SUSAN'S HEART HISTORY 1/21/96

Susan Hattie Steinsapir

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Update for Susan Hattie Steinsapir Sunday, Jan. 21th, 1996

 (Andreas) 00:15 AM

It's near midnight, Saturday night. Susan's nurse just came in and said that there is a possible heart donor. The person's heart is still beating; an angiogram is being performed now: a catherer (tube) is inserted into a neck artery and a device that lets one look into the heart, somewhat like a video camera, is being used to look at the heart. It's fifty/fifty right now as to her getting this heart.

In an hour, they will make a decision. It'll be midnight. If it happens, then it'll be around six o'clock in the morning.

I'm here with the laptop at Susan's side. When the nurse told us, Susan began panting with fear. She's asking for a rabbi. I feel weak in the knees. Susan just said "isn't life odd?" I put a blanket over her to keep her warm.

Keep an eye on the time stamp for these e-mails.

-- Yrs,Andreas

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I'm keeping a notepade next to the table.

When the nurse told us that there was a possible heart, Susan's heart monitor jumped from her normal 112 to 120.

11:30 pm: Susan asked for a rabbi. The UCLA on-site minister, a protestant, called around to find a rabbi. While waiting, Susan had to use the toilet, a portable chair toildet that is brought into the room. While she was sitting there, the rabbi called. Yes... nature called and God called. She's laughing.

11:42 pm: Susan wants to brush her teeth and wash her hair. With two nurses in the room, she brushes her teeth. I promise her that if there is a go on the heart, we'll wash her hair. There's her hair dryer here.

11:45 pm: Her nurse, a very charming, very funny Australian named Judith (that's right: the Tin Man went to Oz for a heart) came in to draw blood for the laboratory.

11:50 pm: Susan and I hug and hold each other. She looks forward to having a normal life again...

11:54 pm: Judith came in again to give Susan some morphine to calm her down. The injection went into a tube that leads into her. She sits still for a bit, and then says "whoa!" A warm, flushing feeling goes through her whole body. She slowly sinks back into her bed, with a soft smile.

12:02 I walk out of the room to answer Bill's call from Seattle. Another nurse cheerfully asks me "Is she going?" It's like getting called to win a contest. I reply that there's no final decision yet.

12;06: Susan is very dozy on the morphine. Judith came in with a cup of potassium. Susan has to drink it. Very foul tasting stuff, like chalky salty brine. She followed it with iced tomato juice.

-- yrs, andreas'


(Andreas) 07:30AM

12:45 AM, past midnight.

It's a go. Judith got off the phone, looked at me with a beaming smile and gave me the thumbs up. She says "it's a go! Do you want to tell her?"

I go into the room. Susan's smiling dozing. I wake her with a kiss and say it's a go. She so zonked she says "I was just dreaming about lamb, roasted, with a yoghurt marinade. and lots of garlic."

She's discussing food with a nurse right now. An hour ago, I was very tired, at the end of a long day. Right now, I'm wide awake and sweating.

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01:20 am. One of the doctors from the transplant team came in. Susan has to give an informed consent, to agree to what they are going to do. He's a big fellow, unshaven, with a grin and a Tennessee accent. He looks up and says "are you a lawyer? uh, oh..." Susan says "that's right. You better cure me or kill me, or I'll sue!"

He starts off. "We're going to perform a heart transplant. That means that we will remove your heart."

Susan says "whoa! nobody told me about this part!" :)

He says "You are Number 603: the 603rd heart transplant at UCLA."

He reads through three pages of what the problems could be, so that Susan is aware of this. Zonked on morphine, how aware can she be? She keeps talking about food.

In the first 30 days, 5% will die. After that, only a few die per year.

Surgery will take about 4 to 6 hours. I can go home (but I'll have to clear out her room first, of hundreds of get-well cards, etc.) She'll sleep for about 12 hours. I should be able to see her again by Sunday evening.

When he finished, Susan said "sounds good to me. Let's do it!" She signed the consent forms.

It's going to be a busy night at UCLA: they are doing three transplants tonight. One starts in an hour. Susan will be next and the third is after her. He is being flown up from San Diego tonight. The donors are young males. I don't know if they are from one accident or separate. Susan says "his heart will live on through me." She plans to write to his family.

