1/29 Biopsy

Today was interesting. Josie’s feeds were stopped shortly before midnight to prepare for her liver biopsy today. At about 10:00AM we headed for the interventional radiology where it was going to happen. She was sedated with a drug called propofol which is a fast but short-acting anesthetic. They pumped her up with a syringe of this stuff and she was out. They took the probe of an ultrasound machine and slipped a plastic bag over it and used it to direct an inserted a needle guide into her skin next to her liver. The ultrasound showed the guide nicely…it was pretty neat to watch. Then he took the big needle and inserted it into the guide straight into her liver, and then extracted it just as fast. He then shoved the very small but long core into a specimen jar with some liquid. The core looked like a very thin worm thinner than the thinnest guitar string. Then he did it again to get a second core. He inserted some coagulation-promoting foam into the hole, threw on a Band-Aid and that was it. The whole process from sedation to the end of the procedure took all of about 10 minutes with the biopsy extraction itself taking no more than about five seconds each time. We’ll have the results tomorrow or Wednesday.

After coming out of the sedation she was moved back up to her teensy-weensy closet. The rest of the day she was feeling really great. There was no indication she was hurting or feeling bad about the biopsy in the least. Josie’s good times are certainly increasing while the really bad times are becoming less frequent and shorter in duration. Still some vomiting and a low fever today but those vomiting events are short-lived. All those blood cultures taken over the last week are all still negative.

We had a meeting with the GI Docs and the surgeon about the big surgery coming up. They went over exactly what the procedure was and the anatomy changes they will make during the surgery. The Whipple is one complicated operation which they say will take them between eight and 12 hours to complete. Due to the complexity of the operation there is between a five and 10 percent chance Josie will not survive the surgical procedure and its recovery. The real challenge will be her recovery and how her underlying Dermatomyositis will respond. If there is a flare before or shortly after the Whipple it could cause all kinds of problems additional.

As y’all know Josie’s had three major abdominal surgeries back in September and October and each one failed as a result of her underlying disease. The hope is that after all these weeks of healing that her insides have improved enough to handle all the slicing and reconnecting required with the Whipple. I’ll go through the whole procedure in a future post for you.

Now our thoughts are on the matter of going home or not. The decision is ours to make if we want to implement some changes two which will allow Josie to come home for a while before her Whipple. It’s a risk to make these changes and it’s unknown the actual risk level. We’ll figure it out and do our best to make the best decision we can for our little Josie.