Beginning Dialysis

This morning a deep line was placed in Mark's neck so that hemodialysis can begin. The procedure to place the line was uncomfortable for Mark. They numbed the area with a topical anesthetic, but did not want to give him any type of sedation due to his past history with anesthesia. The deep line looks a little different than the one he had last week. This one is "tunneled" so that there is less chance of infection and so that it can be in place longer. Mark started dialysis this afternoon. At this point, the Transplant Team is planning on letting Mark receive dialysis today, tomorrow, and Thursday. They will continue to monitor Mark's blood/creatinine levels and will decide after Thursday if he will need to continue with dialysis. If the Transplant Team decides that he will need to stay on dialysis for an extended period of time, they will place an access port in his body. For hemodialysis, the physicians connect an artery and vein in the forearm. For peritoneal dialysis, a catheter is placed in the abdomen. Mark's preference is peritoneal dialysis. Placing the catheter for peritoneal dialysis requires surgery. As you might expect, we're praying that the dialysis Mark receives this week will help Justin's kidney to start working so that Mark can avoid another surgery!

As I mentioned in an earlier post, the Transplant Team sent a sample from the kidney biopsy to a Pathologist in California. The Transplant Team has consulted with several other transplant surgeons in other hospitals. They are thinking that Mark may have antiendothelial antibodies that are triggering his rejection to transplanted kidneys. This is a very rare condition that makes transplantation difficult. The Team is still awaiting the results. I will post the results as soon as we know more.

Please pray for God's peace for our family. Please pray specifically for both of our mothers-Rhonda and Tish- as this situation has been extremely difficult for both of them.

Readmitted/Dialysis

Mark is being readmitted to the hospital today. He had an appointment this morning at the Transplant Clinic. Unfortunately, his creatinine levels have jumped pretty significantly. They were 5.7 when we left the hospital last Thursday and are now up to 7.3. This means that he is going to start dialysis. We are waiting for the admission paperwork to be completed. Then, we'll probably be back up on the 8th floor. One of the physicians will place a "deep line" in Mark's neck. This will serve as a temporary means for the dialysis. I think that they will place a more permanent port later this week. There are 2 types of dialysis: hemodialysis that uses the blood and peritoneal that utilizes the peritoneal cavity. Both require an access "port" to allow for the fluid to exit the body. However, it takes a few weeks after placement for it to be used. In the mean time, the deep line will be used. Mark wants to go on peritoneal dialysis. This type of dialysis can be completed at home. I'm unsure if the placement of the peritoneal catheter requires general or local anesthesia. I'll post more information as we find out what will happen. I'm thinking Mark will be in the hospital until the weekend. Please keep praying for Mark!!!

Heading home until Monday!

The scan of the transplanted kidney indicated that there is still blood flow. The perfusion is poor, but the kidney is receiving some blood. Despite the blood flow and use of anti rejection medications, Mark's blood work is continuing to show that the transplanted kidney is not working as well as we had hoped. His creatinine levels are back up to where they were before the transplant-around 5.0. Although the kidney is not functioning perfectly, we are thankful that there is still blood flow. We're happy to be going home with Justin's kidney as this means that there is still a small chance that it may one day recover. It will be a "waiting game" for quite a while as the Transplant Team will continue to monitor Mark to decide if the use of anti rejection medications and other treatments (which carry their own risks) are really helping and if continued use of the medications is worth the risk involved. The Team will also monitor Mark to determine if and when he'll need to go on dialysis. So, at this point, we're heading home until Monday.

The Transplant Team has sent Mark's kidney biopsy and blood work to several other Transplant Clinics in hopes of learning what seems to be going wrong. Please pray that some type of answer is found. If this transplant is deemed unsuccessful and no type of conclusion is found, Mark may no longer be a candidate for transplantation. This would mean life on dialysis.

Mark's issues with digestion are getting better. He is no where near feeling "normal" or ready to eat three meals a day, but things are improving slowly. Mark is feeling weak. He's lost about 25 pounds. His spirits are low as well. We're hoping that he can regain his strength as he is able to eat more and rest more comfortably at home.

Please don't stop praying!

Update on Mark

I'm happy to report that Mark has only thrown up two times since this morning! I'm keeping my fingers crossed that he will have a better, more restful night tonight. His bowels seem to no longer be as obstructed as they were initially. However, he is still cramping and in pain. He was able to eat a few bites of chicken noodle soup today. In addition, he was able to lay still long enough for the renal scan this afternoon. We'll find out the results in the morning. We're praying that the kidney is still perfused. If so, we may go home soon! Mark would be monitored at the Transplant Clinic two to three times weekly and would continue with the anti rejection medications in hopes that the kidney will start working. If the scan shows that the kidney is not perfused, the Team will most likely remove it. This would mean another surgery which would make the issues with Mark's bowels even more difficult as the use of anesthesia slows down the digestive system. Thanks for all the prayers-we've really needed them. We'll update the blog as soon as we learn more in the morning.

More rough nights

Mark is still in a great deal of discomfort. He has been vomiting and unable to drink or eat since Saturday. As you might imagine, he can't rest and is really weak at this point. The evaluation of Mark's kidneys is kind of on hold until everything with his bowels are resolved. Please continue praying for Mark.

Rough weekend

Mark has had an extremely rough weekend. He has been vomiting since Saturday morning. They think his bowels may be obstructed. Please pray for Mark as he is in a great deal of pain and discomfort. He did not sleep last night. The nurses' attempts to help his bowels move have been very uncomfortable and unsuccessful. If you are planning on visiting, please call our cell phone first. We do not mean to be rude, but Mark is in a very tough place right now and has not felt like any company. The Team had planned on re-scanning Mark's kidneys tomorrow morning. But, I'm thinking they will postpone this until the other issues are resolved. Please continue to pray for Mark.

Praying and Waiting

Not much has changed since our last blog on Thursday. Mark received plasmapheresis yesterday evening. He also received IVIG and some other anti-rejection medications through his IV. His creatinine levels are essentially the same. Yesterday, it was up to 4.2. Today, it is 4.0. The Transplant Team is thinking that Mark's kidney function may have reached a plateau at around the 3.9 to 4.0 point. So, they are thinking of discontinuing the plasmapheresis as it seems to not be lowering his levels as they had hoped. We are under the impression that Mark will will remain in the hospital at least until Monday or Tuesday. The Team will monitor his kidney function without the plasmapheresis. I think they are going to do another scan of his kidney Monday morning. As long as there is blood flow into the transplanted kidney, they will not remove the kidney. I would imagine if his levels stay around the same point and there is blood flow to the kidney, Mark will be discharged to home. He would then be monitored until the point where he will need dialysis.

We have heard of some patients who have gone home and then experienced an increase in kidney function. Sometimes it takes a while for the medications to kick in and sometimes dialysis can "jump start" a kidney. So, there is some hope. The amount of hope seems to diminish each day that Mark's creatinine levels are not dropping, but there is still hope. In March, there wasn't hope for the transplanted kidney to work. So, we are thankful for a possibility of it working, despite how small that possibility may be. We're also thankful that his levels are not increasing at an alarming rate.

As you might imagine, this is an extremely difficult situation. We are trying to stay positive, but at the same time we're trying to prepare ourselves for any outcome. Some moments are easier than others. We appreciate all of your prayers and ask for continued prayer for God's healing and peace.