February Clinic

On Wednesday I went back to clinic for my three month review - well it was supposed to have been three months since my last visit back in November, but in reality I was back just a week after and have been having my white cell blood count monitored with regular blood tests and adjustments in medication.

The white blood cell thing has been going on since last May when it became too low. With adjustments in my medication I was getting back to normal. Then I was taken off a drug - valganciclovir - which I'd been on for my first year after transplant and it went all awry and went too low again.

When your white cells get too low there is nothing to fight infection with so it can be dangerous, therefore I had more adjustments in my medication. Next thing, just before Christmas they got too high - when they are too high, there is a chance the white cells may start attacking your new organs as they react as though your new organs are an infection in your body, so more adjustments. 

I was thrilled at last week's clinic as they managed to get my blood tests back before I left and the consultant checked my white cell count and at long last it was just where it should be, so that meant no changes in my medication.

We've have also been monitoring my blood pressure closely as the majority of patients with transplanted hearts go on to develop high blood pressure, which is obviously a risk factor for heart disease and strokes. It is usually inevitable that patients require medication for high blood pressure. My blood pressure is gradually getting higher, so I have to arrange to have a twenty four hour monitor with my GP next so they can look what it is doing and decide whether it is time to start new medication. 

My consultant told me that 100% of Papworth heart transplant patients are on medication for high blood pressure after a year, so seeing I am 16 months post transplant now, I've done really well to avoid it so far. I've always known that this would probably happen so I am not surprised, I'm more surprised that I've got this far without needing it! 

We had an enjoyable and sociable clinic because we got to meet some friends old and new at the clinic and then when we went across to the canteen we ended up bumping into one of our transplant friends Jacqui, who just happens to work at Papworth. We'd just finished speaking with Jacqui when we spotted our 'PH' friends, Kathy and Michelle - so it was an enjoyable morning. That's what I love about Papworth! 

I was delighted to be given three months until next clinic this time with just the blood pressure test to organise in the meantime. This was short lived though and when my other blood tests were checked, the team phoned to say I need to have more tests because of my Tacro levels and kidney function, so I'm now back in a month's time. 

Luckily, I feel really well thanks to all the careful monitoring of my transplant team and hopefully it is just a question of maintaining the correct balance of the drug combination I need.

I was in the local news again the other week after a reporter phoned from the Hertfordshire Mercury following Grant Shapps' anouncements that the government is going to put organ donation on more forms such as passport applications and oyster cards. They had read an earlier blog of mine and picked up on it because Grant Shapps is a local MP in Welwyn Garden City, Hertfordshire and it was another great opportunity to get people thinking about organ donation.

We have had Valentine's Day too. Rob and I didn't really celebrate Valentine's Day in my pre illness days, as it is a bit hyped up and paying for flowers and cards can be a bit of a rip off. Now we use any excuse to celebrate and I was lucky, Rob bought me a new Pandora charm - the latest one in support of the British Heart Foundation -  so at least some of the cost went to charity and one we fully support at that.

Talking of the BHF - I'm taking part in their DeChox during March to help raise funds for them. My link for sponsorship is below.

Kath's DECHOX

Just returning to Valentine's Day, I cannot let this week go by without mentioning my dear friend Stacie, who has worked tirelessly - although she is poorly - to do everything she can to promote organ donation. She was on ITV's Good Morning Britain, on her local radio and in her local papers. You can check out Stacie's blog with all the links below. Our friend John Fisher supported and enabled Stacie to do this. John runs a transplant charity, 'To Transplant and Beyond', which provides support for anyone touched by transplant and they funded the Valentine's campaign she fronted. Hopefully it has got many people motivated to sign the organ do not register. 

Life is Worth the Fight

To transplant and Beyond

This week's photos are taken on or near London's Westminster Bridge. ©Kathryn Graham

Five Months On!

The church at Tewin

Today it is five months since I got my life changing phone call. Time is moving on and life is moving on. I am well and truly back on my feet and feeling much better than I did pre transplant now, following those initial months of recovery. Achieving this and getting to this stage was what having the transplant operation has been all about. The whole aim was to get a better quality of life than I was having beforehand and for me it feels fantastic that I have now reached this point. 

Tewinbury Farm

It has been an amazing journey so far and there has been a lot of stages to get through in a short space of time: from those traumatic days in ITU; the beginnings of recovery on the surgical ward; those first uneasy days at home; the following constant clinic visits and the many brochoscopy procedures, to where I am now - having a five week break from clinic with no future bronchoscopy in sight!

