December 4, 2017 marks my 6 month transplant lungiversary!

Today, we started the process of “assessment” all over again. This time, I’m not being assessed for new lungs but to see just how well these new lungs are working.

Test 1- Bloodwork: On a regular basis, I get bloodwork done in Guelph every 1-2 weeks.  When I come to Toronto, it is fasting bloodwork, I can’t even chew gum or drink water. We try to get here ass early as possible to make sure I don’t have to go too long without eating. One of my anti-rejection mess, prednisone, also needs to be taken with food. With the amount of patients coming in and out of Toronto General Hospital, the wait for bloodwork can be as long as 2 hours! Today I was lucky and only had to wait about 45 minutes.

Test 2- CT Scan: Honestly, I was a little nervous for my CT scan. The last time I had one done at an assessment, they found what they call “ground glass”. Ground glass is described as inflammation and indications rejection in lung transplant patients. Today, I know that no ground glass will be found in my CT scan. While having my scan done, I noticed a small screen next to the machine. I was able to. See my results in real time! While I’m no expert at ready CT scan’s,  I did not see any ground glass in this one! Just new, healthy, shiny lungs.

Test 3- Pulmonary Function Test (PFT): As I monitor my PFT’s at home, I’m always excited for my in hospital PFT’s to see how it compares to last time. I also get to see my favourite technician, Joyce. I have a small handheld device that connects to my phone that I can monitor my PFT’s with at home. The best time to check my PFT’s is a few hours after being awake. My lungs have gotten working, but I haven’t worn them out. Today, my lung function is up to 62%!  Before I went into rejection, I had plateaued at 72%. Just 6 months post-transplant and I’m not too far from that! My goal is to get back into working on my cardiovascular endurance so my lung function can continue to climb.

Test 4- 6 Minute Walk Test: This test is done to see how well my cardio vascular endurance. I am asked to walk as far as I can, as fast as I can while they monitor my heart rate and oxygen levels. During this weeks walk test, my heart rate never went above 120 beats per minute and my oxygen saturation never dropped below 96%! I also increased my distance by 60 metres.

Test 5- X-Ray: Having an X-Ray is a routine part of a clinic appointment. It is done to see if there are any foggy or shady parts that may indication an infection. My x-ray came back clear! There was no shading or foggy parts. Considering I have had sinus infections on and off for the past year, it is a miracle it hasn’t travelled to my lungs.

Clinic: During my clinic appointment, I discussed multiple things with my doctors. I had made a list of everything I needed to talk to them about, which makes things go so much quicker! I have been having trouble sleeping at night and am on maximum doses of my sleeping medication. We discussed the option of medical marijuana. Of course, I would not be smoking it but I wanted to get the conversation started. As there have not been many studies done with transplant patients and marijuana, it is best that I start on a low dose and consistently take the same dose. They recommended that my psychiatrist follows me closely while we try out this option as marijuana can have hallucinogenic side effects. As I’ve been having stomach issues, we also talked about probiotics, one specifically, Kefir. Kefir is a cultured probiotic from cows milk. We agreed that this would be a good option to try and see if it can help at all. The doctors were pleased with all my test results and unless something pops up in the meantime, I will not need to be seen again until my 9 month follow up in March!

Test 6- Bronchoscopy: A bronchoscopy is done on transplant patients to check for infection, clean out the lungs, and take biopsies to check for rejection. Patients are given a small amount of sedation so they are comfortable. Patients are to gargle a freezing rinse, inhale freezing through a mask, and have freezing sprayed down the back of their throat before the procedure. This is to make patients comfortable and not feel the scope being slid down their throat. During this bronchoscopy, I required more sedation than last time. Overtime, patients build up a tolerance to the anesthesia. As well as the fact that I have put on over 15 pounds since my last bronchoscopy! Due to needing more sedation, it took me a long time to recover after. I spent close to 3 hours in recovery! Good news is, they didn’t find any infection, the incisions are healing nicely, and so far no sign on rejection from the biopsies!

