The results of Tuesday's ultrasound and biopsy showed a blockage or restriction in Dan's hepatic artery, so they did an angioplasty yesterday, a catheterization going through the hepatic artery, then inserting a balloon to open the artery (similar to how they do it for the heart). The results were complicated and the surgeon said they have not seen such a complicated case before, and if you know Dan, this is not at all surprising.
1- Dan's hepatic artery, the one that delivers blood to the liver, was not getting enough blood so the liver was not getting enough blood, which could be causing the tiredness and confusion. The artery that supplies blood to the hepatic artery also supplies blood to the spleen - think of a V in the road. Turns out there wasn't a blockage in the hepatic artery, but the speen artery had greatly enlarged and was getting all the blood, this happened in the last few days and they don't know why. So to help the liver, they blocked the speen's artery so all the blood will flow to the liver, this leaves the spleen essentially "dead" and it may have to be removed at some time. The spleen fights certain infections, but they have immunizations they can give Dan for this.
2- There is a restriction in Dan's bile duct and the plan is to insert a stent via endoscopy sometime today depending on how Dan is doing.
3- The dye used in the angioplasty harms the kidneys, and his kidneys are not functioning well anyway, so they gave him medication during and after the procedure, but they may have to do a few days of dialysis to help the kidneys along and get rid of the fluids he still has.
We just got a call this morning that Dan's heart rate started racing again, so I'm headed up to Mayo now. They did move him back to the Intermediate Care pod on the same floor. I will blog more when I get more info, but for the meantime, please pray. Actually I know you are praying all along, but if you could pray specifically for these new complications, we would be grateful.
More later....
Debbie
Thursday, September 11, 2008
Tuesday, September 9, 2008
Tuesday, Sept. 9 updates
Happy Birthday to our Amy! Her name means "blessed one" and she is that to us. We are grateful that God allowed us to be her parents, and now that she's 23 and a wife and mother herself, we are blessed to call her friend. Her presence during Dan's recovery time has been a delight and we are grateful for every moment spent with Amy, Adam, and our grandson Swen.
Dan's kidney CT scan today did show a small kidney stone in his left kidney, however the placement and size would not cause his back pain. So the doctors are convinced the pain is still from the fall and also from lying in bed for so long. So the doctors and PTs have decided to push Dan a little in sitting up more and walking. He walked 1 lap today around the floor, sat up for about an hour then sat up for all 3 meals today. Hopefully these activities will help his back get stronger and lessen the pain.
Meds and meals were more in sync today and his creatinine level didn't change from yesterday, the doctors will still monitor and they are hopeful the kidneys and liver are getting more in sync. His blood sugar is still high though not as high as yesterday. Dan is enjoying reading his new book "Take The Risk" by Dr. Ben Carson, a neurosurgeon at John Hopkins and a man of faith. He's also reading "The Few and the Proud" by Larry Smith, stories from Marine Corps Drill Instructors. It's great that he's able to read again.
Aloha,
Debbie and Dan
Dan's kidney CT scan today did show a small kidney stone in his left kidney, however the placement and size would not cause his back pain. So the doctors are convinced the pain is still from the fall and also from lying in bed for so long. So the doctors and PTs have decided to push Dan a little in sitting up more and walking. He walked 1 lap today around the floor, sat up for about an hour then sat up for all 3 meals today. Hopefully these activities will help his back get stronger and lessen the pain.
Meds and meals were more in sync today and his creatinine level didn't change from yesterday, the doctors will still monitor and they are hopeful the kidneys and liver are getting more in sync. His blood sugar is still high though not as high as yesterday. Dan is enjoying reading his new book "Take The Risk" by Dr. Ben Carson, a neurosurgeon at John Hopkins and a man of faith. He's also reading "The Few and the Proud" by Larry Smith, stories from Marine Corps Drill Instructors. It's great that he's able to read again.