Interspersed in all of this have been moments of great triumph and moments of despair, but the important thing for me is that my family and I have ridden all those early stages now and we have determinedly tried to keep moving forward step by step whatever the setbacks. We always knew it wouldn't be easy and we accepted this from the outset, enabling us to take the difficult parts with the good.

The Herts Wildlife Trust Reserve at Tewin

From the beginning I knew that I had to build my strength back up after being so ill and going through a major operation and all the traumas that followed in those early weeks. I remember feeling so weak at first and felt frightened if I had a setback, such as getting an infection or rejection, I might not be strong enough to fight anymore, having already fought such a hard fight. I set my mind to it when I first came home that I really needed to eat well and get exercising so I could fight the next round when and if it came. I think doing this has carried me through and I've now managed to get myself fitter and stronger to where I am now. I'm still very focussed on keeping this up, the thought of a setback happening still motivates me all the time.

 The freedom of a walk and fresh air!

From hardly being able to eat much in those early days, I'm now able to eat normally and have got my healthy appetite back. It was difficult to eat solid food in the early days after the operation and then came the medication overload and the constant coughing, which upset my stomach often; the constant bronchoscopies upset my stomach really badly and even gave me quite serious allergic reactions at times. 

I had to be wary with the food I could manage to eat and it was trial and error what my stomach could cope with or not at times. As a transplant patient there is also a long list of foods you aren't supposed to have because of your poor immune system too, limiting me even more. Eventually now my medication is reducing and the bronchoscopies are finished for the time being, I'm eating more normally and testing out more and more foods and managing them. So things feel much easier and more settled. 

Sherrardswood Park

I've got used to the medication routines now and that feels more settled too. The medications that were more limiting such as diuretics and nebulisers are gone now and life feels free from those restrictions. It's now just a case of tablets, lots of them still, but they can be put in your bag and taken out and about with you. In fact I could stop out all day and night now if I really wanted! That feels a great thing after the intravenous drugs of my Pulmonary Hypertension days and those earlier days of my transplant. 

So five months post transplant and things are still very positive and looking good. There are still more hurdles to come yet though, but that is all very normal in a transplant journey. 

I am currently at the stage where my medications need to be adjusted. They have recently taken me off an anti - fungal drug, Itraconzole, which has affected my Tacro levels, so my Prograf drug dose was doubled. That still didn't settle my Tacro level, so my Prograf dose has been increased again. I've had to visit my GP a few times now with all the medication adjustments and things, but that has been a good thing too as I feel he is getting to know about me and my transplant better.

With the increase in Prograf has come a nasty side effect of hair loss - I had been warned about this by the Transplant Nurses - I'm not quite sure how bad it is going to get yet, but hopefully it will settle once everything else does. I have quite fine hair, but luckily there is a lot of it, so it isn't showing yet and I'm hoping that's how it is going to stay.  

When my Tacro level does settle they are going to reduce my steroid, Predisolone, but for now that has to stay a high dose until it stabilises. These things just take time I suppose. 

A little bit of late sunlight peeping through!

They are also moving on to looking after my new heart now things are more settled. I've already been prescribed a statin now as a preventative measure as arteries in transplanted hearts fur up more easily and they are keeping a watchful eye on my blood pressure. Blood pressure can tend to get high with a transplanted heart, so there may be blood pressure tablets to come yet in the near future. 

A peek of blue!

I still have a chronic cough and now the problems with the healing join in my windpipe are sorted, they are planning some further investigations in the next few months. They are going to undertake a 24 hour PH test to investigate if there is acid from my stomach coming up to my esophagus and causing the cough. This reflux, if it is there, will also potentially cause permanent damage to my new lungs, so if it is present I've been told I will need to have an operation to tighten up my stomach to prevent it happening. 

I've also got problems with my small bowel and intestine because of all the severe reactions I have had to medications over the last few years and I have been referred to a specialist about this. Again, I may need more surgery to fix this. 

Someone needed a rest. It wasn't me this time!

I'm trying not to worry about any of these things though, in my mind they can just be crossed as I come to it and if surgery needs to be done, then it needs to be done and there isn't much I can do about it other than try and be as fit and strong as I can to deal with it. 

Sometimes it's a never-ending path!

So five months post transplant and there is a lot behind me now and still more things to face, but the most positive thing is how much better I am now than I was pre transplant. I have so much more energy and can do so much more physically now. It always feels amazing from simple things I couldn't do before like enjoying a proper shower to bigger things like being able to go for a proper walk now. 

