Surgery Has Begun

They took Karen back to surgery about 3:45 and started surgery about 4:15. The surgeon said the surgery could last anywhere from 2 hours to 6 hours depending on how much difficulty they encounter.

Thank you all so much for all the prayers. We can truly feel them. God has given both of us an amazing sense of peace about all this!

Surgery This Afternoon

The doctors have made the decision to go ahead with surgery late afternoon. The CT showed the previous hematoma has not increased in size but there are other spots that are bleeding. Continuing to give blood products carries risks to the new kidney so they feel that they need to operate and address the bleeding.

Given the past history with surgery, this is a bit scary but we trust this team and their decision. Please pray for a good outcome and for peace for us about this.

Wednesday AM Update

Karen is feeling pretty good this morning. The hematoma causes a lot of pain but it is controlled well with pain medication. Her hemaglobin continues to drop so that indicates there is still some internal bleeding going on. They continue to give her blood and blood products as well as other meds to boost her clotting and hopefully stop the bleeding.

Her kidney continues to be work well so that is a blessing. They did another CT scan of her abdomen this morning to take a look at the hematoma to see if it is increasing or decreasing but we haven't heard the results. The doctors are meeting today to discuss her case and the plan of action. They are still leaning toward no surgery.

This morning as I was getting ready to head back to the hospital I was feeling a bit lonely and discouraged and overheard a story on the Today show. It was about a woman with ALS (Lou Gehrig's Disease) and how she has only a few years to live and her quality of life will be greatly affected during her remaining time. I believe this was a tap on my shoulder by God to remind me how truly blessed we are. Karen and I have spent some time this morning talking about all those blessings: a great new kidney, loving family and friends, people literally all over the world praying for us and the prospect of greatly improved future health for Karen! We give God the glory for all of this and encourage all who read this to realize how blessed you are as well!

10pm Update

Karen has received the blood products to reduce bleeding but I believe they will wait to do the CT scan tomorrow.

Karen is feeling pretty good and has a good nurse so I have gone "home" to try to get some rest.

I will post an update tomorrow whenever there is new information to share.

5pm Update

We just saw Dr. Montgomery. He really wants to avoid surgery at this point if possible due to the risks at this point in her recovery. He is going to order another CT scan to see if bleeding appears to have stopped and also ordering blood products that should help stop any bleeding. If the CT shows that bleeding has stopped then they will insert a drain to reduce the hematoma vs more risky surgery to remove it. This will take longer but lower risk.

He is also going to discontinue all blood thinners going forward as this appears to cause spontaneous bleeding. He feels that the new kidney is well established so isn't too concerned about clotting or issues with that.

I will post again when we have more info.

3pm Update

The transplant team (without Dr. Montgomery who is the head of transplant and the surgeon who did the transplant) came by and told us he (Dr. M) is coming by soon but has indicated he may choose NOT to operate given Karen's surgical history, but instead may place a drain to try to remove the hematoma. He will decide after he sees Karen.

Fortunately Karen is resting pretty comfortably with the help of pain and nausea meds. And her vital signs and blood level has responded well to the transfusions. This is good if they do decide to do surgery.

I will post again after a decision is made about surgery.

11AM Update

The doctors are giving Karen several units of blood this morning to build her up for surgery early in the afternoon. They have also done an ultrasound of the new kidney and there is good blood flow to the kidney so that is good. Prior to this morning they have been trying to make Karen's blood thinner to prevent clotting but this wasn't happening as fast as they would have wanted. Now that she has to have surgery this is another of God's blessings as there should be less bleeding issues from the surgery.

They have also inserted a naso-gastric tube and drained her stomach. This has helped to reduce the pressure in her abdomen and the nausea has eased up. The pain meds have also reduced the pain so she is resting comfortably right now and very calm.

With Karen's history of bleeding and clotting, surgery is always risky so please pray for a good outcome this afternoon. We know that God is still on his throne and watching over us!

Setback - Prayers Needed

We have had a pretty significant setback this morning. Karen has been readmitted to the hospital. She has severe pain in her back, nausea and passed out and fell when she got up in the middle of the night but woke right back up. They have determined that she has a giant cantaloupe sized hematoma (pocket of blood) in her abdomen and are doing surgery this afternoon to remove it and check out the new kidney. So far the new kidney looks ok and this hematoma is not near the new kidney. They believe the bleed started first and she passed out from that (rather than the fall causing the bleed).

