Natalia's journey.

The goal of the coverage was and still is to tell Natalia's compelling story to bring a human face to the national issue of Canada's terribly low organ donor rates with the hope that it would motivate viewers and readers to discuss their wishes with their loved ones, sign their donor cards, register their wishes with their provincial organ donation agency and/or even better, make their wishes known in a living will (links to further info will be provided in an upcoming post to help you do exactly that).

Best case scenerio, this coverage will help bring a direct donor for Natalia, help in it's own way to alleviate our national organ donor shortage, and hopefully help save and enhance the lives of other Canadians.

Worse case scenerio, the latter two still apply.

So tune in if you can.

If unable to see it tomorrow, we'll be posting a link to it once it's up online.

For those that may not have seen the first two installments:

CBC PART 1:
http://www.cbc.ca/connect/2009/11/on-a-mission-new-lungs.html
CBC PART 2:
http://www.cbc.ca/connect/2009/11/on-a-mission-new-lungs-pt-two.html

Special thanks to Producer/Reporter Nick Purdon - he and the Canadian Broadcasting Corporation are growing members of Team Get Nat Lungs.

Myles

Next Step

Hi Everyone,

Last night at 5pm the decision was made by Dr.Keshavjee, his team, Martin and family to proceed with putting Natalia on the Novalung (option 4 in previous post) due to dangerously high carbon dioxide levels in her blood that were not coming down despite doctors' best efforts and if left unchecked would have poisoned her. Once decided, doctors moved swiftly and by 6:30pm they were performing the 1 hour surgery in her room to connect the device to major arteries near her hip. The procedure went smoothly, her C02 levels immediately started to come down and she slept through the night under heavy sedation.

This stage is a double edged sword. We had hoped that the Novalung would not have to be used....that lungs would have come by now......but are fortunate that this option even exists as it is the only thing that's keeping her alive right now. In a best case scenerio, doctors will be able to reduce Natalia's sedation and if her lungs will allow it, with a bit of time, they may be able to remove her ventilator. There have been cases on the Novalung where patients have been able to walk and talk and eat quite comfortably. Whether the ventilator will be able to removed in Natalia's case is yet to be determined.

Bottomline, the Novalung buys Natalia time until lungs do indeed become available. The only immediate risk to the decision that had to be made was alluded to in previous post: blood thinners are required in order to prevent blood clots on the Novalung and because she had been showing evidence of bleeding a few days ago, this is of some concern. If she starts to bleed, because of the blood thinners, the bleeding won't clot and therefore won't stop. If it's substantial bleeding, there is nothing the medical team can do. If it's moderate bleeding, my understanding is there are steps they can take to help manage things (ie/ blood transfusions) while the waiting game continues but, again from my understanding of the conversation with Dr. Keshavjee last night, it will likely eliminate live donor option due to the risks that are placed on the 2 live donors for an operation that has less of a chance of success. It may also rule out the possibility of a transplant from cadaver lungs. There would be no more options available.

A harsh reality indeed, but at this point in time, merely speculation and only if she bleeds. If she doesn't bleed, there is still every reason for lungs to come in time. The Novalung provides the opportunity for that to happen.

Lungs could still become available in the next few days.

Indeed, if well maintained on the Novalung, she has upwards of a month and because she's high urgency status for both B+ and O type lung types, there's every reason and very high chance that lungs will come with time to spare.

Incredibly, as early as 2 weeks after her transplant Natalia would be released from the hospital.

And within a matter of just a bit of time, she could be and still every reason why she will be pushing Scarlett's stroller with Martin in the park.

Myles

Wednesday, November 18, 2009

Cautious Optimism

Hi Everyone,

Natalia remains well stabilized and has pretty much been completely out since last update. She appears to be more comfortable with the ventilator and tubes than she was when first transitioning into the ICU. For the first few days it seemed her body’s natural inclination was to continue trying to breathe for itself but is now in synch with the rhythm of the pump and at better ease in general which is reassuring to all.

