Home Again

Yesterday afternoon we came home from San Francisco. Angela's liver enzymes started trending down, though they haven't gone far and she's still very yellow. The doctors are pretty sure what she has was caused by some drug given to her in conjunction with her recent illness, most likely an antibiotic, but they say that since she had so many different medications, we may never know which it was.

For now, she needs blood tests twice a week for a while. After they really start to get better, the frequency can be reduced. They were hopeful that her jaundice could be mostly gone within a couple of weeks.

We are so thankful to everyone for their prayers and encouragement. It's great to be back home. Now we need to get the insulin tweaked so her blood sugars are better controlled and keep her exercising to get stronger. God continues to keep us in His care, and is there a better place to be?

Turning the corner?

Yesterday, Angela had a day full of tests and she wasn't able to eat until 6:00 p.m. I can tell you she really enjoyed supper! This morning she said she woke up with her usual appetite, for the first time in days. There weren't many tests today, just several blood drawings, which are a piece of cake with the PICC line. They have asked her to join a study of drug induced liver injuries and gave her a long questionnaire to fill out. All the doctors now seem to agree that it is a drug induced injury, though not all the results are back and they won't say for absolute certainty.

I didn't get numbers, but her liver enzymes looked "slightly better" today. They want her to stay at least two more days, to make sure the downward trend continues and look at the test results that aren't in yet. Then, hopefully, she will just let time make things better. Our bodies, especially our livers, were made with a remarkable ability to heal themselves. We may never know which drug caused this, though it would surely be nice to know which one we need to stay clear of.

It's now another Sabbath, to be spent in the hospital instead of church. We do have a private room and may be able to listen to something on the computer, though it will have to be something we already have as I've been having terrible luck with their WiFi -- it's so slow most sites time out waiting, but they say they haven't gotten gripes from any other users.

God is blessing us by making Angela feel well again and with doctors who are working to find out the cause and hopefully cure for her liver. He's also blessing Angela with a strong desire to spend more time reading her Bible. In all her down time today, I'm not sure if I even saw her pick up a puzzle book -- maybe for a couple of minutes -- but she's been reading from one of the gospels. We are both looking forward to going home -- to Red Bluff, Addy, and most of all Heaven.

To San Francisco

I haven’t written anything for a while because there was really nothing new – just hanging in. Angela had an appointment with a hepatologist on Wednesday and I thought there might be something new after that. Well, when she saw him on Wednesday, he wanted her admitted to the hospital he works at, California Pacific in San Francisco. So, we threw some stuff together and came. It was around 9:00 when we got here. I circled the hospital about three times, trying to find a place to park, finally finding a parking garage several blocks away. I left Angela in the car and went to find where to take her, since she certainly couldn’t be walking around, up and down hills, not knowing where we were going. After I found out, I drove her where I could let her off, and they took her to her room. This time, instead of going back to the parking garage – the first time was $4 – I was able to find a place on the street. By the time the paperwork and all was finished, I left close to midnight.

The hospital has arrangements with a local hotel for patients’ families. The rate is about half and it includes parking and breakfast. They also have a complementary shuttle – but it stops around 6:00 p.m. It is strange not having my car to use as a locker during the day, but I’ll adapt. I really don’t want to be driving when I can’t find a place to park and if I do the cost is astronomical.

One of the first things they did was to insert a PICC line, so they don’t have to keep sticking her over and over. Then another ultrasound. This afternoon she is to have a liver biopsy. They will be going through her neck and will be able to test pressures in her heart and liver blood vessels as well as get a tissue sample. The doctors have several causes they are considering for her liver trouble, but she doesn’t exactly fit the picture for any of them. This morning I was told that her liver is doing its necessary functions of removing toxin and synthesizing proteins, but it is very inflamed. I guess it’s nice to know that it is working any way. In a couple of days, they should have the biopsy results and be able to formulate a plan of attack.

Angela is getting a bit tired of all this, and her mood hasn’t been as upbeat, but she wants to be here and get this figured out. She continues to ask God for strength as well as healing, and we are praying for wisdom for the doctors as they try to discover the cause, or at least a cure, for her liver ailment. God has been so good to us, and I know that isn’t going to stop.

Home but not well yet

Angela did get to come home Thursday!!

However, it's not all good. Her liver enzymes, bilirubin, and blood sugars continue to be greatly elevated, and her hemoglobin & hematocrit are well below what they should be.

Thursday evening, Angela's blood glucose was 475 and she was feeling bad and clammy. By phone, the nurses at Mercy advised me to take her to the ER, so we spent about four hours at the local ER, St. Elizabeth's, where she got insulin and some fluid for rehydration.

Today she saw her primary care physician who said her liver is so bad, she wants to focus only on that until it's better. She stopped all meds and supplements, even multi-vitamins, and put her on only insulin, iron, folic acid, and Metamucil. She's also sending Angela to a liver specialist -- just where and when hasn't yet been decided.

This evening Angela's blood sugar was again very elevated, but we had the insulin and instructions, and could take care of it.

Angela wanted to go to her Bible study, but she was just too tired. She also wants to go to Sabbath School, church, and potluck tomorrow. I have convinced her that is too much, and so we'll try for church.

God has healed her lungs; now we're praying for that same healing for her liver. I know he'll answer us according to His love and what He knows is best.

Going Home - Or Not

Yesterday, Wednesday, Angela had her studies, which didn't get finished until about 1:00. After lunch, breathing treatment, and a walk, she was resting and getting ready to take a shower when the social worker came in and said her doctor was sending her home if the results of the test were negative, as expected. I felt terribly unprepared as I expected a day or two's notice and still felt there were unresolved issues. Anyway, after talking them over with the doctor and with her reassurance, I was OK with it, except for not having the house the way I wanted it for her to come home, like clean sheets on the bed, etc., and the fact that it was too late to arrange for things like a walker, cane and bath seat, that we will need.

