Organ Donation: The Gift of Life
Meeting Minutes for July 13, 2005; #189
Sign up on the Gift of Life Organ, Tissue & Eye Donor Registry at:
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A good time was had at the Millennium Park gathering for our Annual Freethought Picnic (where our new banner was displayed) on July 9. Volleyball, swimming, juggling and other activities along with delicious food were all part of the offerings that day.
This fall we are pleased to bring several authors to speak to us at the FA. Among them, J. Stenesh, Professor of Chemistry at Western Michigan University, will be presenting to us (in August) on his book Rot on the Vine; The Many Dark Faces of Religion. In October, Constitutional lawyer and founder of Camp Quest of Michigan, Edwin Kagin, will speak to us on his book Baubles of Blasphemy. Also in October, Stephen Gibson will speak to us about his book Truth- Driven Thinking. In November, Henry Pollack, PhD, will gibe a presentation based on his book Uncertain Science... Uncertain World.
Speaking of authors, FA member James C. Courtney has his newly published book, Drops of Water, Grains of Sand, Aphorisms, Axioms and Epigrams; Ruminations, Musings and Remembrances available for purchase. This 186 page softcover (Trafford Publishing) is only 17.50. Mr. Courtney's slant on the roadblocks and milestones of life reflect his dry wit as well as his serious nature and is more a mind-tweaker than page turner; one can drop in on any page to find thoughts to reflect upon. He also has copies on cassette of his taping of Godless America available for 2.00 each. This presentation was on the NPR radio program This American Life in early June. Julia Sweeney, among others, gives a full- throated defense, in this hour long program, of godlessness at a time when the separation of Church and State is being ever threatened in our nation.
Past Freethought Association meetings air every Wednesday night on cable television, GRTV-25 in Grand Rapids. Thanks to member Gordon Matousek for all his hard work as camera man and producer.
Jason P. brought in copies of the magazine West Michigan Fresh; A Guide to Local Food from the Michigan Integrated Food and Farming Systems- Greater Grand Rapids Food Systems Council. This is a project of the West Michigan Environmental Action Council. Copies will be available at future meetings on the literature table.
We thank Jennifer Beahan for her many efforts, including her production of the Freethought Association Newsletter (layout, duplication, labels, mailing, etc.), heading up the Freethought Women's group and many other tasks she lends her talents and sharp mind to on behalf of the FA. PLEASE NOTE that the Women's Group will not meet for the month of July but will resume again in August.
On July 20 (7PM), Jason Pittman will host the next Freethought Movie Night, featuring the near-future based sci-fi film with ethical considerations: Final Cut. BYOB and snacks to pass. Please RSVP or request more information by email: firstname.lastname@example.org or by phone: 616-634-2471.
On July 23 the Van Oosterhouts will again generously open their Lake Michigan Cottage in Mears, MI to us for Freethought on the Lake, starting around noon. Request directions and details via email (email@example.com or firstname.lastname@example.org). BYOB, dish to pass, swim suit, instruments, etc.
Our next meeting topic, on July 27, will be The Jesus Smorgasbord: Recreational Christianity in the Northern Bible Belt. This intriguing presentation will be offered by members AJ Koorstra, Jeremy Beahan, and Matt Wylie. Matt provides valuable webmaster services for our group.
The topic for this meeting was Organ Donation: The Gift of Life and was presented by Jennifer Tislerics, education director for the Gift of Life, Michigan; Tami Jacobs, a heart recipient, and Sally Coburn , whose son became an organ donor after his untimely death at age 28.
Some of the things that Jennifer T. addressed in her portion of the presentation included who can become a donor, what one may donate, how to express one's wish to become a donor, explanations about the Gift of Life Donor Registry and about the First Person Consent Law, as well as about the insufficiency of relying solely on the driver's license signature or sticker on the back for organ donor wishes to be carried out. She also talked about costs, how organ donation affects funeral arrangements, religious issues regarding this gift of life, waiting lists and other items pertaining to this topic.
