When I met with Dr. Koji Hashimoto and Tracey Reynolds, RN, my transplant coordinator, last week in Cleveland, I had a list of 20 questions for him to answer. He said, “Wow,” and then wow again when he saw it was three pages long. I’m curious…
But he took on almost every question, and the three of us chatted for about an hour. In an exam room, out of the hustle and bustle of the clinic. The first question (I’m not going over all of them) was about how many surgeons, who was the anesthesiologist, how many nurses and assistants.
There were a total of 13 to 14 people in the OR at all times. There were two staff surgeons – Dr. Hashimoto was number one and Dr. Masato Fujiki was second in command. There were also two surgeon fellows (I believe – no residents, I know that). Two or three anesthesiologists, several scrub nurses and assistants and a perfusionist.
A perfusionist is better known for their role in cardiac surgery for running the heart-lung machine when the patient is without a heart. That person monitors blood pressure, heart rate, breathing and all related matters. There was a period of time when I had no liver.
I was amazed at the number of people there for the whole ten-hour procedure.
I asked who dictated the operative report and Dr. Hashimoto grinned and said, “I did! Do you want a copy?” Wow, I hit the jackpot. Of course I did!
Other items of interest –
- There were no pictures of the old liver (right lobe was atrophied) or the left lobe of the new liver I received.
- Dr. H. made the first incision, on the left side of my abdomen extending up to the midline and then down on the right to just above my waistline (I don’t think surgeons call it the “waistline,” just sayin’).
- The first incision took place at 2:42 pm on 5/22/16, and was closed at 11:13 pm, 5/22/16 – nine-and-a-half hours. I went up to the OR around 11 a.m. so there was lots of prep.
There were two paragraphs in the report that made me weep. When I read “We mobilized the liver,” I knew what was coming. And four short sentences, one dissection and five transections of blood vessels later came this – “…to complete recipient total hepatectomy.” My now-disconnected old liver was then lifted it out of my body. End of that journey.
Then there was some merging of hepatic veins between donor and recipient to “create a venous cuff for anastomosis,” and then this next paragraph:
“We brought the new liver in.” I stopped there for a long time. I’m pretty sure Tracey was in the OR, too, because she told me how they hooked it up to me and it “got all pretty and pink.” Dr. Hashimoto wrote, however, “We reperfused the liver without difficulty.” Same as pretty and pink!
At the end of my questions, I had written a favorite quote of mine from “Four Quartets” by T.S. Eliot, Little Gidding V:
“What we call the beginning is often the end
And to make an end is to make a beginning.”
I’ve carried that thought around in my head since I read “Four Quartets” in 2006, when I was first diagnosed with liver disease. What was the end? What was the beginning? I believe there were many of each. I know this surgical ending and beginning marks a brand-new life for me. I am beginning.
I stumble. I get lost and confused. But I have more energy, more determination, more stamina to get up and move and even sprint sometimes. And I’m not weighed down by illness anymore.
Getting to that point on May 22nd, 2016, was my hero’s journey. I made it. I’ve returned home, changed. I still have challenges and I welcome every one of them. Everyone has a chance to be their own hero in their life’s journey. I’m not sure you know you’re in it till you reach home.
This is Dr. Hashimoto’s idea of a great photo op! Yes, post-op in ICU, pissed off because I was still intubated – and drugged out of my mind! He carries it around in his phone and shows it to people. Here’s gratitude for your 10 hours of intensity, and 2,000+ other transplants. Yeah, I’m badass.