Thursday, January 1, 2009

Transplant Blog Part 3: 30 Days at Jackson

In July, I decided to attend my friend Derek's wedding. He was one of 5 friends who were married this year and his wedding was the only one that I was able to attend. I flew to Connecticut, even though I had just began experiencing stomach pains and did not know what to attribute them to. I fought threw the stomach aches and actually managed to have a great time at Derek's wedding.

That Sunday, I flew to Pittsburgh to join Trine, who was participating as an athlete in the Transplant Games. As soon as I arrived, things began to seriously go downhill. I began spiking high fevers at night and waking up with profuse sweating. During the day, my stomach was settled enough for me to enjoy the events, though I was beginning to take on a slight yellow tinge again. We were scheduled to leave on Wednesday evening, but I could not wait that long. My stomach was killing me, my temperature was soaring and I knew something was terribly wrong, though I was not sure exactly what. A couple we met at the Games was kind enough to change our flights so that Trine and I could fly home to Miami together, and from there we went straight to Jackson Memorial Hospital, despite my fever breaking on the trip home.

When I arrived, my health got worse. I was still getting fevers every night, despite the antibiotics. I had almost daily ultrasounds and through these we got the news that one of my hepatic arteries had collapsed and there was next to no flow through it. The doctor said there were a few possible ways things could play out: 1) the other arteries would pick up the slack, 2) surgery would needed to repair the down artery or (and this is what really took it's toll on my mental health during this stay) 3) I would have to be re- transplanted or possibly die. Oops.

The idea of being re-transplanted began to eat away at my mental stability. The thought of having to repeat all the necessary tests to be placed back on the transplant list was overwhelming, not to mention the waiting. I began to withdraw from friends and family. I would avoid taking phone calls because either nothing was changing or things had gotten worse, and I was tired of telling everyone that. I cut way back on eating and drinking and did not get out of bed and walk nearly enough. The few times I did, it was after heavy cajoling by Trine or my mother. The doctors suggested some psychiatric help, including medication, and I consulted with Trine and my family, but concluded that adding more medication to the mix was not a good idea and I could tough this out. Eventually, my mental health would improve, but that wouldn't be until weeks after my release.

The Infectious Diseases doctors began to brainstorm what could be causing my symptoms. They did a battery of tests and concluded that I may have a rare disease caused by tick bites, and they backed this theory up with my recent visit to Connecticut. I never for a second believed that they were on the right track. I had lived in Connecticut for 26 years and never once was bitten by a tick. The blood tests were not supporting their theories, either, though they did reveal bacteria in my blood. This theory was later dismissed.

The cause of my illness turned out to be very simple: Cholangitis, or strictures in the bile ducts, which limited the flow of bile and caused back up. It was the same issue that I had been having for over a year, on and off. Once the doctors began treating me for Cholangitis, then things improved quickly. I went to Radiology and they preformed a minor procedure called a Cholangiogram. They injected dye into my abdomen to visualize the path of flow and then ballooned the bile ducts so that the bile would be able to flow freely. I was sent home with a long catheter sticking out of my abdomen attached to a bag to catch the excess bile drainage. It was not pretty, but it was necessary, and effective. I also had a follow up appointment to get another Cholangiogram. I ended up having weekly Cholangiograms and the catheter for about 5 weeks.


I was in the hospital for a month…from July 16 through August 14. I watched Michael Phelps win 8 gold medals, Manny Ramirez leave the Red Sox for the LA Dodgers and the Dark Knight blow up at the box office. I was released on August 14 around 8:30pm and the first thing Trine and I did was grab some frozen yogurt and go see the 10:15 showing of The Dark Knight. Surely, this would be the end of the insanity and I could finally begin to enjoy my new liver and get back to good health. Close, but not quite.

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