She’s also more comfortable with the suctioning process. Despite being on a ventilator, her lungs continue to fill with fluid of course which needs to be manually suctioned out on a regular basis. To do this a hose device is pushed down the main tube down into her lungs, you push down on a button to create a vacuum seal and then pull the hose out which brings the fluid out like a siphon into a suction tube much like the one used at your dentist’s office. It was a painful process to witness at first (Martin, her dad Chris and I have actually performed it on several occasions as well) but her body doesn’t react to it in as tense a way as she first did (much like witnessing someone vomiting, but without any sound. [If too much information, my apologies, but as you know, Natalia doesn’t like things sugar coated]).

There have been a couple of things on the medical team’s radar. There has been some bleeding from the lungs that was coming up into the tubes so some bronchoscopies (bronchoscope is a flexible tubular instrument with camera and additional ability to suction lungs) were performed which weren’t able to identify a source, leading them to suspect that it isn’t chronic bleeding (which is a good thing) and likely a result of the intrusive nature of the ventilator.

She had a mild fever yesterday which indicated her body may be fighting an infection. It has since come down a bit which is encouraging.

Also of some concern is that her CO2 levels are higher than doctors would like. For those that may not know, sustained high levels of carbon dioxide essentially poisons the human body and can lead to cell damage, including cells in the brain (that’s worse case scenario, which this isn’t). This is not something that doctors have said explicitly to us, more a process of deduction, but if C02 levels don’t improve it appears to be raising the likelihood of moving to Novalung option which, as mentioned in previous post, is a transplant bridge until other option(s) become available.

There is tremendous upside with the Novalung. It’s actually a technological marvel that keeps people alive until organs become available and Dr. Keshavjee is a pioneer with it. In many ways it would be far better than where Natalia’s at with the ventilator because it’s far less intrusive, would enable the tubes to be removed from her lungs and mouth – it could even provide opportunity to eat and speak and move if she doesn’t have to be as sedated.

The downside is that blood thinners are required to reduce likelihood of blood clots on the Novalung which can be problematic A) if the bleeding in her lungs is more significant than suspected and B) for time when organs come and transplant comes and they need to operate. Also, the body’s natural reaction to the Novalung which is essentially an external organ is to create antibodies against it which has potential to increase chances of organ rejection when lungs or lobes are received. I don’t know what the odds are, my understanding is they are remote, but all factors under consideration and part of decision making process.

On the living donor front, Natalia's brother, mom, dad and aunt have all been confirmed as B+ bloodtypes which is very good, and Martin is O+ which as mentioned before is a bloodtype that can work with others. Efforts are being made for the screening process to move forward in an expeditious manner, but understandably takes time. On a related note, we were actually contacted by a good samaritan who was so moved by Natalia's story that he wanted to be considered as a potential living donor and actually donate one of his own lobes. It's against hospital policy for members of the public to come forward for something like this, which makes sense, but it's testament to how much Natalia's story has affected people. The messages of support keep flowing in. As always, and again on behalf on Natalia and family, thank you.

So the wait continues. With optimism...cautious as it may be. We’ll of course continue to keep you posted as her journey unfolds and decisions are made. All of the above said, and all of the above aside, the best headline in the near future will of course be “LUNGS ARE ON THE WAY!” and the last 6.5 days will likely be something Natalia won’t even remember.

Myles Slocombe

Sunday, November 15, 2009

Fighting Hard

Hi Everyone, this is Myles Slocombe typing, a longtime friend of Martin & Natalia & family’s that has had the privilege to be a part of their team for the last while, including in the hospital over the last few days and as part of what Natalia likes to call “Team Get Nat Lungs”.

First, to start with some great news, Natalia’s brother John and his wife Angie had a baby girl on Friday morning at Mt.Sinai Hospital - mother and baby are doing very well (Sophie Boguslawski, a bouncing 7.6lbs). As you can imagine John is a bit busier than usual so I'm tagging in and submitting this blog post on behalf of Natalia and her family.

