Transplant tale: into the light with merging of science, attitude, luck

Our last night in Malaga in November, Keller enjoyed non-alcoholic beer
while Cookie celebrated with a gin and tonic from our patio above
 the lovely Spanish harbor. (Local cheese, nuts, tomatoes and olives!)

Cookie and Keller celebrated 
last Thanksgiving shipboard.

Keller less than a week after surgery, with one of the attending
surgeons, Dr. Jonathan Fisher. He is part of the gifted Scripps
  transplantation team. He earned his MD at Columbia University. 

Editor's Note: Two weeks ago, we described our journey up the transplant list at Scripps Center for Organ and Cell Transplantation, a world renowned facility luckily 10 minutes from our home.  We detailed the 19-month process leading to the midnight call that a donor had been found. Now -- exactly three weeks from the surgery -- we continue the complex story of the procedure and recovery. We'll finish the three-part piece next Friday with insight into the caregiver's role and an appeal for organ donation.





STORY By CHRISTENE MEYERS
PHOTOS By BRUCE KELLER

Keller leaves Scripps in a record
three days -- we had prepared for
five to seven and three days in
ICU (he was there less than a day.)
 

RIGHT UP until "the call," we'd maintained our hectic lives. Although our brilliant hepatology doctor, Catherine Frenette nixed international travel after the first of this year, she'd sanctioned a November Thanksgiving trip to our beloved Spain, including our annual trans-Atlantic crossing to the U.S. We made the most of it.
It was a spectacular trip, delightful in every way -- beginning with eight days in Malaga then time in Lanzarote, our favorite of the Canary Islands.
WE'D CONTINUED sailing, touring my novel, biking, hiking, teaching, writing, contracting, photography missions. After we were vetted and approved for transplant, we spent six weeks in Asia. We plan international trips two and three years out and while we postponed a return trip to the Galapagos, we kept trips on the books for late 2017 and 2018, hoping my dream was correct: that "the call" would come in mid-May, which it did.

After getting on the transplantation list, Keller continued to
see plays -- sometimes two a week -- here with Cookie, top left,
with niece Amarylla, and Cookie's sisters Misha and Olivia.

Cookie and Keller on their book tour -- keeping the faith.

By May 12, we had read copious literature and statistics, and met with more than two dozen specialists in Scripps' well orchestrated guide for this complex surgery. Like detectives studying a mystery, we learned there would be two teams of surgeons -- one harvesting the organ from the donor, another removing Keller's flawed liver and "installing" the new organ.  The team would make a huge "Mercedes" incision beneath the ribs, clamp and cut vessels from the old liver before its removal then reconnect these to the new liver, sewing it in. We discovered that part of the blood to the heart would be clamped off, with tubes elsewhere to allow blood to flow around the site where the surgeons would work, returning normal amounts of blood back to the heart.
WE LEARNED that the gallbladder of the new organ would be removed, the bile duct reconnected and another "t-tube" would be inserted to monitor quantity and quality of bile the new liver is making.

Keller with his surfboard, a year ago. He plans to catch a wave in weeks.

Dr. Christopher Marsh, chief of the transplantation department, explained later that the pain Keller is still having in his ribs is because of the sturdy clamps inserted to keep his ribs open for the hours needed to complete their work.

Keller and our flashy new bags arrive at Parador Gibralfaro
in Malaga.  Scripps' sanctioned our November trip to Europe. 

OF THE MANY thoughtful Scripps gestures during the long and taxing surgery,  a nurse kept me informed from the operating room at the transplant's critical stages.

Cookie and Keller depart Scripps
Transplantation Center a record three days.

One of our grim considerations leading up to the transplant was that someone must die for us to receive our liver -- a curious thought.  The person whose family gave us this great gift was still alive while we were enjoying our date night three weeks ago-- a sobering thought which we contemplated as we waited, yet celebrated, that Friday night at our date night hang-out, La Jolla Shores.

COMING NEXT: We explore the caregiver's critical role in
the transplant process and the importance of retaining
one's routine and some sense of "normalcy." Here, Cookie
exercises with her Jazzercise pals, niece Amarylla and
great-niece Peny.  Remember to explore, learn live and
catch us weekends for a novel approach to art, nature, life.
  

Transplant Tale: The Prequel
Scripps has a fine international reputation. Its surgeons and doctors are the creme de la creme of prestigious medical schools, Case in point: Dr. Jonathan Fisher, of Columbia University, who met with us before Keller was wheeled into surgery.  He explained that the surgery could take up to 12 hours, but that six or seven hours was more customary.
(We finish the saga next week....please visit us.)