Tests, Tests and More Tests

Welcome to your first day of medical school. I bet you can hardly wait. And what a great field of medicine you have chosen. Liver Transplantation. 

What does it take to get on the liver transplant list.  Tons of tests, that’s what. Let’s get started. Get your learning caps on, as always there will be a trick question. 

First you meet with the transplant surgeon. Last class we learned how much I enjoyed that one. Next you meet with the social worker. If you have a spouse in the room with you, they are asked to leave for a minute so they can ask the “are you in an abusive relationship” question.  No I am not so they let him back in. They go over most of the emotional issues that can arise. 

Then you meet with the financial person. They have called your insurance company to find out if they will cover you. They then tell you how much you will be responsible for.  If insurance doesn’t cover much they give you information on things you can do to get money donated. Fun times. 

After that, all the physical tests are ready for you to pass. First off they send you to the lab to get your BLOOD DRAW. Most the time when you get a lab draw they take two or three vials. Haha. They took 37 (it might have been 27, but that’s still a lot), vials of blood out of me.  I’ll have to ask my coordinator, (hey girl). Thought I would need a blood transfusion after that. You also get a URINE TEST.  As a woman, those are hard to direct your pee into that tiny cup. I have been known to drop that damn thing into the toilet.  Just sayin’. 

HEART TESTS

EKG and STRESS TEST. You will be asked to either walk on a treadmill on an incline, or ride a stationary bike. Here they determine the blood flow within your heart.  Since I had yet to recover from my hip replacement, they had me lay on a table and then injected a drug that mimics the effects of exercise. ECHO TRANSTHORACIC with BUBBLE STUDY. They inject saline after agitation with air to create micro bubbles that the ultrasound looks at in the right heart chamber and the coronary sinus.  

LUNG TESTS

X-RAYS. I especially like when they make you put your arms in the air. PULMANARY FUNCTION. This measures your lung size and air flow. HEPATOPUMANARY. Breathing test

LIVER TESTS

ARTERIAL BLOOD GAS TEST. Measures the oxygen and carbon dioxide in your blood. I will also mention that this one hurts. MRI or CT scan. Here they check for tumors and blood supply. LIVER BIOPSY. All things they can’t see from other tests. ULTRASOUND. Here they check for liver size, shape and circulation. 

MISC TESTS

TB TEST. DENTAL EXAM. If you have bad teeth they have to be fixed before you can get on the list. PROSTRATE or PELVIC EXAM. I told them I wouldn’t get a prostrate exam. That’s where I draw the line. MAMMOGRAM. COLONOSCOPY. 

SIX MINUTE WALK

This test was by far the hardest test for me to pass. It gives the doctors clues about your heart, lungs and blood vessels. You must be able to walk 380 yards in the 6 minute timeline. 380 yards equals 1140 feet which equals a quarter mile. I failed this test 2 times. I failed it one more time but that will be brought up in another chapter. 

Now it’s time for the trick question you all were waiting for me to give.  

How many tests does it take to get on the transplant list???

EIGHTEEN. Yes you read that right. If that was your answer, you have passed.

 Congratulations. 

 

Bedside Manners......Oh My

 

Surgery is not my friend. Three weeks after my hysterectomy, this is how my stomach looked. I looked very pregnant. I also was getting dehydrated. Of course, more times than not, when you need to talk to your doctor it’s the weekend. We headed to the Instacare in the hospital nearest us. They examined me and said that I wasn’t dehydrated, and wheeled me over to the ER. 

ER doc comes in and examines me. I just love the questions they ask. Especially how are your BOWEL movements. I said “well my POOP is kind of dark and looks like wet coffee grounds”. (don’t throw up its all good). He’s concerned that I might have sepsis. Sepsis occurs when chemicals release into the bloodstream. It can damage multiple organs. 

Remember when I showed the photo of the fluid they drew out of my chest sac, this is the fluid they drew out of my belly. Those bottles equaled 6.2 Liters. (1 1/2 gallons). I was admitted to the hospital. After testing the ascites, they determined I had Spontaneous Bacterial Peritonitis. Another infection. It was also determined that I had End End Stage Liver Disease. 

I had the most awesome doctor while there. He was actually the Head Doctor in Charge of all the doctors. Don’t exactly know what that title is. His bedside manner was so cool. He would pull up a chair, we’d sit and talk. We’d even try to crack each other up. He loved my purple hair, and he explained everything so well.  After 3 days of seeing me, he apologized that he needed to start doing his job, but was going to assign me one of his better doctors. See, so cool.  I was in the hospital for a week. With two more fluid draws taken from my body. 

Five days later I was back in the ER at the big Medical Center. I was having a hard time breathing. After running ultrasounds they found I had fluid in my plural area (around the lungs) and ascites in my belly. The fluid around the chest area makes it super hard to breathe. I was again admitted to the hospital. They sucked the liquid out of both places. I met the liver clinic doctors who  informed me they were going to take on my case. I was released 5 days later. 

Two weeks later I was in the Liver Clinic meeting with the Transplant  Surgeon. He was going to determine if I should be able to get on the transplant list. All I can say is his bedside manner was completely opposite of the doctor at the other hospital I told you about. 