A lot has happened since John’s update on Thursday. Natalia has since been moved from St.Michael’s Hospital to Toronto General Hospital (TGH) where she is currently in the Intensive Care Unit. Although it may not sound like it at first, in many ways Natalia is actually in a better place in the ICU than where she was just a few days ago. She is now on a ventilator, so her lungs are being mechanically pumped which has brought her CO2 levels down significantly and she no longer needs to fight for breath. Her vitals are good. And she is in less physical pain with the assistance of additional pain meds. On Thursday night when she was moved to TGH, Natalia's mom summed it up when she said that where Nat is currently at is actually a relief.

Natalia has been under varying degrees of sedation, most often completely out so she can rest, other times more lucid and aware of her surroundings. When more awake, doctors & nurses can ask her questions to get feedback (she cannot speak due to the tubes in her mouth, but has been able to move her head to indicate yes/no and at times has even been able to communicate with pen & paper). As many of you know Nat has always been very proactive and in-the-know with her medical treatments, and that continues. Most importantly, Martin and family are able to communicate their love to her, she is able to receive it, and she is still fighting hard with an unbelievably determined spirit.

As serious as things are right now, please know that there are actually a number of positives.

For those that may not be aware, TGH has one of the most advanced organ transplant programs in the world. Natalia is under the care of Dr. Shaf Keshavjee (Director of the Toronto Lung Transplant Program, and is one of the most advanced, accomplished and highly respected lung transplant surgeons out there) and his huge team, so you can rest assured she is in very good hands. She actually couldn’t be anywhere better.

And, as mentioned, Natalia’s vitals are strong. Her other organs are working well. With the assistance of steroids and a feeding tube she is still a good weight. These are all important factors that mean she’s still in good condition, all things considered, for a successful transplant. And she is an absolute top donation priority. I can't quite say that she's absolutely "top of the list" because the organ donation system in Canada is interprovincial (and sometimes, as in Nat's case, also extends into the U.S) and at times complicated (it's more of a 'fluid' list), but let's just say that for her blood type and the lung size she requires, she is highest priority.

Fortunately, right now there are several options available that are under TGH’s, Natalia, and her family’s consideration:

1) Remain on ventilator for the short term while she waits for “B+” [blood type] lungs to become available which is the number one preference and hopefully happens very soon

2) Remain on ventilator for the short term while she waits for “O” type lungs which might be more likely (“0” type is more common and can be used, albeit slightly less successfully, with other blood types)

3) Living donors: Natalia’s mom Hanna, her aunt Maria, John and Martin are all moving forward with possibility of becoming a candidate to donate a section of their own lungs. All have blood types that would work, but there are other criteria that need to be met via an extensive screening process before this option could move forward if it were chosen. This is a relatively new option in the medical world. It requires 2 donors. A lower lobe is removed from one lung of each of the donors, reconfigured, and transplanted into the recipient. The screening process at TGH starts on Monday to ensure option is available should the time come that it is needed.

4) Be placed onto a “Novalung” as a transplant bridge to buy Natalia more time while she waits for options 1, 2 or 3. Natalia can’t stay on the ventilator for very long mainly because it increases the chance of an infection in her lungs due to open and exposed airway. The Novalung is cutting edge technology that works as an external artificial lung. It’s actually quite small (the size of a few CD cases stacked together), would be powered by Natalia’s own heartbeat, and would work by removing C02 from her blood and enriching it with oxygen (
http://www.novalung.com/ ).

The best scenario is of course the first option, followed by number two, then three, with the fourth being an intermediary step. There are both pluses and minuses to options 2 through 4, which can perhaps be explained in more detail in a future post.

Something a lot of readers and followers of Natalia’s blog have expressed an appreciation for is her candidness in what she has written. The experience she has been sharing. And the way in which it has helped people get an understanding of what people with a terminal illness of this nature often go through and have to face.

While Natalia is unable to speak for herself, we will keep you posted as things unfold. We won't sugar coat it, because Natalia wouldn't want it that way. We'll just try to do her blog and her journey justice.

On behalf of Natalia and her family, thank you so much for your outpouring of support - and for your continued thoughts, wishes and prayers.

Her journey continues.