Wednesday, December 19, 2018

Since the last post until now

Lee has been home for more then a month now and every week we are off to another appointment or procedure to help him on his road to recovery.
November 13th:  The liver team wanted to try Botox treatment once more to see if this will help resolve the achalasia.  This procedure was done by Dr. Boshard he is the lead doctor when it comes to botox treatments.  He had high hopes that the last treatment was impeded by the food remnants in Lees esophagus at the time of the treatment.
November 15th:  Lee had a paracentesis, this is to remove the excess fluid in his abdomen called ascites. Lee has had an issue with this since his hospital stay in September.

Ascites happens when pressure builds up in the veins of your liver and it doesn’t work as it should. These two problems usually are caused by another condition -- cirrhosis, heart or kidney failure, cancer, or an infection.
The pressure blocks blood flow in the liver, which over time keeps your kidneys from removing excess salt from your body. This, in turn, causes fluid to build up.

At this appointment they removed 5 liters of fluid off of his abdomen. Each liter of fluid weighs 1 kilogram which is 2,2 pounds.  Lee had 11 pounds of fluid removed from his abdomen this day. 

On November the 18th Lee was not feeling well at all and he could not keep his footing so I took him to the instacare, they took one look at his history and sent him straight to the ER.  after several test it was determined that Lee had a UTI. 

November 20th Paracentesis removal of 2 liters of fluids which is 4.4 pounds of fluid.

November 21st Lee had low blood counts on his previous labs.  Hemoglobin of 6.8 and Hematocrit of 23.5.  Lee went into IV therapy and received 2 units of blood.  While sitting there waiting Bonnie and Randy came by on their way to Duchesne for thanksgiving weekend.




















November 26th Lee and I had to go into Murray for a gastric empty study,  this was to determine if the botox treatment was successful, which we learned that it also failed.

November 28th Lee had a CT of his head his confusion has just never really cleared and he had fallen a couple of times once hitting his head.  This was mainly to be safe.  Lee also had another paracentesis this day mainly to test for infection. this was less fluid then normal 1800 ml.

November 29th:  for the transplant list there are multiple test that Lee has to do each year. one of the test is a cardiac stress test to ensure his heart remains health.
cardiac stress test (also referred to as a cardiac diagnostic testcardiopulmonary exercise test, or abbreviated CPX test) is a cardiological test that measures the heart's ability to respond to external stress in a controlled clinical environment. The stress response is induced by exercise or by intravenous pharmacological stimulation.
Lee stress teat was perfect according to the Nurse Practitioner in the liver clinic. 
November 30th:  Appointment with the liver team, this was a good and bad visit Lee is doing better there was a couple of medication changes and we got results from the test.  Because of the failed botox Lee was placed into Section 7 on the transplant list which essentially means  he is on hold and will not get any Liver offers.
On December 3rd Lee had a fall hitting his back pretty hard leaving some large bruises.  I took him to the ER I always worry with his liver failure and chronic anti coagulation problems.  Everything checked out fine, Lee is just really really sore.  
December 6th Lee had another fall in the bathroom.  He did not want to go to the ER, on December 8th Lee had a ton of pain and was not even able to get out of bed very well, I took him to the ER once again he has 2 broken displaced ribs and a compression fracture of the t-10 vertebra. 
Spinal compression fractures are also called vertebralcompression fractures (VCF). This type of spinal fracturecan cause severe back pain and adversely affect your overall health. A VCF occurs when one or more of your spine's bones—the vertebrae or vertebral bodies—fractures causing spinalbone to compress.Oct 9, 2018

Lee did not need surgery and there was a debate on weather or not to admit him for pain control.  Lee decided to go home after they decided to let him choose.  Lee had been recovering and we have been trying new things to help him get stronger.  He is continuing working with PT and OT, we have also purchased a pass to the Provo Rec center so that Lee can walk in the pool and enjoy the hot tub and as he gets stronger he can use some of the other facilities.  
December 10th Lee had a parcentesis.  5 liters of fluid was removed that is 11 pounds of fluid accumulated in his abdomen.
December 17th once again another paracentesis this time 4.8 liters of fluid removed. which is just under 11 pounds.  
There are many appointments and procedures to come.
Tomorrow Lee is going to have his feeding tube replaced the current one has been in there for a while and has gotten stiff it is causing a very sore throat and his nose to bleed often.  
Friday Dec 21 Lee is going to Murray for an MRI of the liver, his liver cancer markers was elevated so he needs an MRI just to clear his liver.  
December 26th Lee will get a stent placed in his lower esophageal sphincter.  This is to help with his achalasia, this is to help prevent any further aspiration.  




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