Raymond Rye walked out of the hospital yesterday with a new pancreas, a new life and a feeling he hasn't had in three decades.
"I feel good, I really do. It's the first time in 30 years I can say that," he told well-wishers little more than two weeks after doctors at University of Maryland Medical Center transplanted a healthy pancreas into his body.
"Every morning was a struggle," said the Churchville 34-year-old, a diabetic since age 4. "I'd get up, but it was hard to move around. I was always so tired. Now I actually get up in the morning and feel good."
He becomes the first person in Maryland to have a pancreas transplant without also receiving a new kidney.
The healthy pancreas means no more daily insulin injections and an end to the rapid deterioration of his body, which had created, among other symptoms, vision problems, muscle weakness, poor balance and numbness in his hands and feet.
It also means he can change his diet after 30 years -- from a sugar-free one to an unrestricted one.
His wife, Julie, said the first thing he said goodbye to was the artificial sweeteners in his iced tea.
The pancreas' role in the body is to produce insulin, which regulates sugar levels in the blood and urine. When it fails to function, and diabetes results, the blood vessels are progressively destroyed, particularly in the organs.
In Mr. Rye's case, the destruction has not only been in his eyes, but has, in the last two years, led to a heart attack, a stroke and several bouts with pneumonia.
In addition, Mr. Rye was suffering early deterioration of the kidneys, said Dr. Stephen T. Bartlett, the surgeon who performed the five-hour operation Feb. 18. If the disease had been allowed to continue, he said, it eventually would have led to kidney failure, requiring a kidney transplant.
"Our idea was to preserve the kidneys as well as to forestall complications," said Dr. Bartlett, director of transplant surgery at the medical center.
Since July 1991, the hospital has performed 32 combination pancreas/kidney transplants in diabetic patients who had kidney failure and six pancreas transplants several weeks or months after a kidney transplant.
But this marked the first time the patient got a new pancreas without also receiving a new kidney, and Dr. Bartlett says that shows medical science is moving in the direction of prevention.
"Transplanting a pancreas alone enables us to help patients earlier in the course of their disease, before the complications from diabetes become totally disabling or life-threatening," he said.
The first pancreas-only transplants in the U.S. were tried in the mid 1980s, but failed. Since then, technical innovations and improvements in drug therapy have helped prevent organ rejection.
He added that only a shortage of donated organs prevents doctors from doing more transplants. But he noted that the operation isn't for every diabetic and that there are trade-offs, including the need to take anti-rejection drugs the rest of their lives.
"Some diabetics go their whole life without complications," he said, adding that about 30 percent of juvenile diabetics will eventually require dialysis or a kidney transplant within two decades of diagnosis.
Mr. Rye, who had been on a waiting list for a donor for six months, received the pancreas of a 13-year-old Florida boy who died from a BB gun wound.
Appearing a little overwhelmed by his experience as he left the hospital, Mr. Rye was reticent about his plans. He said he's looking forward most to spending time with his children -- son Kris, 12, and daughter Kelly, 10.
"I want to enjoy my family without being sick all the time," Mr. Rye said. "Before, I always had to make excuses not to do things with them."
Kris and Kelly look forward to having Dad home, too. Both sent Dr. Bartlett illustrated letters thanking him and his staff for renewing the health of their father, who had been a warehouseman at Aberdeen Proving Ground until a back injury accelerated his neuropathy and left him disabled five years ago.
Mr. Rye says he's content to take his recovery a day at a time. He'll feel a lot better, he says, when his "probation" is over, noting that he must return to the hospital for checkups every week for the next three months.