Cadavers and tissue donation and surgery, oh my!

The first time I encountered a cadaver was in nursing school. We had a gross anatomy lab and dissected a full cadaver to learn some hands-on lessons about the human body. The body was of an elderly woman and I remember thinking it was incredible that someone donated their body just so I could learn.

Beyond organ donation (which I knew about), it never really occurred to me that people donated body parts for reasons other than learning purposes (like cadaver lab). I didn't know that bones and ligaments and heart valves and veins and skin can be frozen and used to help improve the quality of life of the living. It certainly never occurred to me that I might ever have cadaver parts sewn into me. 

For my first ACL surgery (7 years ago), I had cadaver tendons used to replace my torn anterior cruciate ligament. I'm somewhat  embarrassed to say that I didn't think much of it. I wanted my knee fixed and the "donated tissue" being used to fix it wasn't even a blip on my radar. Who did it come from? How old were they? Why did they die? I didn't think about any of that. I'm fairly certain I didn't think grateful thoughts to the donor. I certainly didn't understand or appreciate tissue donation. 

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I read a book 2 years ago called Everything to Live For by an amazing woman named Turia Pitt. 

I read the book because it was about a runner, but more specifically an ultra-runner, now an Ironwoman, who was caught in a terrible fire during a trail race. The book was inspiring as hell but, more importantly, educational!  Turia survived only because of people who donated their skin to various tissue banks, primarily here in the US. Australia (where she is from and where the accident happened), used up their supply of skin during an initial surgery for her. Then a terrible infection left her requiring another grafting of donated skin. But there was nothing left. One large tissue bank in Edison, NJ gave her most of the skin that ultimately saved her life. 

Much of the end of her book explains facts about tissue donation, how it is so different than organ donation (far more people are tissue donor candidates than organ donor candidates and don't even consider it), and how many different people (50+) can be helped by just one tissue donor compared to an organ donor (up to 8). 

 

Things I learned:

*there is a special form needed to register as a tissue donor

*being an organ donor does not mean you are automatically a tissue donor, they are 2 separate things

*many times tissue donation isn't even discussed or asked about if the deceased is not an organ donor candidate

*you can still have an open casket as a tissue (skin included) donor

*if you declare that you want to be a tissue donor and have that in your medical record, and your loved ones don't agree with it, their decision is the one that is honored once you die

*talking about your wishes now before tragedy, illness, or death happens and coming to an agreement with your loved ones, is the best way to ensure that your wishes of being a tissue donor are honored

*your family should know the difference between organ and tissue donation, and speak up early at the time of death to ensure your wishes are met

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Thank you for listening to my PSA about tissue donation!

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So this surgery preparation has been different in every way from my ACL surgery 7 years ago. I'm much more obsessed with interested in the details of every part of it. Whether this is a coping mechanism for the lack of control I feel in general over how this all went down, or wise patient behavior, it doesn't matter. The more I know, the better this will all go, I hope. 

I also know a lot more about the process of tissue donation (I'm older, wiser, and read a great book about it) and I know that the tissues being used in me are donated from someone who once lived. I feel like it is an incredible gift I am receiving.

 

In terms of the tissue, I'll be using donor tendons (again) for my busted ACL and a donor meniscus for the transplant. The thing that struck me early on was how Dr. Z spoke about needing to find a good match with the meniscus. A good match means a donor who was my size (height and weight), and born female. The meniscus needs to be almost an exact size, as measured during my first surgery, to fit my knee. It also needs to be from someone who was under 30 years old at the time of death. 

The same day I found out that insurance decided to cover all of the surgery, I also found out that they found the perfect meniscus for me. It will remain frozen until surgery time, but it's got my name on it now.  Literally! I have seen the form that confirms the measurements and the donor # and all of the disease testing as being negative for the donor. 

I've mentioned before that I have an amazing chain of communication between myself and Dr. Z and his Physicians Assistant Lisa, right? So when Lisa sent an email saying that they found a meniscus for me, I was both ecstatic and sad. Some young woman is dead and I'm excited that her meniscus was "just my size."  I asked Lisa if I could know more about the donor. The only info she could tell me is that the donor was female and was 27 years old when she died.

 Wow. 

How did she die? What color hair did she have? Was she a mom?  Was she a nice person? Where was she from? What did she do for a living? There were more questions in my brain but these came up pretty quickly. 

I cannot imagine how intense these feelings/questions are for people who are the recipients of organs that SAVE their life. This donation will improve the quality of my life and I am immensely grateful and feeling all the feelings. Maybe this donor also donated her organs and saved lives that way also!

I inquired through Lisa about being able to write a letter of thanks to the donor family. I guess some families do not want to be contacted, but this family agreed to it at the time they signed the donor agreement, so I have a donor number and an address to send communication to.  

I will most definitely write a letter. Maybe I will send a picture of me playing football with my kids, showing them how their selfless act of honoring their loved one's wishes improved my life. It feels like an immensely important correspondence. Usually with my writing, it sort of just comes to me. The words, the sentiment, the structure. So I will reflect on it more and more and hopefully the right message will come to me sometime after surgery. I will send this letter to complete strangers, and hope they understand how truly grateful I am.