Information Overload

Clinic is over and we definitely got some information.

Let me just start off by saying how SURREAL this whole decision-making thing is. It's not like saying "hey, turkey or ham for lunch today"? Instead, it's like "hey, would you like to live 3 years and remain healthy or maybe just ride it out and see what happens"?

Here are some of the answers:

Tube in or out?-the tube is going to come out. There is the option of leaving it in, but the doctors feel that not only are we prolonging the inevitable, but we also risk completely damaging the kidneys. And, there does come a point that if the kidneys become too weak Geoff will not be eligible for a transplant, ever. I think the Dr. said something like, "sure you can leave the tube in indefinitely (especially if you don't want to go the transplant route) and just ride it out as long as the tube is willing to last". Um, no. Us Dunkles are risk takers, but even that's a little much for us.

So, the tube comes out. With the tube coming out the doctors feel that we should see a significant change to the liver. We didn't get the impression that they felt years would go by without seeing any damage. They stated quite a few times that "there are multiple strictures" in the bile ducts, so they would definitely expect to see "a jump in Geoff's bilirubin" (simply put, that means the liver would be having a hard time). This risk we are willing to take. The plan going forward is for Geoff to stay as healthy as possible, have weekly blood draws, and to help fight off infection he will be on a constant dose of antibiotics. Over time his MELD score should increase and he will be eligible for a normal transplant.

Donor criteria-something new that we learned today. Every pre-transplant patient has a certain criteria that the donor liver must meet in order for the transplant to happen. For example, Geoff''s donor would have to be on the smaller end (because he is a re-transplant and because he isn't a huge guy), preferably younger in age, etc. If time goes on and Geoff is still not transplanted we may have to look into widening our criteria. I. KID. YOU. NOT. when I say that the Dr. mentioned "donors that were in prison, past drug users...". I think I passed out at that point. Obviously, that is a ways down the road, but I tell ya, these doctors have contingency plan after contingency plan. Unreal.

Split-liver transplant-yes, I still think we are considering it, but right now there is not a lot of information on the entire process. We will continue to find out more as we move forward.

Here we go, ready or not. It will probably be a few weeks or so before the tube comes out. The transplant coordinators want to make sure the "new rule" has already gone into effect before removing.