People of all ages and medical histories should consider themselves potential organ, tissue and eye (typically corneas only) donors. One's medical condition at the time of death will determine what can be donated. In addition to deceased donors, living donors may give a kidney, part of a lung or part of a liver. The organs that may be donated after death may include the heart, kidneys, pancreas, lungs, liver and intestines. Tissues may include the cornea/eye, skin, bone, heart valves, veins and tendons. Tyslerics mentioned that skin is not so much in demand now as it had been, with the breakthroughs in artificial skin reducing this need. As to bone grafts, she said that many people receive them without even knowing it as part of oral surgery or when bone fragments are grafted, post- injury, to areas that need to be built up again.
To express one's wish to become an organ/tissue donor, one may fill out the registry card which is pre-paid and available through Gift of Life Michigan 2203 Platt Road, Ann Arbor, Michigan, or one may call 800-482-4881 or go online to www.giftoflifemichigan.org to be included on the Gift of Life Organ, Tissue & Eye Donor Registry. Those who elect to do this should discuss their decision in this regard with family members, who may also wish to become donors. The registry is a confidential, 24 hour a day, computerized database that documents one's wishes regarding organ and tissue donations.
The First Person Consent law makes the donor's wishes the priority. Upon every hospital death, Gift of Life Michigan is notified. Having a donor registration card on file ensures that one's decision to become a donor is carried out. The G of L MI can be contacted around the clock by hospital staff to verify the wishes. Michigan law does not require family consent to carry out one's wishes to be an organ donor. However, if everyone is kept apprised, there will be less confusion during an already trying time.
Signing the back of your license is not enough! The Gift of Life Donor Registry is the only document that is reliably accessed at the time of death regarding organ and tissue donation. In most cases, the driver's license is not located in time to determine a person's desire to become a donor. Tislerics mentioned that if the license is used by police in their report at an accident, for instance, and is not returned in a timely fashion, its effectiveness is lost for carrying out the donor's wishes. Organs have a very narrow window of viability, so any delays can make a difference in what can be used and what cannot.
Since by law, the medical team treating you must be separate from the transplant team, there is no chance of conflict of interest or concern for the potential donor as to how much effort will be put into saving your life, if it is learned that you are a registered organ donor. Tislerics talked about how doctors who are trained to save lives are hit especially hard when they lose a patient even though they did everything they could. When they learn that even though the patient did not make it, through their efforts the donor's organs have been kept viable longer and will help to save other people's lives, this can mitigate some of the doctor's psychological pain. In many cases a single donor can have various organs and tissues go to several recipients, thus saving (or at the very least making vast improvement in) multiple lives.
There are no costs incurred by the donation process, nor are there any passed along to the patient's family or estate. Costs are, Tislerics explained, made part of the recipient's hospital care and procedure bill.
As Sally Coburn, who lost her son, testified to, one may have an open casket funeral after the deceased has donated organs/ tissues; the donation in no way interferes with traditional funeral services. Jennifer Tislerics said that where removal of, say, bone is done that would affect the appearance of the deceased, prosthetics are used to recreate the original form.
One's religion will not make any difference to organ donation. Tislerics said that no major religion has any prohibition against this act that many feel is one of charity. Tislerics stated that even in the case of Jehovah's Witnesses who do not accept the practice of blood transfusions, there is no doctrinal challenge to organ/tissue donation.
Organ donation allocation is blind to wealth or social status. What governs the length of time it takes to receive a transplant are factors including blood type, length of time on the national waiting list, severity of illness, and other criteria.
Gift of Life Michigan is a full service organ and tissue recovery organization that acts as the intermediary between donors, physicians and hospital staff. Gift of Life Michigan, in collaboration with the Michigan Eye Bank, provides all services necessary for organ, tissue and eye donation. In a separate email, Tislerics provided information on the Michigan Eye Bank. They can be accessed by their website: www.mebc.org or tel #: 800-247-7250.
