Lots going on....

...today they were concerned that John is sepsis. Not good news, however, urine cultures and the last abdominal cultures were negative. Tonight they're giving him lots of fresh frozen plasma to get his clotting factor down. If it is, they will go in via endoscope tomorrow and remove the stones. The danger is bleeding, of course, and they may have to do some cutting to remove them. They are also going to remove the drain, remove fluid for cultures and insert it in a new area. The drain's been in for 5 days and that's just an invitation for more infection. I think that's everything for now, but I'm sure I'm forgetting something.

Keep praying!

John looked like crap today. Hard to imagine he seems to be slightly more comfortable. He didn't sleep well, as usually is the case in a hospital. And he is kept mighty busy during the day. Today he had a visit from the social worker who spoke with me yesterday and some physical therapy (very little since he's pretty weak). He also had a visit from a speech pathologist to check his swallowing ability. Tomorrow he undergoes a swallow study. I don't know what's all involved with that. He's been limited to a soft diet and he's not real thrilled with that. His liver specialist told me today that he thinks another infection is brewing. His white count is up again slightly and there's a stone in a bile duct. They're going to do an MRI. This may require an endoscopic procedure, which is very risky for someone in his condition. We'll know more tomorrow.

On the bright side, I ran into an old friend at the hospital. She's a nurse-practioner at UPMC and she was passing the elevator as I was getting off. It was great to see her and we'll meet for lunch or coffee one day this week.

Good day, bad day

Yesterday Anita and Walt visited John. He was still in ICU waiting for a bed. Anita said he looked good, but was irritated. He was hungry but they are concerned about his swallowing, something that has been an issue since his head injury. So he's getting soft foods and liquids with thickener. Yum.

When I went down today, he was in a regular room and sleeping. When he woke up, he was VERY uncomfortable, complaining that his stomach hurt. He tossed and turned, tossed and turned...just couldn't find a good spot. Didn't eat much either, but a hematologist who checked in on him said he could have a milkshake. He liked that idea, so I got him a strawberry milkshake and he drank most of it.

He is still draining, but they only allowed 3 litres over 8 hours. Since his BUN and creatine were good, I think they were deciding to speed it up a little. The sooner the better, in my opinion.

I also spoke with the social worker from the transplant team. She's assessing his support system, living arrangements and other things related to post-transplant care. That's IF he gets approved and actually gets a new liver. It's a daunting task after surgery; he will require someone to be with him 24/7 for at least a few weeks. The follow-up care is pretty intense, but worth it. More to come!

Happy anniversary to Anita and Walt, who married on our parents' anniversary.

Did I say piggy-back?

I meant pigtail. My brain is fried. This is what a pigtail drain looks like:

It was a nerve-wracking day. One of the docs was becoming very concerned about John's condition. They had given him plasma and platelets during the night, but his blood still wasn't thick enough for the radiologist to insert the drain. And the volume of fluid in his body was increasing, causing a strain on his kidneys and respiratory system. The doc called in the doctor from the Transplant ICU who evaluated him and determined they would be able to do the drain in the ICU.

Aunt Esther and I were able to see John after they drained the first litre. I say the first, because when I called around 9:00 pm, he was on #4. If you think that's a lot of fluid, that's because it is! We stayed till the hockey game was over (Go Pens!). His vital signs are okay. Heart a little high, but his blood oxygen levels are respiration rate are good. He will remain in ICU for a couple of days, then move to regular room where they hope to be able to finish evaluating him for a transplant.

Tomorrow Anita and Walt will visit John. I am exhausted. I need to spend some time with the dogs, do laundry and just rest. I'll go back on Monday. Thanks SO much for your prayers!

Another day....

Yesterday John's clotting factor was not in the safe range to tap. So during the night they gave him more blood products. Unfortunately, that also creates more fluid, so they consulted with a doctor from the transplant ICU to see if they would be able to tap him there. So that's where he's at right now. They will insert a piggy-back drain and monitor him in the ICU till they feel he can go back to a regular room. Dicey situation, since there are risks associated with inserting a drain with someone in his condition, but more risky to keep him full of fluid....it could cause problems with his kidneys and respiratory system. If there are no complications, the draining can begin which I'm sure will be more comfortable for him. Once he's completely drained (could take a couple of days), they will scan him to find the source of the infection. One baby step at a time....

Finally

John went to UPMC mid-afternoon and we arrived about an hour later. He's resting comfortably and 2 doctors have already been in to see him. He's doing so much better than yesterday. He looked terrible and the doctors scared the crap out of us. Once they backed off all the blood products, he wasn't so full and congested. Tomorrow they'll insert a catheter and drain the excess fluid over a couple of days. They have no qualms about doing these things...they deal with it every day. John was watching the hockey game when we left. Going back down for several hours tomorrow.

Hurry up and wait

John is going to be transferred to Univ. of Pgh tomorrow morning. Sigh. After the docs said he needs to get there ASAP. We waited all afternoon and evening for the go ahead. But, he is stable and if his condition worsens they will LifeFlight him there. It's the typical gyrations when you're dealing with a specialty such as liver disease. News to me. We're praying he remains stable overnight and can go in the morning by ambulance.

The reason Valley GI doesn't want to tap him (remove fluid from his abdomen) is because he needs A LOT of fluid removed and they don't feel comfortable doing it; it's a high risk procedure for someone in his condition. Jameson Hosp. is capable of doing therapuetic tapping, but not the volume that's required to be removed for John. At UPMC, they do this procedure often in liver disease patients and can monitor him closely afterward. In addition, they will continue evaluating him for a transplant while he's there. Time is of the essence.

They continue to give him albumin to assist in removing fluid. He had soup and sherbet for dinner, so he does have an appetite, which is good. He seemed more comfortable when we left this evening and we prayed with him before we left.

Your prayers are GREATLY appreciated by John and us. I'll update you all as often as I can.