Aloha,
Debbie and Dan
Monday, September 8, 2008
Monday, Sept. 8 updates
Happy "De-Liverance and Re-Liverance" Day to Dan today -- it is 2 weeks today that Dan received his gift of a new liver and an extension of life.
Results of yesterday's back xray were normal, nothing broken or out of place. Dan's dad remembered his recent kidney stone problems and maybe that is causing some/all of the back pain, so we mentioned that to the doctors and they will be doing a kidney ultrasound tomorrow morning to check on that.
Results from the liver biopsy showed several things. One, he had a slight rejection issue which raised the liver counts and the bilirubin which explained the jaundice yesterday. Also there was concern about imflamation or something with his bile ducts, but after further review of the biopsy, doctors decided all is well there. For the rejection, they increased his anti-rejection meds and his steroids, and by this morning the jaundice was gone and the labs looked good. However, his kidney output was down a little and his creatinine was up, most likely from the increased anti-rejection meds and the anti-fungal and anti-viral meds they are still giving him. And his blood sugar went very high, up to 375 this morning, also due to the increased meds.
Today was a crazy day with meds and meals. They brought Dan's breakfast, but he couldn't eat because the doctors made med changes, meds that must be taken 2-hours before or after meals, plus the timing of eating is also based on a blood sugar test then the appropriate dose of insulin is given, then he needs to eat, so he finally got to eat his breakfast at 11am. Then as luck would have it, his lunch arrived at 11:30, but he wasn't hungry then so lunch was held till 1:30, again after all the meds protocol, so the PT and OT had to come back later to get him up and walk around, which he did only 1 lap around the floor today due to the back pain. Dinner came at the usual time and Dan's folks were there to help him while I took a little break. He rested most of the evening while we watched Star Trek Next Gen on Sci-Fi channel. Sure hope tomorrow things can be more "normal" for meals and meds, whatever normal is these days. And now it looks like rehab will be delayed until end of the week, they are waiting for his kidney and liver function to be stable and in sync.
More lessons from everyday things: I'm reading this great book by Francine Rivers called "The Priest". It's another Biblical novel, this time about Aaron and Moses. As I read about the Hebrews praising God one minute and then grumbling the next, how God answered their prayers for freedom in His time, how He provided for their needs one day at a time, how He led them to the promised land the long way through the desert rather than the quick way through the land of their enemies, which the Hebrews didn't understand. I can see how God is doing the same thing for us. He answered our prayers for a new liver for Dan in His time, He is providing for our needs one day at a time, He is leading us to our promised land (Hawaii nei!) the long way through the desert of recovery challenges, rather than the quick way which might have been through the land of our "enemies" of pride and self-sufficiency. And funny how we are actually in the Phoenix desert as well. Our "desert" road leaves us with no self-sufficiency, we only have open hands to receive each day's strength from God, and open arms to praise Him for it. So, it's time to rejoice and remember Dan's "De-liverance and Re-liverance" Day, and to not be dismayed by the long recovery process but expect and receive God's gift of strength for each day.
Now I'm having a 70's flashback..."I've been to the desert on a horse with no name..." Was anyone else an America fan?
Debbie and Dan
Results of yesterday's back xray were normal, nothing broken or out of place. Dan's dad remembered his recent kidney stone problems and maybe that is causing some/all of the back pain, so we mentioned that to the doctors and they will be doing a kidney ultrasound tomorrow morning to check on that.
Results from the liver biopsy showed several things. One, he had a slight rejection issue which raised the liver counts and the bilirubin which explained the jaundice yesterday. Also there was concern about imflamation or something with his bile ducts, but after further review of the biopsy, doctors decided all is well there. For the rejection, they increased his anti-rejection meds and his steroids, and by this morning the jaundice was gone and the labs looked good. However, his kidney output was down a little and his creatinine was up, most likely from the increased anti-rejection meds and the anti-fungal and anti-viral meds they are still giving him. And his blood sugar went very high, up to 375 this morning, also due to the increased meds.
