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Tomorrow morning at 7am, I’ll be back at the Clinic – this time for an endoscopy and possible variceal banding under general anesthesia. I’m not the least bit nervous or afraid since my pediatric gastroenterologist, Dr. Hupertz, will be performing the procedure. I literally trust her with my life, and she’s done this procedure on me probably a dozen times.

The reason I’m back with my pediatric doctor is because I’ve been having choking episodes, and the transplant team wanted me to have an endoscopy ASAP, but I don’t have an adult gastroenterologist and I’m used to general anesthesia (which adults do not get).  So they said to just have Dr. Hupertz do it since I already know her and peds patients get general anesthesia.  Seeing her again makes me so happy.  She’s amazing!

So for those of you wondering what “variceal banding” is… Liver disease causes something called portal hypertension. The blood vessels harden up and blood gets pushed around until way too much blood is shunted into the large portal vein. All of the pressure combined causes what is called portal hypertension which can cause many issues including varices. A varice is a swollen blood vessel, so swollen that it could fatally rupture. Portal hypertension causes these to occur in many places internally, especially the esophagus. Any kind of stress or prolonged pressure can cause them to rupture.

Post-transplant, my portal hypertension is gone, but many varices are left all over the inside of my abdomen, as we have seen on CT scans. There is no longer high pressure to increase the chance of rupture, but the possibility exists that I have some still in my esophagus.

Like I said, I’ve been having several unexplained choking episodes, so while my doctor does the endoscopy, if varices are present, she will ” band” them. She uses a tool to put a tiny rubber band over each varice, and the bands, over the course of a couple days, shut off each varice’s blood supply so they die and fall off.

We’re not sure if varices are present in my esophagus anymore, but either way, we need to see what is causing the choking. These episodes used to occur in the last months preceding my transplant, but I’ve been fine ever since. Until after my splenectomy.

So please pray all goes well and we find an answer to the choking spells.

In other news, my excruciating left arm pain occurring since my splenectomy is still here, so I had an emergency vascular ultrasound on Friday to see if a blood clot was causing the pain. Praise God, there is no blood clot! But unfortunately, this likely means it’s nerve pain, and now I will be continuing treatment with neurology.

And then there was last Wednesday when I lifted an almost-three-year-old up and over into his crib and completely tore out a muscle in my abdomen – yes, a muscle that was still healing from my surgery.  My doctor told me no more lifting and put me on muscle relaxers, so I’ve been trying to take it easy.  It’s so painful – I definitely learned my lesson!!

Lastly, please look into signing up on the bone marrow donor registry. I put a lot of thought into it and then tried to register today, but unfortunately they won’t accept organ transplant patients. And I cannot donate blood either because I’m too anemic. So please do that, too, for me.  Oh, and while you’re at it, sign up to be an organ donor.  :)  One day I hope to be able to give back, even though I know I could never repay what has been given to me.  I will at least try for as long as I live.

Have a wonderful week.  Count your blessings, and do something today to make someone smile.

Love,
Amanda



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