Today was the day of my liver biopsy at Northwestern Memorial Hospital in Chicago. This was our fourth trip to the hospital in the past 2 weeks (2 doctor appointments and 2 procedures). Today's procedure was done in the Interventional Radiology department which is the same place where I had my portal vein embolization (PVE) done last week so I dealt with many of the same nurses and they were all wonderful (again).
I got prepped for the procedure and wheeled into the procedure room where an ultrasound was used to get a good view of my liver including the large hemangioma in the right lobe. The biopsy tissue was taken from the left lobe of the liver in order to avoid any contact with the hemangioma. One of the nurses shaved part of my right abdomen and they "painted" this area with a green antiseptic prior to the procedure. Soon after this I received my general anesthesia and the next thing that I knew I was waking up in recovery. I have a small bandage on my right abdomen where the needle had been inserted to get the biopsy tissue. The procedure took a little under an hour and I was in the recovery room for two hours following the procedure.
It sounds like the biopsy results will be available in a few days (hopefully by the end of this week). As I was wheeled into the procedure room I spoke with the doctor who had done the PVE last week and he indicated that based on the results of today's test the next test would likely be a Hepatic Angiogram (injection of dye into the liver's artery to see the location between the artery and my hemangioma). This test would also done in the same Interventional Radiology department if the test is required.
Tuesday, September 30, 2008
Friday, September 26, 2008
Wiped Out
Today was a rest day (I wasn't very sore today but extremely tired) and a day on the phone with the hospital about upcoming steps. We were told yesterday that we would be meeting with the doctors at Northwestern on Monday. Today there was a change of plans and I spoke with my surgeon about the unexpected results (high pressure in my portal vein) found during yesterday's liver procedure .
There are many different possible causes for the pressure and this needs to be understood better before I have the liver surgery. So next Tuesday I will have a liver biopsy to see if it shows any other problems with my liver (besides the benign tumor that I have). If the biopsy doesn't show anything then there is an additional test that will be done. I don't remember the name of this second possible test but I believe that it is a dye that will be injected into my tumor to see if it's location is causing the unexpected pressure.
My family bought tickets for a big concert tonight at our church but I wasn't up to going. My wife and older daughter went with one of her friends. The main act was Big Daddy Weave and the secondary group was Rush of Fools. I was excited about seeing Rush of Fools since I had seen them earlier this year with Newsboys and they put on a great show. I am sure that it was another good show tonight.
There are many different possible causes for the pressure and this needs to be understood better before I have the liver surgery. So next Tuesday I will have a liver biopsy to see if it shows any other problems with my liver (besides the benign tumor that I have). If the biopsy doesn't show anything then there is an additional test that will be done. I don't remember the name of this second possible test but I believe that it is a dye that will be injected into my tumor to see if it's location is causing the unexpected pressure.
My family bought tickets for a big concert tonight at our church but I wasn't up to going. My wife and older daughter went with one of her friends. The main act was Big Daddy Weave and the secondary group was Rush of Fools. I was excited about seeing Rush of Fools since I had seen them earlier this year with Newsboys and they put on a great show. I am sure that it was another good show tonight.
Thursday, September 25, 2008
Portal Vein Embolization (PVE)
Well today was the procedure to block the portal vein coming into the right lobe of my liver. (see earlier blog post for the reason for this procedure). My wife and I drove into Chicago before rush hour (4:50 to 6:00) and sat around until it was time for my check-in at 7:00 am.
After this I got prepped and eventually made it into the large room where the procedure was done. I don't remember a lot after this except for the following:
- There were a number of people in the room in addition to the doctor and staff that was doing the PVE procedure as it is a less-common procedure and others wanted to observe.
- I was laying on a table which had some imaging equipment above me and which had a large bank of video monitors. I guess this is how the doctor was able to see the veins coming into the right lobe of my liver and plug them up.
