A Bad Scare

The new year brought a new scare for Nikki. In mid-January, Nikki came down with a bad cold that she couldn't shake. Stubbornly, she kept putting off going to the doctor, expecting to get better at any time. After about ten days, she had lost 17 pounds and became *very* sick. Finally going to the doctor, she was diagnosed with the flu. She received treatment for the symptoms and was told to drink lots of liquid. Unfortunately, she didn't get better and started to be unable to work. She'd make herself go in to work, only to have to leave a few hours later.

Finally, there came a day in late January when she dragged herself in to work again. Her manager took one look at her and said "Enough". He had an employee who was off-duty take Nikki to the emrgency room at OSU Hospitals. She spent 12 hours in the ER, then was admitted to the hospital. Batteries of tests were conducted, including lots of imaging. The result came back the morning of the 2nd day; acute hepatic failure. Nikki's liver was failing, already operating at a dangerously low level.

The liver is the body's biochemical factory. It produces enzymes that do a great many things for us. It also converts many potentially toxic substances into non-toxic forms. The liver is very resilient, being the only organ that can regenerate; as little as 1/4 of a liver can grow back to normal size in only 6 - 8 weeks. On the flip side, the liver is irreplaceable; there's no mechanical or chemical substitute for it. When it goes, it's gone, and the only recourse is a liver transplant.

With this diagnosis, Nikki was transferred to an intensive care step-down unit & moved to the hepatic (liver) service. She was consulted by the transplant doctors early on- not because she was at that point yet, but because it takes time to be made eligible to receive a transplant and the docs wanted to get a headstart, in case the liver should completely & suddenly fail. By this time, Nikki was beginning to drift mentally, as toxins built up in her body. With the liver already struggling, they couldn't give her medications for this confusion. The staff expected this, but her family was pretty unnerved by it. She was actually having minor hallucinations and lost track of where & when she was. This lasted for a couple of days, and required Nikki to have a sitter with her at all times.

Finally, progress was seen. She was being given medications to help bolster the liver, relieving the stress on it. And the liver started responding, with hepatic function slowly improving. After a second day of improvement, her confusion went away all at once, and she began to feel better. A final diagnosis was still unclear, although the doctors believed that acetaminophen (Tylenol), alcohol and possibly a viral infection all combined in a "perfect storm" to damage the liver. With all of Nikki's surgeries, she's taken a great deal of acetaminophen-containing pain medication over the years. The theory is that this has caused cumulative damage. Add to that social drinking and possibly a nasty virus, and it was too much for her liver.

In the end, Nikki went from possibly needing a liver transplant on Monday, to being discharged to home on Saturday. She has some permanent lifestyle changes to make, though. First, no more acetaminophen... she'll have to use other medications, such as ibuprofen, and always in moderation. Second, no more alcohol... the doctors stressed that her liver is permanently impaired now, even though it may regain near-normal levels of production. It will always be very susceptible to additional damage. As a social drinker, this is a big change from how Nikki is used to hanging out with friends. However, she has a great support network and has adjusted very well so far. And third, she's to get to the doctor faster when sick. Many illnesses put a strain on the liver, and doctors will be looking for that from now on.

As of today, Nikki has regained all of her weight, her energy is back, and she's her old self again. She'll have a lot of regular bloodwork drawn for the next year or so, just to make sure that all stays well. She also has to wait for a while before going through anymore plastic surgeries, since the docs don't want to strain the liver with anesthesia for a while. When the time comes, there are specific drugs that can be used that aren't as toxic to the liver.

And that's it... just another chapter in the life of my little girl. She's never boring.