Back Home, ER @ IMC

Alright, this is what's currently going on with Sean:

Early Thursday morning, he woke me up because he was having a lot of sharp abdominal pain, nausea, and vomiting. By the time it was time to leave the Major's for the airport, he was still in a lot of pain. He was able to take some Ativan which helped him get through the trip home. We had requested wheelchair assistance through the airport with his ticket and we were glad that we did because that assistance helped get us through security and boarding. When we arrived home around noon SLC time, he decieded he just wanted to take a nap and slept until about 7:30 pm. When he woke up, he still couldn't eat anything and was still having a lot of pain and nausea. I took him to the ER at Intermountain Medical Center (the new IHC hospital in Murray) around 8:00 pm and when he got there and all settled in, they ran a CT scan on him.

The CT scan showed a few things. It showed that he has a small-bowel obstruction which is what they determined was the cause of the pain, nausea, and vomiting. They also said that this is a very common risk of the surgery that Sean had, and since he has had the surgery twice, he was at an even greater risk. As we understand it, they believe that the obstruction is formed by scar tissue in his case.

The scan also showed that he has a blood clot in his vena cava which is the main vessle that supplies blood back to the heart. Because Dr. Beck had to cut out a part of the vena cava during surgery and stitch it back together, the sutures act as a place for clotting within the vessle which is why the clot formed. This is also a risk of surgery (blot clots are also a risk for people with any form of cancer) but happens in fewer patients than bowel obstructions.

Thirdly, the CT scan showed that 2/3 of Sean's right kidney is no longer functioning due to injury to the renal artery which is the vessle that supplies blood to the kidney. Since his left kidney is functioning properly, they are not as concerned about how this could effect him so much so as the bowel obstruction at this point. The doctors are not sure what caused the injury, but having the surgery that Sean did is more than enough for something like this to happen. As of right now, they have no plans to remove the kidney and the only risk they associated with that plan of action is a risk of high-blood pressure for Sean later in life. We think that they will run more tests on his kidney (imaging, and function tests) later to get more information on how that's going to affect his health.

In order to deal with the bowel obstruction, the doctors ordered an NG tube to be placed. This is the tube that runs down his nose into his stomach and suctions out all of the contents (which at this point is just bile). This is to keep his stomach from being irritated and to give his bowels a break from having to process anything that might come their way so that they can work out the obstruction on their own. The surgical team determined that he does not need surgery for the obstruction at this point but they will see how he improves after monitoring him. They told us it could be many days before the obstruction works itself out so we have no real idea of how long he'll be in the hospital. He is on IV blood thinners as well, in order to help his body process the blood clot. He was admitted early Friday morning (straight from the ER, it was a very long night and following day with having no sleep) and is in room T931 which is in the patient tower. He's up for visitors as he's feeling fine. He's on pain medication to help with the abdominal pain that comes from the obstruction so he's a little lethargic but as far as his recovery from his RPLND goes, it's still progressing very well.

In my last post I had mentioned that Dr. Einhorn had ordered his AFP levels in his blood panel and that same order was given by the on-call doctor from Dr. Chandramouli's office once Sean was admitted to the hospital yesterday. We have not heard the results back from either of those tests yet, but we're still hoping that his levels are normal.

I know this is a lot to digest, but the short of it is that he doesn't need surgery for anything at this point, he's being closely monitored for improvement regarding the bowel obstruction, we have no idea what caused the kidney damage, the blood thinners should take care of the clot in the vena cava, we don't know what his AFP levels are at right now, and his incision from surgery is healing just as it should.

I am still planning on going back to work this Monday. We are bummed that he's back in the hospital and we haven't been able to have a night in our own bed since we left for Indianapolis. We've both just been dealing with this like have with everything else but it is weighing on us so keep us in your prayers. I'll post another update when we learn the AFP level results and if there is any more news on an improvement (or unlikely worsening) of his condition. Thanks everyone.

Karen