- Shortly after I was situated in the proper position (45% angle between laying on my back and laying on my left side) and I had been cleaned up, I was given IV medication to put me into a light sleep and to cover the pain.
- After this I was out for most of the procedure. However, as the medication was just for a light sleep (so that I could respond to commands about deep breaths and such), I did feel some pain near the end of the procedure.
- I remember trying to move when I felt the sharper pain and the staff helping me to stay still. Shortly after this I remember hearing, "last one and now we are done" or some similar words.
Later, after I had been in recovery for a few hours, I spoke with the doctor. I apologized for moving during the procedure when I had felt the pain. He indicated that it was all fine and that I had handled the entire procedure well.
It looks like the procedure went well though we learned of one complication from our discussion with the doctor. My portal vein had high pressure for some unknown reason. Because of this I will be needing another procedure to get some liver tissue for a biopsy. I guess if we had had any idea that this would be needed then it could have been consented by me in advance and the tissue could have been collected today. However, since the doctor did not have this consent he was not able to do this and I was drugged out and could not at that point give consent.
After 4 hours of recovery (of which I mostly slept through) I was released and my wife brought me home. I then went to sleep for another 3 hours. Hopefully I will sleep ok tonight.
I have another meeting with my liver specialist and liver surgeon on Monday next week and I am sure that we will discuss the portal vein hypertension as well as the needed biopsy. In the mean time, today's procedure should induce my left liver lobe to begin to grow prior to my surgery which will likely be early in November.
After this I got prepped and eventually made it into the large room where the procedure was done. I don't remember a lot after this except for the following:
- There were a number of people in the room in addition to the doctor and staff that was doing the PVE procedure as it is a less-common procedure and others wanted to observe.
- I was laying on a table which had some imaging equipment above me and which had a large bank of video monitors. I guess this is how the doctor was able to see the veins coming into the right lobe of my liver and plug them up.
- Shortly after I was situated in the proper position (45% angle between laying on my back and laying on my left side) and I had been cleaned up, I was given IV medication to put me into a light sleep and to cover the pain.
- After this I was out for most of the procedure. However, as the medication was just for a light sleep (so that I could respond to commands about deep breaths and such), I did feel some pain near the end of the procedure.
- I remember trying to move when I felt the sharper pain and the staff helping me to stay still. Shortly after this I remember hearing, "last one and now we are done" or some similar words.
Later, after I had been in recovery for a few hours, I spoke with the doctor. I apologized for moving during the procedure when I had felt the pain. He indicated that it was all fine and that I had handled the entire procedure well.
It looks like the procedure went well though we learned of one complication from our discussion with the doctor. My portal vein had high pressure for some unknown reason. Because of this I will be needing another procedure to get some liver tissue for a biopsy. I guess if we had had any idea that this would be needed then it could have been consented by me in advance and the tissue could have been collected today. However, since the doctor did not have this consent he was not able to do this and I was drugged out and could not at that point give consent.
After 4 hours of recovery (of which I mostly slept through) I was released and my wife brought me home. I then went to sleep for another 3 hours. Hopefully I will sleep ok tonight.
I have another meeting with my liver specialist and liver surgeon on Monday next week and I am sure that we will discuss the portal vein hypertension as well as the needed biopsy. In the mean time, today's procedure should induce my left liver lobe to begin to grow prior to my surgery which will likely be early in November.
Tuesday, September 23, 2008
Book Review - "The Innocent Man" by John Grisham
I am a long time John Grisham fan. I have really enjoyed his legal fiction since his first book and I enjoyed his recent non-legal fiction, "Playing for Pizza", even though it wasn't critically acclaimed. I was very curious when I heard that Grisham had written a non-fiction book, "The Innocent Man", a couple of years ago but I was not in a reading phase at the time so I didn't get a chance to pick it up.