Today was a crazy day with meds and meals. They brought Dan's breakfast, but he couldn't eat because the doctors made med changes, meds that must be taken 2-hours before or after meals, plus the timing of eating is also based on a blood sugar test then the appropriate dose of insulin is given, then he needs to eat, so he finally got to eat his breakfast at 11am. Then as luck would have it, his lunch arrived at 11:30, but he wasn't hungry then so lunch was held till 1:30, again after all the meds protocol, so the PT and OT had to come back later to get him up and walk around, which he did only 1 lap around the floor today due to the back pain. Dinner came at the usual time and Dan's folks were there to help him while I took a little break. He rested most of the evening while we watched Star Trek Next Gen on Sci-Fi channel. Sure hope tomorrow things can be more "normal" for meals and meds, whatever normal is these days. And now it looks like rehab will be delayed until end of the week, they are waiting for his kidney and liver function to be stable and in sync.
More lessons from everyday things: I'm reading this great book by Francine Rivers called "The Priest". It's another Biblical novel, this time about Aaron and Moses. As I read about the Hebrews praising God one minute and then grumbling the next, how God answered their prayers for freedom in His time, how He provided for their needs one day at a time, how He led them to the promised land the long way through the desert rather than the quick way through the land of their enemies, which the Hebrews didn't understand. I can see how God is doing the same thing for us. He answered our prayers for a new liver for Dan in His time, He is providing for our needs one day at a time, He is leading us to our promised land (Hawaii nei!) the long way through the desert of recovery challenges, rather than the quick way which might have been through the land of our "enemies" of pride and self-sufficiency. And funny how we are actually in the Phoenix desert as well. Our "desert" road leaves us with no self-sufficiency, we only have open hands to receive each day's strength from God, and open arms to praise Him for it. So, it's time to rejoice and remember Dan's "De-liverance and Re-liverance" Day, and to not be dismayed by the long recovery process but expect and receive God's gift of strength for each day.
Now I'm having a 70's flashback..."I've been to the desert on a horse with no name..." Was anyone else an America fan?
Debbie and Dan
Sunday, September 7, 2008
Sunday, Sept. 7 updates
I took another day off yesterday (Saturday) to rest from this pesky cold, and I am better today and back at the hospital. Thanks to Dan's folks and sister Debbie for spending long hours at the hospital yesterday and keeping me updated.
They moved Dan to a different room on the same floor yesterday, due to needing to consolidate patients as they are doing some construction or maintenance on the floor. So we lost his "suite" and got a smaller room, which is close to the heated blankets "oven", so I can get blankets whenever Dan or I need (yes, it's cold in the rooms).
Today, Dan is having another liver ultrasound and biopsy, along with that lower back xray. His kidney function is lower, so they decreased his anti-rejection meds which improved the kidney function and lowered the liver function/raised the bilirubin so he's a little jaundiced today. Based on the results of the ultrasound and biopsy they will probably increased the anti-rejection meds for the liver. It's interesting how with a new liver they have to give anti-rejection meds, which can cause infection so they give antibiotics for that, which can cause other problems with kidneys etc. so they give more meds for that, and it goes on and on, until his body adjusts to all the changes and grows stronger, thereby reducing the need for the additional meds. Because of all this, his move to rehab may be delayed a few days.
Tomorrow will make 2 weeks since his transplant and a long 2 weeks in bed in the hospital. So many things have happened in that time, we are so grateful for the gift of life for Dan and continue to pray for the donor's family. The funeral is probably over, the out-of-town family probably leaving soon, and life will have to go on for the donor's parents. They may start going through his/her room and continue dealing with feelings of loss. Thanks for joining us in prayer for the family. We will be sending a thank-you letter to the family via the hospital, since we will not be told their names. I think at some point in the future, that option may be given, but for now, we trust them to God.
More updates to come. Enjoy your day of worship and rest today, and enjoy the first Sunday of the NFL! We have a new interest this year in the Redskins, since Colt Brennan from UH is there. And of course, we continue to cheer on the Vikings, hopefully this will be their year.
