It has been over 12 years since my ltx and the time has flown by and I've been blessed with mostly good health. I remember when I first decided to make the conscious decision to live my life on immuno-suppressive medicine. I figured this was a necessary evil, even though sometime down the road, sooner or later, there would be the piper to pay. The MI I had back in 2011 was just a bump in the road and I've been fine, working out as necessary to maintain the improvements in my body's health once a pair of stents were in place in my coronary arteries. Then this past summer, someone at my annual transplant visit suggested I have an ultrasound scan, "just because" we've not seen what's going on inside you for a number of years. Radiology reported something in the right kidney which necessitated a CT and then a CT with contrast die to clearly define what they identified as a renal cell carcinoma. The pathology report from the frozen section showed clear margins, but within a couple of weeks, the report from the permanant slides that there were carcinoma cells in the margins. Then it was a case of what to do next. While meeting my kidney surgeon at his office2 weeks post op, which was about 4 days after I'd stopped using the pain medicine, he told me this and the first thing I said was "I'll run the two blocks to the hospital and meet you at the OR. You book the case and I"ll wait for you to remove the remainder of that kidney." He said "Hold on. There's no need for more surgery." He assured me that the numbers in favor of avoiding a return of a tumor were in my favor and if it did come back, it would be in that same kidney and they could always go get it again. After I shared this with my daughter, the thirty something attorney, she did some research and told me: Dad, you need to speak with your liver tx surgeon and tell him you want to be taken off the Prograf which enabled this cancer to grow in the first place and switch to Rapamune."' She referenced the research she'd rad on the UNOS site and I checked it out. The difference is that Rapamune will allow my body's T-cells to engage the cancer cells and a side effect of the medicine is that it prevents new blood vessels from forming, which would do a fine job of starving a tumor of its nourishment and ability to grow. (New adage: Feed a cold, starve a cancer.) I met with my ltx doctor and he agreed this was the best course of action for me. So, today was my first day on the new drug, having stopped the old one yesterday. It's been 12 hours without any noticeable side effect, which is great because the list of those is quite long. At first, i was concerned, then thought back to the length of the list of side effects that comes with Prograf, and had to chuckle when I again realized that this stuff I take to preserve my life can kill me. Some days, one just has to laugh at the reality of being a transplant recipient and enjoy the gift.

Of course, I may have to quickly get off Rapamune if I break a bone or have a physical injury or surgery, which would require my body to produce new blood vessels to enhance circulation when and where needed. For now, my job is to have none of the side effects as imaginary symptoms as I look forward to the next 12 plus years with this perfectly healthy liver of mine and nurse along the kidneys to last at least as long. And being aware of poetic irony, I'm also being very careful driving and crossing the streets as a pedestrian. LOL. Yep, life's like that.