February 19, 2011

Dilemma…also known as, a quandary, a tight spot, a catch-22, a predicament, an impasse, or simply a problem…do I choose chocolate ice cream or vanilla ice cream.  However, my dilemma is not so simple.

During my last appointment with Dr. Pavlakis, we discussed me being listed on the UNOS list for a pancreas as well as a kidney.  Ultimately, after much discussion, I went with her recommendation to be listed for both. 

One might think that this would be an easy decision to make, especially after having to rely on either insulin injections or messing with an insulin pump for the last 27 years.  I would finally be free of the daily grind of thinking my body was a big, constant chemistry experiment every day, every hour, trying to balance my blood sugar levels - think of it as a seesaw and on one end you have insulin, the hormone produced by the pancreas, and on the other end is all of your carbohydrates and other foods, and you have to try to keep your blood sugars in a normal range (think of the seesaw being level, maybe swaying just a little up and down).

That daily, or hourly, chemistry experiment, keeping the seesaw level, is hard work.  So, given all of that, wouldn’t it be a no-brainer, then, to opt for having a pancreas transplant in addition to the kidney transplant?  The quick answer is yes…absolutely, I would give up having to regulate my blood sugar, and all the worry that goes along with it, in a heartbeat!  But only if I knew that it would truly mean an end to my Diabetes.

Diabetes sucks, plain and simple.  It took the life of my sister, Linda – she was only 24…24!  She was a nurse, and her whole life ahead of her.  Diabetes is the sole reason why I am here today in need of a kidney to live.  It has toyed with my eye sight, to the point of needing laser surgery to repair my retinas.  It has messed with my heart, requiring me to have several stents placed and eventually leading to double by-pass heart surgery.  It has taken away the sensation, or feeling, in parts of my feet – nearly losing one of my big toes because an ulcer was slow to heal (due to having a great foot doctor, I still have all ten toes, but my balance is a little off).

So, if I have a pancreas transplant, there is no guarantee that I would be Diabetes-free for many years to come.  The success rate is about 90% (meaning no need for insulin injections) after one year, and 70 – 75% after five years.  I know I am asking for a miracle, but part of me feels that if I am all in on a pancreas, I don’t want to ever have to go back to the way it was.  I know that is being selfish, and there are those that would say, “hey, at least you had a few years where you didn’t have to take shots every day or adjust your pump.” 

And you know what, they would be right, at least I had that.  It would be bitter-sweet if I had to return back to the life of insulin and worrying about my blood sugar.  I would do it, of course, but it would be bitter-sweet…I would hate it, but I would do it.

There are other things to consider as well.  If this were to happen before Tommy is scheduled to donate a kidney to me (it would have to be a perfect match), that would mean that someone else would have to have died in order for me to live – I still have trouble wrapping my head around that.  Plus, the wait on the list is longer when you are looking for a kidney and pancreas together.

There is also the option of receiving a kidney from Tommy, and then a pancreas becoming available later from a cadaveric donor, and I would have the option of saying yes I will take it, or pass on it.  It is my understanding that if I pass on it, I will still remain on the list and I could be called again to make a similar decision.

If only life were as easy as choosing between chocolate or vanilla ice cream…