Recently I saw a reference to this book again and I read a brief description of the book online. It was at this point that I learned that the book centers on the town of Ada, Oklahoma and a real life crime in this town in the early 1980's and the incredible injustice that followed this crime. I lived and went to high-school outside a nearby town (Seminole) in the same general time frame of the initial events in the book so I really became interested in reading this book.
I purchased the book this past Friday and read it through the weekend and completed it this evening. It really is another great book by John Grisham. The writing and story telling are very compelling yet at the same time the story being told is sad and embarrassing to someone who lived very close to these events. I don't know if the book is 100% accurate but even if it is less then that, the events of the case are both unbelievable and the abuse of power is scary. The main story in the book is about two men, Ron Williamson and Dennis Fritz, who were wrongly convicted of a brutal crime in Ada and many years later were exonerated via DNA testing. The story also includes additional cases of wrongful convictions that overlapped with the main story.
I was very interested in the story as it was very compelling but I was also very interested as the locations and sometimes people were things that I knew about. I was away in college in Norman in 1982 when the actual crime was committed and I was living in Illinois when the trial took place so I did not remember much about the actual events but there was so much in the book that was familiar to me.
Ron Williamson, the primary character in the book, ended his high school baseball career playing for Asher in 1971. Nine years after this I was playing high school baseball and Asher was one of my high school's big rivals. There was also a reference in the book to another unsolved abduction that had occurred in Seminole prior to the crimes in this book. This reference was to a classmate of mine. Other references to places in Seminole, Ada, Norman and other places in Oklahoma all brought back many memories to my high school and college years.
The book is a great telling of a story that really needed to be told. I hope that in some way it may prevent this type of thing from happening again in some other small town. Reading the book was at times a bit surreal due to my familiarity with so much of the setting. I highly recommend the book (even if you are not from a small Oklahoma town).
Recently I saw a reference to this book again and I read a brief description of the book online. It was at this point that I learned that the book centers on the town of Ada, Oklahoma and a real life crime in this town in the early 1980's and the incredible injustice that followed this crime. I lived and went to high-school outside a nearby town (Seminole) in the same general time frame of the initial events in the book so I really became interested in reading this book.
I purchased the book this past Friday and read it through the weekend and completed it this evening. It really is another great book by John Grisham. The writing and story telling are very compelling yet at the same time the story being told is sad and embarrassing to someone who lived very close to these events. I don't know if the book is 100% accurate but even if it is less then that, the events of the case are both unbelievable and the abuse of power is scary. The main story in the book is about two men, Ron Williamson and Dennis Fritz, who were wrongly convicted of a brutal crime in Ada and many years later were exonerated via DNA testing. The story also includes additional cases of wrongful convictions that overlapped with the main story.
I was very interested in the story as it was very compelling but I was also very interested as the locations and sometimes people were things that I knew about. I was away in college in Norman in 1982 when the actual crime was committed and I was living in Illinois when the trial took place so I did not remember much about the actual events but there was so much in the book that was familiar to me.
Ron Williamson, the primary character in the book, ended his high school baseball career playing for Asher in 1971. Nine years after this I was playing high school baseball and Asher was one of my high school's big rivals. There was also a reference in the book to another unsolved abduction that had occurred in Seminole prior to the crimes in this book. This reference was to a classmate of mine. Other references to places in Seminole, Ada, Norman and other places in Oklahoma all brought back many memories to my high school and college years.
The book is a great telling of a story that really needed to be told. I hope that in some way it may prevent this type of thing from happening again in some other small town. Reading the book was at times a bit surreal due to my familiarity with so much of the setting. I highly recommend the book (even if you are not from a small Oklahoma town).
Monday, September 22, 2008
Meeting the Surgeon
So my wife and I went back to Northwestern Memorial to meet the surgeon who will be doing my liver surgery. The meeting went very well. I will be having my portal vein embolization (PVE) this Thursday. We need to be at the hospital at 7 which means we will probably be leaving home before 5. (Today however we had an afternoon appointment and made it to the hospital in just over an hour. What a difference from the drive last week where it took over 2 hours.)
