Friday, September 25, 2009

We're home!

I am thrilled to report that we are home! Mark was discharged from UK late yesterday afternoon. The team decided that an oral antibiotic was sufficient in treating any residual infection. The Team was considering placing a "picc line" in Mark's forearm to allow him to continue receiving an IV antibiotic. However, placement of a picc line can be problematic for dialysis patients. Use of picc lines can potentially ruin the arteries/veins that may be used in creating a vascular access for dialysis. We were relieved to avoid this! Mark will continue to have blood cultures drawn when he is at the dialysis clinic to ensure that no bacteria is growing. Thanks for all the thoughts and prayers over the past week! In addition to Mark feeling so bad, it was really difficult to be away from Mark Thomas for an entire week! We are looking forward to a weekend at home with our little guy!

Wednesday, September 23, 2009

Hospitalized for a few more days

Mark's new catheter was placed in his chest this morning. We are thankful that this is behind us. Mark experienced a great deal of pain when the first catheter was placed. The placement of the catheter this morning was not as bad as the initial one, but Mark is pretty sore. As we've mentioned in previous posts, the Cannon catheter is placed in the chest-just below the collar bone. The catheter is tunneled down into the chest and serves as a temporary port for dialysis. Each time Mark is dialyzed, the catheter is used as the dialysis machine pumps his blood out, cleans it, and pumps it back into his body. The catheter is considered as a "temporary port" because it is not meant to stay in a patient's body more than a few months due to the risk of infection...which we know can happen easily!

It was our understanding that the Transplant Team's plan was to place the new catheter, dialyze Mark, and send him home on oral antibiotics. This morning, the cultures back from the lab that had been drawn from days past no longer indicated the presence of any infection. However, this afternoon, the Team received another report from the lab on a culture drawn a few days ago from behind Mark's old catheter (the one that was removed on Monday). This culture showed the presence of bacteria. Thus, we will have to stay here to receive more antibiotics via IV. This was discouraging news as we were ready to go home! Please pray that the infection clears. We are hopeful that the cultures drawn today will not show any infection. If the infection does not go away and the catheter no longer seems like the cause of infection, the Team will have to consider doing something more invasive to identify a new location or cause of the infection.

Monday, September 21, 2009

Difficult day...but at least the catheter is out!

Today has been difficult for Mark. He started feeling pretty bad late last night and early this morning. Mark went to dialysis around 7:30 this morning. While he was receiving dialysis, he started having rigors and became very nauseous. It was then that the Team decided that the catheter used for dialysis had to be removed. Using the catheter for dialysis seemed to exacerbate Mark's symptoms. I guess this served as proof that the infection had contaminated the catheter. So, the catheter was removed late this afternoon. We were very nervous about the removal of the catheter. However, after its removal, Mark said it wasn't as bad as he had anticipated. The plan now is to wait and see how Mark's blood work looks after having the catheter removed and receiving the IV antibiotics. Hopefully, Mark's white blood cell count will continue to drop. This would mean that we could go home with an antibiotic to help fight the infection. As we mentioned in an earlier post, there is some concern about the presence of an abscess around the hernia repair site. If Mark's blood work does not show improvement, the Team will have to consider something more invasive (i.e. sampling the fluid around the hernia repair site or surgery to reopen the hernia repair site to remove any abscess).

Mark will have another catheter placed in his chest on Wednesday. When Mark had the catheter placed in June, it was painful and nerve wracking. The catheter is "tunneled" down next to patient's heart. The patient is given some type of sedative, but is not under general anesthesia. Mark is not looking forward to this. Please pray for him-especially on Wednesday.

Despite not knowing what lies ahead, Mark and I are trying to stay positive. I've said it before, and I'll say it again, Mark is the strongest and bravest man I know. He has been through a great deal. I admire his strength. We spent some time this evening reading Paul's letter to the Thessalonian gave us comfort to see how other believers have dealt with affliction and suffering. We studied the definition of endure...the Greek word translated for endure is anecho which means "to patiently wait." We know that God gives inner strength to the believer to enable him to be steadfast, to patiently wait in the midst of difficult circumstances. We are just praying for that inner strength!!!

