FOR most people, a handshake is a simple everyday greeting – but for Mark Cahill it means so much more.
A year ago today he underwent the UK’s first ever hand transplant when a team of specialists at Leeds General Infirmary removed his right hand and replaced it with a donor limb.
Twelve months later, and the 52-year-old former pub landlord of Greetland, near Halifax, is gradually regaining feeling in the hand and each day finds he is becoming more dexterous.
There have been setbacks – on several occasions signs of tissue rejection set in and he was forced to increase doses of specialist medicines – but both he and his surgical team are hopeful of further significant improvements.
“I’ve had an interesting year,” said Mr Cahill. “It hasn’t always been going as well, but we hope we’ve turned a corner now.
“It’s something I’ve been very proud to have. I think it’s super.”
He has regained deep feeling in his hand and can sense hot and cold but has yet to see a return of fine feeling. Very often, it has been the small things most people take for granted that have made the biggest difference during his rehabilitation, among them handshakes.
“The first thing that I noticed I did differently was when I dried myself with a towel with my right hand and automatically did it without realising. Another time I had a bottle of water and just took the top off,” he said.
One of his goals had been to hold his four-year-old grandson Thomas’s hand. He said the youngster is “so interested” in his new hand, telling him: “Grandad your fingers are nearly straight now.”
The duo both play Jenga together – it’s good for his physiotherapy and Thomas enjoys knocking the bricks over.
He said the main issue was the return of nerves and there was little that could be done other than wait. The nerve serving his thumb has improved, allowing him to grip between it and his forefinger, but another governing intricate movements has been slower to recover. His medical team has told him it could take another six months but could then rapidly return.
He left the infirmary three weeks after the transplant but regularly attends the hospital for physiotherapy, occupational therapy and psychology, as well as checks from the team led by surgeon Prof Simon Kay, who has even visited his patient at home.
“Any problems and he is straight there,” said Mr Cahill.
He had faced inevitable ups and downs including an operation on his own birthday. There had been several occasions when a distinctive rash developed raising fears his body was rejecting the donor tissue. His team had concluded it was linked to other trauma – such as further surgery needed to repair a plate holding his ulnar bone in place.
Prof Kay said he was pleased with his patient’s progress.
“He is our first baby as it were and as anyone would be, you are very protective about your firstborn and we have kept a very close eye over him,” he said.
“We’ve learned a lot because, although you can plan a certain amount from the experience of other surgeons, until you do it, it’s like learning about childcare and then having to do it.
“I am feeling very relaxed about him now. He’s been through the difficult part and he is now racing ahead. I think he will have excellent function by the middle of next year – it has certainly justified the procedure.”
Mr Cahill has been for a cutting-edge treatment at the Christie Hospital in Manchester, usually used for leukaemia patients, which uses phototherapy on blood cells to reduce the risk of rejection and the need to use drugs. He also faces more surgery to improve the repair on his arm.
He said he wanted to thank the whole team among them Prof Kay, registrar Dan Wilks, physiotherapist Sarah Taplin and occupational therapist Farieda Adams for all their work.
He said he had never had a problem knowing he had a transplanted hand.
“Ninety-nine per cent of people are really interested in it, there’s only one or two who think it’s ghoulish,” he said. “It’s been automatic from day one.
“I sit here playing with my fingers all the time, keeping them constantly moving. I originally had to look at them to make them move but it’s natural now.
“It will be two, three or four years before I get full use of it. I wasn’t expecting a massive change over the first year but everyone is very happy with the progress I’ve made. It’s just like having my own hand and I’ve never thought about it not being a part of me.”