I will have another MRI in 4 weeks to confirm that my left liver lobe has grown sufficiently. My surgery will be 6 weeks from now which will be the first week in November. It sounds like my hemangioma is so close to the center of my liver that the surgery will actually be an "extended right lobectomy of the liver".
I will have another MRI in 4 weeks to confirm that my left liver lobe has grown sufficiently. My surgery will be 6 weeks from now which will be the first week in November. It sounds like my hemangioma is so close to the center of my liver that the surgery will actually be an "extended right lobectomy of the liver".
Sunday, September 21, 2008
Watching Grass Grow... (not)
I have heard some say that they would rather watch grass grow then watch golf on TV. Personally I enjoy watching big golf events and there are none bigger than the Ryder Cup (US vs Europe). I have been having a lot of fun watching this the past 3 days.
Golf is normally an individual sport but the Ryder Cup is all about the teams and it is a lot of fun to watch these teams. The pressure is incredible as these guys don't want to let their teams down and it is so impressive to see their response to this pressure (which is generally very good).
I am rooting for the US team but I love watching both teams and the great golf exhibition that they are putting on.
Golf is normally an individual sport but the Ryder Cup is all about the teams and it is a lot of fun to watch these teams. The pressure is incredible as these guys don't want to let their teams down and it is so impressive to see their response to this pressure (which is generally very good).
I am rooting for the US team but I love watching both teams and the great golf exhibition that they are putting on.
Friday, September 19, 2008
Health Update
Well it looks like I will be having liver surgery after all though it will likely be November or later. I talked to my doctor today and she confirmed the surgery though I need to first go through a procedure that will do something to the veins coming into my liver so that more of the blood goes to the left "lobe" which should cause the left lobe to grow.
I have a 6.8 cm hemangioma/tumor/growth in the upper part of the right lobe of my liver that has been causing me pain. Because of the location of this growth it is necessary to remove the entire right lobe in order to remove it. Normally the right lobe is 60% of the liver and it is ok to remove it as the remaining 40% will regenerate and the liver will return to its original size (or very close to it). However in my case there is an issue as my left lobe is smaller than normal and removing the right lobe will leave me with a smaller liver which may not be large enough to be safe following the surgery.
So the plan is to do this procedure which should send more blood to the left lobe and cause it to grow larger in the next 4 to 6 weeks. After this time I will be scanned again and if the increase is sufficient then the surgery will be scheduled to remove the right lobe.
I meet with the surgeon on Monday to discuss the procedure and the later surgery. I don't know much about the initial procedure but it sounds like it does not involve any cutting (the words of my doctor) so it isn't called a surgery. It sounds like they come up through the groin to get to the liver to do this. None of it sounds like much fun but the hope is that when it is all done that the pain will be gone.
I have a 6.8 cm hemangioma/tumor/growth in the upper part of the right lobe of my liver that has been causing me pain. Because of the location of this growth it is necessary to remove the entire right lobe in order to remove it. Normally the right lobe is 60% of the liver and it is ok to remove it as the remaining 40% will regenerate and the liver will return to its original size (or very close to it). However in my case there is an issue as my left lobe is smaller than normal and removing the right lobe will leave me with a smaller liver which may not be large enough to be safe following the surgery.
So the plan is to do this procedure which should send more blood to the left lobe and cause it to grow larger in the next 4 to 6 weeks. After this time I will be scanned again and if the increase is sufficient then the surgery will be scheduled to remove the right lobe.
I meet with the surgeon on Monday to discuss the procedure and the later surgery. I don't know much about the initial procedure but it sounds like it does not involve any cutting (the words of my doctor) so it isn't called a surgery. It sounds like they come up through the groin to get to the liver to do this. None of it sounds like much fun but the hope is that when it is all done that the pain will be gone.
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