Day +43: Eyeing that Rollercoaster...

This morning I woke up to the news that Zoe's liver enzymes were very high. It simply happened all of the sudden. Manley looked visibly concerned and, based on her recent history of extreme discomfort coupled with this new development, he opined that there was a 90% likelihood that the culprit was either infection or liver GVHD.

Hello, Worry! Was so glad you were gone for a fair bit...

Labs were drawn, meds were transferred back to IV form from the oral versions, morphine dose was raised a bit, and an ultrasound was scheduled.

I sat huddled in a corner generally catastrophizing and reeling from the reminder that Zoe, though she's looked hale and hearty for the last couple weeks, is indeed going through a major fracking process.

Blurg!

(you can really tell the shows I watch by the curse-word euphemisms I use...)

Our favorite nurse, Kelly (and no, she isn't our favorite because of her awesome name--and curses! today was her last day in our unit for two months!), talked me down from my terror tree.
She's a good one to do it as she went through a BMT with her own daughter not too long ago herself. Kelly said that even if it were an infection or GVHD that there would be treatment options--and that Zoe has demonstrated that she responds well to treatment.

She told us to get used to this rollercoaster ride, that it will be like this, will turn on a dime in an instant, that this is the nature of the beast we are riding.

So, we got the lab reports back showing decreasing liver enzyme numbers, and the ultrasound they took of Zoe showed sludge in her bile ducts, gall bladder irritation, and the possible start of a gall stone.

The 10% option had won out; her liver was likely irritated from hard work and lack of food moving through her gut for so long.

Manley came back in visibly relieved. He said that of the things that could be wrong with her liver, this was the best! Zoe was looking pretty good herself by then--not as uncomfortable and out of it as she had been for the last couple days. She even managed a grin for him.

They are switching her antibiotic to one that better deals with gut bacteria making its way up through the bile ducts (in case that's an issue). And, they are going to start all over again and gradually bring her up on the formula feeds through her NG tube. Irritation is best dealt with by getting her liver working on food digestion, but they want to ease her into it.

So, we are not going home on Monday, even though--so far--she's sidestepped a deeper pitfall.

Truth is, I really don't want to go home until it's clear that Zoe is stable. It's very comforting having the professionals always available to keep their eye on things.