Endocrinology: On Wednesday, we saw my endocrinologist at Toronto General Hospital to discuss my diabetes. I want to clarify with everyone, I do not have Type 1 or Type 2 Diabetes. I have a mix of Cystic Fibrosis Related Diabetes and Steroid Induced Diabetes. These are both similar to Type 1 Diabetes. I was diagnosed after my first double lung transplant in March 2015. This was not an easy thing to accept. I already had one chronic illness, had just had a transplant, and now had a new illness to manage. Fortunately, I was connected with an endocrinologist at TGH who also works alongside the transplant team. The past few months, it has become hard to manage my sugars. One way of managing them is through diet and exercise. I am definitely someone who can go all day without eating, and then binge eat at night, spiking my sugars as high as 33mmol/L (dangerous level). I also have days that I don’t eat but still need to do insulin because my Prednisone spikes my sugars. Those days, my sugars can drop to 1.5mmol/L. Part of getting on track with managing my diabetes, is checking my sugars when I wake up, when I take my prednisone, before every meal, and before bed. That’s a lot of finger pricks! Fortunately, they have come out with such things as Continuous Glucose Monitors. They are a small device that is placed on the upper arm, stomach, or thigh (anywhere with fatty tissue). A CGM will monitor your blood sugar levels 24/7 and can stay on for as long as 10 days! My endocrinologist believes this will be a good option for me as we will be able to get a better idea of when, how often, and how high or low my sugars go.The main thing about CGM’s, is that they can be very expensive (as they have to be changed out every 10 days) and insurance companies don’t always cover them.

Psychiatry: Since my second transplant in June 2017, I have started seeing a psychiatrist on a regular basis. I unfortunately had a relationship end as I started to get sick in February. This left me feeling alone and empty. We started some new medications because I was getting so anxious, I was shaking. Before we found the medication that worked best for me, we were desperate for anything that would hold me have. Benadryl, Gravol, and morphine became my best friends. I developed an addiction for morphine. I wasn’t in pain, but I needed it to stay calm, it was my best friend. Every 4 hours, a nurse would come to my room and run Gravol and morphine through my PICC line, Benadryl was every 6 hours. Since then, I am proud to say I have not had to use morphine to treat my anxiety. We found the perfect combination of medication. Lately, I have had issues sleeping. During this time of year in 2015 and 2016, is when I started to get sick. I’m always worried that an infection or rejection could come back and land me in the hospital again. My psychiatrist believes I have Primary Insomnia. This is when you have trouble getting to sleep, but once you get to sleep you stay asleep. We discussed the option of medical marijuana in edible form. As she has not treated enough patients that use medical marijuana for sleep, she is going to connect a colleague in the pain clinic and I will meet with her again in 2 weeks. Overall, my mental health is doing well. I have been able to run my business and start going out socially with friends. We are going to try to cut down on some of the medications as soon as this stressful time of year is over.

Cystic Fibrosis Clinic (St. Michael’s Hospital): For thee first time in a few years, I went to an appointment at the Cystic Fibrosis clinic. I do not have CF in my lungs anymore, but it is still in my trachea, sinuses, and digestive system. I see an Ear Nose and Throat doctor at St. Mikes and a GI specialist also at St. Mikes. The CF team just likes to check in to see how things are going, as they are also in contact with my ENT, GI, and transplant team.

Day 1 – September 8, 2017

Gastric Emptying Study: Since the transplant, I have had very painful issues with my stomach. A month ago, I was started on Domperidone to help my stomach empty; today, I had a study done to see how food moves through my stomach. I was unable to eat or drink 6 hours before the test, and was then given radioactive eggs, toast and jam, and a small amount of water to digest.

I was scanned at the beginning of the test: the 1 hour, the 2 hour, and the 4 hour marks. This test is only done at 3 months post-transplant. We are hoping that the test results will come back showing that my stomach doesn’t have issues emptying, since the Domperidone has helped immensely.

RESULTS: The percentage of the initial gastric content retained in the stomach:

• At 60 minutes: 95%
• At 120 minutes: 93%
• At 240 minutes: 76%

The final result: I have very severely delayed gastric emptying. Due to this, I will stay on the Domperidone for the time being and down the road I will have another gastric emptying test to see if anything resolves.

GI Clinic: Cystic Fibrosis not only affects the respiratory system, but the digestive system as well. Due to the my gut issues, the transplant team insisted the gastrointestinal clinic at St. Michael’s hospital examined me.

Since being placed on the Domperidone, my GI issues have resolved and the specialist is quite happy with my progress. He explained to me that a nerve is often bruised during lung transplants and that is what causes the GI issues post-transplant. I am going to see him again in 6 months because he believes my GI issues will resolved and I will slowly be able to come off the Domperidone.

