The Heart of it All

Do you know how your story will end? 

Do you know where you’ll go when you die? 

The unavoidable truth is that none of us knows how long we have here on earth. But someday, your body will fail. 

Over the past year, we’ve met several others who have told us about friends or family members who were offered organs but, for reasons of their own, declined them. The gift of life at their fingertips, waiting to be accepted. Some don’t want to accept the changes a transplant brings. Some are afraid. Some don’t believe it will be worth it. Some decide at the last minute that they can’t go through with the process. It is a monumental decision, that’s for sure – but an organ donation is never forced.   

If you have been following along, you already know that on April 5, 2019, Bryan received the gift of life. Up until that point, various medications and devices had helped mask the damage in his heart. On the outside at least. He worked harder and longer than most healthy men. He pushed himself physically and mentally, even when others in better health would have given up. He looked healthy on the outside, but a biopsy of his heart showed a completely different picture beneath the surface. 

His diseased heart had expanded in size and weakened so much that it could no longer function. Even with the help of all of the temporary measures that had gotten him this far, his heart simply couldn’t keep up. They were no longer enough to conceal the true state of his health. He was dying, and he was in desperate need of a lifeline. 

The man who always took it upon himself to help everyone else, to save those who needed saving was now helpless to save his own self. And then, with death looming before him, someone gave him a new heart. Someone gave him a second chance. And while this man gave freely, with no expectation of payment or strings attached…it came at the ultimate cost. The gift of life hinged on the loss of another life.

While we are incredibly grateful for the extra time that organ donation has given to us, we know that it is only another ‘temporary measure. It may have given us a few more years with Bryan here on earth, but the ultimate gift of life – eternal life – is found only in Jesus Christ.

Although Bryan pushed past the symptoms of a diseased heart for years, the physical state of his heart never improved. The same is true of us in the spiritual sense. We can attempt to cover up our sin, to appear righteous and worthy of good standing before God, and sadly, many spend their lives doing exactly that. But the reality is this: you can mask the depravity of your heart with good deeds and a life that looks spiritually healthy on the outside, but God sees the true state of your heart. And He has made it clear that there is nothing you can do to save yourself. The Bible tells us in Romans that “all have sinned and fall short of the glory of God.” And that “the wages of sin is death, and the gift of God is eternal life.” 

Jesus has already paid the ultimate cost for you so that you can have eternal life with Him. He has given his own life, carried the weight of your sins and endured the punishment you deserve. Out of His great love for you, He allowed himself to be beaten, spit upon, mocked, and scorned. He willingly allowed his appearance to be disfigured beyond that of any human being and his face marred beyond human likeness. He paid the ultimate cost so that you can be free from the pain of death. He conquered death so that you can have an abundant life. And he is standing at the door, waiting for you to surrender – to admit that your own diseased heart can’t carry you through the divide that separates you from a Holy God – and to receive the gift of salvation being offered to you. The work has already been done, all you have to do is receive it. 

So, I can’t tell you when your life on earth will end. But I can tell you with certainty, that if you’ve never done so, God is waiting for you to invite Him in, to change your heart and give you a new life. 

Will you receive the gift of life He’s offering to you?  

Ezekiel 11:19 “Then I will give them one heart, and I will put a new spirit within them, and take the stony heart out of their flesh, and give them a heart of flesh.”

We are thanking God for today- a one year anniversary for the heart transplant for Bryan! Woohoo!! We’re so grateful for each and every day that God has given us! Thank you to the donor family who made the difficult decision to allow their loved one’s organs to be given so that others would have life. Thank you for health care workers who are devoted, caring, and hard working, and always looking out for Bryan! And thank you for all of you prayer warriors and encouragers through this season!

One year ago today, a precious donated heart was sutured into place in Bryan’s body in place of his failing one, bringing life again to his body. Since then, he has recovered well, adjusting to the new normal of life. Twice per day, he checks his medical stats, three times per day takes his meds, and then goes on about life as normal. We have stayed out of public gatherings (yes, we’re somewhat familiar with quarantining!), made necessary dietary changes, and he’s also had some major changes at work. But he breathes well at night! He can hike up to 4 miles on occasion! And he no longer has heart disease!

In this past year Bryan has been checked by the transplant doctors once a month, with no signs of his body rejecting the heart. He’ll continue to be checked for rejection for the rest of his life as his immune system could ‘discover’ the foreign heart in his chest at any point in time. Its for this reason that his immune system is kept in a suppressed state. The immunosuppressancy has brought new challenges which we’ve adjusted to, and are a daily reminder of the gift of life that Bryan has been given.

