Recent retired police officer of the age of 65 years is now bed rest watching his body rapidly deteriorating. Diagnosis; idiopathic pulmonary fibrosis. Meaning somehow someway his lungs got so deteriorated and caused it to get thicker like scar tissue. Lungs is a type of tissue that requires it to be so thin that allows oxygen and carbon dioxide to exchange so you can breath. The thickening of the tissue delays that action. This cause could have been by genetics, environmental such as pollution, caused by smoking, etc. After diagnostic examination it was found that he would require a bilateral transplant (meaning both lungs replaced) because of the severity of his lungs. Luckily he qualified and passed the qualifications of receiving a transplant, and the surgery was a success. So we thought!
When you receive a transplant of any kind it is considered a foreign body that is inside your body. Your body will automatically try to fight it as if it was an infection by your immune system, which is why many transplant patients are on immune suppressant drugs. But we would think that the transplant would save his life but instead it was the one thing that speed up his death. His body was slowly getting new symptoms. His kidneys were failing and now needed dialysis, his liver levels were elevated (enzymes ALT and AST), the pancreas levels were elevated, he was experiencing rectal bleeding, than required a ostomy bag on his tummy so he can have bowel movements there and allow his rectum to heal. He was on oxygen a lot longer than expected. We figured that this was way out of the expected. Could it be? We did a diagnostic exam to rule out the worst diagnosis he could get "graft vs. host disease". This disease is caused by the transplant. The transplant also has its own immune system from the previous donor. And in this case much more powerful than the patients immune system. So now the whole reason because of all his organs failing (multi-organ failure) was because of the transplant. This is a very rare to happen and its listed as one of the complications. But my God who would have thought. His lungs that were transplanted to give him life is instead killing him. The immune system is your defense system against anything, foreign objects, infections etc. and in this case the lungs immune system was by far more powerful killing than the patients own. Now its now like we can put the old lungs back or retransplant him again because the survival rate is not likely. All we can do is manage is symptoms. He is cognitively intact and totally with it. And I can not imagine how a person like him to can go through such a traggic death, dying slowly, watching your body fail and deteriorate. To know that your body is giving up, and that there is nothing no one can do brings chills and makes my hair stand every time I would take care of the patient. There is nothing no one can possibly do to save him.
His time was near, and to think he just spend all of his life working saving others, protecting the community, risking his life everyday. And when his time came to retire and rest, his life is once again put at risk. He told me he saved his money to buy a pool that his just recently got made in his back yard and a huge playground for the kids. He spent 25 thousand dollars, and now he would never have the opportunity to enjoy it with them. He made it so all his nephews can come over and he could take care of them when his retired.
He was my most difficult patient to have taken care of because he was so sick, so many things were going on and you have to be very particular with his care because he can crash on a nurse at any given night. One night he turned off the lights and then he took off his oxygen to go to sleep, luckily I had a continuous pulse ox to monitor his oxygen at all time, and when I walked in to tell him to keep his oxygen on at all times and pulse ox, he was found passed out, he was not responding, there was a pulse but his lips were blue, skin was pale, and we initiated CPR. We were able to get him back breathing.
What I got from him and the advise he told me was to not work so much, enjoy your family and love ones now, because if not you will be like me, working so hard and in the end never getting at chance to share his love. "Love now, spend time with them now, not later"
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