Living Donor: 1 Year Check-up

Derek and I were at Lahey on Friday; I was there for my one year check-up Derek was there for a regular old check-up.

The one year living donor check-up involves blood work, a CT scan–with and without contrast–and a meeting with a surgeon. We arrived around 7:15 am and both got our blood work done (the couple that visits the phlebotomist together, stays together? I feel like I’ve made this same stupid joke before.) then it was off to CT. This was a much quicker scan, but I still got the IV to pump the weird contrast into my veins which leaves the taste of pennies in my mouth, and makes my head feel hot, then spreads through my body like a hot flash. 5 minutes later I was changing back into clothes and we headed upstairs to the 6th floor to see our beloved nurses and hopefully a few of the docs. The doctors had just finished rounds, and we saw the fellows and our favorite PA, Tom. Tom hugged us both in succession about 3 times. He was genuinely thrilled to see us both and we talked about scars and bilirubin and how nice it was to visit instead of being a patient. Then we turned the corner and saw a few of Derek’s favorite nurses and the nurse manager. They too were thrilled to see us. What a difference a year makes was the common refrain.

Then we went down to the clinic for our dueling appointments. They split us up this time so I would have the opportunity to ask questions and get the surgeon’s undivided attention. While Derek was in an adjacent room with one of his surgeons, I was with his other surgeon. (My surgeon was out of town.) He looked at my blood work which looked good. Then he looked at my CT scan and let me take photos while he toggled back and forth between the old liver and the new liver. It still basically looks like a liver, it’s just in a different spot. It took a little time to figure out how close my liver was to 100%; we took a field trip to his office, then wandered to another desk to ask someone else. The hospital just got a new computer system and it’s apparently a big ol pain in the you know what so accessing my initial scan was a bit of a challenge. When we finally found it, they did the math and it turns out, it’s at about 87%, roughly the same size it was the last time they checked, 3 months after the surgery. Yup. That’s it, that’s likely as large as it will get.

Top photo is my liver from November of 2013. Bottom photo is from April 24th.
Top photo is my liver from November of 2013. Bottom photo is from April 24th.
This is basic shape and volume of my liver now.
This is the basic shape and volume of my liver now.

Turns out, female living donors average 87-95% of previous size, for males it’s a little larger. Recipients for some reason are more likely to make it to 100%. I was surprised as I had believed I would get the whole thing back, but it works great, so nothing to worry about there.

The CT scan and the examination of my scar did reveal something to worry about. It turns out I have an incisional hernia. The good news is that I haven’t noticed it and it doesn’t hurt. The sort of bad news is that it’s small. Hernias are weird. None of them are good, but a small hernia means a higher risk, or greater potential for a strangulated hernia. Currently a little bit of my bowel is sticking out of a hole where my two rectus abdominus muscles meet, right above my belly button.

In this illustration, the line that is pointing to the linea alba is where my hernia is.
In this illustration, the line that is pointing to the linea alba is where my hernia is. This is the same angle/view as the CT scan above if that helps orient you.

If too much of the bowel goes through that hole, there’s a potential–because the hole is small–that it won’t easily make its way back through. That’s a recipe for emergency surgery. Currently, I have no symptoms, but it’s there. (And because I know it’s there and can actually feel it if I choose to, it’s a source of concern, and I am super good at worrying.) It is easier and better to fix a small hernia as opposed to a large hernia. I’m weighing my options in terms of timing, but I will have to have surgery and they will insert a piece of mesh to fix the hole and then pull the muscles together a little tighter. Just for fun, I looked up naturopathic remedies for incisional hernias. The ‘natural’ remedy is surgery.

Having my incision cut open again is not something I am looking forward to, but it’s a relative walk in the park in comparison to partial liver resection and it’s a day surgery. I need to do a little more research and have another chat with the surgeon, but I will likely schedule the surgery for the fall, which will hopefully give me enough time to recover for ski season. This is a pretty common complication with this kind of surgery and I am pretty bummed out it happened, but it is a very small price to pay. I have a husband who has more energy than he’s ever had before, and we are both very much alive.

In Derek news: his appointment went well, his friend Bilirubin is at about 4, which is ok, and all of his other labs look great. He’ll go back in 3 months for another check-up, but everyone was in awe of how amazing he looks and they were especially thrilled to hear he’d been running and his general fitness. It’s nice to be a part of a winning team, and the doctors and nurses sure do love to see success walking around.

3 Replies to “Living Donor: 1 Year Check-up”

  1. Well that sucks! But I love your optimismic view (as usual.) Hope no symptoms show up and you can take care of this on your own terms.

  2. keep that bowel on the inside, logs! sorry to hear you have to have surgery again, but glad the liver is looking good!

  3. Your re-assurance is good to have. Only puzzle is timing of surgery? What am I missing? Maybe next time you address this topic, I’ll better understand. Love you guys. sQs

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