Day 2 – September 11, 2017

Full PFT’s: Every week I have a full work up done of my lungs, this is called a Pulmonary Function Test. This test indicates how well my lungs are working and how effective they are at bringing oxygen to the rest of my body. Every 2 weeks, I complete this testing at the Toronto General Hospital. While I’m home, I will have a handheld spirometer that will test my FEV1; an FEV1 is the vital capacity that one is able to blow out in 1 second.

RESULTS: My FEV1 is now up to 51%; before going into rejection, I was up to 76%. It is still early post-transplant and doctors have said that it can take up to a year to reach maximum FEV1.

ABG: An arterial blood gas is a more accurate type of blood work for measuring the levels of oxygen, carbon dioxide, and acidity in the blood from an artery. When I had my first transplant, I had CO2 levels that should have left me in a coma. Now, my carbon dioxide and acidity levels are in the more normal range.

X-Ray: The findings of my x-ray came back as normal. As one point, I did have some fluid on my left lung, but this has completely resolved itself. ECG and EP: An electrocardiogram checks for problems with the electrical activity of the heart. Due to having an atrial flutter in February and needing cardioversion to fix it, regular ECG’s check to see if the flutter returns.

A cardioversion is when an electrical current is sent through electrodes to return the heart back to a normal rhythm. Today, my ECG came back normal. My electrophysiologist has recommended I wear a holter monitor for 48 hours. An ECG only checks the heart rhythm for 10 seconds, but a holter monitor will record over the course of a few days.

Clinic: Overall, the doctors are very pleased with my progress. Nothing showed up in any of my tests that worried them, however, over the past few days I have been experiencing sinus migraines. Because of this, they believe I have a sinus infection in the works. Since I am not able to see my ENT specialist at St. Michael’s hospital until October 3, I have been placed on Ciprofloxacin to treat the infection. As long as I do not have any issues with my lungs in the upcoming months, I will not need to return to clinic until my 6 month assessment in December.

Day 3 – September 13, 2017:

Bronchoscopy: A bronchoscopy is done with a small camera that goes down my throat. This allows the doctors to check out my lungs for infection, rejection, clean out my lungs with saline, and take biopsies.

To do this, my throat is frozen with a gargle, inhaled treatment, and spray. The doctors also spray freezing as they go down my throat. I am partially sedated for this and have a towel over my eyes to keep me calm and relaxed. The results will not be in for another week as they let the biopsies they’ve taken grow in a lab.

RESULTS: No infection and no rejection!

A Manageable Illness

One weekend, I went to the movies and as I was leaving, someone behind me said: “I don’t want to get diabetes and die”.

This was obviously an uneducated comment: diabetes is a manageable illness. Sure, people have died due to diabetes and related complications, but it can very well be managed with the right time and care.

As some of you may know, I myself have diabetes. Type 1 diabetes is a disease where the pancreas does not produce any insulin, or very little. Insulin is the hormone that helps your body control the level of glucose (sugar) in your body. There is no known cause for Type 1 diabetes and it is not preventable.

Type 1 diabetes can be managed by:

1. Creating an exercise plan
2. Checking your blood sugar level
3. Using appropriate amounts of insulin
4. Staying hydrated
5. Being prepared in the case that you hit a “low”
6. Adjusting your plan as needed

There are many companies and foundations that can help you manage your diabetes and support living a long, happy, and healthy lifestyle. Here are a few of my favourites:

Myabetic – Kyrra Richards founded Myabetic after she was diagnosed with diabetes. Myabetic makes a large range of fashionable diabetes fashion cases. I have the Banting Diabetes Wallet in blush and I love it! Bags carry all the essentials I need on a day-to-day basis. Check them out at:

http://www.myabetic.com

Pump Peelz – Pump Peelz lets you dress up all your diabetes gear! You can even submit your own design for your pump, patch, meter, and dexcom! Check them out at:

http://www.pumppeelz.com

Beyond Type 1 – Founded in 2015 by Juliet de Baubigny, Nick Jonas, Sarah Lucas, and Sam Talbot, Beyond Type 1 connects those with Type 1 diabetes through social media and technology. They also run a pen pal program connecting those with similar interests (other than just diabetes, y’know). Check them out at:

http://www.beyondtype1.org

To learn more about diabetes and ways you can help, visit Diabetes Canada at:

http://diabetes.ca

Edited By: Ryan Antooa

Hi everyone, welcome to the University of Guelph’s Shinerama event in support of Cystic Fibrosis. My name is Pearl Cooley, I am 21 years old and I have Cystic Fibrosis. As some of you may know, Cystic Fibrosis is a genetic chronic illness that affects the respiratory and digestive system. I was diagnosed when I was 2 months old and have had 2 double lung transplants due to CF.

