Juana Boyland won medals in several events in the 2002 Transplant Olympics. She underwent a lung transplant.
I had not recognized the deep bonds between sisters until I saw my two daughters holding each other in a long embrace after the older one returned from college.
Thinking back, I should have recognized this bond from my two patients, twin 51-year-old sisters whose first names are separated by only one letter. Both were admitted to the hospital a few months ago. Juana Boyland is three minutes older than Tjuana Boyland, their younger brother told me at Tjuana’s bedside, and Juana required a lung transplant in 1997, seven years before Tjuana.
They share a common illness, sarcoidosis, a hereditary disease of unknown origin that over decades causes the patient’s lymph nodes to enlarge and ravage the lung tissue. Dr. Mike Smith, a pulmonologist, cared for the sisters, periodically placing scopes in their lungs to identify pneumonia or lung rejection. He also cared for them when Juana participated in the 2002 National Transplant Olympics and won medals in high jump, long jump, softball throw and shot put.
Transplants are not simple procedures, especially lung transplants. The enlisting process takes months, waiting time can be years, the surgery lasts up to 8 hours, and the post-op recovery period can be weeks. The average survival is about five years, and even then you are not let off easy.
The life-threatening aspect of any transplant, whether kidney, heart, liver or lung, is the risk of recurring infections: viruses like cytomegalovirus, bacteria like Pseudemonas, fungus like Aspergillus and parasites like Pneumocystis. Then there is more: the nausea from a regimen of a dozen or two dozen pills each day, diarrhea from antibiotics, fear of a possible organ rejection from insufficient immune suppression and serious depression from all of the above.
Juana and Tjuana have both experienced many of these challenges of being transplant patients. This time, Juana was admitted first when simple pneumonia deprived her of sufficient oxygen, requiring her to be intubated and placed on a ventilator. Tjuana came for visits nearly every day, sitting by her sister’s bedside, talking to her, braiding her sister’s long black hair, while Tjuana herself was suffering from abdominal pain due to gallstones. Soon, Tjuana was admitted for a cholecystectomy, an operation to remove her gall bladder, which went well, but then she, too, developed pneumonia and needed to be intubated. By then, Juana was extubated and discharged from the hospital, and she came daily to visit her sister in the ICU.
I have often wondered why the Boyland sisters have done well and beaten the odds. The data show that only one in three lung transplant patients lives beyond a decade. Juana has done well for 15 years and Tjuana for nine years.
In part, the answer lies in the embrace my daughters gave to each other. Social and family support plays a critical part in patient recovery and survival. One 2010 meta-analysis of 148 studies found that strong social relationships led to 50 percent increased likelihood of survival.
Discussing the benefits of social support, a friend told me about her recovery from hip surgery. She told me about the support she had received from her husband and woman friends and then said, “I am sorry, I don’t mean to be sexist, but men just can’t take care of a woman like women can take care of women.”
In fact, data show that daughters are more frequent caretakers than sons. According to a 2004 Kaiser Family Foundation, 12 percent of women are taking care of an aging or chronically sick relative compared to 8 percent of men. Nearly 30 percent of these care providers spend 40 hours or more each week in providing hands-on care.
I see this often in hospital rooms. I notice more daughters visiting and caring for their parents compared to sons. I am not being chauvinistic, but just stating an observation. Women doctors are also rated as being more compassionate than men.
Tjuana’s recovery from pneumonia was slow. Still hooked to the ventilator and having recurrent nausea, she was ready to give up. Yet with her sister, brother, mother and cousins at her bedside, she was encouraged to fight on. Last week, Tjauana left the hospital.
We often do not realize that after our parents pass away, the only family from our childhood we have with us are our siblings. We may have spent more of our lives with them than with our own spouses.
So during my older daughter’s stay, I watched as the girls spent hours together, listening to music, chatting, watching funny YouTube videos and even sleeping in the same bed.
Smiling, I said to my wife, “All this is therapeutic over a lifetime, much more than we realize.” Neither of us has sisters, and we have not experienced the love of a sister firsthand. It made me happy to know our daughters will have each other, like the Boyland sisters, for bedrock support as they face life’s challenges.
Source : Commerical Appeal