Friday, November 2, 2018

From the hospital to the Himalayas: One patient's journey

ADVENTURE AFTER SURGERY: Parmelee at the Annapurna base camp in Nepal

South Sudan is the world’s youngest nation. The landlocked country in East-Central Africa was forged in the shadow of a 14-year bloody civil war, gaining its independence in 2011 only to erupt into a political power struggle and new civil war in 2013. These wars crippled the fledgling nation, increasing poverty levels and stalling the development of infrastructure in most areas, from agriculture to transportation to medical care. Amid this chaos, many relief groups and dedicated individuals have helped refugees, including Bruce Parmelee of Binghamton, New York.

“In 2014, I deployed to assist in an aid mission stationed in Abyei, South Sudan, very close to the Sudanese border,” says Parmelee. “My role was to assist in the immediate needs of repatriating refugees – folks who had nothing but a bundle on their back, no home and were sleeping on the ground. As part of our efforts we distributed shelter kits, designed and sourced locally, and instructed people in how to assemble them.”

Parmelee, who was 65 years old at the time, was used to working in intense environments. For years, he assisted in humanitarian efforts across a host of war-torn areas throughout the Middle East and Africa. But this mission was different. He noticed he was losing his stamina quickly, becoming increasingly ill with each passing day.

“Almost overnight, my energy disappeared,” he says. “I was unable to keep pace with the daily rigors which had never impacted me on this level. Finally, I realized something was medically wrong.”

After seeking medical care, Parmelee was advised to leave the country immediately. After returning home he was admitted to his local hospital’s emergency room. Three days later he was diagnosed with liver cancer. His sister encouraged him to seek treatment at the MGH, and he began the process of evaluation for a liver transplant while also undergoing cancer treatment.

“There is a lot of information provided to patients when we first meet people like Bruce, and it can be quite difficult to absorb it all,” says Suvranu Ganguli, MD, associate chief of MGH Interventional Radiology. “Patients hear, ‘You have liver disease. You have cancer. You need a liver transplant. You need cancer treatment. These are all your options and we need to do it fast.’ So, of course, it can be very overwhelming.”

Parmelee underwent a minimally invasive image-guided procedure known as a microwave ablation to “burn” his liver tumor. He rested a day, then drove 300 miles back to his home in New York. Parmelee visited the MGH quarterly to make sure the cancer hadn’t returned, which would preclude him from a transplant. Parmelee began the long process of waiting for a new liver.

On Nov. 29, 2015 – following two false starts – the call came while Parmelee and his wife were in church. “I never bring my phone into church, so the transplant folks tracked my daughter down, who then called my wife who had her phone with her.”

Due to the Thanksgiving holiday, traffic was backed up on the Mass Pike for 28 miles into Boston. “But,” says Parmelee, “I made it.”

With 15 minutes to spare.

Parmelee says when Heidi Yeh, MDMGH transplant surgeon, came in to his room, he held his breath. “She smiled and said, ‘this liver is beautiful.’”

Five days after his transplant, Parmelee was discharged, but he stay in the Boston area for the next three weeks for regular monitoring. He returned home on Dec. 26, 2015 and was back at the gym the following day.

Last January, Parmelee – now 70 years old – was catching up with a friend who said he wanted to go to Nepal to go trekking in the Himalayas. “Let’s do it,” Parmelee said. They bought the tickets that evening.

Less than three years after beating cancer and receiving a new liver, Parmelee left for Nepal in April with his friend and three other trekkers. The group made it to Annapurna Base Camp I at 13,500 feet and back down in nine days. “The five of us had an age range of 68 to 71, so this was definitely a bit beyond the typical troupe who commits to scaling any part of the Himalayas,” Parmelee says.

Parmelee remains positive about his transplant experience and the future. “I am really grateful for the care I received at MGH. I’m always impressed at how dynamic the encounter is. My entire team truly cares – while also making me feel welcome and championing my continued growth beyond the transplant.

“If I can impart one piece of advice, it would be to prepare for all scenarios, good and bad, and to remain as optimistic as possible. In all things – aiding humanitarian crises, my trip to Annapurna Base Camp in the Himalayas or preparing for the transplant – there simply isn’t time to second guess or worry. Just put your head down and prepare for the journey ahead as much as you can.”



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