Get this…..We are waiting for Wayne to pass gas. UNBELIEVABLE!!!! Never in a million years would you think this could be a problem. But of course we have to make sure his bowels are working. I don’t know why they don’t believe me when I tell them this shouldn’t be a problem.
All surgical patients need to be typed and cross matched, just in case they need blood. Fortunately Wayne did not need blood, but he did get typed and crossed matched. His blood type is A+. So? Wayne’s blood type in August was 0+. BUT the donor’s blood type is A+. Wayne’s blood type now is A+. What does it mean, it means he has engrafted. Yes, YES, YES!!
Here is a catchy tune that Wayne might be singing (which of course we know he can’t sing or remember words to songs but.. if he could this might be the song of the day: “Thought I couldn’t live without you It’s gonna hurt when it heals too It’ll all get better in time And even though I really love you I’m gonna smile cause I deserve to It’ll all get better in time.” What happened: Sunday – Wayne looking not so hot. By that evening, he is laying on floor moaning in pain. Finally, I pull out last trick from my bag of tricks -meds, he sleeps while I work on my plan. Monday: Wayne thinks he is going to clinic, so I am able to get him to hospital where I have a room waiting. In his weakened state he could not catch me and “ring my neck.” First impression by medical team, Peeches is over reacting. Boss man, transplant doc, determines possible gallbladder or the dreaded Acute Graft vs Host Disease. By 8:00 P.M. it is decided, big bad looking gallbladder with possible mass had to go. No easy feat for a BMT patient, so the surgical specialist is on board. Tuesday: This is one for the surgeon’s memory book. (No one wants to be one the physician will remember, it is always better to be unremarkable- which just doesn’t seem possible for Wayne.) Wayne’s gallbladder is dead, has been dead for several days, it does not even have a blood supply to it, and falls apart when the surgeon attempts to remove. Pieces removed, mass determined to just be a “ball of sledge” and he is back in room recovering. How come he wasn’t in pain, how come the dead gallbladder didn’t cause all kinds of problems, infection, possible peritonitis, abscess? Gallbladder pain can come and go, so when he had the pain and went to hospital, the pain would subside and they couldn’t figure it out what it was exactly, told us to “beet it” or treated him for ulcer. People with transplants can have all kinds of reasons for belly pain. Infection, he is on so many antibiotics that it suppressed the problem. And last but not least, he doesn’t have a working immune system or blood system that would do all the things it could to get rid of the bad gallbladder and would make him sick. I guess that is a good thing in this case, I mean he feels sick enough as it is. It’s gone now and now he can actually start to feel better and GAIN WEIGHT!!! YIPPEE!!!!!
Can you believe the “gall”? We are finally, finally getting somewhere. And just where would that be? Well…we are headed to the operating room to have Wayne’s gallbladder removed. Wayne’s gallbladder is incapsulated in infection, has become enlarged, thickened and full of “sledge”. A person’s gallbladder is positioned under the liver and stores bile produced by the liver. While the bile sits in the gallbladder, it becomes more concentrated, intensifying its effect. When a person eats foods that contain fat, the gallbladder releases bile, which emulsifies fats in partly digested foods. Removing a gallbladder is most often done by making 4 small cuts on the abdomen through which the surgeon will insert the laparoscope (a tiny telescope) and remove the gallbladder. We are keeping our fingers crossed that the surgeon will be able to remove Wayne’s gallbladder laparoscopically, but with all that is going on, the likelihood they will have to make an abdominal incision is considerable. How fortunate we are that the liver transplant surgical specialist is handy! Boy am I glad, I mean, I remember the days when there was no such thing as a liver transplant, so who would have needed a liver transplant surgical specialist. But this is the guy you want, especially if you have had a bone marrow transplant, are immuno-suppressed, whose engraftment syndrome has recently resolved, blood counts are low, etc.etc. It’s gotta go. Removing the gallbladder is not generally associated with any health or digestion problems and is easily tolerated. It’s just gotta” go.
It does make you wonder if, when he was dealing with the complications of the kidney stones, could that have increased the risk of producing gallstones, hummm… And for those of you who are curious, he says the pain from the gallbladder attack is second to the pain of kidney stones. I “gall darn” hope he doesn’t have anything else he needs to compare the pain to.
Tough days. He has had to really work to make the best of these days. Just when he seems to rally, the rally takes it out of him. He seems to be on a slippery slope, which of course holds all kinds of bad visions for those of us who know him. Wayne on any slope can be a bit nerve racking. His fatigue has gotten worse, appetite decreased, increased weight loss (not really a surprise) and he can’t drink enough to bring his electrolytes back in the normal range. I guess the doctor felt he was validating Wayne when he took one look at him and said “you don’t look very good.” And just think, I might have thought the patient could start to wonder, “wow, I must not be doing as well”. Of course, I too could have told Wayne this, but I don’t get paid to say those words of wisdom. He just doesn’t feel well, so we will be headed back to the hospital for some real inspiration and maybe more.