This is the air we breathe, this is the air we breathe, Your Holy Spirit, living in us.
Scotts support is far more than anyone knows. Continuous prayers being lifted. ~ Jane D.
Monday, May 26th, 6:30pm: Surgeon just came and spoke with me. Scott is stable. Praise God! He is medicated to sleep comfortably for now. They may try to wake him up later. He is still covered in support to keep him stable right now. He’s in good hands.
The surgeon said that all of the doctors are in town now, but not on schedule. They’ve consulted, and would like him to gain strength. So we’ll wait.
They have booked an operating room for tomorrow morning, but are hoping that things are going so swimmingly that they can hold off until possibly Wednesday. That said, he assured me they (the SPECIAL/best team) are all on-call, equipped, and ready to do this at any point if they need to.
Surgeon was very confident. And kept great eye-contact with me. That matters. And his comforting accent.
Though he is still in critical condition, I think we are out of the darkest part of the woods of this episode. And will have the best doctors now that holiday/weekend are over “enough”.
I’m breathing again.
Scott’s liver – tho’ it functions perfectly – has nodes in it that won’t allow blood to flow through as quickly as normal, so his body has rerouted it over years, enlargening his spleen, and creating large veins in his esophagus and, as of last fall, his upper stomach. He goes in annually to have his esophagus varix banded, as needed. His spleen is stable he’s just not supposed to do contact sports, etc… but the upper stomach varices are more dangerous, and cannot be banded.
We’ve known this could happen for years, though have been grateful for no problems ’til now.
The surgery will essentially divert half+/- his blood flow away from his liver, reducing pressure/veins as a possible longer-term fix (as well as immediate). It will be using a shunt between his spleen and kidneys (not the common portal shunt, or TIPS, since Scott’s is not an option). Because of his maze of veins throughout his abdomen, and because this surgery is no longer used regularly, and because of his decreased health, it brings a lot of risk.
Until now, it wasn’t worth surgery. Now it makes sense to. And the doctors that will be with him are abundant, and are brilliant.
They learned the other night that they can’t do any of the “quick” fixes because of his complicated anatomy, so we’re jumping ahead to the bigger fix.
Let me expound…
Note all of the smaller, blue veins in the photo below. The ones near the esophagus are the ones that the doctors band with a scope in Scott’s throat, when needed. Last fall, two were found bulging inside his upper stomach, likely rupturing, causing these recent bleeds.
The liver team was proposing that they take the vessel leaving the kidney, and the one leaving the spleen, and laterally sew them together for a large portion of space. This would effectively send all of the extra pressure out through the kidney vein to the vena cava, which is a high pressure system leading to the heart. This would potentially remove all future risk of bleeds, even putting him in a safer, better place than when we started all of this. The doctor mentioned Scott growing old “normally” if it was successful. This means the surgery would potentially leave him healthier than when we started all of this. He had me at “growing old”.
This surgery, though more common in the 1970′s, is extremely rare, performed about one per year nation wide.
The surgeon, Dr. Michalski (or, “The German Doctor” as we lovingly dubbed him for weeks) didn’t only explain the benefits, he also explained the potential risks, some rather huge. Death obviously being the worst.
Scott could get Hepatic Encephalopathy (confusion because of toxins) since some blood would be re-routed, not going through the liver to be filtered. We talked about why that was unlikely, based on the amount of blood his liver was already re-routing over the years. There would probably be no more or less after surgery. There are medications to help this if it happens, and that they could reverse the surgery, if necessary.
Dr. Michalski explained that the shunt could clot, causing the surgery to have been worthless. This was most likely to happen between 3 to 5 days after surgery if it were going to happen. He assured me that during surgery they would have a plan A, and then A1, A2… then B, B1, B2, etc… They would map out multiple plans, including many alternatives, as detours deemed necessary. They would meet tomorrow morning to discuss further.
Our team would consist of the best of the best.
As he was wrapping up, I had to ask: “Are you excited?” Continue Reading »