That is all I know and will post updates after surgery. Please say an extra prayer for Karen.

What a Difference A Day Makes

Today is an amazing day in Baltimore with sunny skies and temps in the 60's and everyone is out and about. For the first time we have been able to sit out on the deck of the rowhouse and enjoy the sunshine. You can see Camden Yards (Orioles Stadium) behind Karen.

Making the day even more special, Russell Palmer made the drive down from NJ and spent part of the day with us. Russell was in the College Park Baptist Church youth group years ago when we were youth workers.

Karen woke up this morning feeling great. God is so good!

Friday March 8 - Another Bump In the Road

Thursday was a quiet day with no major issues. This morning we hit another small bump in the road and spent all day (7am-7pm) in the emergency department (ED) at Johns Hopkins. Karen woke up early this morning with nausea, elevated blood pressure and mild pain/pressure in her chest so we called the transplant team. They suggested we go to the ED. Of course the ED doctors assumed it was a heart attack but ultimately cooler heads prevailed (the transplant team) and heart issues were ruled out. They have concluded that it probably resulted from one of the anti rejection drugs that is known to cause nausea. This all resolved itself and Karen is feeling fine now and they have adjusted meds to try to avoid a reoccurrence.

The new kidney is doing great and we thank God every day for this!

Wednesday 3/6/13

Today was a day full of clinical visits and it was a long and stressful day. We left home about 7:00 and didn't get back until around 4:00.

We are now past the initial euphoria and learning to deal with the realities of all the side effects of the medicines and all the tweaking that goes along with that.

As is fairly normal with transplants, Karen is now having to monitor blood sugar and give herself insulin shots. This may go away over time as other meds are tapered back. They are also not happy with the levels of blood thinner so have begun new medicines to try to address that to avoid clotting. And of course, when we leave Baltimore, all of this monitoring will have to be transitioned to providers in Winston-Salem (another point of stress!)

But the good news is that the new kidney seems to be functioning great. We are a bit exhausted and stressed tonight but tomorrow is a new day and we are still so thankful for what we know will be a better new life!

Discharge!

Karen finally got discharged around 5pm this afternoon (OK... EVERYTHING at Johns Hopkins doesn't work like clockwork!). Russ flew in this afternoon as well so it is great having them with me tonight at the house.

The picture above shows us walking across the bridge from the hospital to the parking deck on our way out.

We give God all the praise for this and so thankful for our donor and all the wonderful staff at Johns Hopkins.

As I mentioned before, my posts will be more spaced out now but will give updates for important events.

Slight Delay - Discharge Saturday

Our discharge has been delayed until Saturday morning. One of the labs they drew on her anti-rejection meds was drawn at the wrong time so they have to redraw it and wont have results until tomorrow. There is no problem but just have to have this before discharge.

We have waited a long time for this kidney so another day is not a big deal!

Getting Discharged

Karen will be discharged from the hospital this afternoon! All of her lab values are excellent and she feels great. We will have to remain in Baltimore until mid March with frequent visits back to Johns Hopkins for lab tests and clinical visits while they dial in and regulate her anti-rejection and blood thinning meds and continue to closely monitor her kidney function. But we are looking forward to a bit more freedom.

We are extremely impressed with Johns Hopkins. The entire staff has been great, things seem to happen in a timely fashion and they are so "on top" of everything. It has been an amazing experience and a model for what health care can and should be!

We have been "adopted" by two local churches. One is Hunt Valley Church that we attended our first week here through a connection back in Winston-Salem. The other is Redeemer City Church which is a new church plant from Summit Church in Durham (the church Russ attends while at NC State). These churches have been great at caring for us and providing meals etc.

Russ flies in tomorrow to spend a week with us and we look forward to that. Ashley had to cancel her visit due to her family being sick and she did not want to expose Karen to this (with her compromised immunity).

I will probably discontinue daily posts to this blog but will update every couple of days or when there is a significant change. Thanks again for all the comments on the blog, emails and cards. We love reading them.

Rusty

Thursday Update

We continue to make steps forward. This morning her surgical site drain was removed so the only remaining "leash" is one IV. We have not seen the doctors today but assume we are still on schedule for a Friday discharge.