Today, on the anniversary of transplant, those family who are local surprised us by showing up in our front yard to sing “Happy Heart Day” to the tune of happy birthday, with posters of encouragement. (Of course, they were practicing social distancing!)

12 Days Post Transplant

We’re thanking God that today Bryan will be released from the hospital!! His first heart biopsy came back with a score of ‘Zero’, which is the best it can be! We are overjoyed that his body is not rejecting the new heart!

We’re so looking forward to Bryan moving into the apartment we’ve rented here in Virginia. It’s been a very grueling 40 days in the hospital, many days an emotional roller coaster, and though the care here at Inova has been phenomenal, we couldn’t be more happy to leave! Though we’d love to be going home to Pennsylvania, we’ll need to stay nearby the hospital for some time, in case of emergent needs arising. Rejection can occur at any time, and the transplant team will follow Bryan closely in the next year to monitor things.

This isolation period will also be difficult for us in a place far from our friends and family, so please keep us in your thoughts and prayers!

Marathon 1, The Wait for a Heart – completed! A few years back, Bryan had a stone at the end of our driveway engraved with his life verse: “I can do all things through Christ who strengthens me.” (Phil. 4:13) It’s only by God’s grace poured out in strength that we were able to face each day!

Marathon 2, The Transplant – completed!
A caring family in their loss donated the heart of their loved one to give our family the hope of more years together. (Maybe Bryan will see our grandchildren get married!) We are so thankful for our Great Physician and the gifted surgeon, Dr. Bogar, and her team!

Marathon 3, The Healing from Surgery – Still in process! 12 days in with an unknown end- still relying on Gods strength to get us through, and for Him to continue the healing process.

Bryan is doing very well 6 days post transplant! He has been taken off all IV’s and has a lot more freedom to get up and move around at will. He was transferred out of ICU into the step down unit yesterday – so we are one step closer to release, which is being planned for next week!

Bryan’s new heart is functioning at a 65% ejection fraction. This is the measure of the squeeze of the hearts pump, with the average for a healthy heart being from 55-70%. Bryan’s old heart was at 15%, so it’s no wonder that with his new heart he’s already walked 4 laps with a goal of 12 today!

He is scheduled for a heart biopsy tomorrow, which will check for signs of rejection. We’re praying that there will be none, as this presents an ongoing battle. The transplant coordinator likened it to ‘not letting the horses out of the barn.’ Once the fighter cells in the immune system sense that the new heart is foreign, they’ll go to work to destroy it.

We’re still learning how all this works, but my understanding is that it’s our job is to keep germs at bay so that the immune system doesn’t bolster up its defenses. We’ll have to lay low and have very few visitors for the first month, and then keep away from crowds for the first three months. Life will be different, but every day we thank God for more days together!

Thank you for all of your continued prayers and support! We’ve been so blessed by each of you, often brought to tears by the outpouring of love from so many, some even strangers.

• 

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Day 4 Post Transplant.

Day 4 of a new life. 

My first waking thought is of Dad. He has been the first thing on my mind every day, all day, for months now. The difference over the last four days is that, instead of worry and fear, I wake and can’t seem to stop smiling. Words cannot encompass the incredible relief and gratefulness that I feel every day when I see his smiling face. 

I spent a week and half with Bry when he was first admitted. I returned again on March 31, arriving just in time to hear the news that the first heart wasn’t a good fit. Although this news was disheartening, the possibility of a heart brought me to him. I was able to spend the days before transplant with him. The hardest part was the WAITING. It has felt like climbing a mountain and not knowing when, if ever, we’d reach the summit. 

Waiting and not knowing how much longer until the perfect heart would come. 

Waiting from ten in the morning until midnight, once we received word of the possibility of this heart, to know if it would turn out to be another dry run or not.

Waiting all through the very long night of the transplant for updates from the surgeon, while we all sat (or laid) in a huddle in uncomfortable waiting room chairs… Imagining each step of the way what might be happening.

Waiting for a long and very scary fifteen minutes after the nurse took us to a small waiting room to hear for the final word of success from the surgeon. 

Waiting to finally see him and know that he was truly okay after the surgery, because even though you’re told, seeing for yourself brings such peace. 

And finally waiting to see him awake, smiling and talking to us. He lovingly told us to stop smiling at him this first visit, but it just wasn’t possible. ❤️

Now we’re finally on the other side of the mountain and I am so relieved. It won’t be easy for him, just as climbing down an actual mountain can be incredibly taxing, but there is an end in sight now. He still has much waiting and fighting to do, but there is an end in sight. He has started to talk of preparing to be home and what changes that will entail. 

