Friday, February 06, 2009

what happens next

I got the call and am being driven to hospital this morning by ambulance. I've had some tests and am waiting to see whether or not there's a susitable liver available - should find out some time in the next hour or so. When I get to the hospital I'm going to firstly go through some checks and forms. They will test blood pressure, heart rythym, etc. and do blood tests. Then they will go over the consent paperwork that I signed and make sure I understand all the small print etc. Finally they will give me a little gentle sedation to just keep me calm while I'm being prepared to go into theatre. During this time my donor liver will be being flown/driven in, and examined by the head surgeon to ensure he is satisfied it is suitable. There is a chance that he may reject it, in which case I'll be sent home. All being well I'll be taken in to theatre, given general anaesthetic and have various tubes inserted. There will be a large ventilation tube into my throat, and several blood-lines from my neck, torso, and leg to allow them to re-route blood around my liver. They will put several electrodes on my skin to monitor my heartbeat. One team of surgeons will then get started preparing the donor liver by warming it, cleaning it, and getting the cuts clean and ready for stitching in. The other team will make a long incision below my rib-cage and a short one down to near my belly-button. They will start cutting the cartilage around the liver, and then clamp off the blood arteries and vessels and reroute them via the lines they put in earlier. Once this is done, they finally remove the old liver, then put the new one in place. Each tube is carefully glued and/or stitched to the new liver, and blood is pumped back through it. Finally they stick me up, and take me out to recovery in the liver intensive care unit. Over the next 24 hours I'll remain unconscious while they monitor me and introduce the immunosuppresant drugs. If there is no sign of rejection then they will start waking me up and checking that I'm responding properly before removing the breathing tube. I'll remain heavily sedated for another 24 hours or so while they being to remove some of the lines. At this time I'll get transferred to Todd Ward. I would expect to be there for around 3 weeks while they gradually take out more lines, ensure I start becoming mobile, and gradually start moderating the doses of immunosuppresants. Toward the end of this time I will be learning to time my own medication, and they will be preparing me to leave hospital. While I'm on the Ward I'll be very tired, and most patients become a little depressed during the first week or so due to the drugs and also the come-down after the excitement and anticipation. It is possible to visit in the afternoons up to 8pm, though I'd appreciate a text or an email before so that I can a) put you off if I'm not up to it, and/or b) make sure not everyone turns up at the same time. I will have access to email/facebook etc. on my laptop though I don't know how with it I'll be. The hospital website is Kings College Hospital. Bear in mind that the car park is enormously expensive, and always full (it usually has a queue of up to 20 cars waiting up to half an hour to get in). Public transport is best: Thameslink train to Loughborough Junction, or there are trains from London Blackfriars, London Bridge and London Victoria to Denmark Hill station. Anyway, I'm hoping someone in my family will post a few updates when I'm out of the operating theatre, and hopefully within a few days I'll be writing a new one myself! Wish me luck for some DeLiverance (geddit?)

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