When I was 18 and away at Georgian College in Barrie studying marketing, my health started to decline. I was a typical teenager who was more interested in a social life than taking care of my health. In February 2015, I made the decision to leave school and go home to focus on getting healthier. The night before I planned to head home, I felt a sharp pain in my back and couldn’t catch my breath. I walked down the hall of my residence knocking on doors but no one was answering. The last door I knocked on happened to be someone I know who was studying Pre- Health. They called my parents and 911, explaining the situation as I couldn’t speak for myself. 4AM the next day I was having a chest tube placed to help re-inflate my lung. My lungs were so congested with mucus, that my lung was unable to fully expand right away. I was admitted and they started the treatment for a chest infection. I was getting sicker by the day. I could hardly eat and dropped down to below 90 pounds. We urged the doctors to contact the CF centre in Toronto at St. Michael’s Hospital, but they insisted they had things under control. The carbon dioxide levels in my body were so high, I would of been in a coma if my kidneys weren’t so healthy. My lung healed but I was still very sick. I had a fever, the chest infection wasn’t clearing up, I was on a bi-pap machine at night to help remove the carbon dioxide from my body and make it easier for me to breathe. Again, my lung collapsed. The ICU doctor came in right away that morning and inserted another chest tube and contacted St. Michael’s. He had realized this was a serious situation that they just didn’t have the means to handle.

When arriving at St. Michael’s ICU, it looks like the basement of the hospital. Beds are separated by curtains and there are only 2 isolation rooms; I was in one and an inmate was in the other. The doctors did a full work up on me when I arrived, making sure I was comfortable after being choppered in by ORNGE. The next day, my family met with the CF team that works along side Toronto General Hospital for transplants. I was told that the only way they would assess fixing my lung, was if I would agree to a transplant if all else failed. I was transferred over to TGH to begin being assessed for ways to fix my collapsed lung, as well as for a double lung transplant. Days later, we found out there was nothing they could do for me, my lungs were too diseased. On March 8th, 2015, I was listed for my first double lung transplant, and just 16 days later, I was being wheeled into surgery. Recovering from such a major surgery was not easy, physically or mentally. I had some complications after, such as rejection, infection, and fluid around my heart that caused me to go into cardiac arrest for 2 minutes on Easter Sunday.  Again, I was rushed into surgery where they drained the fluid from around my heart and placed a chest tube to drain any other fluid that may build up. Now it was time to start my physical rehab. This meant getting out of bed with a feeding tube, a breathing tube, 2 central lines, 5 chest tubes, 2 IVs, and an arterial line. This was not easy to navigate around the ICU, so the team brought a treadmill into my room. All I had to do was stand up, and walk. Easy, right? No, not easy. Recovering from 2 major surgeries took a lot of energy out of me. But I had one specific motivation; a puppy. The longer I walked, the stronger I would get, the closer I would get to a puppy. On Mother’s Day weekend, I was discharged from the hospital and started to live the new normal. I still needed to remain in Toronto for the last 6 weeks of my physical rehab but I was no longer hooked up to machines and was able to do things on my own. Father’s Day weekend we moved back to Guelph, and just 2 days later we picked up Felix, a golden retriever-Australian Shepard mix.

Things went extremely well for me for almost 2 years. I worked multiple jobs and ended up starting my own personal training business. I went back to school for Pre-Health sciences, with hopes of continuing my education in the health and fitness industry.

Unfortunately, on February 17, 2017, I started to feel short of breath. The next morning, I could hardly walk up the stairs without being winded. We went to the Guelph General Hospital emergency room where I was diagnosed with a heart flutter. Most likely caused from a build up of scar tissue in my heart from the trauma my body had been through just 2 years earlier. They tested my lung function which showed a dramatic decrease of 40% in just a few days. Later that week, I was discharged and went to clinic at TGH. They told me I was most likely in rejection and that we would start a course of high dose steroids to try and tackle it. Unfortunately, it didn’t work. I went through 2 other treatments to try and treat the rejection, but it just seemed to make me sicker. My lung function dropped to a measly 11%. I was re-listed for a second double lung transplant on April 11.

