The Fine Line 11: (Liver) Offers I Can’t Refuse
Back in a New Hospital Room…
In that new room the dozens of doctors came and went, but there was one really only one doc who could best explain what was happening.
My transplant doc would inform me that my stay in this new room would not be long, as my MELD score of 35 meant that liver offers would begin to come my way. Getting a MELD score can be tricky but in order to understand what the number means it’s important to know what the score is relative to when transplantation occurs in your region. Due to the poorly drawn lines of the United Network for Organ Sharing (UNOS), patients in need of a liver transplant in states like California find themselves waiting sometimes years longer than other states. San Diego County is barely the exception to the entire state, it is one of many reasons I still live here. San Diego’s average MELD score at transplant is slightly lower than areas more impacted by demand like San Francisco. In San Francisco, a MELD score of 30 may never see a liver offer before they die.
This is one of a multitude of reasons that it is paramount we become organ donors. Having HCV does bar a person from donating blood, but not organs, because of the shortage of organs they’d rather transplant then treat the HCV if needed.
While I was only in the room for about two days, the clocks felt as if they intentionally lagged between the seconds as if to extend my stay further. As my condition stabilized I was hobbling around my room, more antsy than anything else. While the pain was unyielding, between the constant alternating supply of fentanyl and oxycodone I was content. It is my intention to only use pain medication when absolutely necessary because constant use can lead to addiction. Fighting against the disease, stigma, and a very complicated healthcare system is hard enough. We crept closer and closer to election day, and the day prior, on November 7, I was given not one, but two back-up liver offers.
Before going to Mexico, before I was septic, I was called in for a backup liver offer. While I waited, prepped and ready, it only took them five hours to tell me “not this time.” Thankfully my best friend was by my side the entire time. Because the moment someone walks into their room on a transplant ward, their life is out of their hands, so it helps to have loved ones nearby.
My things were sorted and separated, I wasn’t supposed to come in contact with my bug-out bag in my room in the transplant ward. The transplant ward is what’s called a clean floor, patients there have to be cleaned before admission, new clean sheets, everything. It’s important to minimize infection because transplant patients are immuno-compromised.
The community shower they wheeled me to was similar to the one I’d been in before. This one was nicknamed the carwash, the nurse who helped me made it very clear why it was called that. Not only were most patients wheeled to the shower, it was the case that it was incredibly quick and efficient. Towels prepped, washcloths prepped, she explained that I would need to continue showering until I’d used the entire bottle of special soap.
The soap was specifically designed and dried out my hair like no other. But I’ve never felt more clean. My nurse was also Russian, which in hindsight made me clean faster. Something about a very serious nurse telling you what to do in a Russian accent really commands attention and demands expedience.
Once cleaned off, I looked at my very empty room, it had a window facing some bushes and a parking lot almost too far from my bed to really see well out of. My things were waiting for me in the only chair in the room. The room felt cold, and my nurse cleaned off my phone as I would need it to explain what happened next in a series of several posts on Instagram and Facebook cataloging my immediate experiences.
Anxiouly Waiting in the Transplant Ward
In my new room I was on NPO or Nil Per Os and for those of us without a background in Latin, it means nothing through the mouth. Normally I’d be on an IV, but when I was switched to the transplant ward no new IV was set up. Which meant that not only couldn’t I eat or drink, I was also slowly being dehydrated. Cool. The reason I was on NPO is because when a patient is about to go into surgery they generally want to avoid any stomach contents interfering with the surgery. As many forms of pain meds cause vomiting, it’s important. It’s doubly important when that surgery deals with the GI Tract, as you can imagine working on an engine when the car is on is just generally a bad idea.
My nurse told me that we would know at around 3 AM, when/if the liver would be available. Then she turned off the lights and reminded me of the bed alarm.
The lights out in my room, the tears running down my face as I watched the hours go by rereading all the comments and messages regarding my current hospitalization.
The clock’s ticking, off in the darkness of the room, but the clock on my phone taunting me as midnight struck. My mother was right, nothing good ever happens after midnight.
Check back for more from Rick’s series “The Fine Line”