Sunday, August 30, 2009

Airlifted to UK last night...home today

As many of you have heard, Mark was airlifted to UK last night around 9:00pm. We had been enjoying a typical Saturday in Harlan. Around 4:00, Mark started having severe abdominal pain. He also started vomiting (a sign of uremia/kidney failure). We called the Transplant Team's 24 hour nurse who advised us to go to the local ER. At ARH, Mark's creatinine had increased to 5.1. Not only had Mark's creatinine's levels increased, but his potassium was very high. Uncontrolled potassium can lead to heart problems. ARH gave Mark medications to help control the potassium and pain. They also completed x-rays of the hernia around the transplanted kidney. The x-rays indicated that his bowels in the herniated area may have become entangled or obstructed. Given the elevated creatinine, potassium, and the results of the x-rays, ARH made the decision to airlift him to UK. When Mark left ARH, we were under the impression that he may need emergency surgery to repair the hernia. However, this was not needed. When he arrived at UK, the ER physicians repeated the x-rays and blood work. The x-rays showed only air pockets in the hernia. Mark's creatinine had dropped down to 4.6 and his potassium was much better controlled. He was only in minor pain. So, around 2:00am, we were discharged! The ER physicians expressed that you can never be too cautious with transplant recipients. They did not have an absolute explanation for what caused the severe pain or what caused the results of the x-rays to differ. Personally, I do not believe Mark's pain was due to air pockets in the hernia. I don't think ARH made a mistake in the x-rays or misjudged sending him to UK. I suspect that Mark's bowels were obstructed or entangled initially. Maybe the pain medication allowed him to relax which helped the bowels return to a more normal position. To me, the best explanation is that the Lord performed a miracle on Mark's behalf. So, I invite you to join me in praising our Lord for His mercifulness!

Thursday, August 27, 2009

Good news at last!!! Please keep praying!!!

I am so happy to report that we received good news from the Transplant Team today!!! As I posted in the previous blog, Mark has a hernia around the transplanted kidney. Before scheduling the surgery to repair the hernia, the Transplant Team wanted to complete a new scan of the transplanted kidney. If the scan had shown decreased blood flow to the transplanted kidney, the surgeon would have removed the transplanted kidney when repairing the hernia. However, the scan today indicated an improvement in blood flow since the last scan! At this point, we are cautiously happy! Mark's creatinine is around 4.0. This is still high. As we've mentioned in previous posts, successful kidney transplants usually result in creatinine dropping to the 1.0 to 2.0 range. The Team decided to have Mark skip two dialysis sessions-the session on Friday and Monday. They will recheck his blood work on Tuesday. I suppose this will give them information about how the transplanted kidney is filtering waste without the help of dialysis. Upon receiving the results of his blood work, they will reassess the situation. Mark is scheduled for the surgery to repair the hernia on Wednesday of next week. His hernia is quite large-so he will have to spend at least one night in the hospital. As always, we are asking for continued prayer. We are praising God for the encouraging news we received today. In addition, we are praying that the blood work on Tuesday indicates continued improvement and a drop in creatinine. Finally, we are praying for the surgery to go smoothly on Wednesday.

Sunday, August 16, 2009

Update on Mark

Once again, I'll start by apologizing for not updating the blog in several weeks. It has been really hectic at our home lately. As I mentioned in the previous post, we had hard wood floors installed in our foyer, living room, and dining room. What we thought would be a three day project turned into several weeks! We decided to have a wall knocked out and to install wainscoting in the dining room. Despite the fact that our house has been a huge mess for several weeks now, we are thrilled with the results!

On Wednesday of the week before last, Mark had a appointment with the physician who places catheters for peritoneal dialysis (i.e. the type of dialysis that can be done at home while you sleep). Remember that the infection Mark had contracted a few weeks ago postponed his appointment with this surgeon. We were hopeful that the surgeon would schedule the surgery the following week. However, he expressed concern about the surgery due to Mark's abdomen being swollen and somewhat protruded around the site where Justin's kidney was placed. There was also some concern about the placement of the "mesh" the Transplant Surgeon had placed around Justin's kidney during the second surgery in June. Thus, the surgeon wanted to wait until he had spoken with the Transplant Team before scheduling the surgery.

Mark had his check up with the Transplant Team on Thursday of last week. We were eager to meet with the Team to find out about the surgery for the peritoneal catheter. In addition, when we had attended the weekly check-up prior to this visit, Mark was seen by a Nephrologist who is not the physician who is following our case. This physician had no new information and couldn't answer any of our questions. Although Mark was seen on Thursday by Dr. Waid-the Nephrologist who is following his case, we unfortunately received some bad news. Mark has a hernia around the transplanted kidney. Not only does this mean that he cannot have the surgery to place the catheter for peritoneal dialysis anytime soon, it means that Mark will have to undergo two different surgeries sometime in the near future. One surgery will be completed to repair the hernia. This will be an inpatient surgery requiring general anesthesia. Secondly, Mark will have a surgery to create a fistula in his forearm to allow him to continue with hemodialysis. Remember that hemodialysis is the type of dialysis that uses the blood and is typically completed at a dialysis center. At present, Mark has a catheter in his chest to allow for hemodialysis. However, this catheter serves as a temporary port. The type of catheter in his chest frequently causes infection. Thus, if a patient is going to be on dialysis for an extended period of time, a more permanent port is created. The fistula will be created by joining an artery and vein in his forearm. This surgery will be outpatient and requires only a local anesthetic. Needless to say, Thursday was a rough day for us. Hemodialysis seems to be very draining for Mark-both physically and mentally. Going to a center for 4 hours three times weekly with people who are much older and seem much sicker than you would have to be difficult. In addition, hemodialysis requires a strict diet that is frustrating at times. We were really looking forward to being able to complete dialysis at home. Mark is eager to go back to work. Peritoneal dialysis would have allowed him to do this. We were viewing the surgery for the catheter for peritoneal dialysis as one step closer to a more normal lifestyle. So, Thursday was a bad day to say the least.

We did find out some more information about the sample of Mark's blood that was sent to UCLA and John Hopkins for testing. I will post more information on this sometime soon. It is not necessarily good news, but at least it is news! It is kind of complex and difficult to understand. I'll do some more reading before I attempt to blog about it! As always, thanks for the continued prayers.

Despite the twists and turns of this journey, I still believe in the power of prayer and the power of our God. I am still praying that God will place His healing hand upon the transplanted kidney and allow it to start working! I understand this may be a long shot. I know this may sound cliche, but I believe in miracles. A miracle is exactly what Mark needs. So, I'm not going to stop praying for one despite how bad this situation may seem. Please don't stop praying for Mark!