Post Transplant – Days 18, 19, 20, & 21

Things are going well.  Anya’s been walking like a champ.  Today, she walked about 300 feet stopping only once to look outside of the hospital window.  It’s been a long time since she’s been able to walk this far, this fast without getting winded.  It’s pretty amazing really.

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I think the pulmonary arterial stent helped.  It opened up the blood flow to her left lung allowing her to push her new lungs a little harder.  The proof is in the walking.

The pulmonary doctor performed another bronchoscopy on Anya on Monday.  They sucked away quite a bit of the dead white tissue inside of her new lungs, revealing the healthy lung tissue.  They said that it’s going to take a few more weeks, perhaps.  There’s no real timetable on how fast her lungs are going to heal, but they are encouraged by what they’ve seen recently.

A few other things popped up over the past few days.  Her chest x-rays showed a splotch of fluid around her right lower lobe.  The doctors ordered a CT scan which revealed some pleural effusion which is just fluid between the outside of the lungs and the inside of the chest cavity.  It wasn’t a significant amount of fluid, but enough for them to investigate.  The doctors determined that they were just going to leave it alone.

Pleural effusion a few weeks post transplant is not an uncommon thing and usually the fluid just gets reabsorbed back into the body once the nutrition and movement comes back.  Anya  mentioned that she had this same thing happen to her after her first transplant and the doctor used a big needle to extract the fluid but there’s a risk/reward ratio that the doctors at Methodist don’t feel is worth it at this time.  From what I’ve read, the pleural effusion is not uncommon and usually harmless.

The other thing that popped up is that there’s a new bacterial growth in her lungs from the bronchoscopy on Monday.  They don’t know exactly what it is yet, but they are waiting for the daily culture reports from the lab.  In the meantime, they’re putting Anya on a new antibiotic until they determine the actual bacteria that’s growing.  The doctor told me that it may just be something picked up from the room air during the procedure.  I’ve seen them do the bronchs and sometimes the long black tube that they use to put into her lungs touches the bed or a glove or something that’s not fully sanitized, then they put everything in a jug and send it out to the lab.  The doctor said that so long as the bacteria doesn’t show up in the culture report then he’s not going to worry too much about it for now.  I think once Anya’s lungs heal, it’ll be harder for the bacteria to stick to the walls of her lungs. Right now, the white stuff and the mucus in her lungs make it easier for the bacteria to grow.

So, we’re moving along here.  The doctor said that Anya will most likely make the move over to Kindred by Friday or early next week.  Anya wants to stay for the weekend, at minimum.  We have a bronch scheduled for tomorrow and then another one on Saturday.  The main thing is that they’re still waiting for the inside of her lungs to heal.  They’re doing pretty much everything they can to facilitate that process.  Once they feel comfortable with the progress then I think they’ll get a little more aggressive with the physical therapy, weaning Anya off the vent, and ultimately sending us home.  I don’t feel as though we’re too far away from that point now.

Walking with her PT, Chris

Walking with her PT, Chris

Some friends from the weekend (from top left: Darlene, Colette, Sharon, Quentin)

Some friends from the weekend (from top left: Darlene, Colette, Sharon, Quentin)

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