OK: Enough of you have castigated me for "threatening to cut you out of the loop" that I'm going to continue my periodic updates regarding Linda's situation.
As for cheering her up, she's in the Transplant ICU, Room 5, at University of Indiana Hospital, 550 North University Boulevard, Indianapolis, Indiana 46202-5149. Cards would be welcome. Because the Transplant ICU is filled in part with post transplant patients who are severely immune compromised, hospital policy prohibits live plants or anything else with soil in it, since soil always contains potentially pathogenic organisms. In my personal view, cut flowers are nice, but under the circumstances I am about to describe, a bit too funereal at present. What Linda really would like is a phone call during daylight hours from her friends and family. The direct phone number to her ICU room is 317-944-9915. Also, I have my cell phone here.
Linda was scheduled to have a liver transplant from a live donor at Northwestern Hospital in Chicago on May 18, but the surgeon there refused to perform the operation at the last minute due to a celiac artery stenosis which was found on a radiology study done on April 21, but which he didn't get around to looking at until May 10. As a result of that decision, and the fact that Linda was not nearly sick enough at that time to qualify for receiving a cadaver liver at Northwestern or any other center in Chicago or Wisconsin, Linda was transferred by ambulance from Northwestern to Indiana University Hospital here in Indianapolis under the care of Dr. A. Joseph Tector. After six days of testing and paperwork, she is now at the top of the transplant list here for a type O cadaver liver.
Friday evening we were told there was a cadaver liver on offer for Linda, and we waited all night long for her transplant surgery to begin. At about 1:30 a.m. Saturday we were notified that the liver went to someone else. Later Saturday afternoon I spoke with Dr. Tector and he explained that the donor liver had a large clot in the portal vein and the potential need for a jump graft around Linda's possible celiac artery stenosis made the use of that particular liver for her transplant too risky for her survival.
During the day today Linda has been steadily getting sicker, and the doctors have put her on around the clock dialysis because her kidney function is declining. She is getting respiratory therapy every four hours to reduce fluid buildup in her lungs resulting from the kidney failure. She is unable to eat or drink much because of the risk of aspiration and pneumonia when she swallows or if she vomits, and her doctors are becoming more and more insistent that she have a small bowel feeding tube inserted through her nose and down her throat. She has a triple lumen central venous catheter in the right side of her neck, an arterial line in her right wrist,
and a femoral artery catheter in her groin for the dialysis machine. She has an oxygen cannula in her nose on 4 liters per hour of oxygen. This afternoon they took 6.5 liters of ascites fluid off her abdomen in a paracentesis procedure. She is hooked up to a heart monitor with 6 leads pasted on her chest, arms and legs, and a pulse oximeter sensor on her right index finger. She has a Foley catheter in her bladder. She has a Bair Hugger warm air machine under her blankets to counteract the effect of the dialysis machine, which chills her blood as it circulates outside her body. All the sensor, infusion, dialysis and comfort equipment attached to Linda produces a constant cacophony of chimes, jingles and other alarms all night long. Also, so many lines connected directly to her makes it impossible to get her out of bed to the restroom when she needs to move her bowels three times a day as the liver doctors want her to do, so she is forced to use a bedpan for that purpose.
Needless to say, the psychological effects of all this on Linda are extremely depressing. She keeps asking "When can I just go home?" Her mantra this morning is "I don't want a feeding tube." Her encephalopathy is increasingly slurring her speech, and making it more difficult for her to find the words to express her customarily articulate thoughts. She cries out in frustration when she feels she isn't making herself understood to her doctors and nurses. It's an extremely difficult scene to watch. Linda is painfully aware now that her continued survival completely depends on the death of some stranger who was generous enough to become an organ donor, matched her blood and tissue types, and was young and healthy enough to have a transplantable liver for her.
You all know what a fighter Linda is, and has been, during all the last seven years she was on the liver transplant list at Northwestern. It is a sad thing to see the fight ebbing out of her now along with the tide of bodily fluids gushing through all the tubes, lines and catheters the surgeons at her bedside have punctured her body with over the last 2 days. It is such a shame Dr. Abecasis' thoughtlessness in leaving that radiology study sitting in his in box unreviewed for three weeks robbed Linda of her last three weeks of better health during which she could have been down here, and perhaps transplanted already.
Colorful, cheerful cards or balloons would be very nice. Phone calls to cheer Linda up are welcome at any time. She often wakens at 3 a.m. wondering who to call just for a chat. I'm here at her bedside 24/7 doing everything I can to keep her focused on the future, and any help cheering her up offered by you as her cherished friends and family is certainly welcome.
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