He cooks for his wife Kim, hikes and bikes with her on the Boundary Bay dyke and is starting to get his running legs back. This summer, he’ll be off to college in Vancouver.
Talk about a new lease on life.
Last spring, Delta’s George Keulen was nearing the end of his.
At age 27, he was spending more days in the hospital than at home, his mucus-filled lungs unable to fight off bacterial infections that were the result of cystic fibrosis.
A nebulizer (face mask) fed clouds of antibiotics into his lungs, and he was on 24-hour supplementary oxygen to keep his body functioning.
He couldn’t walk more than a few steps—part of deterioration that started in his early 20s. (In his teens, despite cystic fibrosis, Keulen had played hockey and ran track-and-field.)
The big slide began in the fall of 2006, when his body couldn’t fight a bacterial infection on its own.He met the BC Transplant team the following year to discuss the possibility of a double-lung transplant.
“They agreed that it was time to start looking into it,” he recalls. “My health had deteriorated to a point where the transplant became the most viable option.”
The work-ups began in 2008—tests of every kind. By the end of that year, he was put on the organ waiting list.
There were a number considerations before getting on the list, he explains.
“You don’t want to be transplanted too soon, but there’s no knowing how long you will wait for your organ, so you want to make sure you’re still healthy enough when you’re wait-listed that you’re able to survive the amount of time that you have to wait for the transplant.”
Keulen knew the risks.
“It is still a last-resort treatment. It is a huge deal. It’s not something (you) just jump into and take lightly.”In February 2009, his right lung collapsed twice, and Keulen spent three weeks in the hospital hooked up to chest tubes.
After that time, he had no reservations about being on the waiting list.
“My lungs were pretty much finished. Things were getting very serious.”
The waiting wasn’t easy. Moods wavered with stories of successes, and then dry spells, in the close-knit transplant community.
By mid-2010, his doctor gave Keulen four to six months to live, and he was already 18 months on the transplant waiting list. Any further delay would mean he’d be too weak to handle a double-lung transplant.
The dream-like day, Keulen says, was a “beautiful sunny June morning.”
At 5 a.m. two nurses burst into his St. Paul’s Hospital room and said that BC Transplant had called—a set of lungs were available.
At 7 a.m., he was transported to Vancouver General Hospital.
For whatever reasons, surgery was pushed back several times during the day—each time suppressing raised hopes. He had heard before that 30 per cent of transplant calls were false alarms.
“It was all so surreal,” he recalls, describing the day’s events as thrilling, exciting and emotional.
At 9 p.m., he was ushered into pre-op to say goodbye to Kim and was then wheeled, movie-like, through the halls into a hustle-and-bustle room to see the table he would occupy for the next eight hours.
At a point like this, he explains, “you have to let go of all your fears and misgivings and trust that it’s the right thing to do and it’s gonna work out.”
Keulen says there are no words to describe how he felt just two weeks after the transplant.
He was off the ventilator six hours after the transplant, out of the ICU in 30 hours, and took his first steps down the hallway 30 hours later—”which I could barely even do before the transplant.”
The recovery was difficult—he was tubed and lined like an octopus for the first several days— but he felt confident about every step. The pre-transplant sense of despair when tasked was gone.
“Just the hope that transplants give … the life that you can have afterwards is night and day. Anything that a regular person can do now, I can do.”
Keulen, while living as normal life as possible, still faces a lifetime of immunosuppressant drugs to keep his body from rejecting the lungs, and must stay away from people who are sick, since his own immune system is weakened.
He was thrilled when a two-week cold he got last December stayed in his head, something he never experienced before, as colds had always targeted his lungs.
The immunosuppression also means that he can’t go back to his old job on the family dairy farm a few blocks away.
“Being amongst the animals isn’t a good thing,” he says.
Then there’s the W-shaped scar across his chest—he depicts the surgical incision as opening the hood of a car—but he expects it to fade over time.
Keulen describes the lungs and the freedom they give him as a “gift” from their anonymous donor.
“I wish there was a better way to describe the gratitude,” he says. “It just leaves me so speechless.”
Becoming an organ donor
Out of more than 784,089 British Columbians, just 17 per cent of the population has registered with BC Transplant’s Organ Donor Registry. On average, with 25,000 deaths occurring in B.C. each year, less than one per cent of those will happen in a way that enables organ donation.
By health region, the number of registered donors are as follows:
• Fraser (which includes Surrey and Delta) – 222,162• Interior – 149,042• Northern – 47,448• Vancouver Coastal – 174,515• Vancouver Island – 169,200• Unknown – 21,722
The Organ Donor Registry is no longer tied to drivers’ licences, says Lubna Ekramoddoullah, senior public affairs officer at the Provincial Health Services Authority. That sticker system was eliminated 10 years ago.
Ekramoddoullah says the public—more than 85 per cent of whom have no objection to donating their organs—still doesn’t know how easy it is to register online.
“Maybe, like house insurance, it’s one of those things that people just haven’t gotten around to,” she says. “Take the time to do it. It could save someone’s life when the time comes.”
For those with cultural or religious objections, the “Yes, I will” decision can include restrictions to specific organs or the use of them.
No organs are “donated to science” through this process.
BC Transplant, which works to send its message through South Asian radio stations, also offers Punjabi language registration cards that can be received by calling 604-877-2240.
Organ transplantation can be the difference between life and death for some patients. For others it represents a total transformation in their quality of life. For example, for a kidney transplant recipient, it means freedom from kidney dialysis treatment—a treatment that is required three days a week for four-hour sessions.
Organ transplantation also has a long-term economic benefit in reducing patient care costs. The typical kidney dialysis treatment cost approximately $50,000 per year, while a kidney transplant costs about $20,000, plus about $6,000 a year for the immunosuppressants (anti-rejection medication).
Three transplant centres (St. Paul’s Hospital, Vancouver General Hospital and BC Children’s Hospital) and six regional clinics (Victoria, Kamloops, Kelowna, Prince George, Penticton and Trail) have been established to treat patients.
Today in British Columbia, there are more than 370 people on the waiting list to receive a solid organ transplant.
BC Transplant is celebrating its 25th anniversary this year, and set a record in 2010 with 295 transplants.