Did she give you a picture of Michael?
Yes. I keep his picture on my bathroom mirror, along with a cross his mother made me. Sometimes I talk to the picture, like, "It's going to be a tough day today," or whatever. All in all, the guy's a part of me now.
Did you share with her that you were having another transplant?
Yes, and the day of the [next] surgery she sent me a text: "Hey, I know you've got the procedure today. Don't worry. My son is within you, he will protect you, SO SMILE."
Were you expecting to have a second transplant?
I always knew there was a possibility I would have to have two. The first one gave me 750,000 islet cells, and you need over a million cells. And the immunosuppressant drugs you take after transplant don't allow those donor cells to reproduce. The heavier you are, the more cells you need. I weigh 192 pounds; I cycle a lot and have a lot of muscle mass. Normally people get a second transplant six to seven months after the first one. For me it was 13 months, so I was lucky.
Were you having trouble with your first set of donor cells?
I wasn't having hypoglycemic episodes but my sugars were starting to rise. I did a motorcycle ride from Arizona to British Columbia and a 104-mile bike ride, and both times I let myself get dehydrated to the point that some of the cells started to die and my sugars started to rise. That's something I will never do again.
Are you sure that killed some of the islet cells?
It must have, because I noticed my sugars started to go up afterwards. So I always hydrate a lot now.
You had been insulin-free. Did you have to start taking it again?
I started again when I noticed my sugars rising. Just a tiny amount to bring my sugars down. As soon as I had my second transplant, I went off it after two or three weeks.
Was the transplant procedure the same as the first?
Yeah, it was. I asked Dr. [Andrew] Posselt [co-director of the Pancreatic Islet Transplantation Program at UCSF Medical Center] if I could look at the islet cells, because I'd heard they look like gold dust. He said, "Here," and pulled out a vial of cells and it was true – it was like looking at gold dust. It was amazing.
How many were transplanted into you this time?
I think about 850,000. So if you figure that 100,000 died, I'm still left with 1.4 million overall.
Do you notice any difference between the first and second transplants?
This time around I want to really, really take care of the transplanted islet cells. So I used insulin on occasion at first, like if I was at a business meal and knew I would eat more than I should. I want these babies to latch on and be good.
How are you feeling?
I feel fantastic.
Will you contact this donor?
Absolutely. I just need some time to put my head together to write a letter. By the way, when I met Michael's mother, she said other people got her son's heart, liver and lungs, but they never sent a thank-you letter. I was the only person to do it.
Does the transplant team suggest that recipients write to their donor's family?
It's up to you, but some people choose not to do it. I'm not built that way. I think it's important to say thank you – that's just the way I look at life.