Hello Fellow Traveller

 

My name is Doreen and my journey started in late 1993 when I developed an itch which would move from one part of my body to another over time.  I had recently moved house and initially put it down to some allergic reaction to my environment and/or personal or laundry soap powders being used.  After a tedious process of eliminating various products and completing planned house renovations, the itch was still there and, if anything, had worsened.  Other than the itch, I felt fine although I had found it difficult to stay awake at meetings after work but I put that down to my being in a very pressured and stressful work role.

 

In early 1995, I visited my gynecologist for an annual check-up and I asked whether my itch may have been due to a build of bile salts.  He suggested that I have a Liver Function Test (LFT).  On receipt of my results, he was amazed at my heightened readings in many of the areas, particularly my gamma GT reading which was nearly 600 when it should have been less than 65.   I was referred to a gastroenterologist who, on hearing of my presenting symptoms, diagnosed within minutes that he thought the problem was a life threatening liver disease, called Primary Biliary Cirrhosis (PBC).  He prescribed medication, Destolit, (later changed to Ursofalk), which he advised would not cure me as they did not know what caused the disease, although it was thought it may be due to a breakdown in my auto-immune system.  Ursofalk would slow the deterioration of my liver and, hopefully, would postpone the need for an organ transplant for a few more years.  Together with my LFT results, I visited him bi-monthly so that he could keep my condition under review.  Within that first year of diagnosis, I had visited the Liver Transplant Clinic at Royal Prince Alfred (RPA) to enable the Clinic to meet with me and obtain some details.  However, I agreed to remain under the care of my own gastroenterologist until my condition deteriorated sufficiently to warrant being placed on the liver transplant list.  I didn’t find out until a few years later that I was already in Stage 4, the final stage of my illness, at the time of my initial diagnosis.  On being diagnosed with PBC, my initial reaction was one of shock and I was scared with having to face my own mortality.  However, I knew that I had to remain positive and have complete faith in medical science and my medical team.

 

Due to the effectiveness of Ursofalk and Questran Light in keeping my condition reasonably stabilized, I continued working until March 2000.  Right up to the time of my transplant, my energy levels were OK, although, once I had retired, it was wonderful to sneak an afternoon nap, particularly if I had an evening commitment.  From mid-2000, I had quite heightened LFT readings and my skin and whites of my eyes had gone a distinct shade of yellow.  Finally, in November 2000, I was referred to the Liver Transplant Clinic at RPA.  My Bilirubin reading was then around 170.

 

After meeting with the Liver Transplant Medical Specialist, I underwent a comprehensive range of tests to ensure that I was a suitable candidate for organ transplant.  Once I was given the “all clear” on those tests, I was placed on the “activated” list and told to expect a phone call at any moment although it could also take months before a suitable donor organ could be found.  For the first month, I was a prisoner of my phone, as I ensured that I was always contactable and did not travel anywhere that was more than two hours drive from RPA.  Then I realized that I had to reclaim my life rather than have it dictated to by a phone call, so a semblance of normality returned to my life. 

 

However, the reality that I was finally in line to have the transplant, although expected for so long, took the wind out of my sails.  While I knew the Transplant Team’s “track record” was second to none, I was also aware of the inherent risks associated with the procedure.  My family and friends were wonderfully supportive as were the professional staff at the Clinic but the transplant is something that you yourself have to get your head around.  That is, the transplantation journey is uniquely individual to each of us.  I found the Pre-Transplant Education Day and other sessions arranged by the Transplant Clinic where I met most of the people associated with the procedure to be extremely informative and re-assuring. 

 

In early 2001, my spirits remained fairly high as, fortunately, I still had enough energy to maintain a few of my interests, going to language classes and the theatre and socializing with friends.  However, by mid-2001 (and “that” phone call still hadn’t come), my condition visibly worsened and my quality of life was diminishing.    I had developed a persistent cough, which despite the efforts of a Respiratory Specialist at RPA, would not go away and my Bilirubin started to shoot through the roof------it was around 430 when I finally got the call from Graham Kyd on September 11, 2001------a day that dramatically changed me and the world forever!

 

The phone call from Graham saying that they may have had a liver for me elicited such a range of emotions---from tears of relief that the call had finally come, to feelings of fear and apprehension as to what lay ahead, and, finally, to an acceptance of my situation and a realization that I was ready, whatever happened.  The waiting in Emergency and the preparation for surgery went quickly and appeared somewhat an anti-climax after the nine months of waiting on the “list”.

 

The surgery was complicated (so they tell me) but after about 15 hours, I was wheeled into Recovery with my new liver already functioning.  After four days in Intensive Care, with my stay there extended by problems relating to a massive allergic reaction to surgical tape, I was sent to the Liver and Kidney Transplant Ward, where I remained for about four weeks.  By the sixth day after surgery, I was showering on my own and walking up and down the corridors to get my lymphatic system working more efficiently and for exercise.  While feeling stronger with every passing day, my recovery took longer than expected.  My LFT tests were erratic so they would not disconnect the bile bag and my wounds were not healing as well as expected.  Finally, on October 11, I was discharged.

 

Once home, it had been arranged by RPA for the District Community Services nurse to come by every other day for about a month to dress my wounds.  After about five weeks, I returned to RPA to have my T-tube removed, so now the only physical evidence of my transplant is the “Mercedes-Benz” tri-star logo and a few drainage tube scars on my torso.

 

Since my discharge from hospital, I have felt wonderful, both physically and mentally.  The four years plus since the transplant have seen me resume a broad range of activities, from attending language and art appreciation classes, to spending time quietly reflecting and savouring the moment.  I have also been fortunate to have done some overseas travel in that period and have had no difficulty obtaining travel insurance.  Only recently, I spent three weeks on a ship which included five days visiting the remote location of Antarctica.

 

Moreover, over that period, my LFTs have shown little or no rejection and while I am still taking relatively high doses of medication, there have been few side effects.  My yellow complexion virtually disappeared by about the sixth day after surgery and while there was some initial difficulty gaining weight, that has not been the problem for the past three years plus!  While there has been some necessary changes to diet etc and lifestyle, I wake each morning and think how blessed I am to have been given the ultimate gift of life.  Finally, I just wish to say that this journey of transplantation has been such a rewarding one for me, in terms of personal, emotional and spiritual growth.  May you also reap such bounties and keep positive!

 

Doreen Cheong