Anya had a stent put into her pulmonary vein yesterday around 5pm. The pulmonary doctor told us about this problem a few days post transplant, but they didn’t make anything of it until Thursday. He told us that when the surgeon connects the new lungs to the body, sometimes the pulmonary veins heal in a way that causes some scarring inside the connection. When the scarring occurs, the blood flow to the new lungs is restricted. Normally this is not a big deal, but for someone recovering from a new lung transplant, it could be a big thing.
The main concern is that Anya’s new lungs aren’t healing as fast as they would like. With the stent, hopefully the proper blood flow will help speed up the healing process. The vascular team was able to lower the pressure gradient in the pulmonary vein from 12 mmHG to 4 mmHG (0 is ideal, which means unrestricted flow). Anya is getting much better blood flow to the new lungs now.
As far as paralyzed diaphragm problem, it looks like that was just a false alarm. They did a sniff test on her and she passed, so it doesn’t look like her diaphragm is paralyzed. It’s just weak from 3 months of being on the ventilator pre-transplant. It will take some time to rebuild the muscles around the diaphragm.
The team also found a blood clot in her neck where the IV line was inserted, so they’ve been giving her an IV heparin drip for the past few days. Yeah, it seems like it’s been one thing after another post-transplant, but I think things are moving in the right direction.
So, it looks like we’re probably going to stay in the ICU for a little while longer. That’s just my guess. With the new stent and the lungs still healing, I don’t think the transplant team feels comfortable releasing her to Kindred just yet. They told us that it may take some time for the new lungs to heal. Maybe even months.
Marion and I were in the room when they did Anya’s bronchoscopy today. The pulmonary doctor showed us the inside side of Anya’s new lungs. On the right side, the lungs looked pomegranate colored with white patches here and there. Kind of like what you would expect from a healing flesh wound. On the left side, the lungs were mostly white in color. It looked like that white layer that forms over a skin scrape as it’s trying to heal.
I don’t think the doctors are too concerned. Anya’s breathing has been pretty good. Her oxygen levels have never really desaturated post transplant, even while on the trach collar. As a matter of fact, the other day as she was sleeping, the trach collar pulled over to the side a little bit, so she was literally breathing room air and her oxygen saturation levels were hovering right around 93%. She was on the trach collar for about 8 hours today and she looked great.
So, it looks like we’re still very much in a hurry up and wait mode. The infection, the pneumonia, the second surgery, the new stent…these were all unexpected events post-transplant, but the fact is, it’s only been about 2.5 weeks. No one recovers from a double lung transplant in 2.5 weeks. Anyways, we’re moving along here. I’m not going to lie though, I’d feel a lot more comfortable once they discharged us from the ICU…