I am pleased to report that our donor's father did not have a stroke. He has pneumonia and dehydration and is feeling much better.

Prayer Request-Donor's Father

Our donor is on her way back to NC and received a call that her elderly father has had a stroke and is on his way by ambulance to the hospital.

Another Step Forward

We took another major step forward today. They removed Karen's perm cath from her chest. This was what they used for dialysis so a good sign that dialysis is a thing of the past! They are also talking about a Friday or Saturday discharge which would be great since Ashley and Russ (our other daughter and our son) are flying in this weekend to Baltimore to spend some time with us.

Our donor is feeling much better and was officially released today by the Johns Hopkins doctors. She and her family member left today driving back to Winston-Salem. But what a gift she left behind through her donation! We can never thank her enough for her sacrifice!

Please do me a favor and include your last name when posting to the blog as we have several sets of same first names! We want to know who is posting.

Rusty

Discussion about Discharge

Everything continues to go well here in Baltimore. Kidney function is excellent and Karen feels great. The doctors are beginning to discuss possible discharge from the hospital as early as this coming weekend with frequent followup appointments over the following weeks at Johns Hopkins. We are still expecting to be able to go home sometime in mid March.

Update - Improvements

They stopped Karen's blood thinner temporarily and the blood in her urine has completely cleared up. Praise God! They have restarted it but will take it up slowly and will have to moderate it closely. The rash is still there but much better.

Another great ending to the day! God is so good!

Real Food/Photo

Today Karen was finally put on a regular diet. She has had only liquids since last Monday and really enjoyed her first real meal at lunch today. She also went to physical therapy. She walked 1000 feet, climbed 18 steps and other tests and passed with flying colors and dismissed from any further PT.

Creatinine (measure of kidney function) is really good. It is lower than it has been with any of the previous transplants.

She is dealing with a bad rash which may be an allergic reaction to her antibiotic and having more blood in her urine so they are going to back off on her blood thinner and do a CT scan to just make sure everything is ok. But these are hopefully just bumps in the road. Please say a prayer for us about these.

Here is a post-transplant picture. I think she looks great!

Sunday Update

Things are still going well. No big changes since yesterday. Karen and the new kidney continue to do well. Karen did a lot of walking Saturday here around this floor of the hospital.

Doctors continue the balancing act with meds. We are so excited about the new life we see coming!

Good Day Today!

Karen continues to feel really good and kidney seems to be working well. She is not using any pain meds at this point. They removed her from heart monitors so we are down to just IV's. This makes walking much easier just having to push one IV pole.

The transplant surgeon came by this morning and moved her to clear liquids. She has been NPO (nothing by mouth) since Monday night. She said that this is the best jello she has ever eaten!

Much of her treatment and meds are now a balancing act (blood pressure high enough for good blood supply to new kidney but not too high, blood thin enough to prevent clots but don't want to increase bleeding, etc.). Still having some bleeding from the drain from her surgical site but slowing down.

Forgot to tell you but she is on the same floor that the guy was on that got the double arm transplant! This place gives incredible patient care and we know we are in the right place! Thanks so much for the blog comments, cards and especially the continued prayers.

Friday am

Karen's kidney is still doing great and she is slowly getting rid of lines, etc. Bleeding has slowed quite a bit so that is good news. Once bleeding stops they will start her on blood thinners to prevent clotting which was the problem with the last transplant. The doctors have to walk a fine line between the bleeding and the clotting because of past issues with both.

Our donor is doing much better and has been discharged from the hospital! She will stay with us in the rowhouse until her follow-up appointment next week.

Heather and our donors husband flew home yesterday and our donor's daughter flew in yesterday to help her mom. More family on both sides will be coming and going during our stay.

We are praising God for all the successes!

Thursday Update

Karen is still feeling really good and the new kidney is working great. She is having some bleeding from her surgical site and the hematologists are keeping a close eye on that. They don't want to be too aggressive treating the bleeding for fear of causing clotting and will instead give her blood as needed (2 units today). Karen is calm and confident about all of this and I am working on achieving the same level of peace!

Our donor is feeling much better today and has been up and walking around.

Sorry I am a bit late with this update but have been waiting for more info on the bleeding issue. I will give an update tomorrow.