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I had my biopsy evaluation today ...

Posted Feb 21 2009 11:35pm
I had my biopsy evaluation today and got a detailed description of what's going to happen. Look away if you're squeamish.

About an hour before the actual procedure, I'll be sedated (hooray!), then a small incision will be made in my neck, accessing my jugular. A guide wire will be threaded into the jugular, then a needle will be threaded over that. The wire will be removed and a catheter will be inserted over the needle in my neck.

Here comes the good part. The needle/catheter will be threaded down my neck, through and down my heart until it accesses a small vessel adjacent to my liver. The needle makes a small punch and the whole contraption is fished back up and out of my neck.

I've been assured that this is much safer than going through the abdomen and taking a punch of the liver. Since I've had so many catheters placed in my chest/heart, I suppose I can be a bit blase about this.

My transplant team has taken pity on me and cancelled my ATC appointment tomorrow. The original plan was that I would have the biopsy, then go and get my IV meds. The actual biopsy should only take an hour to perform, but the recovery time is something like four hours. I have to have my head and neck held at a 30 degree angle during recovery. I'm sure I'll just sleep through that bit. I've been warned that there will be some discomfort. Really?

Imagine having to go from that to hanging out for another four or six hours while you get an IV infusion. I still have to have the infusions, but I can do that using intermates at the apartment.

I did have to pay the price for having the day off tomorrow by having an extra long day today. Normally, I get IVIG on Thursdays. I had to have it today, instead. This meant an extra three hours tacked on to my day. This made for a thirteen hour day. On the plus side, or not depending on how you feel about it, I got to skip physical therapy today. Who doesn't like a little break from working out?

Now I have a little bit of irony for everyone. My liver enzymes have steadily been climbing for the last two weeks. This is what has led to a tentative diagnosis of GvHD of the liver or Venno- Occlusive Disease. Take your pick. A third option is trauma caused by medication. This last one was ruled out because I stopped taking the likely culprits and my numbers continued to climb.

Today, my transplant doctor made a special trip up to the ATC just to see me because I won't be around to see her during rounds tomorrow. Have to love a doctor who will take time out to do something like that just for you. She started out by telling me that we definitely want to do the biopsy tomorrow and she reassured me that it wouldn't be a big deal. My words, not hers. Here comes the irony: my liver enzymes have come down. One of them significantly. Liver toxicity from medication is once again the front runner for what's going on. I have to have the biopsy just to rule everything out. Ha ha. Believe it or not, I really do find this funny.

I can never do things the easy way. At least I get to look forward to a really excellent drug induced nap tomorrow.
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