Another nurse came in and put ID tags around her foot and wrist. In a few hours, they'll paint her with antiseptics and shave her front torso. Her heart monitors look great: good steady pulse, etc. She'll be wheeled down the hall to the other end of the hospital where the surgery rooms are.

Susan continues to talk about food. She's very anxious. Judith the nurse gives her yet another dose of morphine. After ten minutes, she's finally asleep. I'll be awake all night, here with her. Before they take her to surgery, I'll remove her wedding ring, it's a huge emerald that I got for her in Colombia. In the next few days, I'll tell you'all the story of her emerald.

Before Susan fell asleep, I told her that when she sees the bright white light and the old man in flowing robes, be sure to ask for Monday's lottery numbers. She gave me the thumbs up. She says to play all varients of her #603. I sang her one of her favorite cat songs. She's sound asleep now. I'm wide awake. It's 2:20 am.

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5:15 AM: Two nurses came in and removed Susan's clothes and bed sheets. they shaved her and painted her with an antibacterial solution. The lights in the room are turned up: it's bright surgical lights. She asks for her sunglasses. She lays there, basted in a shiny orange color.

They give her the first of her anti-rejection pills; she'll take these for the rest of her life.

5:30 AM: Judith shows me the Surgical ICU (SICU) where Susan will be brought afterwards. It looks like sickbay from the Starship Enterprise. Outside, on the floor, sits a family, holding each other, some are weeping.

6:10 AM: The anestheia people come in and tell Susan what may happen. More informed consent. Death, brain damage, etc. By this time, Susan has had so much morphine that she smiles and says "sure, whatever..." :)

6:30 AM: Everything is ready. All the forms are signed; the team is getting ready. We wait.

The nurses and doctors whom Susan has gotten to know over the past two weeks drop by, to say hellow and wish her luck. Susan is napping. I'll walk with her to the surgical theater in the basement.

Afterwards, it's home to sleep. They'll call me sometime this Sunday afternoon. It looks like a beautiful day in Los Angeles. I'm crashed from emotion and exhaustion. I'll post when I hear something.

-- yrs, andreas


(Kay) 10:29AM

I just received a phone call from Andreas. He called to say that it's happening. Surgery started at 8:00 this morning PST. Now we just wait to celebrate Susan's new birthday. Andreas said he will be posting as he hears more.

I have to say that Andreas sounded very excited. He was out of breath. He said he was exhausted. I said he would never be able to sleep. He told me that he took something to help calm him down. Hopefully he will be able to get some much needed rest before Susan wakes up from the operation.

I'm sure that all of you are thinking of Susan. She has not left my mind all morning. Take care, all.

Kay


(Andreas) Noon.

Bill from Seattle is here again. We went to see Susan. She's stable; the bleeding has stopped. She's still in a very critical condition. Her chest is still open. By late Tuesday, they may began to close. She reacted briefly to a nurse's command to squeeze her fingers and flex her toes. She's still heavily sedated. I slept, but only with sedation.

Yrs, Andreas


(Kay) 03:23PM

I just talked to a very physically and emotionally exhausted Andreas. The surgery is over. It was a success! The quote Andreas gave me from the thoracic-caridiac surgeon is that the operation "went extremely well."

Susan is currently being moved from surgery to Surgical ICU (SICU). She is still unconscious. She should be waking up around midnight tonight. Andreas will be there when that happens. Andreas thinks she will wake up ravenous. I'm not convinced. She will be on IV for two days.

Susan still has all sorts of tubes going in through her mouth. (Is that right? Andreas made me take notes but maybe I could have done a better job of that.) The tubes are helping her breathe. The tubes will come out in about 9 hours.

Andreas says that Susan will be running all of us ragged now. He said it will be like she got a change of batteries. I look forward to a day in the near future when I can say to Susan, "Slow down. I can't keep up. You're going too fast."

OK. We can all breathe now.

Kay


(JB) 04:00PM

I spoke with Andreas right after Kay. He also told me she is doing fine. The new heart is beating so well that she has high blood pressure. Her kidneys are pumping away so she is getting cleaned out real good.

She will sleep for the next 12 hours. After that she will be on IV fluids for 48 hours. We will then discuss with Andreas what Susan will be able to eat and how soon we can bring it to her.

Andreas said that it was better that the heart came this week rather then last week because Susan was much stronger after the dialysis last week. We were all dissapointed last week when they passed on a heart for her. Maybe God was telling us it was better to wait.