Sunday, September 20, 2009

Update on Mark

We're happy to be out of the ER and in a room on the Transplant Floor. The cultures are showing Mark has a rare infection that only immunosuppressed patients can acquire. The exact location/cause of the infection is still undetermined. Mark's incision site around the hernia was somewhat red on Friday morning. The Team ordered an ultrasound to investigate if the infection was related to the hernia repair. The ultrasound of the incision from Mark's hernia repair showed a potential abnormality. However, Mark's abdomen no longer appears as red. He feels much better and seems to be responding to the IV antibiotics. To further investigate the hernia repair site, the Team completed a scan late last night to help identify any abscess. At present, we are waiting for the results of this scan. PLEASE PRAY...if the scan shows an abscess, Mark would have to undergo another surgery! The Team decided to wait to remove the catheter in Mark's chest used for dialysis. Typically, when a patient has a temporary port and an infection, the Team will remove the port and not replace it for a few days. This allows the patient to go a few days without a foreign object like a plastic catheter in his or her blood stream. However, Mark's potassium is elevated. He may need dialysis tomorrow to help combat the potassium. Given his high potassium and the fact that the scan results are not yet complete, the Team will make a decision later today or tomorrow about whether or not to remove the catheter. As always, please pray for Mark! His spirits are low-especially considering we could see Commonwealth stadium from our room on the 8th floor but could not watch the game-even on television! Mark is beyond ready to be back at home!

Friday, September 18, 2009

Back at UK

Unfortunately, Mark is back at UK. He had a rough past couple of days-feeling very nauseous and weak. Yesterday evening he had a fever and starting having rigors. We called the Transplant Team as this can be a sign of infection or rejection. The Team advised us to come to the ER at UK. We arrived at the ER at around 9:30 last night and we are still here!!! We've been informed that a room on the Transplant wing has been assigned to us. I guess the process of cleaning and preparing a room for a transplant patient is complex. Hopefully, this will be finished soon! It seems so crazy to have a transplant patient wait in such a germy environment!

The blood work completed on Mark last night shows an elevation in his white blood cell count. The physicians are trying to determine the location and cause of infection. The infection could be around the incision site from the hernia repair. This would be the worst case scenario as it may require a surgery to remove the "mesh" used to repair the hernia. The infection could also be from the catheter in Mark's chest used for dialysis. Temporary ports or catheters in the chest for dialysis frequently serve as an infection site for patients who are immunosuppressed. If this is the case, the Team would remove the catheter and replace it in another location. This is also a troublesome scenario as Mark experienced a great deal of discomfort when the catheter was originally placed in his chest. It is my understanding that the infection could also be from another reason (i.e. exposure to bacteria, etc.). This is probably the least likely given Mark's situation, but it is the situation for which we are hoping! As you remember, Mark was hospitalized in late July for an infection. This infection was not due to his catheter and was treated with strong IV antibiotics. He was in the hospital for about 3 days and was released. Hopefully, this will happen again! We will update the blog as we learn more. Please keep praying for Mark!

Friday, September 4, 2009

We're home!

Mark was discharged from the hospital yesterday evening. His potassium, creatinine, and blood pressure were high yesterday morning. The Team would not discharge him until his potassium dropped to a safer level. Because of the high levels of potassium and creatinine, Mark received dialysis while at UK. The Team is now trying to figure out how much dialysis is necessary (one time weekly, two times weekly, or three times weekly). It seems that the transplanted kidney is working better than expected prior to the scan last Thursday, but it isn't working well enough to avoid dialysis all together. Mark will go back to the Transplant Clinic on Thursday. Hopefully, we'll find out more information then! We plan on enjoying a great Labor Day weekend at home with friends and family. We hope everyone does the same! Thanks for all the prayers!

Wednesday, September 2, 2009

Surgery is complete!

The surgery is complete! All went well! There were no complications. Dr. Gedaly said the hernia was quite large, but he anticipates that Mark will recover from the surgery with no problem. Mark has been in the Post Anesthesia Care Unit most of the afternoon. Transplant patients are usually placed in rooms that require special preparation due to the patient's immunosuppression. We had to wait until the room was ready. However, we're now in room 832. We should find out in the morning what the Team will do about Mark's increase in creatinine. Mark is in some significant pain. Please pray for him tonight!

Mark is in the OR

Mark just left the prep room and is now in the operating room. The surgery should take about 2 hours. I will update the blog when he is out of surgery. Please keep praying!

Surgery update

Mark has been instructed to report to UK at 8:45 this morning. His hernia surgery is the second scheduled surgery today unless an emergency surgery causes it to be postponed. If it works out that his surgery truly is second, I am thinking it may be completed around 11:30 or 12:00. Yesterday Mark's blood work indicated an increase in creatinine. It was 4.0 last Thursday and is now 4.9. This is not good news-we will find out today what the Transplant Team will decide about dialysis. As always, we are asking for prayer. Please pray specifically for Dr. Roberto Gedaly-the Transplant Surgeon who is completing the surgery. Also, please pray for the Anesthesiologist who will be assigned to Mark's case today. Mark had difficulty waking from the anesthesia during the first transplant. So, we are always especially apprehensive about general anesthesia! Also, please pray for my brave husband. Although he is the bravest and strongest man I know, it is difficult to see him face his sixth surgery since March! I will post more as we learn more this morning. I am hopeful that I can get our laptop to pick up the wireless signal at UK today!