Another Trip to the Hospital

We went to the ER in Logan on Sunday afternoon because Larry's skin color was yellow, he had been itching from head to toe for several days, and he was having severe abdominal pain. After all of the blood work, an ultrasound, and an MRI we learned that our situation was way more serious than we had thought. We learned that there was an almost complete bile obstruction that was causing the jaundice. This was the root cause of his severe itching. Normal bilirubin counts are 1+ and Larry was 8+. He was taken by ambulance to IMC in Murray, UT.

Yesterday they went in to do an ERCP to replace the pancreatic stent that was missing, but were unable to put one in because the inflammation was so severe. We also learned that the necrotizing (death of tissues) was more severe than we had realized and is now affecting both the pancreas and small intestine. He also has several infectious spots on the liver that are being treated antibiotics. In order to allow the bile to drain from his body he had a tube surgically inserted into the liver.

He is scheduled for a TPIAT (total pancreatectomy with islet auto transplantation) at the beginning of September at the University of Minnesota where they will remove his pancreas and then harvest his islet cells and inject them into the liver. During this procedure, the pancreas is removed and the islet cells are separated from the pancreas. Those cells will be returned to his body using an injection into the liver. There they will take root and continue to produce insulin, decreasing the chances for diabetes. This surgery takes approximately twelve hours. He will stay in the hospital for the first couple of weeks and then we will have to stay near the University of Minnesota for six more weeks for his post op care.

Due to the severe damage that has been done to his pancreas over the past eight years, he is in a higher risk category for surgical complications and the most important thing we can do at this point is to get his inflammation down as much as possible and pray that we can get to the surgery without any future pancreatic attacks.

We met with the Surgeon and Director of Medicine, Dr. Ott, this morning and our new plan is as follows:

• Have a pic line placed for total parenteral nutrition (TPN). This is a method of feeding that bypasses the gastrointestinal tract. Fluids are given into a vein to provide most of the nutrients the body needs. This method of feeding will allow the pancreas to completely rest and get the inflammation down.
• Start regularly checking blood sugar levels
• Keep the biliary line in place until the surgery in September.
• Run a coarse of antibiotics to keep the infectious spots at bay.

This last episode has been a roller coaster ride in so many ways and we are both just ready to have this eight year pancreatic nightmare come to an end. If all goes well he will be home by Thursday.

Even though it has been a very difficult couple of days, we have witnessed many miracles and tender mercies and we feel very grateful to Heavenly Father and his watchful eye over us.