Nick has experienced a lot of ups and downs since the transplants. He was doing really well in the first week after surgery, his pain level wasn't too high and many of his chest tubes and the liver drain were able to be removed. He didn't have much of an appetite but was drinking and eating things like water ice and ice cream.
Last Thursday night, 8 days after his surgery, he was moved from ICU to the surgical step-down unit. Unfortunately that same day the doctors decided his kidneys were just not recovering like they should and they started him on dialysis. He also had his first heart biopsy done that day. The biopsy is a minor surgical procedure where they go in through his neck and cut out several small samples of heart tissue. The samples are evaluated for the presence of antibodies, which shows whether or not the body is rejecting the new heart. It was a really long day for everyone (I was a the hospital for 16 hours) but I was glad to see him settled in his new room that night.
The next day Nick was not feeling well and by Saturday he was feeling even worse. He'd gotten 2 more rounds of dialysis and his heart biopsy results were great (no rejection!) but he continued to not feel good. Saturday night while sitting in a chair his blood pressure crashed and he passed out. He was immediately moved back to the ICU, where blood tests showed an elevated white blood cell count which indicates an infection. They took a lot of cultures and he was started on a really strong broad spectrum antibiotic Sunday morning. The doctors also had to put a feeding tube in because he wasn't eating much and they were concerned he wasn't consuming enough calories to help his body fight the infection. His white blood cell count improved over the next few days but they never found the source of the infection, and the high protein supplements they were giving him through the feeding tube made him really sick. They ended up putting another tube in to suck out the contents of his stomach so he wouldn't continue to get sick and he wasn't allowed to eat for 3 days!
On Wednesday he was moved back to the surgical step-down unit and he worked with the physical therapists who helped him march in place and walk to the end of the hallway. Yesterday was another long day...in the morning Nick had a more permanent port placed in his chest for dialysis, then he had a round of dialysis and some tests done on his heart in the afternoon. The dialysis caused some abnormal heart rhythms and changes in his blood pressure so they ended the session early. This morning he had another heart biopsy done and we should hear the results on Monday.
Unfortunately the abnormal heart rhythms have continued and the doctors aren't sure why. Around 3pm today they decided it would be best to move him back to the ICU for the weekend where he will get a higher level of care and be closely monitored. So, back to the ICU he went again! We're trying to remember this is a precaution and not a set-back. He has been started back on a clear liquid diet so I got him some Jell-O for dinner at his request. The doctors may order some tests tomorrow to try and determine what is causing the abnormal heart rhythms.
Please say some prayers that Nick's kidneys start to heal as we are very hopeful he does not have to continue with the dialysis once he's released from the hospital, that the cause of the abnormal heart rhythms can be found and treated, and that this is his last visit to the ICU!