Saturday, November 10, 2012

Time

We have a 2O something yr old on our service who is probably going to die sometime soon. 
I don't know if he knows it
I just want to hug him
His MELD score is 40
2-3 months
He needs a liver STAT
He is probably, most likely not going to get it
cos more than likely he will be denied from being put on the transplant list
Why? 
Dude is an alcoholic and he drank his liver to death
He's been given multiple chances to turn his life around, but it hasn't worked out. 
Does that mean he shouldn't be accepted on the transplant list?
I just want to hug him
He looks so sick and i feel so bad

I am on transplant medicine this month, which means all our patients either have had a transplant or need a transplant. One of the attendings gave me and my resident a teaching talk about transplants yesterday and while it was very informative, the big question i had at the end of the talk was, what's the use? Fear no let me ask because it seems like a very callous question to ask. Long story short, getting a transplant only buys you time. The organ eventually fails, maximum 15 years if you are lucky. You live longer and it's cheaper than if you were on dialysis  but it's not a permanent fix.

So pretty much everyone on our service is living on borrowed time. I know we are all going to die but i wonder what it's like knowing that i only have 10 - 15 yrs to live. Now i'm not saying anyone who's transplanted organ is failing automatically dies, no! You get put back on dialysis or/and if you are lucky, you can get another transplant. I had a 33 yr old pt last week who has had 3 kidney transplants. Life is not easy sha. I am learning a lot both about medicine and about life.

Life is short! We have to make the most of it. I was already conscious about these sort of things before, but now it has more meaning. It's so real. It's all about not sweating the small stuff and just living and being in the moment. I'm trying to squeeze whatever enjoyment i can out of life, which is why when i really wanted that milk chocolate cookie this evening, i bought it, ate three pieces and threw the rest under my bed. LOL. After all, they did say resist the devil. I tried. Going through life with a pot belly is not sexy, so we still got to watch that.

Have a wonderful week you guys and don't do too many bad things. Just one or two is okay :)

11 comments:

  1. Long story short, getting a transplant only buys you time. The organ eventually fails, maximum 15 years if you are lucky. You live longer and it's cheaper than if you were on dialysis but it's not a permanent fix.

    I never knew this before now. I had honestly thought that with a transplant the problem was as good as solved. Now I recall a popular broadcaster who had a transplant some years ago, he eventually died 2 years ago and I was like arrgh !! even after the transplant? Now i know better. Thnx, quite educating.

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  2. Knowledgeable one there sweets and true life is terribly short. Enjoy it while you can

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  3. Wow, I had no idea that a transplant wasn't a permanent fix!

    *sigh* I always have to remind myself life is too short, but sometimes we forget and sweat the smallest stuff. Lol hope you enjoyed every bite of your cookie ;)

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  4. Like you said, we all know this but reading stuff like you just posted just makes you check yourself for real. We only get one shot at the Game of Life so we better quit squandering it.

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  5. Really life is short,as it can be cut off any time.

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  6. Reading this reminded me of a RMD and Stella movie from years back where they fought tooth and nail to pay for a transplant. Had I known then that a transplant was only a temporary fix, maybe I wouldn't have wept as much at the end of the movie.

    Life truly is short, I guess that's why they say live every day like it's yourlife or 'live your life like it's golden'

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  7. Life is indeed short. We have to make the most of it. The people in this part of the world I must say are lucky. In Africa we don't really have second chances when it comes to medicine. Eventhough the kidney transplant is not a temp fix, it is still something. An added one year to one's life can make a diff or patch relationships

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  8. blessings.....
    15 years is better odds than 3 months. Truth, they may very well out live you and I because we don't know when our numbers is up. Example, the storm in the US impacted us here in Canada, though not as fully the impact was felt non the less. A woman when to STAPLES (electronics/stationary department store)she gathered her purchase left the store and on her way out the parking lot the STAPLES sign fell and killed her. Now i ask you, did you think she new that this is the way or the time for her to die? Absolutely not. It just is what it is, you have to enjoy every moment and even in your struggles to rise up, live up to and be remember your blessings.

    For the 20something, my blessings go out to him, the fact is we don't truly know his struggle (psychologically and emotionally) that prevents him from realizing his greatness. We've only to validate his presence by letting him know he matters at the end of the day that is what we all want, validation that we matter no matter how pitiful our existance.

    peace...
    thanks for sharing.

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  9. Wow... I never knew transplants failed after a while. This kinda reminds me of lasik surgery. I heard that it can restore vision to near perfection but weakens the eye muscles much more meaning you'd have to do it again.

    Wow... Life really is so short. 15years would give one enough time to do a total 180 degree life change.
    God help him sha.

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  10. I wonder this every time we have a patient come in for repeat lung transplant, repeat kidney transplant, etc. etc. It's a rough life for them even after the transplant. Lots of immunosuppressive drugs, constant lab work, constant doctor visits. Your life becomes drastically different, but one of my patients who was having a repeat double lung transplant put it to me like this, "I want to live and enjoy the same things every one else does. My fiance proposed to me last week and if I survive this second transplant I will get to have the wedding every little girl dreams of." I wish I could share the video of her life with you but I think that would be a HIPAA violation. Regardless many of these transplant patients are amazingly strong people and seeing their struggle reminds me to thank God every day for my health. Now for the ones who directly caused their disease process, that's another story...

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  11. Wow, I never knew that after some years the transplant fails. Nice and educative post madam sting, we all have to be health conscious in life.

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