Saturday, August 29, 2009

Last Appointments...

My apologies in advance, but this will be a very short update. I have a ton of stuff to do. ~sigh~

Well, even though my liver biopsy was 11 days ago, the center of my chest still gets really itchy and I can feel a ridge there. Hard to explain, but it just feels weird! The good thing is the bruising is gone and the area itself doesn't hurt anymore!

Yesterday, I went to my family doctor for my second 'Twin-Rex' shot...only one more of those to get and that won't be 'till January 2010!

Ok, so on August 27/09, I received what should be my final schedule for my last round of appointments at Toronto General. I would have posted this sooner, but the last few days have been pretty hectic and all. No really, they have been hectic!

Tuesday September 8/09
9:00 AM 2nd Surgical Consultation
10:00 AM Blood Work
10:15 AM Pre-Admission
1:30 PM Meeting Transplant Coordinator

I'll post another update later this week, I have soooo much to do! Yikes!

Saturday, August 22, 2009

Clean Bill of Health!

Late afternoon Friday, (August 21/09) I got a call from the transplant office. The results of my biopsy came back clear and everything is a go!! Whew! All that worrying for nothing! I was also given a new surgery date 2 days earlier than originally posted. T-Day is now September 14th, 2009. I still have some minor appointments at the hospital, ( ECG, surgical consults & pre-admin stuff) which could be scheduled this coming week. The testing may be done, but this journey is far from over.

Friday, August 21, 2009

The Biopsy.

On Monday August 17th, I received my schedule for the biopsy along with this email..

"We sent a requisition for you to do some labs required for your biopsy…….sent to ""Life Labs"", there are many scattered about Ontario but if you have a lab that is easier for you we can re-send in the morning. You'll need to go anytime tomorrow or Wednesday morning to have the results for Thursday."

Luckily for me, Life Labs has a location a few blocks from my work and I was able to go in Tuesday for the blood work! The biopsy itself was scheduled for 9:00am on the 20th of August, but they ask that you arrive an hour early.

The biopsy procedure took place in the Medical Day Unit on the 7th floor of Toronto General. After registering at the reception desk, they led to me a room with 2 beds in it, kind of like a regular hospital room, but much more 'clinical' looking. At the foot of each bed, on a table, was this cloth bundle of 'tools' for the procedure. After 5 or so minutes, my transplant coordinator and doctor walked in and we chatted for a bit about the test and just made general small talk. The doctor started prepping the items needed for the biopsy and explained that the surgeon was running late with meetings, but was in fact, on his way to the room. She also explained that this surgeon was the best one to be doing this procedure, after all, he is the director of the Liver Transplant Unit. To my surprise, she also told me they would freeze the area before they took the sample! Score!! It was also explained to me that I may have some shoulder pain and that pain medication would be available to me if needed. Also, I would have to stay in this bed for at least 4 hours to make sure there was no bleeding.

As I was waiting for the surgeon, another young fella scheduled for the same procedure came into the room. Turns out this guy, Richard was his name, is donating a piece of his liver to his dad...and if his biopsy results were good, his surgery could happen as soon as next week! Pretty cool! We chatted back and forth until the surgeon arrived.

The surgeon was pretty cool, he explained the procedure to both of us as he prepped more instruments of 'mass biops-ity', then the drapes were pulled around my bed and I was instructed to put on...wait for it.....
a robe!!

Yes, the open front robe! For a brief minute I was in robe heaven! Sadly, there was only one robe to be put on as an exchange for my shirt. Guess they don't want to get 'biopsy goo' on your shirt. The surgeon talked more about the procedure stating that even he had undergone the procedure so he could experience what it was like! Nothing he said could never have prepared me for what was about to happen.

