Thursday, June 11, 2015

Saving Tyrion Lannister - Homecoming: Fail


As many of you know….Tyrion’s homecoming never happened.
Ryan and I traveled to Philadelphia on Sunday.  We were able to see Tyrion on Sunday evening as his Internal Medicine doctor was still at the hospital.  I couldn’t wait to see him.

Although I was hoping he would recognize us right away, I was a little sad that he kind of shied away when I tried to pet him.  We got to meet Phish Food (originally named after the Ben & Jerry’s ice cream flavor), who is now officially Jaime Lannister,  and he was as sweet as could be.  Even though I thought Tyrion didn’t remember us, he cried for a long time when we left. 
Not an effective water drinker.  Half in his mouth, half on his face.
Monday morning we arrived at the hospital at 9am. We began getting versed in our new regimen/way of life.  Lots of medications and instructions.  It was overwhelming.
As a last precaution, Tyrion’s labs were checked that morning. 
The staff at U Penn had even arranged a grand send off for him.  Someone had got him a little crown, (because if you are a Game of Thrones fan, you know Tyrion will someday be king – we hope), they had made him a sign, they even had a photographer there.  
Dr. Cleroux - one of Tyrion's lifesavers

So much fanfare for this special little kitty. 
Wanxin - another Tyrion caregiver/fan. 

We were within 20 minutes of springing him from kitty jail when the team of vets told us to slow our roll….Tyrion wasn’t going anywhere.
Something was going on with his new kidney.  His kidney values had doubled and his white blood cells were very elevated (indicating a possible infection).  Needless to say, we were worried.

We quickly rebooked out flight, remaining hopeful that we would return with him on Wednesday.
The rest of Monday was spent trying to figure out what exactly was going wrong.  No one seemed sure if he was rejecting his kidney (because it was *really* early for that to be happening), had an infection or something else that was an unknown. 

By Tuesday morning, we still had no answers.  He had spiked a temp overnight and was looking punky in general.  Late Tuesday morning they began rejection protocol with him, which involved flooding him with cyclosporine (his anti-rejection medication), as well as treating him for a possible infection.

Ryan and I thankfully got to spend a lot of time with him on both Monday and Tuesday.  The typical ICU visit (where he was on Tuesday) is 15 minutes.  We stayed for an hour and a half.  He perked up when we got there, but was pretty sleepy in general.

Things were not looking good for a Wednesday return.
Not the look of a well kitty.  It's all in the eyes.

His had inflammation in his kidney, which has nearly doubled in size and continued to look, as Dr. Aronson likes to call it, “dumpy”. 
Even though I remained hopeful that he would turn it around, like he always does, it just didn’t happen.  We went to the hospital Wednesday to tell him goodbye for now.  We were crushed.  I cried most of the plane ride home.
The minute the plane landed and I turned my phone back on, Dr. Aronson called. The news was not great.  We asked to call her back as we were being blasted with a very loud flight attendant and I just couldn’t bear the news at that point.
Tyrion’s kidney values were still high.  Higher than they had been on Monday, yet no one was sure if that was an improvement or deterioration as there were no labs done the previous day.  He was suddenly very anemic again and needed yet another (what I think might have been his 14th) blood transfusion – this was probably part of the reason for his dumpiness.
The plan was made to support him and see where he was in 24-48 hours.
In the meantime, we had a new kitty to bring home.  Jaime Lannister had escaped the life of having no home.  We are pretty sure he’s never had a house, a bed, or a family.  
The last few minutes of being a Pennsylvania kitty!
He seems incredibly grateful.  In the past, we have kept our new pets separate from the rest, especially the dogs and our beaver of a cat, Khleo, but being that he was so relaxed and submissive; we just threw him right into the crazy.  Ryan gave him a tour of the house.  He was a little spooked by the ceiling fan and the stairs.  We are pretty sure he’s never even been in a place with stairs! Or dogs!  I think he looks at Roscoe and thinks, "dang, that is a BIG cat".  When bedtime rolled around, Louis fell asleep in our bed and Jaime quickly cuddled up right next to him, then by me after I put Louis to be.  