Medical Research Centers for Whole- Body Donations are the University of Michigan; Office of Medical Education, 3626 Medical Science Building II; Ann Arbor, MI 48109-0608. 734-764-4359. www.med.umich.edu/anatomy/donors . Michigan State University; Department of Anatomy; E206 East Fee Hall; East Lansing, MI 48824-1316. 517-353-5398. www.rad.msu.edu/ANATOMY/pages/willed . Wayne State University; School of Medicine, Dept. of Anatomy; 540 E. Canfield; Detroit, MI 48201. 313-577-1188. www.med.wayne.edu/anatomy/BEQUEST . And University of Wisconsin; Cadaver Procurement Program; Rm. 329 Service Memorial Institute; 1300 University Ave.; Madison, WI 53706. 608-262-2888.
The point was made that you never knows when this issue will affect your life or the life of someone you love. One is advised to learn the wishes of his/her loved ones and to make sure one's own wishes are expressed to other family members. It has been found that having an expressed plan for organ donation helps the survivors in the grieving process as well as knowing that your life will give hope and help to others after your own death.
Sally Coburn spoke movingly about her own son, who had been going with friends to a football game in Pontiac, Michigan on December 4th, at around midnight a decade ago. They were celebrating and had rented a limousine. At this point in her story, I assume that most listeners assumed there had been a car crash. Ironically, the injury occurred when he was running from a restaurant to the auto, where he tripped and fell. In the wee hours of Dec. 5th Sally received that call that every parent dreads. The drive to Pontiac was the longest one of her life as her mind roved over what she would find when she arrived at the hospital.
Her 28 year old son, James Hale, a handsome, athletic looking man, with a future-looking gaze (Coburn showed us a photo of him) was unconscious with a severe brain injury when Sally got there. She said that he responded viscerally to touch and the neurosurgeon allowed that he thought something may still be there. However, a day and a half later, after Sally had hoped against hope for his recovery, he was pronounced brain dead. A battery of tests had been conducted on him to conform this devastating conclusion. He had severed his brain stem in the freak accident. In this case, his driver's license was recovered in time to note his wishes and the hospital suggested organ donation; he was a good candidate since even though he had been head injured, all his bodily tissues and organs were intact and healthy. After discussion with the Gift of Life Michigan, Coburn knew that all would not be lost and her dear son's life would have meaning for others in their own lives being saved.
There was an open casket funeral, which is never a problem when the deceased is an organ/tissue donor. This gave a sense of closure for friends and family. A trust was set up for him and the funds generated were and are used for public awareness for organ/tissue donation. There are annual fundraisers and golf outings that celebrate his life where friends gather to honor and remember the popular young man who, incredibly for friends and family, has been gone for ten years now. At one of these events, Coburn met the man who had received her son Jamie's liver. July 30 is the next fundraiser event.
Transplantation techniques and the ability to sustain organs and tissues for viability are very good these days; the challenge now is in simply having the quantity of donated organs/tissues to draw from. Those on waiting lists get more critically impaired and more desperate, never knowing if they will receive a vital organ for transplantation in time to save their lives.
Tami Jacobs addressed us next. She was a heart recipient and it had been two years since her transplant surgery. Her donor, a young woman, saved her life. Strangely, her donor also was the victim of a fall that left her head injured and ultimately brain dead.
In 1993 Jacobs had been diagnosed with heart arrhythmias and rapid heart rate and her blood pressure was way down. She suffered more episodes where she came just short of fainting, and as time went on, was put on a heart monitor, and had numerous EKGs. It was discovered that she had an enlarged heart. Jacobs' overall health worsened as she was assaulted by episode after episode of heart complications and she was implanted with a defibrillator. She described the defibrillator's shock as acutely uncomfortable, with the pulse stronger and more painful each time. On one occasion, the implant went off seven consecutive times.
After '93 she was diagnosed with congestive heart failure. For some, the condition worsens, for others it maintains at a certain level that is not life threatening if there is not too much stress put on the organ. She was put on medications first, then other interventions were tried. A heart valve then began leaking, which prompted surgery that she was told could last for ten years. In her case, unfortunately, it lasted only one year. Some factor, that my notes are unclear on, is normally at 60% (blood volume in the heart, perhaps?) while for her it was only at 15%.