It all started with me raising my right arm above my head as I was laying down, some sterile sheets were draped across my chest and he swabbed my rib cage with stinky sterile goo. He tapped his fingers around my chest explaining he was locating my liver, once he found the spot he would take the sample from, he pressed a quarter into my skin making an indentation. More stinky goo was swabbed on and he explained he was going to start freezing the area. The first couple of needles didn't really hurt, it just felt like pressure. As he went deeper though, I could feel he was jabbing around, he was talking the entire time. He then said he was ready to take the sample, he picked something up off the table and I felt even more pressure on my side. In a split second, it felt like something tore through the middle of my chest straight up! It startled me so much I looked down at my chest expecting a frickin' alien to shoot out! Holio Christ it hurt! Then it was over...and immediately, a really dull pain shot through my shoulder. The surgeon taped a huge pad of gauze to the biopsy site and then showed me the needle he used to get the sample. Now there was no way that needle made it in to the middle of my chest, but that's how it felt. It was the weirdest sensation I have ever experienced!! Both the surgeon and the doctor explained that to get the sample from the liver, they had to go through some pretty sensitive nerves and tissue. As soon as I caught my breath, I yelled over to Richard that he was in for a treat! Nurses then came in to monitor my temperature and blood pressure. They offered me pain medication but by this time, there really was no pain, just some discomfort in my shoulder. My whole chest was frozen!

After Richard had his biopsy done, we chatted about the weirdness of it all and I tried to get some sleep. When I was allowed to leave the hospital, I shook Richards hand and wished both he and his dad all the best. By the time I got home, my side was sore, red and tender. It almost looks like dye! Needless to say, I slept on the couch Thursday night.

Saturday, August 15, 2009

Biopsy ahead!

On Thursday, I came home to both an email & a phone message from my transplant coordinator. She had the radiologist review my scans, turns out my anatomy cleared and I'm cleared to go onward!! She also booked another appointment for me on August 20/09....the dreaded liver biopsy! ~shudder~ This, I believe, will be my biggest hurdle to date.

The biopsy is needed to rule out any fatty infiltration in my liver. During my initial testing, one of the tests, the abdominal ultrasound, showed signs of fatty deposits. Even though none of my other tests confirmed this, the discrepancy must be addressed and a biopsy will provide the definitive result. ( pretty technical sounding huh? ) Other than the catheter, this is the one procedure I am dreading most....I've had a biopsy before, and it hurt.

Years ago, I found this painful lump under my nipple. I actually dismissed it as a skin irritation until it got to be quite big and painful. Clothes hurt it, laying down made it hurt, if anything hit me there it hurt. When it got puffy, it really started affecting my daily routine. My doctor ordered blood tests, ultrasounds and even a mammogram (now, as a guy, I have no breast mass, but they were able to stuff what little of me I had into that machine, ladies, I share your pain) but no cause or definite diagnosis was given. In the end, I underwent a biopsy. The doctor that performed the procedure told me they can't numb me up or freeze the area because they wanted a 'clean' sample. I was strapped to a bed, told to take deep breathes and then they shoved this thick, long needle through my areola and into the mass, plunging around for what seemed like minutes for a sample..not once, but three times! It hurt. It actually hurt so much my penis inverted itself, shrivelled up back into my stomach and stayed there for a week! Ok, it didn't really do that but it did hurt and I'm not ashamed to admit I had tears in my eyes when it was finally over. In the end, my painful lump turned out to be nothing more than a benign mass. Day surgery took care of it and I've been fine ever since!

With this memory fresh in my mind, I've been assured if the same procedure was performed today, it wouldn't be as bad and the whole thing is quite simple. Uh-huh. The parting line on the email from the transplant coordinator states, "They typically require people to have someone drive them home afterwards, please let me know if this is a problem and I will speak with the doctor".

Can't wait!

Tuesday, August 11, 2009

More Confusion...

Just checked my email and as promised, there was an email from my transplant coordinator. She writes....

""I am surrounded by confusion.........sorry about the mess-up in the lab. They still didn't draw everything!

Review today looked okay to proceed, there is some confusion regarding right vs left lobe d/t the new findings on the CT cholangiogram. The surgeons reviewed for about 20minutes and waffled back and forth about cancelling all together or going forward so I am having one of our radiologists review everything for a final opinion.

I promise to let you know ASAP and then we will book outstanding assessments - I am presuming a positive outcome.""



Wow! Monday's appointments turned out to be a hectic day of confusion! It was the hottest, muggiest day of the year in Toronto too! Bleh!

My first scheduled meeting of the day was with my transplant coordinator. She explained to me what tests I was having this day and we had a general chat of future events and appointments outstanding. She also told me they have a recipient in mind for me, a 'small female adult'. (That's all I know, and that's all I will probably ever know as I'm doing this anonymously.) We also discussed a tentative surgery date. September 16th! As she reviewed my chart, she added a blood test for me to get before I left for home. Our parting conversation was that she would be in touch with the results of the CT cholangiogram as soon as she gets them.

