He is a fighter with a strong will to live. After this 3+ hour surgery he was trying to remove tubes and oxygen and whatever else he could. But this time the doctors have learned a lot about him and won't let him mess-up their hard work.
What we discussed earlier today was that the original surgery to remove the blockage and get the bile flowing wasn't working. His blood work showed an increase in white blood cells (infection) and the ultrasound showed the bile duct was distended again. As if it was still blocked. They planned to go in and dismantle all the work from the first surgery and abandon using the bile duct because it was blocked and/or leaking.
They were going to pull part of his intestine up to the gallbladder and attach them together so the bile could flow into the intestine. The bile would be going into a lower part of the digestive system than normal and it might cause digestion problems for BigMac but it was their best option.
After they went in they saw that the liver is already healing and looks much better than just 4 days ago. The original J-tube opening that BigMac pulled out had healed, the area where they resected part of the bile duct wasn't actually leaking (they tested it with fluid.) They removed the stent and opened up the bile duct again. It was being blocked by gunk... bile gunk... they described it as looking like green jello or jelly. The bile was too thick to go through the stent so they took it out. The flushed the duct, the gallbladder, the duodenum and stomach (I think... that's right.. I know they flushed and tested the flow between organs.) So the stent they put in to support the bile duct was too narrow for the gunky bile.
Anyway long story shorter, is that the original repairs did NOT fail... only the stent was too small and got clogged. So they cleared it and made it more open. They also added another hole in the gallbladder right next to the duct and connected the duodenum right to the gallbladder. So now the bile has two routes to follow out if one area gets clogged. Obviously the thick bile has to be addressed at some time. These two routes are still at the natural location so his digestion will be more normal.
The drain from the stomach was also blocked - so for the past two days the lack of drainage gave a false sense of good news. There was fluid in his stomach that they didn't see until the ultrasound today. This tube was clogged by the omentum (lining of the stomach... kind of like fat) whicht helps seal off infection. But in this case it sealed the drainage tube.
He has a new J-tube that is longer, bigger and is tied in tightly. He is wrapped in something like a strait jacket to prevent damage to it. ohmygod_smile
He has a new drainage tube that is larger and shouldn't get clogged as easily.
New central line to get blood since the other one quit giving blood. New IV. No E-tube.
He might need a blood transfusion tonight so they ordered some for him.
He will need to be in a hyperbaric chamber soon to help with healing.
The other thing they discussed was his reaction to the pain medication. They believe he had difficulty dealing with the feeling of being drugged. When they backed off the dose, he did better. I do agree that he was much calmer yesterday & today and he rested calmly and purred loudly. Much better than when he was looking around wildly all the time. They will administer a different medication and only give it as much as needed if he seems to be in distress. The doc said it is easy to give more if he needs it but they can't take it out if it is too much.
I saw him after the surgery and again he was trying to roll around and get the heck out of there. I didn't stay long because it was hard to see him and he still had the doctors and nurses working with him. I will call tonight around 11 to see how he's doing.
All in all a good result and more encouraging than I anticipated.
As I left tonight I told the receptionist that - "...see that guy was WRONG. I wasn't waiting in the death room." The reception smiled. She overheard the earlier conversation and was pretty horrified at what he said.
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