We are definitely not out of the woods

Dr. Visser told us after the surgery on Monday night that we are not "out of the woods" until Mary is able to complete step 2: Her liver is functioning and supporting her body.

Definitely, we are not out of the woods. In fact, we are far deeper in the woods than any of the medical team has ever been before. Mary has gone from Tuesday where she was alert, awake and even challenging her team of surgical residents to being totally uncommunicative. All of her vitals are good (heartbeat, BP, temperature, breathing rate, oxygen content) but some of her liver metrics have started to move in the wrong direction after being stable for several days. The docs are puzzled and that goes for the lead surgeon and the members of the surgical team, the lead pain meds doctor and his team and the ultrasound/radiologists that read her CT scan and ultrasounds today.

The CT scan was negative for stroke, the ultrasound confirmed the surgery was successful for blood and bile flow. The liver metrics, even though they are moving in the wrong direction are not in a panic range.

The most plausible theory is that she is overloaded with narcotic pain killers and her liver, which normally does a slow job of processing them, is really, really slow because only 1/5th of it remains. They have given her narcan to help cancel the narcotics but it has had no effect.

The decision was made to move her from the post-surgery nursing unit to "monitoring unit". The benefit is that the nurse to patient ratio is much better and she is constantly hooked to the remote monitoring equipment. By 7PM, the doctors decided this was not enough and they are now putting her in ICU for the night. More intensive nursing and staffed with doctors all night. The fear is that she finally processes the last of the pain meds, wakes up and is in screaming pain because there is nothing in her system. The preparation to counter that is a feeding tube that allows them to put different, non IV medicines in her such as neurontin.

We are rolling to ICU in a few minutes. I don't know if they let me stay with her or not. I'll find out soon.