By Paula Walter
Christina Dugger, a 33-year-old mother of four, is on a waiting list for a heart transplant. She carries a cell phone at all times and is ready at a moments notice once she receives notification that a heart has become available. Time is of the essence as Dugger, who lives in Johnson County, has a mere four-hour window to make to the operating table at Vanderbilt University Medical Center in Nashville, Tennessee.
Roughly 12 years ago, Duggers cardiologist discovered she had developed nonischemic cardiomyopathy (DCM), a condition where the hearts ability to pump blood through the body becomes decreased as the left ventricle, the hearts main pumping chamber, enlarges and becomes dilated and weak. With time, the muscles of the heart walls begin to weaken and are not able to pump effectively. This puts a strain on the kidneys, as fluid will build up in the feet, ankles, legs, lungs and other organs. As the body retains excess fluids, it leads to congestive heart failure.
Approximately 10 years ago, Dugger was diagnosed with a condition known as sarcoidosis, an autoimmune disorder. Close to 90 percent of cases will present in the lungs, but can be found in any organ in the body. Sarcoidosis causes small lumps known as granulomas that typically will heal and then disappear without any medical intervention. The tissue in the lumps that do not heal can become inflamed and scarred. For 90 percent of sarcoidosis patients, it is not a fatal disease.
According to Dugger, the disease was manageable for the last few years as it had not rapidly progressed. Recently changes in her condition have left her physically weakened. She was placed on the nationwide transplant list on March 1, 2012. According to Dugger, the typical wait time for a transplant is two years. I am very tired and very fatigued, she said. It has become a way of life for me. Dugger explained that she has some good days where she can be out and about, but the next day she may be so ill she is wheelchair bound as breathing becomes difficult and labored far too quickly. To be on disability at 33 years old because you are dying is overwhelming, she said.
For Dugger, the most difficult aspect of her illness is preparing her children, who are 15, 13, seven and five, for the unexpected. She explained that the younger children are calmer and do not understand the severity of her disease, while her two teenagers are much more aware of their mothers condition. When Mommy gets the call, they may never see me again, Dugger said as tears began to well up in eyes. I put them on the bus, and that may be the last time I may ever see my kids.
Finding a match for any organ transplant is a detailed and precise process. The donors height and weight must be close to the recipient with matching blood and similar antibody types. Age is not a factor in determining compatibility. The location of the donor comes into play as the heart has to be harvested by the transplant surgeon, evaluated and examined to ensure the organ is viable.
The process for placement on the national transplant list is extensive and thorough. Dugger first had an initial evaluation to determine if she met the heart transplant criteria. She spent three days in the hospital as they ran tests to determine if any of her other organs had been compromised by her condition. According to Dugger, she also underwent a standard psychological evaluation to determine if she is emotionally sound. The information is then forwarded to a transplant committee who determines if the patient is an ideal candidate for the procedure. They reviewed her medical and psychological information, as well as looking at the overall life of the patient. Basically, your life has to matter, she said. Dugger spends as much time as her medical condition will allow advocating for the rights of special education children. Three weeks after her evaluation, Dugger was placed on the transplant list.
For the rest of the story, pick up a copy of this week's Tomahawk.
By Paula Walter