Debbie and Dan
They moved Dan to a different room on the same floor yesterday, due to needing to consolidate patients as they are doing some construction or maintenance on the floor. So we lost his "suite" and got a smaller room, which is close to the heated blankets "oven", so I can get blankets whenever Dan or I need (yes, it's cold in the rooms).
Today, Dan is having another liver ultrasound and biopsy, along with that lower back xray. His kidney function is lower, so they decreased his anti-rejection meds which improved the kidney function and lowered the liver function/raised the bilirubin so he's a little jaundiced today. Based on the results of the ultrasound and biopsy they will probably increased the anti-rejection meds for the liver. It's interesting how with a new liver they have to give anti-rejection meds, which can cause infection so they give antibiotics for that, which can cause other problems with kidneys etc. so they give more meds for that, and it goes on and on, until his body adjusts to all the changes and grows stronger, thereby reducing the need for the additional meds. Because of all this, his move to rehab may be delayed a few days.
Tomorrow will make 2 weeks since his transplant and a long 2 weeks in bed in the hospital. So many things have happened in that time, we are so grateful for the gift of life for Dan and continue to pray for the donor's family. The funeral is probably over, the out-of-town family probably leaving soon, and life will have to go on for the donor's parents. They may start going through his/her room and continue dealing with feelings of loss. Thanks for joining us in prayer for the family. We will be sending a thank-you letter to the family via the hospital, since we will not be told their names. I think at some point in the future, that option may be given, but for now, we trust them to God.
More updates to come. Enjoy your day of worship and rest today, and enjoy the first Sunday of the NFL! We have a new interest this year in the Redskins, since Colt Brennan from UH is there. And of course, we continue to cheer on the Vikings, hopefully this will be their year.
Debbie and Dan
Friday, September 5, 2008
Friday, Sept. 5th updates
Dan is doing so well. He started reading and writing today. And he got to eat real food for all 3 meals today, along with drinks mixed with the thickener, though still no thickened iced tea - yuck. His doctors are very pleased with his progress.
He did only 2 laps with the OT today, his lower back is sore from that fall a few days ago, the doctors have ordered an xray just to be sure nothing is broken. Dan really enjoys visits from the OTs (occupational therapists). They get him up and to the sink for grooming activities, walking his laps, then arm exercises with a towel. The hard stuff comes next week when they move him to rehab - 3 hour workouts with short breaks, but Dan says he's ready for the challenge. They also do some fun stuff, like bake cookies or go shopping...where do I sign up?! Right now, the plan is 7 days in rehab, so he might get to come home after next week.
Today, the endocrinologist came by to teach us about insulin and how to do blood sugar maintenance. Some of this I already knew since my Mom is diabetic, and she uses insulin pens rather than syringes, Dan will get to use these also. Alot of info to absorb, but Dr. Childs explained everything so well - if you watch the tv show Frasier, Dr. Childs reminds us of Niles only with dark hair. I'm glad they give us just a little info each day, I think we'll be ready come time to leave the hospital.
And today's word from everyday things around us: we watched Mayo's educational video on taking care of a new liver (did you know your liver performs over 5,000 functions?). One very important thing for Dan now will be to stay infection-free. He can't be around sick people, he needs to avoid big crowds for that same reason (Hawaii ohana, don't be offended if Dan isn't able to hug you all). He will need to practice good hand-washing hygiene and even be very careful not to get cuts or skin abrasions, believe it or not, a little cut infected can harm his new liver which will harm the entire body. God spoke loud and clear to me about the need for purity in my life and in the Body of Christ. Just like a little cut can ultimately harm Dan's entire body now, sin (even a "little sin" only I know), could ultimately harm the Body. And just like Dan needs to avoid folks that are sick, we need to avoid unhealthy relationships, media, anything that might cause a "sin" infection in the Body. 1 John 1:5-10 comes to mind.