He is such a sweet boy.  So relaxed.  We didn’t think we’d see Khleo for a week (she likes to hide when there are new pets on the scene), but the two of them have been cohabiting fairly peacefully so far.  I was so happy to give him the home he deserved because, after all, he saved Tyrion’s life and was the reason he was still with us, yet still upset that Tyrion couldn’t be back in his home and is instead spending what is going on his 6th week in a cage (kitty jail). 
The bright side is he is very loved by the doctors and nurses (and even the front desk staff!) at U Penn.  Everyone knows him.  When we found out that he couldn’t go home on Mondayeveryone was disappointed.  They had worked so hard, literally night and day, to keep this kitty alive.  As Dr. Aronson said, it was if he was never going to look back.  He bent the minds of everyone there and challenged them on so many levels.  It is truly a teaching hospital….Tyrion has taught them so much.
Going into today was nerve wracking…we received a call this morning from Dr. Aronson who said he looked significantly better; bright and energetic, eating again like a little pig (eating so much they had to take away his food, worried he’d gorge himself), but his lab results would tell the true story. 
What a HUGE difference a day makes!  Looking good Tyrion Lannister!
Thankfully, the news was good.  He turned it around.  AGAIN. His renal values had decreased by almost half…things were headed back in the right direction.  One theory was that he had a GI (stomach/intestinal bleed) which was causing his labs to go bizerk. We may never know.  He is being treated for infection, rejection and a GI bleed and it seems to be working so far, but we still have no idea when we can bring him home, which is all I want right now. 
I am so happy that he is eating well again.  He had gained some weight (a whopping 0.4lbs!), but is still just skin and bones.  I could feel his little spine and hip bones.  Knowing what a little belly he used to have on him, it broke my heart. 
While we were in Philadelphia we were able to see some of the sights.  We celebrated the 4th anniversary of our first date Sunday night at Del Frisco’s (which is by far the most beautiful restaurant I have ever been in - the building itself was over 100 years old) and instead of returning home on Monday we explored the city (aka we walked A LOT) and saw the Liberty Bell (there is a *really* long line for this) and all of that fun stuff.  Philadelphia is such a beautiful city!  It wasn’t anything like I expected (although I’m not sure what that was?).  The University area put the campus where I went to college to shame.  Even though I would’ve rather been taking Tyrion home as we had planned, I was thankful we were able to see some of the city. 

So for now, Tyrion remains at U Penn for an undetermined amount of time.  We hope every day will bring improvement and continue to move towards another homecoming trip.  We can’t thank our family enough for stepping in and helping us while we were away all of those unplanned days, as well as our friends (and family too!) for their continued prayers and thoughts.   We couldn’t do this without all of the support we have been so graciously been given.  We continue to be so grateful for the care he is being given at U Penn.  They are hands down, the best.  All of them.  Secretly I think they just want to keep him, but he is such a pain in the rear with all of his issues - I know they want to see this be a success as well. Tonight we joked with Dr. Aronson that we all have Tyrionitis.  It's serious.  It's contagious.  It's difficult to treat.
Here’s to hoping I make another trip to Philadelphia soon!

Thursday, June 4, 2015

Saving Tyrion Lannister - Update

Sorry for the absence of updates lately, but for once I'm happy to say, there isn't much to update!

Tyrian's transplant surgeon Dr. Aronson calls every morning and says that he is looking great and there are no concerns and good days are certainly starting to outnumber the bad.


But not without a few blips in the radar.

Last Saturday night he spiked a fever of 105. Unsure of where it was coming from, one of the critical care docs was called in around midnight to investigate. Likely, the source was one of his lines, his IV catheter or his feeding tube, and hopefully nothing systemic. For most a fever would mean a spell of illness, for him a high temp could've secondarily put his new kidney at risk. Yet even with the high temp, clinically he looked great.

Anyway, it was determined that it was his feeding tube, so it was removed. We were all pretty confident, due to his "healthy" appetite, that he'd be just ok without it.

His temp came down and he had another great day in Sunday.


Monday his blood pressure went up a bit. Apparently, this is not uncommon in transplant patients. He was started on a low dose of blood pressure medication, but only needed it for a day. He was moved from the ICU to the transplant "ward" of the hospital. This morning his urine concentration was checked (we want him to have concentrated urine - a good sign that the new kidney is fully functional) and it was perfect.  I know he is doing better than ever expected.


Seriously, I cannot get over how this tiny kitty (now weighing in at a whopping 4.1lbs!) just bounces back at whatever adversity is thrown his way. It is a miracle that he made it this far after all of the complications he's been through & an even bigger miracle that he will be returning home on Monday!

I also cannot express my gratitude to all of our friends and family who continue to reach out to us with love & support or even ask how he's doing. It makes me SO happy to finally tell people - he's coming home! While we were always hopeful this day would come, I know there were plenty of times I'd never thought I would get to say that.

The doctors and nurses at Penn Vet - miracle workers by day and night. They have pulled out more brilliant moves than I have ever witnessed in the 20 years I've been in human health care. Tyrion was so lucky to have them as his team.  We were assured this morning by his internal medicine doctor, Dr. Cleroux, that he is being thoroughly spoiled, held and hand fed....a lot!

So that's all for now! The next time I update will likely be when we are all home. Four more sleeps.