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Rejection
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Mom came up on a Tuesday morning in May to take me to the lab for my monthly blood work.  After that, she helped me run errands.  When we returned, there was a message on my answering machine from the transplant office at OU Med Center.

    “Your creatinine level is elevated.  We think you’re having a rejection episode.”

    Mom and I looked at each other, not sure we’d heard correctly.  I played the message again, and called Oklahoma City.  They wanted me over there as soon as possible.  Terrified, I packed an overnight bag.  My only knowledge of organ rejection came from Hollywood portrayals of it.  In those stories, the transplant patient always died.  While I knew this was most likely over-dramatization, I thought it meant I would lose my new kidney and pancreas.  This was my worst nightmare.  That could mean the end of my healthy new life.

    If there was a silver lining, it was that Mom was still in town, so she was able to take me to my parents’ home in Greenwood, rather than having to come to Fayetteville and get me.  She and Dad quickly packed for a few nights out of town, and we rushed to Oklahoma City.    

    Dark thoughts crowded my mind on the drive, in spite of my efforts to think positive.  I’d never asked many questions about rejection.  Without knowing what to expect, my imagination took over.  I had passed the all-important one year mark.  After that the chance of rejection decreased.  But here I was going through it anyhow.

    As we drove west on Interstate 40 toward the setting sun, I sat in the back seat, trying not to think of all the possible outcomes.  My imagination wouldn’t let up. 

    What if I come home without my new kidney and pancreas?  Would fate be so cruel to give me a taste of a better life, only to take it away after a year? 

    I placed a hand over each side of my lower abdomen.  Nothing felt tender.  Nothing felt the least bit different. 

    It’s going to be OK.  It’s going to be OK …

    Hurrying to Oklahoma City like this was eerily reminiscent of the year before.  What had been an uneventful day had suddenly become frantic and hurried.  But this time, I had no idea of what to expect.    

    The next several hours are a blur in my memory.  I found myself on the same floor where I had spent three weeks the year before.  Some of the same nurses were there.  After a few unsuccessful attempts, one of them managed to get an IV started in one of my veins.  She layered on several strips of tape to secure it.  My forearms, which had been hairy to begin with, had become a forest – one of the side effects of the anti-rejection meds. 

    That tape’s going to hurt like hell when they pull it off.

    Bags of Solumedrol, a potent drug used for rejection episodes, were pumped into my veins.  It would reduce my immune system back to almost zero, but might just save the organs.  The problem was, the tiny soldiers protecting my body from unwelcome invaders had discovered my kidney and pancreas and waged war on them.  They were just doing their job, but the transplant had changed the rules.  Now all those dutiful defenders would have to be killed.  In time, their numbers would grow to where they had been.  My immune system would have to start over from scratch.  Again.  As long as the new soldiers left the transplanted organs alone, they would get to stay.

    I asked Dr. Squires how this could happen.

    “It may have been brought on by your broken foot.  Sometimes a trauma can turn up the immune system.  One of my patients was in a bad car wreck.  She wasn’t hurt badly, but the trauma caused her to have a rejection episode.”

    So I was going to have to be more cautious.  Besides the obvious reasons for avoiding injury, it could also jeopardize my transplanted organs, which was far worse.  This was a connection I’d never considered. 

    The good news was that it was extremely rare for a transplant patient to lose an organ due to a rejection episode.  To my relief, real life was nowhere near as dramatic as the Hollywood version.  Not that it wasn’t dramatic.  My transplanted organs were like my children.  I had wanted them.  Waited for them.  Fought for and suffered to get them.  I took care of them. 

    I loved them. 

    And I would get to keep them.  But before I could leave the hospital, the creatinine number had to get below 2.0, back around 1.7 – what it had been for the last several months.  Each time someone came to take blood for the lab to test the number, I concentrated on my target number, willing it to decrease from 2.0.  Each time, the results were closer to that magic number.  I started to relax, but I really wanted to get out of there before my birthday.  Turning thirty-five in the hospital would be depressing[csw1] . 

    After 5 days in Hospital Land I went home with only two days to spare.  There would be frequent blood tests in the near future and an extremely high dose of prednisone each day.  It would gradually taper off, but no one made any promises as to when I could return to the low-maintenance dose of 5 mg again.

    Even though I was in my own bed, I didn’t sleep the first night back.  The prednisone kept my mind racing and my nerves on edge.  The close call of the rejection had really scared me.  But once we’d reached Oklahoma City, I had put the fear on a shelf, to be dealt with later.  Instead I focused on the task at hand – saving the organs.  Now that was behind me, but the raw, primal emotions of surprise, dread, determination, uncertainty, and fear were still buried inside. 

    As the sun lit my bedroom the next morning, a downpour of rain unleashed the floodgate of pent-up emotions inside me demanding to be set free.  It was time to open up that jar of fear, now that the danger had passed. 

    That’s how I’ve dealt with fear on other occasions.  Put it aside, but don’t wait too long.  Fear is like leftovers that have been pushed to the back of the fridge.  The longer you wait to open up that container and experience it, the more unpleasant it will be.  That wasn’t an option on this particular morning, when my emotions were so close to the surface from the prednisone.

    I curled up on my side, watched the rain falling outside my window, and let it all out in sobs that barely sounded human.  That jumbled mass of extreme survival emotions – fear, relief, gratitude, and stress – all amplified by lack of sleep and the highest level of prednisone I had ever experienced.  The pounding rain helped muffle my cries, which didn’t last long.  All it took was two or three minutes of letting out something dark that was tangled deep within my gut.  It, like the rejection, had wrapped itself around the two things in there I wanted most to protect.  Finally, I was spent.  I lay there, silent and unmoving.  The rain slowed to a steady, soothing pace.  My mind was clear.  My body relaxed for the first time in several days. 

 


 [csw1]How long did that give you from the day you went in?

  More Excerpts

Abyss

Fireworks

Waiting For Someone to Die

Hurry Up and Wait, Wait and Hurry Up

Taking the New Body for A Test Drive