Your prayers have all helped,

JB (for Mimi)


(Bill Kim) 05 PM

Susan came up from surgery and is in the Surgical Intensive Care Unit (SICU) where transplantees are held.

Susan's chest has began bleeding. Due to the radiotherapy for her Hodgkin's cancer 20 years ago, the left lung is mostly scar tissue. The periacardial sac, which is a membrane around the heart, was also scarred. This made the chest a difficult area into which to place the heart.

Susan began bleeding and the chest filled up, which put pressure on the heart. The new heart stopped beating. The team had expected that and she was revived right away. Her chest was then reopened so that they could have access to the sites which are bleeding and to reduce pressure. She was taken back to surgery, where the transplant team examined her closely, especially the area under the new heart.

I waited outside until 7 PM, when her family came and took me to dinner. We ate and returned.


(Kay) 18:24

Andreas just called me with the latest news at the hospital. Here's what is happening.

Before I start this story, let me say that everything will be OK.

Susan is in the SICU. She began suffering a lot of internal bleeding. She developed a blood clot. The clot caused too much pressure for the heart and the heart stopped. This was forseen by the medical staff. Her chest has been reopened. The bleeding is coming from tissue scarring from her previous cancer treatment. In 10 minutes they are taking Susan back to surgery. They will raise up the heart and clean her up. She will be in surgery for about an hour.

Susan was briefly awake. She looks healthy. The staff says that she is in good condition. The doctors also say that she received an excellent heart.

Andreas says he will call me with a new report when Susan is out of surgery. I will repost then.

Don't let down your guard. Keep your thoughts going in Susan and Andreas's direction. The battle sounds like it is not over.

Kay


(Kay) 20:22 PST

I just received another call from Andreas. I can't tell you enough how tired the poor man sounds. I wish there was something that could be done for him. As he told me, the only thing he wants now is for them to tell him that it's all over and everything is going to be OK.

Susan is out of surgery. She is stable. Andreas is going to be allowed to see her in about a half hour. Personally, I'm glad he can go in. The thought of them being separated tears me to pieces.

Have a good night. Keep sending all of those positive thoughts to UCLA medical center.

Kay


(Andreas) 9 PM

Her condition is sufficiently stable that I was allowed to enter. I wash my hands and put on surgical gloves, mask, and cap. The SICU is far more advanced than CCU. These folks really like technology. I'll bring my camera tomorrow and take photos so that you can see.

Susan is on a surgical bed, a large flat bed. She is completely unconscious. Her hands and feet are restrained. A small doughnut, the size of a frisbee, is a pillow to hold her head still. A single sheet covers her. Four doctors and nurses watch her constantly.

I held her hand and talked to her but she is unconscious. I held her and talked to her anyway. She looks a mess: tubes lead in and out of her mouth and nose; a number of tubes into every available artery, including tubes for urine. Her nurse told me that I could look under the sheet if I liked. I carefully lifted the sheet. Her chest is open. A sheet of clear adhesive plastic, like Saran Wrap, covers her chest and seals it. A plastic tube, as thick and as large as a finger, holds the sides of the sternum apart. Inside her chest, her new heart is beating strongly. More tubes lead away from the chest with suction to remove blood. Her toes are a good pink color, which means that the heart is moving blood well through the lungs and her body is getting a good supply of oxygen. Her kidneys are working strongly.

Susan is extremely critical. She has only barely made it off of the surgical table. They will keep her chest open all day Monday and most of Tuesday. If the bleeding stops, then they will began to close her chest slowly, a centimeter at a time. If upon reaching the final centimeter her bleeding stopped, then they will close her chest. She is on several powerful sedatives and pain suppressors. She won't remember any of this. By early Wednesday, she will began to wake up.

The heart transplant teams knew about her lungs before they started. They were aware of the possible problems. They've dealt with this sort of complication before and they feel confident that she will recover. It will be slow and critical, but Susan's in great condition, young (40), and has a strong will to live.

I covered her up, tucked in the sheet around her neck, and brushed her hair out of her face. I walked out of the hospital in shock and began weeping in the car and couldn't stop until I got home and sat here for a while. She's a very sick little kitten and I love her very much. I keep her emerald wedding ring with me.

It's Sunday night. I don't know if I'll be able to sleep tonight.

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