 One of the first things he said to me was, “YOU A FATTY”. Yes to my face. He left the room to go out and get a measuring tape, proceeded to have me lie down, and measured how high off the table my huge ole stomach was. Then he said I needed to follow everything he told me to do and not to do. I said ok. Here were the 3 he told me I couldn’t do. 

1.  No being a prostitute. 

2.  No going to jail. 

3.  No getting a tattoo while in jail. 

WTH!!!!

 Do I look like a prostitute?  NO

Have I ever gone to jail?  NO

Do I have tattoos?  YES

Would I ever get one in jail?  NO

Needless to say, I left the clinic in tears. Not only because I was told I needed a Transplant and could actually die before ever getting one, but because of how his bedside manner was. 

This is the start of a wonderful journey. 

Holy Blood & Breathing Batman!!

Previously on “My Life” 

We saw me in the ICU. After they determined I didn’t need to be in there, they sent me to the orthopedic floor of the hospital. 

POW!

Why the orthopedic floor?  Well, because I had a hip replacement Duh.  Let’s discuss why that is not the best floor to be on when you are in a different crisis. The nursing staff are used to dealing with people that aren’t sick. People on that floor are just having rehab. Not this girl. I can’t breath without oxygen. I can barely walk myself into the bathroom. I’m so sick, no rehab is happening. I should have been on a surgery recovery floor. Those nurses are used to sick patients. 

HOLY QUIZ SECTION BATMAN!

While in the hospital, the liver team came in and “visited” with me. They informed me that my liver had not faired well during the surgery. They also said I needed to start going to a hepatologist. They are a branch of medicine that manages the liver, gallbladder, biliary tree and pancreas.  They gave me the name of a doctor to go see. 

 I had already been diagnosed with NASH

which stands for NONALCOHOLIC STEATOHEPATITIS

(a buildup of fat in the liver) so I knew my liver was already sick. This was when I had just lost my job, so we didn’t have any insurance. Which makes it very expensive to have any medical treatment. Thank goodness after a 3 year battle, I was able to get on disability.

 (Remember these medical terms, there will be a quiz later) 

BOOM

I was having such a hard time breathing, that I was sent home on oxygen. I was on it for 6 months. When you are on oxygen, DO NOT take it off while taking a shower. You will feel like you’re dying. 

BAM

A couple of months after finally getting off oxygen, we had a family reunion. It was in the beautiful canyons where we live. Of course those fabulous areas have the gross toilets. I usually try not to even use them. All of the sudden I felt like I was losing everything inside of me. I run in there and pass something that looks like this

The blood clot that exited my body was even bigger. WHAT THE!!! And of course, there was very little toilet paper. I did the best I could and told my family I had to leave. After the weekend I made an appointment with the gynecologist, she ran a test but told me she was pretty sure it was UTERINE CANCER. You read that right. Yay me.  She lined me up with an Oncologist Gyno, who confirmed that is was. Lucky for me it was only stage one. Oh and BTW, I had gone through menopause about 10 years earlier, so any kind of bleeding was super weird. She had to get permission from my hepatologist do give me a hysterectomy. He gave it, I had the surgery, went home the next day, at which time all hell broke loose. 

My Right Hip Bites The Dust

I went in to get a hip replacement and all I got was this lousy scar. Oh wait. I just lied. My bad. I got a whole bunch more. Let the rollercoaster ride begin. 

As the car starts up the steep incline,  I roll into surgery when the anticipation hits.  On that first drop I learn that while in hip replacement surgery, you are twisted and turned like a pretzel.   WHAT THE!!!  This was told to me by my physical therapist who said they have to watch all the surgeries so they know what the patient needs help with. Now if you want to know what that yellow spot is on my scar, I got burned by the drill. Apparently, according to my surgeon I have really strong bones, they had to push really hard on the drill. Lucky me.  

Here is the look of my old hip vs my new. 

The ride continues on. I get to the first curve. I wake up in the morning and the PA is in my room saying I’m not breathing well. Oh goody. What does this mean. He says, we are going to have to transfer you to the medical center. (I had surgery in the orthopedic surgery center). NOOOO. 

In come the local ambulance guys. Yup, another part of the ride. They load me in for the short ride to the hospital. Giving the guy a bad time all the way there. We are cracking jokes with each other.  I’m never mean unless you’ve pushed my final button, which will be in one of my chapters. 

I’m taken right into ICU. What!!!  They do their first assessment, and then allow my husband and daughter in. They have taken an X-ray (or that terrifying photo they take on the rollercoaster), and this is the view of my lung. 

See the left side of this X-ray. That is my actual right lung. All that white area is fluid in my plural cavity. This is a membrane that surrounds your lungs. That white area is full of fluid, known as ASCITES. Pronounced AS-CI-TES. (You will learn a lot of medical terms in this blog). You’re welcome. 

How do they get rid of it. This is the most terrifying part of the ride. They stick you between your ribs, insert a tube, and suck the fluid out. 

This is what they removed from my plural cavity. Doesn’t it look yummy. That was 1400 milliliters which equals almost a half gallon. Just think about carrying that fluid around your chest. No wonder I wasn’t breathing well. 

What is the next ride I go on?  Stay tuned for the next chapter.