But while the paperwork was being done and transport coming to get her - which took a couple of hours = Angela dozed off and wasn't really able to wake up for me. The nurse was able to wake her up and she said she felt like her blood sugar was high. The tested it and it was again over 400, so they gave her insulin and decided to keep her overnight. I am so glad it happened there and not after she came home. That was one of the issues I felt needed better addressing, but I don't think the doctor was aware that this has been happening frequently. Her sugars had been much better the previous day or two in Mercy than they had recently at the rehab hospital.

The fatty liver diagnosis explains most of what is going on, but it doesn't deal with the anemia. She's staying pretty stable, not getting worse but not getting better, either. Maybe there is some connection to the fact that they draw blood from her every time they turn around. Anyway, they decided to give her two more units of red cells last night. She should feel stronger today. The cause of this needs to be figured out. The hosipital doctor wants her primary doctor to order a bone marrow biopsy.

So, I expect I will be bringing her home this evening, 72 days since she's been here!

Praise God!!

Maybe an answer

I saw Dr. Johnson, one of Angela's ICU doctors, in the hospital today and told him she was back and why. He said it's fatty liver, then looked at her chart and scans and said she needs to be eating less (though she is eating relatively well) and having her blood sugar more controlled. Then he called her current doctor (the one who admitted her last night was just filling in) and gave her his opinion. When I met this new doctor this afternoon (I wish I could remember her name - I do like her), she said she wanted another test and a discussion with a GI doctor, but basically agreed with Dr. Johnson.

I've spent some time looking up the condition, and it seems that there isn't really a "fix"; Angela just needs to lose weight, keep her diabetes under control, and exercise--things we already know, and maybe take some antioxidants. If it's early enough, it can be reversed. Otherwise, it's progression can at least be stopped. If not, it can lead to cirrhosis, so it's important to take care of it.

That's my short version - hopefully it's correct. At least this makes sense; it's frustrating asking questions and not getting answers.

We are extremely grateful to God for Dr. Johnson and for running into him today.

Back to Mercy Again

The jaundice is getting worse and the liver enzymes are really rising, but she still isn't in pain--enough to get sent back to Mercy Hospital instead of going home. Whoever created "the system" didn't care too much for efficiency. We again spent many hours in the emergency room after the Rehab Hospital doctor was told Angela couldn't be directly admitted. The triage nurse at the ER said she could have been, but we obviously were the victims of a failure to communicate somewhere along the line.

She now has another doctor, who is also baffled by her lack of symptoms to go with her labs and appearance. He's ordered a test or two for tomorrow, and I'm not sure what happens next. Hopefully, something will show up, something fixable.

I am praying that the doctor will be given the wisdom to order the right tests and interpret them correctly.

When this gets resolved, I expect her to go directly home. She has rehabilitated well enough that she doesn't need to return to the rehab hospital. She will still have to work hard at regaining her strength, but she can walk well with a walker or cane - certainly enough to get around her house.

Tentatively Tuesday

Angela has a tentative date to go home, next Tuesday, June 9. Her rehab is coming along fine. With the therapist, she is walking with only a cane and doing fine. She hasn't been cleared yet to do that with me or one of the aides, though. She is getting stronger and working hard to get her muscles back to what they were.

Medically, she is still jaundiced. Her doctor is still sure it is her gallbladder and that it will have to come out at some point. I'm not sure, but he obviously knows more than I do. Her anemia was a little better the last time it was checked, but with a hemoglobin of 8.0 she still has a ways to go. Her cellulitis is better - her legs are still red, but that's not abnormal for her. They are no longer hot. Her ankles are still swollen, not so bad after a night of elevation, but then worsening during the day. She tried TED hose, but unbelievably they seemed to make it worse, with her foot and ankles swollen even more, but her calves were fine. Her blood sugar is still way too high, and she is resigned to coming home on insulin. I am hopeful that at home, where her diet can be more controlled, maybe we can get a better handle on it. They feed her actually quite well, but she does seem to get a lot of stuff made from white flour - garlic bread, pasta, pancakes, etc.

We continue to pray that she will be completely healed from all the issues that remain, but God knows best, and she is in His hands. He is so good to us.

Very Little Change

I haven't written anything lately because there hasn't been much change in Angela's condition. She is still getting stronger, still jaundiced, still having difficulty with blood sugar control, and still having ankle edema. Actually, her leg edema has worsened. Yesterday, her legs were red and hot, in addition to being swollen, and she was started on antibiotics for cellulitis.

Today, she again showed her independent spirit, deciding that she wasn't going to use a wheelchair or walker but was going to walk by herself. Fortunately her CNA came by and so I didn't have to be the "bad guy". Later, she did take a walk with me and the walker, in spite of her feet being swollen and somewhat painful.

Her doctor has been off for the weekend, and the weekend charge nurse has been trying to figure out the jaundice--she left him a couple of long notes. It doesn't seem certain that it is her gallbladder--too much doesn't fit. I've spent quite some time on the Internet, and I've found lots of information, but getting it to exactly fit her symptoms and labs is much more difficult than I had thought it would be.

Angela's Bible study group came to visit her on Friday evening. They brought flowers, sang songs, had a study from Hebrews, and prayed. She was so blessed by the visit and told them that, Lord willing, she'll be back meeting with them in two weeks.

We continue to thank God for His healing power and grace.