Sometimes it's the simple things that feel special, one little thing I've noticed recently is how I can wear heels again. Before transplant my legs and feet ached so much all the time it was impossible to wear anything on my feet that wasn't flat or nearly flat, now I'm back wearing my shoes with heels! And belts, what's special about wearing a belt? Well when you have had a pump stuck on your waist for three years, it's just wonderful to get your waist back again and wear a proper belt. 

Which way? If we get lost at least I can walk now!

I think the best feeling of all, is that one of well being, the feeling that I've got some strength in me at last and renewed energy to do things. For now, I am staying focussed on this and enjoying all the positive things that have come from my transplant and the new quality of life it has given me. I'm just simply enjoying living life properly again!

Enjoying one of my many walks and taking lots of pictures!

Sunshine and Snowdrops

Snowdrops and sunshine at last!

I was back at the Transplant Clinic again this week for all the usual tests and this week I escaped having to have a bronchoscopy, so it was just a morning visit. After all the tests, I saw the consultant and transplant nurse and they said they were really happy with me. My lung function is now up to 90%, it has got better each clinic visit and my new lungs looked good on the x ray. My last bronchoscopy results were looking really good and the part of my windpipe that they have been watching closely for the last few months has now healed nicely. They explained I wouldn't need to have any more bronchoscopies for this now as all is fine, so that was fantastic news. 

The snowdrop walk

They are still tweaking my medication and have stopped another drug called Nystatin, which I had to take four times a day, so I was pleased with that too. They are also planning to reduce my steroid drug, Predisolone, once they are happy with my Tacro levels and that my Prograf dose, which they adjusted a few weeks ago, is correct. I am just awaiting a phone call following my blood test results then hopefully it will reduce.

Crocuses enjoying the sun

They also explained that they need to start giving me more medication to help my transplanted heart and they will be focussing on this a little more now. This is for preventative reasons and not because there are problems with it. The arteries in transplanted hearts can become furred up quite easily, this isn't because of diet or anything, they just do for some reason, so they have prescribed me a statin for this, Pravastatin. We had a bit of a laugh about this, because Rob has just been prescribed a similar drug for his cholesterol, which, because of genetic reasons, is high. These drugs have to be taken at bed time, so we had a bit of a joke about how we would be able to share them and take them together when it was time to go to bed! It all seemed very apt, as it was on the radio and in the press that day saying how doctors have been given the go ahead to prescribe statins to help prevent strokes and heart attacks and there has been a lot of debate about whether this is a good or bad thing. I think in our cases, it can only be good!

Peeping Snowdrops

They also explained that they will probably need to introduce blood pressure tablets too at some point, but I seemed to get away with that one for now!  It seems to be a case of losing some drugs and then gaining some more. I'm still on 18 or 19 tablets a day, depending on what day it is, but it still feels a lot easier than my Pulmonary Hypertension days and the intravenous drugs. I just rattle now instead!

A little bit of colour in all the bleak!

So all in all it was a good visit, all is going well and I now don't need to go back to clinic until the middle of March, when I won't be too far off being six months post transplant. I am getting on for 5 months post transplant now and don't know where the time is going.

We decided to enjoy the rest of the day after clinic and went to a pub called the Poachers in Elsworth, which is near Papworth for lunch. This was a pub that my family visited while I was in hospital following my transplant. The transplant nurses had recommended it while they had long days and hours visiting. It was nice to see where they had been as they keep telling me stories about the nice pubs they had found. I think I have one or two more to visit yet! 

A dwarf iris flowering in the sun

While we were in the pub, the weather turned very nasty and the gales started blowing up again as well as the rain setting in yet again, so we had a bad journey back home and were glad to get in and batten down the hatches again. We had been planning to go to the Lake District for a few days and had already packed, but seeing the forecast of gales, gales, rain, rain and more storms, we decided to abandon our plans and stay put. This is the second time we have been all packed and ready to go to the Lakes and then had to change plan because of the awful weather. We aren't complaining though as we are having it very easy compared to thousands of people who are struggling with floods. 

First signs of blossom

Today has been the first day of the week that we have had some sunshine, a little bit of respite before the next storm sets in tomorrow. We went off to Benington Lordship Gardens to have a look at the spectacular display of snowdrops and winter flowers. I felt determined to find some colour amongst all this dismal grey we keep having to put up with! Benington Lordship is a seven acre garden standing on an ancient fortified site and is famous for its display of naturalised snowdrops, there are over 200 snowdrop varieties as well as other winter flowers.

