Posted in A.P. Roberts, On Writing, Reality in Fiction, Useful Sites

Reality in Fiction: Transplants Part Two

Warning: This post is the continuation of last week’s post. It was even more difficult for me to get through as some of these issues are still current in my SO’s health. If you have questions, please ask. As well, if you have opinions or information, please feel free to share in the comments.

POST-TRANSPLANT

Recovery is different for every transplant but in each instance recovery can take time. Most transplants require patients to be hospitalized for at least a few days post-transplant so that the doctors can closely monitor their recovery process.

Each patient reacts to recovery in a different way. Some patients may find they recover at a fairy quick pace without many incidents. Other patients may find they recovery quickly at the beginning but start to slow down the further into their recovery that they get. There are patients who find their recovery is a slow process which may require another transplant before they reach full health. And, sadly, there are patients who may never recover their health after transplant. All of these occurrences are normal.

Two years past his transplant date, SO was given the ok to go back to work. However, he is still not at full health as some of the medications he was given have caused other problems. He is now on different medications and has to get his blood work done monthly so that his transplant doctor can make sure nothing else goes wrong. It has been awhile and there has been some back-tracking but SO is slowly getting back to normal.

GRAFT-VERSUS-HOST DISEASE

For bone marrow transplant patients who have a slow recovery, it may be that they contracted graft-versus-host disease (gvhd). This happens when the transplant treats the host body as an attacker. The transplant then attacks the body which makes the patient very sick and can lead to serious complications.

There are two types of gvhd, acute and chronic.

Acute gvhd occurs within the first three months post-transplant. Severe cases of acute gvhd can be life threatening but most cases are treatable with immune-suppressants.

Chronic gvhd occurs after the third month post-transplant. While chronic gvhd can occur in any patient (except those who received their own cells) it is more common in those who also had acute gvhd. Chronic gvhd is a lifelong condition which is treatable and not life threatening.

We are lucky that SO has not contracted gvhd. However, as SO is still in the first five years post-transplant it is still a possibility. This means that we are constantly on the look out for painful rashes, thicker nails, stiff joints, and other symptoms of gvhd.

GRAFT REJECTION

Some transplants are rejected by the host body. When this happens, the body treats the transplant as an attacker and tries to destroy it.

As with gvhd, graft rejection has different levels of severity. These range from hyper-acute, acute, or chronic.

Hyper-acute rejection occurs in the 24 hours post-transplant. The timelines for acute and chronic are the same as with gvhd with acute being within the first three months and chronic being within the first five years.

DONORS

It is possible for a patient to never meet their donor or their donor’s family. And that is alright. Some donors do not wish to have contact and the patient needs to respect that decision.

Other patients may receive contact from their donor through the transplant doctor. Contact between donor and patient may be regulated by the transplant doctor. Part of this is because of the emotional nature of a transplant.

SO has received a note from his donor but as SO is still in the recovery process, he has not been able to respond. This is because SO has had several setbacks since receiving the note and we do not wish to burden the donor with that knowledge. We would rather contact his donor once there is no danger of SO having a life-threatening setback.

THERAPY

Going through a transplant is life-changing for both the patient and their family. Sometimes this weight is so heavy there is a need to talk it through with someone. This is perfectly normal and is encouraged by transplant doctors.

Most transplant hospitals have therapists who specialize in different transplants. As well, there are group therapies available for everyone who is affected by the transplant.

In the cancer clinic where SO received his transplant, there is a therapist who specializes in BMT-related issues. She is available to all of the patients and their families. When SO’s recovery first started to slow we began speaking with her. Just being able to talk to someone who understood was an amazing help.

I have also found that writing a journal about the experience, as well as writing these last few posts, has been a form of self-therapy. By putting everything on paper I have been better able to understand what has been happening.

OVERALL

As Deby noted in the comments of part one, transplants don’t happen on the fly. Even when the transplant occurs quickly there is a period of time post-transplant before the patient may feel they are fully recovered.

 

Trigger Warning: Some of the following links contain graphic images. Those links are marked with a * to help you avoid them.

Graft-Versus-Host Disease

http://www.stbaldricks.org/blog/post/st-baldricks-researcher-tests-new-treatment-for-graft-versus-host-disease?gclid=Cj0KEQjwvJqvBRCL77m2-uKczsIBEiQAkx8VjIOmp4iQyFddLaKNL8fd7mSSmbPhb3mVIpUppl_DLIUaAkYx8P8HAQ

https://www.nlm.nih.gov/medlineplus/ency/article/001309.htm

http://www.cancerresearchuk.org/about-cancer/coping-with-cancer/coping-physically/gvhd/about-graft-versus-host-disease

https://bethematch.org/for-patients-and-families/life-after-transplant/graft-versus-host-disease/gvhd-signs-and-symptoms/

* http://emedicine.medscape.com/article/429037-overview

Graft Rejection

https://www.nlm.nih.gov/medlineplus/ency/article/000815.htm

http://www.webmd.com/a-to-z-guides/organ-transplant-after-the-transplant

http://transplantliving.org/after-the-transplant/staying-healthy/preventing-rejection/

https://www.kidney.org/transplantation/transaction/TC/summer09/TCsm09_TransplantFails

* http://biomed.brown.edu/Courses/BI108/BI108_2004_Groups/Group04/Rejection_overview.htm

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