Nancy is not only fighting the tumor in her liver (which is actually operable), but she also is dealing with a rare condition called Cushings Syndrome. This creates a increase in her cortisol level (her level was over 100 when it should be closer to 20). The raised cortisol level has hidden many of the issues she has had, as well as hinder her ability to heal. They have meds they can give to lower the cortisol, but it also lowers her blood pressure, which was dangerously low to begin with.
The first surgery they did was exploratory. They said she was too weak for surgery initially, but her condition declined so much that they were confident that if they did not get in there and find the problem, she would not have survived more than a day, maybe 2 at the most. They found that she had two stress ulcers, one of which lacerated (I believe only one did, I forget). She had an infected gallbladder, and she had 2 liters of pus in her abdomen. They cleaned out the pus, and closed up the ulcer and cleaned everything up. They removed the gallbladder. She came out of that and the doctors were pleased in that they found what was putting her in immediate danger.
The next day, they found some bile leaking in one of the many tubes, sorry I forget which one. They had to go back in, clean her out some more, and insert a T-tube to take care of the leak. From this point on for the rest of the week, she mainly held her own with her blood pressure holding a little above normal, slowly being taken off the 3 different meds that was holding her blood pressure at a safe level. She was able to hold her own level without any meds. Her cortisol level slowly came down as they were working the meds in a little at a time to bring it down, but had to be careful as to not create an issue with her blood pressure again.
On Monday, this week, they found a opening in her esophagus during a scan. Looking closer they realized she had two tears that were close to one another. Due to her blood being too thin, they couldn't do a surgery right away. They put her on meds to thicken the blood and thankfully that worked quickly. They had three surgical options, but decided that she would likely not survive two of the options. The third option was to install a stint in the esophagus that would essentially block the holes that were causing leaking and ultimately her lung to deflate. The chance they were giving her of surviving this surgery was 25%. As you can imagine, we were all VERY nervous and stressed as they performed this surgery. We all went into to see her and talk to her before the surgery, even though she was out at this point.
The surgery took about 2 and a half hours. They insert the stint which was driven up from NY that day specifically for this surgery. It had to be specific size as it essentially is held in place by barbs that dig into the tissue, and it has to be able to flex with the esophagus. The surgeon said they rushed through the surgery, although carefully as she was so weak they did not want to keep her under any longer than necessary. When he came out to talk to us, the first thing he said was, "she did miraculously well". He stressed that she did a lot better than he thought she would, and she came out of the surgery fine. Since monday, her levels have come back to around normal, or at least a lot closer to normal. Her kidneys have started to operate more (they had completely shut down last week during the issues that led to the 1st and 2nd surgery). She is holding more than 15 liters of fluid in her cells that has her very bloated with an extra ~30 lbs of weight. Some of that has started to leak out via her urine now that he kidneys are functioning as well as some fluid is weeping out from some holes in her hands and feet that were made for various checking of levels.
Today, she was the most awake and aware she has been since coming in to ICU. They had her sitting up some and tomorrow will swing her legs over the side of the bed for a bit in a seated position for a little bit. They are hopeful they can get her off the ventilator (she has two tubes down her throat and has for 13 days now) and will put a trach in, which although it sounds more serious will be better for her and she will be a lot more comfortable.
In all, today was the best day in two weeks. We are still cautiously optimistic. We have to take it one day at a time, but seeing any progress is a good feeling after two weeks of very little good news.
I want to thank everyone again for their prayers and well wishes. I also want to say a special thank you to Jason Tynes for lending me a crew and wire to get a large prewire that sprang up quickly done. Without his help it would not have been impossible. He's a great guy and a true professional. Thanks again bro.
