On Saturday night at around 7:00pm something happened. The plastic bulb–the Jackson Pratt for those of you playing liver transplant bingo–that acts as a receptacle for the bile coming out of Derek stopped collecting bile. This was a dramatic change from the previous few days when it needed to be emptied every couple of hours. It seemed a little odd to both of us, but Derek felt ok and his jaundice was on the decline so we weren’t super worried. Not super, but a little. See, while we were at the hospital, anytime we would point out that there sure was a lot of bile, everyone would say, “Oh! That’s a GREAT sign! That means the liver is working.” So did no bile mean the liver wasn’t working? One of the surgeons referred to the dark substance filling up as “black gold” and said he’d never seen a liver fail that was producing that much good stuff.
Sunday when he woke up, still no bile. Hmmm. Vexing. At some point I remembered a conversation with one of the nurses about the path of least resistance when it comes to fluids. Maybe this was what was happening with Derek’s bile. The tube that is connected to the drain originates where bile is produced so if it isn’t going out the tube, then maybe it’s just going where it’s supposed to go? Maybe the liver is starting to function normally? Maybe all that food is working!
Curiosity got the better of me and I called the answering service at the hospital and asked if the surgeon on call could give me a call back. Minutes later one of my surgeons called back. I explained my observations to him, reported on Derek’s vitals and asked what he thought. Without hesitation he said that’s what is bound to happen, and when Derek goes in for his appointment on Tuesday, they will likely remove the JP bulb and cap the tube. (The tube has to stay in for awhile for a couple of reasons. One so they can inject dye if they need to, and two because there’s a stitch holding it in place and they need to wait for it to dissolve so the tube will come out easier.) I asked if my path of least resistance theory was correct and he said, yes, exactly. I told him I was working on an honorary degree as a Derek liver specialist. He laughed and then asked how I was doing. I told him I was doing great, and thanked him for taking such good care of me. He told me to call anytime with questions.
Our good friends from Rhode Island are visiting us and graciously helping with some chores. We all went for a nice walk to the Pretty Park a.k.a. Wagner Park and Derek looked real peppy. So peppy in fact that he went the whole day without a nap! At 9:00pm the day caught up with him, he was exhausted and shuffled off to bed. It was a long day, but it was a good day. We had solved the mystery of the missing bile which was a big relief and were able to get some exercise with great friends on a beautiful day.