Aloha from the desert,
Debbie and Dan
He did only 2 laps with the OT today, his lower back is sore from that fall a few days ago, the doctors have ordered an xray just to be sure nothing is broken. Dan really enjoys visits from the OTs (occupational therapists). They get him up and to the sink for grooming activities, walking his laps, then arm exercises with a towel. The hard stuff comes next week when they move him to rehab - 3 hour workouts with short breaks, but Dan says he's ready for the challenge. They also do some fun stuff, like bake cookies or go shopping...where do I sign up?! Right now, the plan is 7 days in rehab, so he might get to come home after next week.
Today, the endocrinologist came by to teach us about insulin and how to do blood sugar maintenance. Some of this I already knew since my Mom is diabetic, and she uses insulin pens rather than syringes, Dan will get to use these also. Alot of info to absorb, but Dr. Childs explained everything so well - if you watch the tv show Frasier, Dr. Childs reminds us of Niles only with dark hair. I'm glad they give us just a little info each day, I think we'll be ready come time to leave the hospital.
And today's word from everyday things around us: we watched Mayo's educational video on taking care of a new liver (did you know your liver performs over 5,000 functions?). One very important thing for Dan now will be to stay infection-free. He can't be around sick people, he needs to avoid big crowds for that same reason (Hawaii ohana, don't be offended if Dan isn't able to hug you all). He will need to practice good hand-washing hygiene and even be very careful not to get cuts or skin abrasions, believe it or not, a little cut infected can harm his new liver which will harm the entire body. God spoke loud and clear to me about the need for purity in my life and in the Body of Christ. Just like a little cut can ultimately harm Dan's entire body now, sin (even a "little sin" only I know), could ultimately harm the Body. And just like Dan needs to avoid folks that are sick, we need to avoid unhealthy relationships, media, anything that might cause a "sin" infection in the Body. 1 John 1:5-10 comes to mind.
Aloha from the desert,
Debbie and Dan
Thursday, September 4, 2008
Thursday, Sept. 4th updates
Dan walked 5 laps around the floor this morning and is very proud of that! All the IVs are out today, the pic line is still in his left arm for taking blood tests and giving some meds. He still had his feeding tube, we hope it comes out soon. He ate several meals today, lunch with me was vanilla pudding, vanilla yogurt, and V8 juice with thickener. He's not a fan of yogurt or V8 but with steely determination ate it all. We still await the urologist visit. The kidney doctor is concerned about his creatinine level which measures his kidney function, so they continue to give him lasix and albumin. The endocrinologist came by with more instructions on how to manage the diabetes which hopefully is temporary. Mayo has several videos for us to watch on how to manage life after transplant, info on meds which must be given at exact times each day. It's all a little daunting to me, thankfully Mayo is giving us lots of reading materials and a little education each day. I think we have to take a quiz before we leave the hospital! Dan is also anxious to start writing again, we'll post his writings as soon as he's ready.
As for me, I am feeling much better, Amy picked me up around 10pm last night so I could sleep at home, then she brought me back this morning after Swen was up from his nap. I'll probably continue this for the rest of the week. Dan is well taken care of at night, and God impressed upon me the importance of taking good care of myself, as when Dan gets home I need to be in good shape to help him.
A menehune (playful unseen elf according to Hawaiian folklore) came to Dan's room while I was at lunch today and left a delightful fruit basket (thanks, Nancy). Other menehunes sent gifts in the mail this past week, for which we are humbled and grateful. God has sure taught us a lesson to be joyful receivers of gifts, it's a lot easier for us to be joyful givers, isn't it? Hopefully, as we joyfully receive, we will then in turn joyfully give, and "God's creditline" continues to revolve and supply needs.
Hau'oli ë! (happiness and joy),
Debbie and Dan
As for me, I am feeling much better, Amy picked me up around 10pm last night so I could sleep at home, then she brought me back this morning after Swen was up from his nap. I'll probably continue this for the rest of the week. Dan is well taken care of at night, and God impressed upon me the importance of taking good care of myself, as when Dan gets home I need to be in good shape to help him.
