The news about Dave is not so great today, but all of it can be handled with medications.
First, he is showing signs of bowel rejection. Yesterday’s biopsy revealed the small intestine is showing mild rejection. This is being monitored closely. The ouput thru his ostemy is the visual sign of rejection which signaled the biopsy was needed. Meds should reverse this rejection.
Second, he has some fluid retention. A pocket of fluid in his abdominal cavity shows a small amount of infection. More antibiotics are being administered to handle this.
Third, his liver enzymes are elevated slightly, but may be from the TPN, which is Dave’s nutrition in a bag. The Drs will continue to monitor this closely. There is no sign of rejection here.
Dave got his walking done for the day BEFORE all of the above news was received. Linda and Dave hit the Duke store on the hospital campus and family members will soon be donning their Duke gear in support of the great job the Duke team has done and continues to do for Dave. This task was high on Dave’s to do list.
The 2nd item on his “Duke” list is planning a thank you for the unit before he leaves, whenever that might be.
Linda and Dave also had their first education session today on what to expect after discharge. They found out today that Dave is their first long distance patient for a bowel transplant. He will need to stay in the area at least 3 months after discharge. A plan for his care after returning to Florida still needs to be figured out. Plus he will need another surgery in 6 months to reverse the ostemy.
Some things we learned about the critical first 3 months after discharge (highest risk for rejection period) are: No kissing, hugging or handshakes. No crowds. No buffets. Suggest movies during matinee times and shopping malls on week days, not weekends. Weight, temp, food intake and output will be monitored daily and reviewed during weekly clinic visits. Weekly lab visits are required in addition to weekly clinic visits.
Prayers have been answered getting Dave thru surgery, but it looks like he still needs more to help get over this newest hurdle. Dave is in good spirits and is confident this is only a minor set back, all will be good.