And I'll dream of the things I'll do

Sunday August 28th 2016 began just like every other Sunday really. My mum would trot out to Mass while I lay in bed still, enjoying a good quality lie in. I had long since given up going to Mass as I had felt that good came in the acts of people, not divine intervention. It honestly wasn't some hysterical 'Oh I've got cancer, where is God now?' affair. I hate that sort of thing as much as I hate death bed conversions. Hedging your bets like that just offends me, and it should offend those with actual faith too. It was a long and considered decision for me. That said I do still like it when people tell me they pray for me, as much as anything because it helps them make sense of things and I would never wish to deprive them of that.

After Mass was over the mammy would return usually with one or more of my siblings and their kids in tow. My brother Mark's daughter Chloe would usually come up to see me and ask if I wanted a cup of coffee. This Sunday when she came in the phone rang, and I answered it, as you would. 

At the other end of the line was a transplant co-ordinator (not my usual one unfortunately) and she started the conversation with one of the strangest opening gambits you're ever likely to hear. She said "Paul, we have a set of lungs that are a match for you. Would you be interested in coming down?".

Would I be interested? 

It took me right out of the moment as all of a sudden it felt like a cold call for windows or car insurance or something. I had dreamt of this phone call for years and this wasn't really how it was meant to pan out. Then, quite suddenly, I snapped back to reality and said "Of course I would. What do I need to do?". At this point I said to Chloe to go and get her dad as this was very important.

The co-ordinator told me the ambulance was on its way and I'd probably have about 15 minutes to get ready. No time for a shower or anything, but that was fine as I'd need to get one down there in preparation for surgery anyway. So I got myself dressed and Mark got the last few things I needed for my travel bag ready. My 'pregnant lady' bag had been prepared for some time already. Then I just sat on the stairs waiting and sent a few emails and text messages to the people I promised I would let know in the event of this actually happening. I was remarkably calm. I think I was the only one. The chaos around the house had unfortunately upset Chloe a bit and so attempts were made to convince her that this was actually all good. She was still a bit teary as I left but she seemed to understand that it was ok. It was a lot for a 6 year old to take in really.

The ambulance arrived and the paramedics got me on board and as comfortable as you can be in those things. Mark went to get some stuff of his own and followed us down. I had the full benefit of the lights and mee maws when traffic got in the way. I had a light snooze for part of the journey and carried on sending messages to (and responding to) people for the rest of the journey. I know I'm repeating the point but still at this stage I was very calm. 

I feel I should explain that, at this point, things had not been going very well. Finally, after years on the transplant list, and the deterioration that came with it, I was getting a bit too close to the point where you can be removed from the transplant list. This happens when you're just too dangerous to operate on. I was very weak indeed. I had actually started thinking about how my life was going to end. Again, this was not hysterical but a sober assessment of how things were going at that time. I was scared I wouldn't survive another winter is basically the crux of it.

So I expected to be quite overwhelmed if and when the call came, but I just wasn't. Even arriving at the Freeman, where my life was going to change quite dramatically in the next day, I was just all business.

When I got there we had to go through nearly all the same tests that I had undergone at the assessment stage, just in case anything had changed, like liver and kidney function for instance. For those I had to get a venflon in my arm, which isn't always easy as my veins can be a little elusive. A few attempts though and it was in. I had an ultrasound on my heart and an ECG, which showed no problems at all. I did the lung function tests too, which were a much less rigorous version than those used at assessment thankfully. Then I did the walk along the corridor. All of these were to see if I was strong enough for the surgery, and everybody was very happy that I was.

All this took a bit of time so we were well into the afternoon and early evening by the time I got the shower I so dearly craved. Prior to that though I had to get my chest shaved, which was an odd experience that I simply hadn't thought of beforehand. Of course I would need it done but it just hadn't occurred to me. So that was done and then I got showered very slowly indeed and with hibiscrub to make sure I was as clean as I could be. I got my brother to take this picture just after I got out as a bit of a 'before' photo. This is pretty much what I feel I look like. It will be a long while before I look like that again, if ever really. Don't get me wrong, I know I was frail and very poorly then but at least I was physically just about well balanced and not hooked up to a million lines, tubes and monitors. 

At this point there was a lot of bureaucracy as several consent forms needed to be filled in. I spent a good time with the anaesthetist going over the procedure and it became obvious quite early on that, even though I had read voraciously on the subject when put on the list, there were things that I had simply forgotten as well as the fact that there had been advances in surgical techniques in the intervening time. One of the things that I had plain forgotten was that post operation there would be a sort of scaffolding structure in my chest post-op to basically hold my rib-cage together. Of course nothing was going to stop me going ahead with it at this point but I had to get my head around it all to give genuine informed consent. Almost everyone assumes that the surgery requires the saw cutting down the sternum to open up the chest cavity but what they do is called a clam shell incision. As the name suggest they literally open you up like you would a clam shell and get access to the chest cavity from underneath instead. There are many reasons for doing this but they don't really add anything to this story.

Now the operation was always going to be done overnight but it was at this stage that the actual surgeon arrived to make his displeasure known that a lot of the peripheral things for the operation hadn't been addressed yet. I actually found it terribly amusing to watch but I could also see why he was getting so annoyed as these things are genuinely time sensitive. I've always had an affable relationships with the cardiothoracic surgeons but it isn't warm by any stretch. I suppose they just don't (pardon the pun) operate that way. Once they've done the surgery and the immediate post care their job is done, and that is absolutely fine.

By this stage Mark had got his accommodation for the night sorted and I gave him the last of my personal stuff to keep and gave him the code for my phone should he have to contact anyone with it. I was wheeled along to the theatre suite just prior to midnight and I got myself from the chair onto the operating table where they went through all the same safety checks again to make sure they weren't going to slice open the wrong person. Then, after a short conversation with the anaesthetist, I started counting backwards and it all went black.