A menehune (playful unseen elf according to Hawaiian folklore) came to Dan's room while I was at lunch today and left a delightful fruit basket (thanks, Nancy). Other menehunes sent gifts in the mail this past week, for which we are humbled and grateful. God has sure taught us a lesson to be joyful receivers of gifts, it's a lot easier for us to be joyful givers, isn't it? Hopefully, as we joyfully receive, we will then in turn joyfully give, and "God's creditline" continues to revolve and supply needs.
Hau'oli ë! (happiness and joy),
Debbie and Dan
Wednesday, September 3, 2008
Wednesday, September 3rd updates
God's ways sure are confusing sometimes. Labor Day, Sept. 1st, I felt a cold or something coming on so I had Amy take me home to rest and get away from Dan, since his immunity is suppressed he could catch anything easily. By the afternoon, I had a 101 temp and everything hurt. I stayed in bed the rest of Monday, all day Tuesday, and half day Wednesday (today). I am thankful for my family: Dan's folks spent long days with Dan in the hospital, Amy juggled taking care of Swen/visiting Dan/bringing me medicine and water. By this afternoon, my fever was gone and I felt among the living again. After enjoying watching Amy and Swen in the pool, Amy brought me back to the hospital for a short visit with Dan; I'll sleep at home tonight to be sure I'm completely well before I start spending the night at the hospital again. Not sure why God would allow me to get sick in the hospital, maybe He thought I needed more rest, who knows. Enough about me.
Dan is still progressing well. Here are the updates I received today:
* Heart: Cardiologists decided not to do the 2nd echocardiogram, deciding that any issues with his heart are from the liver transplant. He continues to receive the blood pressure medicine.
* Liver: They did an ultrasound and biopsy on his new liver and confirmed his liver is working perfectly.
* Infections: Dan is still getting the antibiotics, I need to find out more about this.
* Swallowing: Dan passed the swallow test today, so he got his first "meal" - a liquid diet enhanced with thickener - he didn't mind the taste of everything except the thickened iced tea, which sounds pretty gross to me also. They might take his feeding tube out tomorrow if his swallowing continues to go well.
* Walking: He walked with the PT around the floor 3 times today.
* Concerns: His blood sugar has been all over the place, from low at 64 to way high at 275. The doctors have been contacted, it may just be from his pancreas trying to heal and Dan starting to "eat" again. Also, Dan had a fall today, I don't know all the details since I was still home sick, but he went down hard on his rump. Praise God no broken hip or broken anything else, but I'm sure he will be sore tomorrow. Rules for Dan now state he needs 2 nurses to help him up.
I'll update more tomorrow, time to get home to take more medicine and rest up for tomorrow.
Debbie and Dan
Dan is still progressing well. Here are the updates I received today:
* Heart: Cardiologists decided not to do the 2nd echocardiogram, deciding that any issues with his heart are from the liver transplant. He continues to receive the blood pressure medicine.
* Liver: They did an ultrasound and biopsy on his new liver and confirmed his liver is working perfectly.
* Infections: Dan is still getting the antibiotics, I need to find out more about this.
* Swallowing: Dan passed the swallow test today, so he got his first "meal" - a liquid diet enhanced with thickener - he didn't mind the taste of everything except the thickened iced tea, which sounds pretty gross to me also. They might take his feeding tube out tomorrow if his swallowing continues to go well.
* Walking: He walked with the PT around the floor 3 times today.
* Concerns: His blood sugar has been all over the place, from low at 64 to way high at 275. The doctors have been contacted, it may just be from his pancreas trying to heal and Dan starting to "eat" again. Also, Dan had a fall today, I don't know all the details since I was still home sick, but he went down hard on his rump. Praise God no broken hip or broken anything else, but I'm sure he will be sore tomorrow. Rules for Dan now state he needs 2 nurses to help him up.
I'll update more tomorrow, time to get home to take more medicine and rest up for tomorrow.
Debbie and Dan
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