A little Setback

First, my apologies for not posting an update sooner. I think the last note I added was on Tuesday, and it is now Sunday. Quite a bit has transpired over the last 4 days.

You may have heard that, as recently as Wednesday, the Drs. were actually considering the possibility that Sandy could come home by this weekend. Frankly, I was not thrilled about this. Miraculous recovery or not, she would be restricted to living on our first floor. This would require sleeping on the sofa in our back family room, which many of you know is essentially part of our kitchen. The room is surrounded by full length windows and lots and lots of bright, natural light all day long. It is also not very well insulated and the room gets cold at night. There is a lot of traffic through this side of the house, too. It’s a great place to visit, but you wouldn’t want to live there. You can probably see now why I was not thrilled with the idea. Fortunately or not, this is not an issue now.

A few major milestones were passed this week, most notably that the liver is certainly working. There is no concern about the viability of the liver at this point and the grafts seem secure. Much to her relief, Sandy was finally allowed to begin eating solid foods on Wednesday. They started her on liquids (broth and jello) and then gave her yogurt. Thankfully, Hopkins stocks the family favorite—Danon (fruit on the bottom) and her nurse searched the kitchen for peach. Sandy ate her first (peach) yogurt Wednesday morning, another (peach) at noon, another (peach) early in the afternoon….and so on. She moved to frozen yogurt by the end of the day. After not eating for a week, it tasted like ambrosia. You could see the increase in energy grow with each bite. She was beginning to feel much better, much faster.

Fast forward about twenty four hours— As you might expect, Sandy has a series of drains that allow fluids to be removed from her body. You would be amazed at just how much fluid can be pumped into your body (and how rapidly your body can expand to accommodate it!). The drains allow the fluids to escape from the body. These fluids are collected and analyzed to monitor the health of the patient. The analyses have shown that there are no infections and things look pretty darned good. Then, on Thursday, they noted an elevation in an enzyme produced by the pancreas. This is noteworthy because, in the Whipple procedure, they actually removed the head of the pancreas. The rest of the pancreas was left behind to do the things that a pancreas is supposed to do. The only way this enzyme would escape the pancreas and show up in the drainage is if there was a leak in the pancreas. So much for the solid food.

They took Sandy off of solid foods again on Thursday (no more peach yogurt for a while), and essentially forced her gastrointestinal system into dormancy. It may take a while, but it is expected that this will allow the pancreas to resolve itself. Sandy was put back on IV nourishment exclusively. They will install a new central line over the weekend so that it does not have to go through a vein in her arm. The veins in her arms have been thoroughly insulted and are not happy about having yet another needle stuck in them. So, now she sits with a big white bag (which I have nick-named “Anna Nicole”), about a gallon in volume, with “pre-digested” calories with vitamins, minerals, etc. It looks a lot like soy milk. She will be fed this way for an estimated two weeks while the pancreas heals itself. Yep, that’s two more weeks.

Imaging studies on Thursday showed a collection fo fluid around the liver that slso needed to be resolved. Late on Friday, Sandy was taken back into an OR to have a drain installed in her back to allow this fluid to drain. Not a big deal, and very simple to resolve. Once it drains in a few days, that should be the end of it.

It was a little discouraging for Sandy to hear the news about the drain and particularly the pancreas, but really, it’s not a big deal. This will allow her body significant additional time to heal before coming home. She is up and walking (some) now and should be able to climb some stairs before too long. I really think it will be better for her to be more mobile before coming home. I am sure she will appreciate the comfort of her own bed, the convenience of cable TV (and onDemand programming), and a bedroom door that shuts!

More later.