An Amazing Gift

15 December 2009Peter Blackmore often thinks of the person whose heart beats in his chest. Understandably so.

Privacy rules are strict around transplant surgery, for both recipient and donor families. Peter knows his donor was a middle-aged woman, and speculates that she was a marathon runner because the heart, affectionately dubbed "Thumper", is so strong.

"Even now lying in bed at night it's like having a stethoscope in your ear."

The transplant surgery in June last year was the turning point in a 22-year battle that began with a heart attack while Peter was scuba-diving in the Coromandel. He had a second attack on the way into hospital after the airlift got him to Thames, and he recalls an out-of-body experience perched up in the corner of the room watching the medical team working quickly below to keep him alive.

When he gives talks now, he tells people not to fear death, remembering the golden glow and the calm, warm feeling he felt in that room. "This is why some people call it heaven." Peter says his heart problems are hereditary, aggravated by stress from his job as an insurance broker. The next two decades were to be a gradual slide and in 1998 he had the first of many stent operations (tubes fitted into the coronary arteries). In mid-2000 "I was told to get my affairs in order. That was a bit of a shock".

That November Peter had open-heart surgery to sew in a Gortex patch to repair his left ventricle, and also bypass surgery. In 2003 his first pacemaker-defibrillator was implanted.

By the following year, Peter was running out of options. As his wife Jan says, "the plumbing had got a bit slack and now the electrics were going as well, His left ventricle was sloppy like an old football". Peter had to relinquished work.

Jan, who was also in insurance, had retrained as a beauty therapist, and they moved from Auckland to Richmond in 2005, where the health battle resumed. Peter feels Nelson was one of the best places he could be in terms of the high standard of cardiac care. He reels off a "thank you" list of specialists and staff at the hospital, especially cardiologists Andrew Hamer and Nick Fisher.

Despite their best efforts, he was by now skin and bone, barely alive, with a heart working at 7 percent efficiency, compared with the normal 60-70 percent.

"The blood was getting out of my heart but it wasn't getting around my body."

Nelson Hospital became familiar ground. Peter had a pioneering "balloon pump" attached to his aorta to give the blood flow "oomph".

Transplant was the only hope left but at age 62, he was too old.

But Peter Blackmore has one hell of an angel on his shoulder. The transplant age had been raised to 65, and specialist Bruce King trawled through Peter's thick tome of medical notes before firing off a recommendation to the heart transplant team in Auckland for Peter to be assessed.

He flew up just before Christmas 2007 to be put through a rigorous assessment, including gauging his support people (rock solid, from family on both sides) and his state of mind, looking, as Jan puts it, for someone "bloody-minded" enough to survive the operation, the recovery and the copious drug-taking that lasts for the rest of recipients' lives.

"Any doubt and you're out," says Peter.

He was accepted on to the programme and added to the "inactive" list. In January last year, after further assessment, he made the "active" or priority transplant list, but was failing fast. That May Peter was air-ambulanced to Auckland, and Jan says this time they knew it was a one-way ticket unless he could find a new heart.

Peter was admitted to Auckland City Hospital Coronary Care Unit. He had surgery to fit a powerful pacemaker-defibrillator with three electrical stimulation wires instead of the usual one, and was also given a potent cocktail of drugs to further support his failing heart.

"I was so ill they actually took me off the active list."

But he had already passed his "bloody-minded" exam. The $100,000 device and drugs gave Peter enough pep to rally himself. He climbed from bed and struggled around the ward using a walker. The gutsy gesture was enough to get him back on the active list the very morning that a suitable heart became available.

"That's when all the emotions start going. You feel elated and scared."

The heart had been matched for blood type, tissue and size. Peter and Jan don't even know which hospital it came from. The cardio-thoracic team flew out to remove organs from the donor and return to Auckland.

After six hours of surgery, the heart was beating in Peter, and the lungs had been given to his transplant "twin", a young woman he first met in the next bed as they waited for their operations. The unknown donor had saved two lives and possibly more with her other organs.

Peter spent two weeks in Intensive Care, recovering in a room filled with "amazing staff" and a battery of machines. Jan and Wendy Wadsworth, Peter's sister from Nelson, took it in turns to be at his bedside. He then spent five weeks at Hearty Towers, the old nurses home at Greenlane Hospital where all the pre- and post-op heart and lung patents and their support people reside.

Just over a year later, sitting on a sun-filled deck in Richmond, Peter looks tanned and healthy, with a determination to live life to the full. Five months after his transplant he took part in a walking relay round Mt Taranaki with other organ recipients, plus support people and staff. He does martial arts three times a week and can handle a four-hour tramp.

He was out at the Motueka airfield recently to watch skydivers when he spotted a tandem hang-glider pilot offering flights. "Should I?" he texted Jan in Auckland. "Go for it," she replied, and Peter was soon soaring over the Abel Tasman in the motorised hang-glider.

He is on once-a-year check-ups now, and has a huge list of people he credits with saving his life. Some of the medical staff in Nelson, Auckland and Thames have become friends. Peter describes himself as spiritual, though not a church-going Christian. With the heart popularly regarded as the seat of emotions, he feels he has taken on some of the personality of his donor.

"I know how it's changed me and I think she must have been a lovely person."

Jan terms organ donation "an amazing gift". She recalls hearing of a Transplant Games competitor who sent his gold medal to the donor's family. They appreciated the enormity of the gesture, and returned the medal to its rightful owner.

Peter wrote to his donor's family, via the transplant team. The family did not reply, but he's unconcerned.

"I thank her every morning."

By Bob Irvine - Mudcakes and Roses - Dec 2009/Jan 2010