She went through various tests that examined not only her physical condition but also her mental state to see how good a candidate she would be for organ transplantation. It was stated during this evening's presentation that this is the norm before transplantation will take place. The recipient must be someone who will likely take care of the donated organ/tissue and is not generally sickly. Tami's condition worsened until she was put on the heart transplant waiting list, where she was even given a beeper to be notified the moment something came through for her.
Jacobs was in the ICU for three and a half weeks by the time there was a heart available. She related that she was within hours of death when a heart was available but on the positive side, she was already in-patient and all set for the procedure. At this time her heart was only working at 5% capacity! Then, post-op, her new heart stopped, she was on life support and she had multiple strokes. At the time of this medical odyssey, she had three young children at home and she spent four long months in the hospital where she could not function as a mother and her children would visit her to find her sprouting tubes and be at death's door repeatedly. As she related her personal saga, Tami became teary in recounting all that her family endured and, of course, she as well. Her gratitude for her family's sustaining presence and the donor who made her eventual recovery possible was immense. Her ordeal was not yet over, however. She also had been afflicted with spinal meningitis and was still going through rehab to learn again how to walk and talk in the aftermath of her strokes.
For all her calamitous medical misadventures, Jacobs also had some fortunate (believers would say Providential) positive timing occurrences. One was that her donor had only expressed her personal wish to be an organ/ tissue donor just a scant two months before her untimely death. Another was that her husband, who is a farmer, had only just finished harvesting his crops when the call came that the transplantation was to commence. She spoke of meeting the donor's family and how good that was for both parties~for her: to be able to put faces to those who played a part in saving her life; for them: to meet the person their family member had granted a second chance at life to.
Jacobs also related having been in a coma at one point and how she was there to tell us that people CAN indeed hear others speaking to them. It is not a waste of time or silly to do so, she asserted. She spoke of how she tried desperately, but to no avail, to will her eyes to open or to speak or otherwise let those surrounding her know she heard them. One of our members asked if she had ever heard of the film, in Spanish, called Talk to Her, which addressed this subject.
Jacobs also spoke emotionally of her increasing debilitation before her transplant and how hard that was for her~to not be there fully for her family. She could not climb stairs or exert herself in any way. And she related her feelings of initial guilt over being a heart recipient after the transplant. Apparently this is not an uncommon feeling to have for recipients. There were three other people who were saved by her donor's generous gift of life.
Other complications occurred after receiving her transplanted heart, so that what is typically a two week, in- hospital recovery process became, for her, an on-going ordeal, including rejection eight months post-op! She has had to be on numerous medications and has had to get heart biopsies. She has to be closely monitored for upper respiratory infections and temperature. The drugs made her sick and had other challenging side effects. She also shared with us that she had had skin cancer (four spots had been removed) and the spinal meningitis she had told us about occurred twice! Despite her litany of physical and emotional trials and burdens, she said it was all worth it. She is now fully engaged in her family life, she can breathe easily, conquer stairs and exercise without problem. Every day of life is a gift.
Because there was a smaller audience than normal assembled and there was no camera operator and no audio record being kept on tape nor microphone passed around, this meeting was less formal. People just spoke from where they were seated as they were recognized by the person presenting at the time of the question. Attendee reaction was more pronounced than usual in the intimate setting; reaction resulting from the cogency of Tislerics' information presented, and the emotion-laden content of Jacobs' and Coburn's personal stories.
We discussed how different parties coordinate their efforts to make transplantation of registered donor organs and tissues go smoothly, funding issues, what Gift of Life Michigan is federally mandated to do and the role of public education they take on.
Jennifer Tislerics said that one thing that they do better now than had been done in the past (since their inception in 1971) is that they work more diligently to take care of donor families. They have donor memorials and other commemorative activities, families are encouraged to have a quilt square made to honor their loved ones, there are slide show presentations of the donors and their families, and they link donor families with recipients and their families when this is desired.