I will leave to return to my home in Colorado early tomorrow (I’ve been here for ten days now). I leave feeling utter relief that he is on his way to recovery. It is so hard to leave him and my mom; being here gives me such a sense of peace and reassurance. I am already so eager to return when the school year concludes at the end of May. I will be counting down the days.

Dad doesn’t yet refer to his new heart as his own. He calls it “the heart” instead if “my heart”. His mindset is positive and extremely grateful. He is overwhelmed by the sheer number of you who are following his journey, praying for him, and rooting him on. I am not surprised though, because he has been an incredible role model of love and kindness in my life too.

Bry started physical therapy today: standing on his own, walking from the chair to the bed five times, and simulating washing up. The surgeon came in this morning and said he is doing well. His ‘numbers’ show no signs of rejection, but a biopsy later in the week will confirm. He is already weening off of pain medications and the swan and chest tube will be removed this afternoon. Then he’ll take a walk if he’s up to it! Dad continues to impress us with his determination and courageousness. He is the strongest man we know and we are so very PROUD of him!

With much love and gratitude,

Melissa

Bryan’s doing well today, and they helped him to sit in the chair!

He and I (Cheryl) had a short conversation comparing our experiences of the transplant surgery before he drifted off to sleep again. I’m waiting for the doctor to make his rounds to get the medical details, but the nurse says he’s doing great. He does have a lot of swelling from excess fluids, which they say is normal after a surgery. This should come down within a day or two.

Thanks to all of you who have been praying so fervently for Bryan and our family! I was reflecting on the drive in to the hospital this morning of all the ways that God has comforted, guided and given us His peace on this rough journey. Many of you have reached out through text, email, phone calls, sending cards and flowers, and many of you are prayer warriors who continuously bring us boldly before throne of God!! We are SO thankful for each of you! We have also been blessed by an amazing team of caring medical professionals here at Inova, who’ve gone above and beyond the call of duty and touched our lives deeply. Our heartfelt thanks goes to all of you who have journeyed this far alongside of us! ❤️ 

God is always faithful, His timing always perfect, and His ways are not our ways!  He is teaching Bryan and I to walk in His strength in a deeper way than ever before, regardless of the circumstances that threaten to rock our lives. Though not much of anything seems normal in the past 30 days, God IS! He is steady and unchanging, His lovingkindness remains, and He is a Rock that we can stand on in the midst of this turmoil. As we look to Him through Jesus, He fills us with His peace and strength! 

Nothing else in the world can bring that like Jesus can! He’s in the business of giving new spiritual hearts – Bryan got an added bonus of an additional physical heart!

We covet your continued prayers as we now enter what Bryan and I call our Marathon #3- the Healing Marathon. We’ve completed #1 -the Waiting Marathon, and #2- The Surgery Marathon. We’re SO Looking forward to Marathon #4 – transitioning back into life at home marathon! 

Love you all.

Post Transplant: 

A woman in maroon scrubs entered the family waiting room that served as our makeshift home for the past several hours. 

Her eyes fell on us, “Ralston family?” 

We all sat up straight, eyes and attention glued to her face, waiting for some indication of how the remainder of my dad’s surgery went.

“You can come with me to the other room and the surgeon will be in to update you.”

We jumped up and walked to one of two private rooms across the hall. Hours earlier, we had said that these were the bad news rooms; the rooms you didn’t want to get called into for an update, because it meant you needed the privacy to mourn. The six of us crammed in and waited anxiously for the surgeon’s update…the possibility that our earlier speculations might have been correct echoed loudly in our minds. 

Dr. Bogar, his surgeon, walked in. “The surgery went great….” As soon as she said the words, I felt the weight lift. She went over some details of the surgery, and ended with how amazed she was by the perfect match, how it couldn’t have been any better. “It’s like it was made for him.”

In my head, I had imagined what this news would be like. All of my fears, the “what ifs”, the exhaustion, the wait…it would all melt away. But instead I felt a new set of emotions rush in. Relief. Gratitude. Excitement. But also unfamiliarity. 

What now? 

Waiting for this day was so hard. It has been over 12 years since his original diagnosis. Nearly 10 since chemo accelerated our concerns. And then the gradual decline ever since. It’s been just shy of 6 months since that first right heart catheterization showed us how much his heart was struggling beneath his skin. 28 days since he was admitted to the ER and told he wouldn’t be leaving without a new heart. And 23 grueling hours from the time we were told about this heart until now. But I had become familiar with the wait. I hated every second of it…but I had also settled into it. And now that we’ve climbed that first mountain, the next one is looming in front of us with all of its unfamiliar paths and obstacles along the way. 

