Bilirubin Blues: Update on Jordan's Hospitalization

Jordan first went to the hospital February 22^nd for throwing up blood.  After turning the waiting room into a crime scene by throwing up again they rushed him back and hooked him up. He was deficient in everything, they had him on so many drips the first night that he had three IV’s going. He doesn’t really remember the first few days he was in there very clearly. Come to find out on his discharge that they gave him plasma and a blood transfusion because he had lost so much blood.

The first night he had an emergency endoscopy, which scopes the esophagus and the stomach. Because they drained him in the ER by shoving a tube down his nose to draw the blood out they didn’t find anything unusual, just an empty stomach. There was concern that maybe a varice, a varicose vain in your esophagus and stomach, had burst causing the massive bleeding in the stomach.

Instead during the consolation the doctor told me that all the organs are under pressure because the liver is not processing blood like it is supposed to. It cycles it through insufficiently. His organs were bleeding from the pressures being put on them and the blood collected in the stomach to expel it. It will either get rid of it via the esophagus or the rectum. Both are alarming.

As Jordan was joking with a nurse like he always does, the nurse told him he had blood coming out of places it shouldn’t be and that’s cause for concern.

For the next 3 days they monitored him and sent him home with a bag full of medications and instructions to take it easy.

That following Friday, a week after his hospitalization, Jordan met with a family medicine doctor, who will be our primary care doctor, for a follow up appointment.

The doctor was alarmed by Jordan’s reports and told him that a liver transplant or some kind of procedure would be in his future. So they moved his appointment with the liver specialist from July 1^st to March 18^th because they knew the severity of the situation.

On Sunday, March 6^th he was throwing up blood at home again. I was at work so Jordan drove himself to the ER right after it happened. When he came into the ER this time his heart rate was elevated, his blood pressure was low and so was his hemoglobin count. He had another endoscopy that revealed a varice had burst and was bleeding into his stomach. The doctor was able to clamp to vein to stop the bleeding.

He got two more units of plasma, to help the blood clot because his liver could not produce what was necessary to do that, along with another transfusion. They moved him to intensive care and monitored him.

Tuesday was a sobering day. The internal medicine doctors that were on call during the day came and talked to Jordan. They talked about a liver transplant and the qualifications that it requires; sobriety through a qualified program that documents commitment for 6-12 moths, and no smoking. Because a liver transplant is so invasive they discussed another option. It’s a procedure where they basically rewire his body by moving a vein that is imputing blood through the liver to be cleaned and move it to the heart. So the vein will go around the liver instead of through the liver. This is thought to relieve pressure caused to other organs because the liver cannot process the blood efficiently.

He received a CT scan of his abdomen to get a 3D image of his insides and they will be doing a test on the heart to determine if the heart can handle additional blood flow. All of these tests and discussions are to determine what the best path to take before putting him on the transplant list. They want to know if there is another way to relive the pressure now so Jordan can continue to recover and discuss transplant options in the future.

Jordan asked if there was anything he could do the help the process and they only said to do what they say. Which means take what we give you and rest when we tell you too. He will be close to bed ridden when he does come home.

Tuesday night got a little more eventful. After a steady day of monitoring he was moved from intensive care on the 4^th floor to progressive care on the 3^rd floor. They wanted to keep an eye on him but he was stable and doing better.

And then around 8pm he had a bright red bloody stool. Once he alerted the nurses the room got busy. They took his vitals, hooked him up to the monitor, removed all his food because he can’t eat now, and ordered more plasma. The on call doctor that night wanted to stop the bleeding immediately by possibly transferring him to IU University downtown and doing an emergency endoscopy there to get a definite solution. He still had the clamp on but they needed to look again to see where the bleeding was coming from and if they needed to put a kind of glue to help it indefinitely. That equipment was only at IU University downtown.

Well, there was bed crisis in Indy. All the hospitals downtown; St Vincent, Methodist, IU University, and Eskenazi, were all full. So Jordan would most likely be transported downtown to do the procedure in the morning and then right afterwards be transported back to IU North because they have a bed for him here. When I left last night at 11:30pm they were still waiting.

It’s been a long road for Jordan and he is weary. When you think of him please pray that he would have the strength to endure. He is in a lot of pain so pray that he will be comforted. He doesn’t know all the details about his options yet so pray that he will be hopeful.

Through all of this Jordan has maintained a positive attitude and knows that whatever happens is in God’s hands.