The CT cholangiogram was an ordeal! As I was registering at the reception, one nurse remarked that the department was way behind in appointments. I was a little spooked because I didn't want to be late for the next appointment at 3:15. I only had to wait about 15 minutes before I was called in though and was led down the familiar hallway to the change rooms....then I was handed the gowns! I don't know what it is about the gowns, but I really do like them! One goes on in front, like how a surgeon would wear one, the other goes on like a robe, true comfort! Truth be known...I go commando underneath! The boys are free, cool breeze and sway-age! Nobody knows, and I like the freedom! Anyways, the tech guy leads me into this little room where he starts getting all this stuff ready. Needles, IV tower with bag of solution/contrast and a little vial of something. As he's prepping we're making small talk, then he says I can't drive for 5 hours after this scan......huh?? That wasn't in the plan! 'Sorry fella' I tell him, 'but I'm driving'! He leaves to consult with the head guy and they both come back to talk to me. Turns out, the little vial has Benedryl (or something like it) in it. They add it to the contrast medium so the patient doesn't have an allergic reaction to it....but the Benedryl makes you drowsy. So, at this point, my option is take the test with the Benedryl, or the test gets cancelled. Now, since I wasn't ready to take the gowns off, we compromised! They only put 1/3 of the Benedryl stuff in with the medium. They hooked the IV up, let it empty into my arm, which took about 15 minutes, then they gave me the scan. This scan was to further highlight my biliary anatomy so the surgeons could assess them more closely. Modern medicine is fascinating isn't it? When it was finished, I didn't feel drowsy or tired at all. As I went to change back into my street clothes, I was sooooo tempted to steal the gowns, but I figured I'd get caught and it would be embarrassing explaining my hospital gown fetish to the cops. ~sigh~ I leave the department gown less.

The Pulmonary Function tests were strange! I was lead into the 'testing' area, it's a huge room partitioned off into cubicles made of curtains, and every where I look, there are people sitting in chairs with their mouths wrapped around this white tube hooked to a machine and technicians are screaming at them....BLOW BLOW BLOW!!!! MORE! HARDER! BLOW! Of course in my immature mind I'm thinking...'what the hell kind of porno set have I entered??' This, however, is the test! They pinch your nose shut with a clip, and they get you to breathe into this white tube-y robes though. You do regular breathing, panting, fast exhales, fast all measures lung capacity and it's all hooked up to a machine and computer. I was expecting something totally different, but it was actually pretty neat. As your doing the test, the technicians are literally screaming at you to blow, blow BLOW! KEEP GOING!!! The test took maybe 20 minutes, no dizziness or lightheaded-ness and still no drowsy effects from the Benedryl! At the end of the test, I was told this was more for the anesthesiologist....makes sense to me!

My last stop was the at the blood lab. I gave the receptionist my cards and the test number, but they were confused. They called me in and drew blood, 8 vials, but they were still confused. They asked me who ordered the tests and when I told them, the names didn't match and the tests didn't match. As they were finishing up, they promised me they would take care of things and I was on my way. At least I have a surgery date scheduled! Things are looking good thus far!

Saturday, August 8, 2009

More Tests!

I don't know if it was me, my computer, or the interwebs in general, but I have had a hell of a time logging into this site to do an update!! Sheeesh! If this continues, I may move to World Press!

During the weekend,last weekend to be exact, I decided to email the hospital to see if there was any news, on Tuesday they replied with three new appointments.

Monday August 10/09
1:00 PM General Meeting
2:00 PM CT Cholangiogram
3:15 PM Pulmonary Function Tests

Not a big fan of the CT scans. It's not a painful process but they pump this dye into you and it just makes you feel weird! Anyways, this test involves a different 'contrast medium' that will highlight the biliary anatomy for the surgeons to assess more closely. Apparently these tests are hard to schedule...hence the delay in my appointment schedule. Truth be known, I kind of like the airy gowns they give ya to wear while in the machine itself! Very comfortable and breezy. Ummm, perhaps I've said too much.

I'm thinking the pulmonary function tests is to gauge lung capacity and how well said lungs move oxygen. A google search revealed "forced breathing and rapid breathing may produce light-headedness during and after the test". Nice!

That's the update for now, I'll post more Monday night or Tuesday.