1/30 Five Months

Josie celebrated her five-month anniversary in the hospital yesterday. The milestone was celebrated with a nap and a biopsy…that’s about it. Never ever thought it would be possible that she’d be in the hospital this long. I remember asking a nurse when we were about 10 days into this thing how long some folks had been there. The answer was “…some people have been here for several months…” This was shocking at the time how anyone could be there for so long – and here we are at five months and counting.

The biopsy results are in and here’s the report: Portal fibrosis, ductular proliferation, ductular and canalicular colestasis, mild acute portal inflammation. That’s all a fancy way of saying that Josie’s liver is a bit of a mess. These are all abnormal reactive changes most likely caused by the months of IV feeding Josie was on. This is a known side effect of the TPN IV nutrition. Other possibilities are chronic sepsis (which they think she has had), biliary obstruction (which she might have, but not yet determined), and less likely drug toxicity (which she most definitely has had). She’s just put her liver through the ringer these last five months and it’s crying out ‘uncle already’. The docs are confidant that her liver is not damaged beyond repair and when she regains her health after her Whipple then the liver should repair itself nicely.

We’re still working the project to get Josie home but are continuing to run into trouble finding a way with her drug regimen. They’re trying to find a good a low-risk solution to the problem without making many changes to Josie’s drug course. We’re in a let’s-not-rock-the-boat-too-much-because-we’re-in-a-pretty-good-place-right-now mode. Any major change could throw Josie’s relatively stable condition totally out of whack before the surgery and no one wants that.