I tried to go home on oxygen and IV antibiotics but the doctors continued to worry with my rapid decline. I was hospitalized indefinitely. On June 3 at 4PM, a doctor came to speak with my family; they had a possible donor for me. We called my sister and brother in law so they could bring my nephew and see me before surgery. June 4 at 10AM I was wheeled back into surgery. This time, I didn’t have such harsh complications. I had trouble coming off the breathing machine but I forced myself to do what I needed to do to get stronger. I may of only been able to walk a few steps the first couple days, but it was what I needed to do to get my lungs working. This time, I only needed 4 weeks of recovery time in the hospital. I was discharged the first week of July. I still had 8 weeks of physical therapy but I was able to get lots of extra rehab outside of the hospital, such as walking down Bloor street to Tiffany & Co.

This past weekend, I was able to move home. Having CF and 2 double lung transplants have given me a different perspective on life. The type of person I am has definitely changed. From someone who was selfish and hated everything because of how sick I was, to someone who appreciates the little things in life and runs annual fundraisers for CF. I have become more of an advocate for those with CF and those that need transplants. I have to say, I was a little scared going into this second transplant. Just 1 year ago my friend passed away after having her second transplant, just a week after I had seen her. I have friends waiting for their first and second transplant. 50% of CF patients that have a double lung transplant, will need a second transplant within the first 2 years. There are currently 76 people in the Trillium Gift of Life network waiting for a lung transplant. Signing the forms that come with your drivers license and health card, could help save someone’s life one day. Make sure your family knows of your wishes, have the conversation with them about organ donation. If you are unsure if your organs can be donated to someone, they can always be donated for research. My organs cannot be transplanted, but I will be donating them to research which may lead to the cure of Cystic Fibrosis one day. Please visit the be a donor booth today to learn more about organ donation, including being a living donor. My name is Pearl Cooley and I am here today because of organ donation.

Friday August 18th – I received a call from my transplant coordinator about the prior mornings’ blood work, revealing that my kidneys were under some stress. The coordinator recommended I come in for IV fluids in that case that I was dehydrated and needed to flush out my kidneys; at this point, I had already drank 2.5L of water and was feeling fine. We decided to see how the rest of the weekend went before rushing to the ER.

Although doctors want me to be treated for whatever necessary, they also want me to avoid being in the hospital as much as possible due to the viruses and bacteria I’m susceptible to. I continued feeling fine over the course of the weekend until Sunday afternoon; I was so nauseous I couldn’t even attempt to drink any water. We went to Toronto General Hospital ER at 4PM and the waiting area was quiet; we didn’t want long before I was registered and in a bed.

Luckily, I was able to get a room and not on a stretcher in a hallway. They started an IV and quickly pumped me full of 2L of fluid. They ran blood work and my blood sugars were 20mmol/L. My kidney levels had jumped from 87 to 174 in a matter of 4 days. They were working in overtime, to say the least.

My transplant team decided to admit me since my blood sugars were having trouble stabilizing. With the increased Prednisone, eating whatever I wanted, not keeping up with my endocrinologist, and not drinking enough water…

My blood sugars were starting to affect my kidneys. I spent 24 hours in the ER before a bed was available on the nephrology unit. I met with the on call endocrinologist the next morning and figured out a plan on how to handle my blood sugars. I was prescribed 12 units long acting insulin in the morning and a sliding scale of rapid insulin throughout the rest of the day.

What this means is that the long acting insulin will peak when my Prednisone peaks, just before dinner, and will be able to keep my blood sugars normalized most of the day. The amount of short acting insulin I use will be based on what my blood sugar is at the time I test it and what I am going to eat. I will also need to keep on top of drinking 2L-3L of water a day to keep my kidneys flushed; this will also help keep my blood sugars down. I was discharged from the hospital Tuesday the 22nd feeling much better. As of now, my body is still retaining some fluid so I have been put on some medication to help with that. I have a follow up appointment with my endocrinologist September 13th.

