June 24, 2010

Last night Linda had a major setback in her recovery from her liver transplant surgery.

It all started Tuesday morning when she had some shortness of breath during her occupational therapy session. She had been getting stronger and lasting longer every day in both occupational therapy and physical therapy. The doctor in charge of her case at RHI decided to send her back to Indiana University Hospital for evaluation of the breathing difficulties. When we arrived back at IU Hospital chest X-rays disclosed another accumulation of fluid on Linda's right lung, and a thoracentesis Wednesday morning removed 1.3 liters of clear, blood tinged fluid from her right chest. By nightfall, however, a repeat chest X-ray showed the fluid had reaccumulated, and that her right lung was almost completely collapsed. The resident doctor advised that she needed an indwelling chest tube so the fluid could be continuously drained off her lung to make it easier for her to breathe.

However, when the resident inserted the chest tube at Linda's bedside in the ICU, he pushed the tube through her diaphragm into her new liver. At about 3 a.m. a CT scan revealed this error, and Linda was taken to an operating room on an emergency basis for surgery to control the bleeding and repair her new liver. After a lot of fuss, the doctors and hospital personnel allowed me to sit in a corner of the operating room during this procedure so I could watch and listen to exactly what they were doing for Linda. Nearly got myself arrested by the hospital security officers before this could be negotiated, however. I had to tell the doctors they had no consent to operate on Linda unless they would let me observe in the OR.

The surgeons completely reopened the incision from Linda's transplant surgery, though the incision was completely healed, and she had been scheduled to have her surgical staples removed today at the transplant outpatient clinic. The surgeons removed the errant chest tube and repaired the hole in her new liver. After the bleeding from that location was controlled, they evacuated the newly accumulated fluid from her right chest and placed an indwelling chest tube so the right lung area can be constantly drained to help with her breathing. Dr. Tector, the head transplant surgeon, came to the OR to look over Linda's repaired new liver before the other surgeons closed her up, and he tells me it still looks good and he expects the organ eventually to recover completely from this new insult. She came back to ICU from the recovery room about 5:30 this morning,  still intubated and drowsy after her ordeal. By 9:40 this morning the lawyers or administrative staff here at IU Hospital were already Googling my website to see what kind of lawyer I am.

As I write this, Linda is awake but still on the ventilator. I have asked the respiratory therapist and her nurse why there is blood coming up from her stomach in the suction tube along with the bile being suctioned off. No answer yet.

Naturally, Linda was frightened nearly to death by all this drama. As the various attendants come in and out of the room, when she opens her eyes they are as wide as tea saucers, and you can see the fear and sadness in them. It is obvious to everyone that all the hard won progress Linda worked so diligently for in the four weeks since her transplant has been lost as a result of this episode. We will be here at IU for several more days before she is stable enough to get back up to RHI and start over with the physical, occupational and speech therapy she will need to get back on her feet and come home. I'm focused on trying to forget about how pissed off I am about all this and concentrate on encouraging Linda to face the repeated efforts ahead of her to get herself back to where she was Monday evening.

Clearly the July 5 discharge date we were given for bringing Linda home has gone by the boards, and it will be a few weeks before we have any definite news about how soon that could happen. Right now we are very lucky she is still alive. Please keep us both in your thoughts and prayers, and remember that hearing from you guys is what keeps Linda motivated to work hard toward her complete recovery. You all have been great friends and supporters through this time in our lives, and we need you now as much as we ever have.

Today, and probably at least through the weekend, Linda is in B-11, Room 4528, Transplant Intensive Care Unit, Indiana University Hospital, 550 University Boulevard, Indianapolis, Indiana 46202. The phone number in her room is 317-944-9874. She can't talk to anyone right now until they take out her endotracheal tube, which may not be until late this evening or even tomorrow morning. This weekend would probably be too soon for her to entertain any visitors, but by then calls will be welcome, along with cards and balloons - remember, no flowers or live plants allowed in the TICU because every patient here is immune compromised.