She also described what typically occurs in head injuries, where the brain swells as a result of the trauma, shutting off critical blood flow to the cognitive organ. This stage, ironically, is where most of the loss of function occurs, rather than from the actual traumatic incident itself in closed head injury cases. If the person is placed on a ventilator, the body's organs and tissues still remain oxygenated and healthy, keeping the window of opportunity open longer for transplantation, once the person is determined to be brain dead. The testing for this determination is extensive, involving several separate examination procedures including, among others, checking for any electrical activity in the brain and seeing if there is any automatic, instinctive brain stem level reaction or not. The work that is done to save any possible cognitive function of the individual or the life itself, is the same as that done to keep organs and tissues viable! for when the patient does not make it.
There are people who can facilitate the organ procurement at all hours of the day and night and who can arrive at the hospital within one and half hours after notification of brain death of the donor. The family has been notified their loved one is gone before any procedure has been started. Tislerics said that in 96% of cases the family goes along with the donor's wishes, without resistance, giving full consent to go ahead. The organs are removed from where the donor was when determined to be brain dead and only the organs/tissues are moved; the body is not transported to where the recipient is. Tissue donations such as bone, certain veins and the corneas can be recovered even in instances where organs such as the pancreas, heart, liver, etc. are not usable.
Tislerics stressed the importance of the Donor Registry Form, as it is the number one way to insure that your wishes to be a donor are fulfilled. A call is made immediately to the Gift of Life Michigan to check the database for the individual, even if there is no record accompanying the individual.
One person asked what happens when someone is traveling to a different state. State laws are paramount and they vary from state to state.
As to matching, medical technology is now to where differences between donor and recipient are not stumbling blocks. However the more similarity the better.
80% of donated organs stay within the state (MI) but this is mostly based on the narrow window of time available for effective transplantation before deterioration sets in; the longer distance for transportation, the more time is involved.
Long standing diseases can affect multiple tissues and organs detrimentally but even in the worst case scenarios, corneas can still generally be recovered, since there are no vascular issues to complicate matters. Those who have had laser eye surgery are not candidates for corneal donation, since their corneas are considered to be like prescription lenses.
Michigan has eight hospitals with organ recipient transplant centers, but all are able to work as organ donation facilities. There are generally anywhere from 550 to 2700 people on waiting lists in Michigan for organ/tissue donations. Tislerics told us that Michigan is actually a good state for organ donation; saying that about 60-65% of MI families who can donate, DO donate. Another statistic she gave was that 95% of people in Michigan who were organ donors were brain dead, with the remaining 5% being extremely severely neurologically impaired. She also explained to us the waiting time required after a patient is taken off a ventilator (as directed by a family member) and the wait after the heart has stopped that is required before organ harvesting can be undertaken. Deterioration begins immediately upon cessation of oxygenated blood flow, so time is always a critical factor.
There are five federal agencies that oversee Gift of Life Michigan. States all grow up independently but are working together more now to save more lives. The national waiting list is a federal one.
Medicaid/Medicare pays for all kidney transplants. This is because within two years of organ transplant the cost breaks even with dialysis. Dialysis ends up costing more, since it goes on year after year, so in the long run it is less expensive to just cover the surgery.
The Gift of Life deals only with deceased donors; living donations are separate from what they work with. There is a lot of testing done with living donors to make sure they are mentally/psychologically, as well as physically, ready to take that step. There is a system being put in place for simultaneous transplants, to coordinate good matches effectively for living donors, when a spouse is not a good candidate. By '07 the list will be more efficient and detailed.
While we had a small number of attendees for this meeting, those who came were very supportive of the work being done by the Gift of Life Michigan and many Donor Registration Forms were signed and witnessed after the presentation. We thank Jennifer Tislerics for providing us with such good information on the organization she represents as well as our other two guests for sharing their personal stories openly from their respective vantage points as organ donor family member and recipient.
Secretary: Charles LaRue.
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