Hope you have enjoyed the pictures taken at Benington of the flowers and the little hint of spring, it must be somewhere hiding nearby and ready to pop out! Come on spring, we are all ready for you!

To a Snowdrop

Lone Flower, hemmed in with snows and white as they

But hardier far, once more I see thee bend

Thy forehead, as if fearful to offend,

Like an unbidden guest. Though day by day,

Storms, sallying from mountain-tops, waylay

The rising sun, and on the plains descend;

Yet art thou welcome, welcome as a friend

Whose zeal outruns his promise! Blue eyed May

Shall soon behold this border thickly set

With bright jonquils, their odours lavishing

On the soft west-wind and his frolic peers;

Chaste Snowdrop, venturous harbinger of Spring,

And pensive monitor of fleeting years!

Wordsworth

'Harbinger's of Spring'

Moving House, Moving On

It's been another busy, busy week with lots going on.

Waiting to unload!

Monday started with Sarah and Oli getting the keys to their new house. They started the process of buying the house just before I had my transplant, so I was hopeful I would see them get the keys and see them settled in their new house, although I knew I wouldn't be able to help them in the condition I was in with my pulmonary hypertension.

And we are in!

I'd forgotten how stressful buying a house is, how you have to keep chasing solicitors constantly and keeping up to date with what stage things are at and then chasing again and again. It always feels like everyone is sitting about doing nothing until you keep pushing and then another little thing gets done, small steps at a time. I'm sure it could all be a lot quicker and efficient, but nothing seems to change over the years. So it hasn't surprised me that it's taken four months to complete the sale, with the little blip of my transplant and Chistmas thrown into the mix as well!

Most important job - getting the internet sorted!

Because of my transplant, what has been really amazing is that I was actually able to help out with the house move. Of course I couldn't do any of the lifting boxes and heavy furniture, but I was able to help unpack boxes and put things away. So I was left in charge of sorting out the new kitchen and making the tea. I had plenty of energy for both, not like old times when just getting to the new house would have been an effort, let alone trying to do much to help.

That was a lot of boxes - tea break needed!

It felt another big milestone in my journey since being unwell - to see my daughter buy her first home with Oli and help them move in. It is something that as a mother I have always looked forward to doing. We are planning a shopping trip or two next to buy some nice bits and pieces for the house and I'm looking forward to helping them transform the garden in spring. There seems so much to look forward to now, especially as I'm able to do much more than I could.

Kitchen looking good!

Tuesday was time for the transplant clinic again, both for blood tests to check my Tacro levels and to collect more drugs as my Prograf drug dose has been increased. It was a quick visit for once and we had time to visit Sarah and Oli on the way back - they are nearer to Papworth than us now - exactly 38 minutes to be precise! That may come in handy!

At last - all unpacked!

Next up was a visit to the dentist, my first one since my transplant. I've been going to my dentist for 22 years now, so he was interested to know all about my transplant. He needs to know all about the medication I am on and keep a very watchful eye on my teeth. My medication can cause problems with my teeth and gums and it is one of the stipulations of going on the transplant list that you visit the dentist for check ups regularly and continue to do so. I was pleased that all was fine, especially in the light of my operation and being on a ventilator and having various tubes and cameras in my mouth,  throat and windpipe, which can also cause damage to your teeth - in the process. I also had to rely on other people cleaning my teeth for me during those first weeks after the operation and no matter how hard someone tries it isn't the same as doing it yourself, so I was a bit bothered my teeth had taken a hammering. 

Smile please!

This morning it was time for a photo shoot and a photographer working for the British Heart Foundation came to visit to get some photographs of me for their article on Pulmonary Hypertension. I was interviewed for this article earlier this month and it is going to be featured in the May edition of 'Heart Matters'. Now I was a bit nervous about this one as I got a whole itinerary from the Art Director about what to wear, what they want to achieve and how it may take a few hours - all the other photographers for the newspapers and radio that have visited usually just take a few quick shots and it's all done and dusted in a few minutes. So I found myself worrying about what I should wear and chopping and changing my mind every five minutes about it. A typical woman, I suppose! It turned out to be lots of fun though and hopefully there might be a few good pictures! 

Oops think we need another!

You can sign up to the 'Heart Matters' magazine on line, it is a useful and interesting magazine both for people with heart problems who want to learn more and for those who just want to be healthy and look after their heart health. Click on the link for more information and to sign up to get the magazine - it is free. Look out for the May edition if you do sign up!

www.bhf.org.uk/heart/how-we-help/information/heartmatters.aspx

Another smile...that's better!