While on a fabulous trip to Canada with my boyfriend in 2014, I sat on a pier in Vancouver and thought about another man. I cried about him a little bit too but mostly my feelings were of happiness and gratitude. The man I refer to was not someone I had ever known but because of him, I sat and looked out on the Pacific Ocean, sun on my face, hair blowing in the wind – and feeling healthy. He had donated his liver to me in 2006 and, following some serious teething problems, my body had accepted it and adapted to this new graft. His / my liver had allowed me to follow many of my dreams; tandem skydive, learn the clarinet, spend more time with precious family and friends, travel as much as possible and learn to appreciate my life – and me.

A few weeks and a long-haul flight over the Atlantic later, I was irritated by itchy feet. I have a blood disorder called essential thrombocythaemia (ET) which is one of a number of myeloproliferative neoplasms (MPN). Usually caused by a genetic mutation, my platelets are too numerous (almost 1 million at their highest in contrast to less than half that number in the normal population). This disorder and a hepatic vein clot cost me my liver in 2006. Symptoms include severe fatigue, drenching night sweats and aquagenic pruritus. When my feet itched after my holiday overseas, and my abdomen was a little distended, I asked my GP practice nurse to check my LFTs (liver function tests or my liver enzymes). They were ‘off kilter’ she reported to me when the hospital lab technician flagged the results as very high.

A trip to St. Vincent’s University Hospital and a few days later, I was told the most devastating news. My liver was failing as there was an extensive clot in my hepatic artery. The liver surgeons admitted that a transplant might not be possible and so my life flashed before my eyes. Weeks later, I was at home and doing ok…plus my hepatic artery thrombosis (HAT). In the next few months, I returned to work and life was normal – except for the constant haunting thoughts of how poor my health actually was.
In November 2016, 10 years and eight months after my transplant for a clotted hepatic vein, I was placed on the transplant waiting list. Since my 2006 transplant was unorthodox, requiring some ‘re-plumbing’ due to extensively clotted blood vessels, I always had the knowledge that a second transplant would be a complex and intricate surgery. Admittedly, the surgeons still did not have a plan of how to proceed with my complicated and potentially high-risk second transplant, but I simply needed a new liver to live.

I was admitted to St. Brigid’s Ward in January 2017 with horrible ascites (a build-up of fluid in spaces in the abdomen), a ruptured ovarian cyst and abdominal bleeding. Little could be done to resolve these issues while on the transplant waiting list, so I needed constant monitoring and couldn’t be discharged from hospital. It just wasn’t safe for me to travel home to Mayo. And so began an almost-year of living in a hospital which encompassed almost daily blood draws, scans, endoscopies, fevers, meetings with many patients and many nurses and physicians, fortisip (both consuming and disposing of it!), dreadful hospital food and constant weighing. The fluid / ascites became very severe until I weighed twice my typical weight! Bradley Walsh (The Chase) and Ben Shepherd (Tipping Point) were like friends to me, as were hundreds of characters from the tens and tens of books I read to escape my horrible scary mundane life. My family, parents and sisters, and nieces visited as much as possible, and I felt so supported and cared for, but also so alone and helpless.

In early July my kidneys failed, and a stent of dialysis followed. This brought me to my lowest point; I just felt so ill. When Yvonne, the liver transplant coordinator called to me weeks later and said there was probably a new liver for me, I didn’t feel excitement, joy, hope, nervousness or fear. I just felt ready – to live or to die. I needed to either let go or have my opportunity to fight for my life.

So, I fought, and I lived. I owe another person my huge gratitude, my sincere admiration – and my love.

Karol xoo