Bile Duct Update

So, this gets a little complicated to give an update on Naomi. So I will enlist some pictorial aids.

When Naomi had her gall bladder out, laparoscopically, the surgeon nicked the common bile

duct. Unfortunately, this is a known common risk in laparoscopic gall bladder surgery. This led to her leaking bile. Bile according to wikipedia is "a bitter-tasting, dark green to yellowish brown fluid, produced by the liver of most vertebrates, that aids the process of digestion of lipids in the small intestine. In many species, bile is stored in the gallbladder between meals and upon eating is discharged into the duodenum." In your mind you can equate bile to battery acid or something super painful. If you have this stuff leaking in you, you will lose your mind with pain and require Michael Jackson level painkillers. Which it did, and which she had.

So when the docs went in to repair the nicked common bile duct, they used her intestine and did a roux en y procedure to remove her common bile duct altogether, and suture the duodenum to the common hepatic duct. So the right and left bile ducts drain through the common hepatic duct directly into the duodenum.

Are you with me?

And BTW luckily we've had no problem with the Sphincter of Oddi or the Ampula of Vader.

These ducts are approximately 2 mm in size, and in a small person they are especially delicate. And she is very small, she has lost 14 pounds since this whole thing began. Because these ducts were sutured, and they are full of blood vessels, they get a little mad when you stitch them.

So she got fever and feeling punk, and when we checked it out the ducts were dilated. So it seems they were skinny in the middle and dilated on the ends. Also her liver numbers were all funky, and white blood cell count very high. We had an ultrasound and she threw up the water she was supposed to drink. So they made her drink contrast fluid and did a CAT scan and she threw up the contrast fluid. Later they did an MRI and that went fine.

So therefore, we re-entered the hospital this week on Wednesday and went on some wicked antibiotics. Oh, and in the midst of it she developed a stress ulcer because of everything going on. The treatment worked, and she is now out of the hospital as of Friday.

We will be watching her liver numbers by blood test monthly, and watching her like a hawk to see if she starts feeling punk. The doc gave her a medicine that will help her produce more bile, so we will whoosh a lot of bile through those little ducts to try to stretch them open bigger. If they don't, and they start to stricture (or narrow), then we will need maybe a stent or something which is like inserting a straw inside the bile ducts to make sure they don't close and can process enough bile.

We had plenty of new doctor and hospital adventures that are good tales to tell:

• We looked at old pictures in the hallway of all kinds of nuns - nuns kayaking, Alaskan nuns, nuns in school, and, well, lots of other funny situations but me without my camera


• We got a private room in the pediatric floor with the view and great nurses


• I had a very serious conversation with the surgeon while in my pajamas (those surgeons come to visit the patients early in the morning BTW)


• Naomi read The Last Song by Nicholas Sparks in its entirety


• I ate meat at the hospital (last time was during Lent) and amazingly enough, meat did not improve the quality of the cafeteria food


• We visited with our pal Chaplain Mark


• We went to the cafeteria and avoided Chaplain Mark, who was in the cafeteria and had a lady loudly crying due to some trauma, and let him do his job


• I very dramatically told the doc "I just don't want Naomi to end up on dialysis" and he patted my knee and said "dialysis is for the kidney, not the liver" and then we cracked up


• All the nurses admired Naomi's nails and were amazed she did the French tips and flowered toenails herself


• One of our doctors admired Naomi's attitude and positive spirit and tried to talk up his son, who is sixteen years old, in a fit of doctor-patient matchmaking


• We watched prehistoric TV with no Tivo that required us to purchase a TV Guide so we didn't miss anything good, and got all the good pictures from Glee


• We discovered that Matthew Morrison, the teacher in Glee, used to be in LMNT, which is the offshoot boy band of Otown, when we were watching Making the Band, and loved Ikaika Kahuano who formed LMNT, and whose album we own


• We found a very cool birthday gift for a friend of Naomi's in the gift shop, and her birthday is this month


• A giant hospital visiting dog came around and visited with Naomi


• We got to take home a giant foam mattress cover, the Geo Matt, which has allowed Naomi to sleep on her stomach for the first time since the surgery and solved her problem of waking up in the night


• We watched the Saturday Night Live celebration of the 2000s and I don't know who enjoyed it more


• I almost broke my nose when I flipped down the seats in the van to fit the Geo Matt in there so we could see out the back window

And that, my friends, is what the Blog Adventure staff did