Edited By: Ryan Antooa

P_COOLEY

August 9 – X-Ray, blood work, pulmonary function test, and clinic. A usual day in the clinic.

Pulmonary function testing is done to see what my total lung capacity is: it’s a measure of the volume of air moved in and out of my lungs and the volume of air that is exhaled during the first second of forced expiration.

My blood work is done weekly: it checks the levels of anti-rejection medication in my system, as well as my electrolyte and vitamin levels. No matter what time my clinic is at, I usually end up waiting a couple hours to see the doctor. If I’m lucky, I’ll get a clinic appointment at noon, so I’m one of the first patients they see – but sometimes I get stuck with the 4PM, and don’t get it of there until 6PM.

August 10 – 21: I’ve had more surgeries than serious relationships.

HAPPY BIRTHDAY! I made it to my 21st birthday. I’ve had more than my fair share of days that I didn’t believe I would make it to this age, but being here has changed everything.

At 18 I was begging for doctors to keep me alive as they rolled me into the operating room so I would be able to meet my nephew. Now, he’s almost 2 and I can’t get enough of him.

At 21, you start to think a little differently about birthdays (at least if you’re me). I’ve had 5 surgeries and a cardio version: that’s more surgeries than the number of relationships I’ve had.

Yes, I am grateful for the friends and family I have that I get to celebrate such an occasion with. However, it does get lonely sometimes.

See, everyone else around you enjoys themselves with their significant others and the emotions they get to express to them.

I mean, I guess it’s sort of the same feeling as when you wake up from surgery, alive, when you didn’t think you were going to – that’s how I’d relate it.

So: when someone tells me their birthday made them feel lonely, don’t think of them as selfish: they likely have family and friends around them, but maybe they need a little more to life: more to love.

August 11- Exhausted. My stomach has not been the same since transplant. I often get nauseous and bloated and have a hard time getting enough calories in (2,500-3,000).

After going out for dinner the night before for my 21st birthday, I definitely felt gross. I went to physiotherapy that morning and tried my best to complete the tasks assigned to me, but it was all too uncomfortable. I ended up having to go home and sleep the rest of the day. I could hardly eat until dinner, and even then, I had to take Gravol to keep any food down.

August 12 – Draaaaanks. Celebrating your 21st birthday usually involves a lot of alcohol, which…mine did.

Despite my doctors telling me otherwise. I had everything planned for the evening. My friends would stay the night in Toronto, starting things off with swimming in the rooftop pool and overlooking the view of the CN tower. Spending hours getting ready, we were ready to start the night off. Whilst popping champagne and knocking back shots of tequila, I could feel my confidence building.

…fast forward to 3AM and I’m puking my proverbial guts out, in the gutter, in front of The Madison. Luckily, my mother is very understanding, so when I called her and wasn’t making really any sense, she accepted what I would be like when I came home.

August 13 – Hungover. Wow. Although I remember a lot of the night before, it really hit me when I could hardly stomach water.

The average recommended daily amount of water for an adult is between 2 – 3 litres. Needless to say, my mom was disappointed that I came home so sick. Well…she basically funnelled fluids into me before we went to dinner that night. Sitting in a home sans air conditioning was not how I planned on spending my day. Luckily I had my nephews antics to distract me from how uncomfortable I was. Not only was I hungover, I was also extremely anxious that I wouldn’t be able to eat the meal that was prepared for me, making me even more nauseous.

August 14 – Sick. Again. Oh look, I’m sick again!

This time it consisted of a fever, chills, headache, and nausea. We went right to Toronto General Hospital for blood work and met with my transplant coordinator. I was booked in for an X-Ray, PFT’s, and a clinic appointment later. My blood work, X-Ray, and PFT’s all came back normal and by the time I saw the doctor my fever was gone and I was feeling much better. It wouldn’t be for another week that we would figure out what was really going on.

August 15 – Her. I finally met her. His sister. The one he speaks so highly of. He is so proud of everything she has accomplished. It must of been hard when she was on the other side of the world hearing about her brother over the phone. She’s pretty. Really pretty. It…almost made me nervous to see him with her.

As someone who has yet to complete any post-secondary education, I didn’t think we would have much to talk about, as she is so academically inclined.

