Liver Transplants

ICJ wrote:

If you start posting your liver updates in the World of Warcraft base, the only people who will have your liver updates will be people who play World of Warcraft.

Only Wowcrap players . . . and people who watch 9 News! That story has numerous factual errors, somehow. I was never in a coma, my brain didn’t swell, the liver came from Wyoming, and I didn’t seriously believe I was merely suffering from dehydration. Jesus Christ. Good thing neither doctor told an anecdote about a guy with cyrosis all through his liver or that woulda been the single sentence included in the piece, I bet.

Basically, I was sick for a couple weeks — not feeling great, no appetite, just generally sick. I became concerned when I bought a McRib and ate exactly one bite. I was working during this stage. Then one day I turned yellow. My co-workers were like, YUO HAVE TEH AFRICAN SHIT O_O. I said, you guys are really smart but I’m going to see my doctor anyway. By coincidence, the day I turned yellow was also the day that I’d previously scheduled an appointment to see him. It was also the day before Thanksgiving. The theory espoused was: hep-a. They took some blood and I went home.

Or rather, I went home and packed up a few things then went to my Mom’s house, with the intention of staying there for the 4 day weekend. Maybe I could recuperate better with her feeding me and stuff. Monday rolls around and I’m still yellow and sick, so I worked from home. Doc calls and says he wants an ultrasound done, scheduled for Tuesday morning. Tuesday morning, my Ma drives me out to the clinic to do this thing. I start to feel faint and weak, like nothing I’d experienced before. I said, “I’m in trouble”, and things get really fuzzy after that. Nobody understood that I meant that to be maximally ominous, partly because I was unable to follow up with more explanation. I stopped talking for some reason (I have no memory of this).

So dipshit clinic guys do the ultrasound and wheel me out to my Mom’s car in a wheelchair. She’s driving me home and now I’m talking, but making absolutely no sense at all. She decides to take me to the nearest emergency room. The ER guys are on top of things, and notice a) my body temp was 90 degrees and b) my liver was falling apart before their very eyes. They did a great job stabilizing me and bringing my temp up to 94.5 or so – at which point I woke up and have memories again! – and calling an ambulance to take me to the hospital in town that does liver transplants. (Actually there are two, but the week of my surgery, the other one had a mysterious death and their program is now suspended, pending an investigation.) I totally remember the ambulance ride and arrival at the transplant hospital, then things go dark for me again.

Most of the rest I learned about days later. My liver quickly degenerated until I was placed at the top of the liver transplant list. They have a metric for quantifying how bad off a patient is, called a MELD score: measure of end-stage liver disease. They stop calculating it at 40, since that’s too fucking high and you’re already at the top of the list at that point. But one of the nurses, just for the hell of it, kept track and reports that my MELD score got up to 52. They were pretty surprised that someone could still be alive at that point. The warm fluids they’d pumped into me to keep my temperature up had turned me into a swollen balloon, my hands were like hams and my arms were double their usual diameter.

I had occasional moments of lucidity, and stretches of delirious nuttiness. My Mom told me that my brothers were going to be in town shortly, and I said, “why?” I didn’t quite get what was going on. My eldest brother got on a plane basically the instant after hearing I was in deep shit trouble. He arrived and asked the doctor what he had to do to get tested to see if he could help me (live liver donation). The doc replied, “He’s absolutely not a candidate for a live transplant. He needs a whole liver and he needs it immediately.” O_O Another stretch of lucidity for me was before another ultrasound. I watched 30 minutes of fucking Mike and Mike in the morning at 4am and talked to my nurse a bit. The superstar liver transplant surgeon guy stopped by – I had no idea who the hell he was – and said he thought I’d need a liver transplant. WHAT? I hadn’t heard anything like that. So I just said, “I think we should be extremely cautious about that.” Holy crap.

On the nutty delirious side, I guess at one point I’d decided I needed to get out of bed for some reason. My clotting factor was 9 (way too high, my brother was afraid to touch me because I’d probably bruise — it’d eventually get up to 20!) so falling down was a serious risk for me. I wasn’t saying anything at all except “GODDAM IT”, “MOTHERFUCKER”, and “FOR THE LOVE OF GOD”. I’m glad that last one got in there, that means I’ve programmed Moe Sizlak into my brain stem. A+. Anyway, the nurse put me in some kind of restraining vest. I’m not sure what kind of person gets restrained by this vest thing, because my arms were free and I was still plenty strong, relatively speaking. My brother reports that I was well on my way to removing the offending garment, so my arms were tied down. Foiled!

A helpful timeline here: The ultrasound and crash, followed by being admitted to the hospital was on Nov 30th. Everybody was in town by the 2nd, including my younger brother and his family from Perth. (“We had a family meeting, and we’re flying out asap.”) Quite a logistical achievement. That same day, a liver became available, and the surgeon flew up to Wyoming to examine it and bring it back. So I went into surgery on Thursday night (the 2nd still). Some friends of mine and my family all had dinner together that night at a restaurant while waiting for news on when the surgery got underway. The doctors and nurses said it could take up to 12 hours (although the surgeon said he thought it’d be maybe 5). In the event, he walked out afterward and declared it a “99.99”. It had taken 3.5 hours (they finished around 2 am Friday), and he’d only needed two units of blood instead of 8 that are usually needed. Normally the patient takes three days to wake up, I woke up on Saturday morning (the 4th), still intubated.

STILL INTUBATED. And still tied down. My eldest brother was there, and a cute nurse. And I was OUTRAGED. I had no ability to make any sound at all, because no air was going over the vocal cords at all. My brother and I had foolishly failed to come up with a system of complex eyebrow movements to communicate in such a situation, so it was just the most frustrating thing ever. It still pisses me off, thinking about it now. FUCK THAT. >:[ They finally take the tube out and I said, “Do I have a catheter?” Yes. “GODDAM IT.” Turns out, I was peeing out such a tremendous amount of fluid that I’d be urinating 24/7 if they’d removed that. So as I got more information, I was pretty okay with it.

Ever since then, my recovery has been way beyond what was expected. I was sitting in a chair drinking water on the 4th, the same day I’d woken up. I didn’t need pain meds. The first day, I barfed up my anti-rejection drugs (I puked three times), and I was very worried, but I didn’t puke again after the morning of the 5th. I think I started eating solid food and walking around the ICU on the 6th. I basically didn’t need any pain medication at all – I had two very low dosage morphine injections that lasted an hour, and I took two percocets in the 10 days I was awake at the hospital. Pretty crazy!

During the next week, hospital people kept stopping by to say hi. They’d say “you don’t know me but I helped drill the hole in your head!” or something like that. “You looked terrible and we didn’t think you’d make it. It’s amazing to see you walking around!” Or one doctor said, “A case like yours is why I got into transplant medicine. To see the turnaround here is just incredible.” I started to realize the magnitude of what had happened to me, and it was a little overwhelming.

My ICU room was huge and at one point I think I had 8 or 9 visitors, friends and family, all in there at once. There was room because they’d started taking out the bigass trees of machines from the first day and the process continued until I was transferred on the 8th to a non-icu ward.

Fast forward to now: I did get readmitted to the hospital for a heart arrhythmia on Christmas night, around 10:30pm, and stayed for about 40 hours. Other than that, it’s been pretty much good news. I’m now taking 14 instead of 17 meds, and they’ve dialed back the really heavy hitters somewhat, so the nasty side-effects are less. I feel great, use my pain pills only when I get a headache, and my endurance and weight are back up to decent levels. Hooray!