Years ago, I would’ve told you that a heart transplant was a cure. That a surgeon could swap out a heart, patch you up, and send you on your way, good as new. But years ago, I was naive. I know now that a heart transplant comes at a cost. It’s worth it of course, but it doesn’t come freely.  

The struggle has shifted now. Instead of waiting and uncertainty, we are met with the challenge of healing. The fight to keep my dad’s body from rejecting this new heart that’s pumping life through his veins. It’s the balance of keeping him free of infection and illness while adding in medications that will work to suppress his immune system and prevent it from rejecting the heart in his chest.

It’s accepting the fact that we’ve essentially exchanged a terminal disease for a chronic illness. And while we are all beyond grateful for this second chance of LIFE, we aren’t blind to the fact that for the rest of his life, he will face challenges that most people won’t ever have to. It’ll be a hard adjustment. And it is one that we face with both open arms and trembling hands. 

The surgeons made it clear that surgery is the easy part. That afterward, he would feel like he had been run over by a truck. The physical pain would be excruciating. The healing process would be hard. And there would be a lot of hurdles along the way. 

I’ve never met a person as strong as my dad. He can do anything and everything – he could outwork just about everyone even in the midst of heart failure. So if anyone can climb this mountain, it’s him…and yet, when we walked back and saw him…in that bed…with all the tubes and wires connected to his body, he just seemed so…helpless. And all I could see as I stood there by his bed was how much work this man, who has already been through so much, still has left. Oh how I wish I could change places with him…to go through this for him and be able to give back some small part of what he’s given selflessly to everyone around him his entire life. I should be so happy. I am happy. But I’m also sad. What he went through, what he still has left to go through sits like a weight on my chest. Is he hurting? Can he feel the pain? Can he hear us? Does he know we are here? That he’s not alone? I feel so helpless.

But he’s breathing. He’s alive. He’s right there in front of me with a heart beating so steady and strong that I can see it pulsing in his body when just a few hours ago his heart was so weak it was difficult to even feel a pulse at times. He’s there. I can touch his warm skin, see the life moving through his veins, and watch the rise and fall of his chest…Because he is alive and slowly regaining his strength. 

To the donor – you gave us all a gift more beautiful and valuable than any I’ve ever received.

You gave 9+ grandkids a chance to grow up with a Poppa they absolutely adore.

You gave us more Sunday dinners together.

You gave us the chance to hear that truck engine roaring down the road, and the screams of our kids exclaiming “Poppa! Poppa!” as they bolt out the door to greet him. 

You gave us another year to squish our growing families and different dynamics under one roof at the beach for a week of memories. 

You gave us the security of knowing our dad is there – the safety net he’s always been and the comfort of knowing we can still call him “no matter what.” 

You gave us more laughs, more smiles, more witty-banter back and forth. 

You gave us the chance to see that twinkle in his eyes when he plays a trick on someone.

You gave us more memories and more stories to tell. 

You gave us the gift of time. 

You gave me my dad, a man who means more to me than I can ever put into words. 

And I am so, so thankful for the gift of life you’ve given. I know my dad has a long, hard road in front of him, and as difficult as it is to be on this new path, I’m incredibly grateful that you’ve given him the chance to continue this journey. 

He’s already climbing the mountain: they’ve removed his breathing tube. He’s awake (though very tired), and asked to see my mom. He told her that he’s feeling good and that he’s overjoyed and relieved that he made it through the surgery. He was so happy to see my mom when he woke up and told her “now that I’ve seen you, my angel, I can have a good night’s rest.” His strength, it’s already shining through. Every detail of this transplant was orchestrated perfectly – so perfectly his surgeon was amazed. I can only trust that the next portion of this journey will follow the same pattern.

Thank you all so much for praying for him – you will never know how much it means to us to know that we have an army of people covering him in prayer. Please continue to pray for him – his recovery, his pain levels, his adjustment to the medications he needs to be on, wisdom for those taking care of him, and everything else in this next stage that we’ve entered. We will post an additional update a little later!

The surgeon just came up to speak to us – she said everything went great! He is back in the CVICU now where he will be recovering for several days. He is currently still on the ventilator and sleeping, and could remain that way for “hours to days.”

The surgeon said the heart couldn’t have been a better size, or a more perfect fit for him. She said she got it in his chest and saw it and “it was like it was made for him.” ♥️

The surgical team has been updating us periodically while we wait. Bryan’s surgery started at 3:30AM, and at 5:52 we received an update that they were sewing in the new heart.

We still have several hours to go, so please continue praying!