But, we do have one thing in common: him. We both want what is best for him, even though right now might be difficult. Seeing is face light up when they talked was amazing. He was so happy to see his big sister. 20 minutes was all we had but it was more than enough for me to realize just how into this guy I might be.

August 18 – Shoe Museum. The Bata Shoe Museum. As boring as that may sound for the average 21 year old, it was actually quite interesting! The stained glass slippers hanging from the ceiling made the perfect centrepiece to the entire gallery: on the first level, there were shoes on display dating back to Egyptian times, all the way to the first pair of shoes for your pet. The most interesting exhibits was from the Victorian era, showcasing the tight corsets and small shoes that were reflective of that time and culture. Unfortunately for those during that time, the green dye used to colour to dresses contained arsenic and were slowly poisoning women wearing them.

Although I wish they had of more of an exhibit dedicated to Nike, Converse, or Vans…it was a quiet way to end the day.

August 19 – Logan Lucky. As most of my family knows, I am terrible at picking movies. If it has Ryan Gosling in it, we’ve watched it (and I was the only one who enjoyed it – but not really).

This time, someone else picked the movie – and even they fell asleep during it. In all seriousness, it wasn’t that bad of a movie, just a little on the slow side. Above all, it was nice to spend some time together as a family. But I would of enjoyed just about any other movie.

Edited By: Ryan Antooa

P_COOLEY

PERSONAL X MEDICAL

August 4, 2017 – When depression hits, it his hard: you’re unable to focus on life, your surroundings, or anything, really – and then you get the message we’ve all received:

Someone you care deeply about needs you.

But, you’re unable to do anything. You can’t contact them; they have to contact you. Eventually, it’s just all too much to cope with. It doesn’t matter where you are: you break-down, whether it be in tears, rage – whatever you need to do to make the process easier to handle.

In my case, I had the option of travelling to the comforts of home for a few days to take my mind off things.

Being surrounded by pets and loved ones definitely helped me relax, but I was also anxiously awaiting a call that could change things for better or for worse in my situation.

August 5, 2017 – Pain: Waking up with sore, aching muscles is much like a familiar friend; months have gone by with a chiropractor and massage therapist and I had little to no pain.

Then I became bedbound and had my chest cracked open. My bones had to fuse back together (although my sternum was held together by wires). My muscles had to reconnect and start building all over again. My skin had been stapled together but it still pulled. The chest tubes pulled whenever someone moved a sheet or adjusted my bed just a little too much. The scars look like bullet wounds. The date of my first transplant intertwined within the scars.

August 6, 2017 – Anxiety: Waking up with a fever of 101 F, in pain, and severe anxiety. Not how I wanted to start my day.

When I originally went into rejection, I woke up one morning and couldn’t breathe. The same thing happened this morning. The good news? Just a panic attack.

A horrifying panic attack. I thought coming home for the long weekend would keep me calm, but anxiety never sleeps. We began debating whether or not we should drive back to Toronto and go to the hospital. Fortunately, my fever started to go down throughout the day and we realized it was just a sinus infection. Something I am prone to and awaiting surgery for.

August 7, 2017- Him: He called. I didn’t think I would be so nervous.

“Pearl?” he said.

I could feel my heart rate spike. You know that feeling, right? Is it good? Is it bad? This time, it was so good. I hadn’t heard his voice since April, then we lost touch. I swear he kept asking if I was okay because I could hardly string a sentence together. Finally I just spit it out:

“Can I come see you?”. I think he was in just as much shock as I was at what had come out of my mouth. We only had a couple minutes left. But, the plans were final, I was seeing him tomorrow.

August 8, 2017 – Glass Wall: Well, here I was. Told to take a number and wait until it was called. I handed over my ID, put my things in a small locker, and walked through a metal detector. Cleared. Funny how we get nervous walking through the airport or around cops. We haven’t done anything wrong, but we still get nervous.

Combine that nervousness with seeing someone for the first time in four months. I walk into a long rectangular room, others are there waiting to see their loved ones. Then, there is a loud buzz and a few seconds later I see him.

It’s him. I’m here. He’s here. I had my hopes set too high: I just wanted to hug him. The glass wall separating us made things even more stressful. Again, he continued to repeatedly ask if I was okay. Hell, I was great. But walking out of there, I knew I had a decision to make. Do I continue seeing someone I appreciate and care about or will I listen to my parents and do what they want?

Edited by: Ryan Antooa