2022 · My Health

My 1st TIPS Surgery Anniversary

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The fog rolls in at Echo Lake.
December 4, 2021

Saturday night, we’ve got the Christmas tree decorated in the front room. I stepped with my camera outside to capture photos of the tree in the front room window, when I began to feel nauseous. I took some deep breaths to no avail feeling better. I went back into the house to put my camera down, telling Kevin how I feel and that I go to the bedroom upstairs. After resting in bed for about five minutes, I had to go to the bathroom. I had nasty diarrhea and blamed it on the hotdog, I had eaten earlier in the afternoon. But when I looked at my bowel, I noticed something concerning: it was dark brown, almost black. After I laid back down, I could sleep for two hours. I felt fine until I turned on my side. I was sick all night. And in the morning, I had the same color in my vomit. I let Kevin look at it to confirm if it was blood. He wasn’t sure but looked concerned as well. That’s when I said: “I’m not messing around with this. I want to go to the ER! A doctor needs to see this. Especially knowing, I’m chronically anemic.” Kevin agreed with me. Later that day I found out, this was a lifesaving decision.

In the ER I got a bed fairly quick, granted how busy the place was that day after I stated: “Nausea, vomit, diarrhea with the possibility of blood in vomit and stool”. After a CT scan, ultrasound, urine & stool samples, and a couple of other bloody puking episodes, I’ve got an answer: “Pancreatitis with the possibility of an ulcer in my stomach; not even to mention my portal vein”. At that point, Kevin and I knew I would stay in the hospital overnight.

In the following days, more tests were done. And I kept finding out more as we went. Meanwhile, the doctors put me on an intravenous liquid diet to keep me hydrated. No water, no food for three days, due to tests and healing. On Monday, I’ve got an esophagogastroduodenoscopy done. Later, I found out I had some bleeding in the esophagus and a stomach ulcer. The doctor also discussed my history of portal vein thrombosis, the possible cause of a hemorrhage and narrowing in the portal vein, and that I might need Transjugular Intrahepatic Portosystemic Shunt Insertion (TIPS). A team of doctors began to communicate with a group of Gastroenterologists at the Yale-New Haven Hospital about my health situation. On Wednesday, I found out I’ll get transport to Yale. While waiting for my bed in New Haven, I was finally put on a Clear Liquid Diet. Thursday night, a room and a bed were ready for me. And I arrived at Yale at about 1 am on Friday. At 4 am, a doctor discussed with me my health situation, more tests, the TIPS procedure, a possible timeline, etc. and I pressed for some iron infusions as well. WTH, I lost a lot of blood already. And my hemoglobin level is in the basement. I do not want another panic attack episode, due to anemia ever again. It sucks!

Since I arrived in New Haven, I’ve got another CT scan done, can eat on a regular hospital diet, and found out a bit more about my portal vein problems. Unfortunately, I have another blood clot in my vein. But the GI doctors will discuss more, how they will put that shunt in my vein to keep it from bulging out, bleeding, and narrowing due to a former nasty blood clot, I had back in the Summer of 2018. I will stay positive because I feel I’m in good hands with a great GI team here at Yale. Doctors keep me updated as they go. Due to today’s medicine and technology, there is a great possibility, that doctors can remove the clot, while they do the TIPS procedure. The nurses are wonderful in both hospitals. Now, I’ve got the weekend off with tests and can relax a little bit. There is not much that I can do than follow the doctors’ advice to have a positive outlook, eat and drink on a hospital diet, take my medication, and keep my mind busy by reading a book, watching TV, writing my blogs, communicate with family and friends online. One doctor said: “We will have you fixed by Christmas. This will be your Christmas present.” Well, it definitely will be a very nice Christmas present. I can’t think of a more precious gift, than a healthy life.

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December 8, 2021

So, now I have a bit more detail about my Portal Vein Thrombosis and Hypertension. The GI Team discussed my case for almost a week, before a surgeon came into my room, explaining, what is going on and how they try to insert that shunt into my vein.

Here is what I’ve learned: The portal vein is connected to a completely different vein system than the regular veins that transport blood back to the heart. Imagine, you drive on a highway (in this case blood through the portal vein). The highway has a narrowing, due to construction (blood clot). Lots of cars try to drive on that highway and it becomes congested. Now, people get the idea to get off Exit 1, Exit 2, … etc. In the beginning, this is no problem. Unfortunately, there are not only a few cars; there are hundreds of cars trying to get off these exits. Now, the traffic at these exits gets congested as well. Everyone tries to get around the traffic, and it becomes jammed as well. The exits in my case are the veins to the esophagus and stomach. They got congested, bulged out, and began to bleed. Therefore I had blood in my vomit and stool, last week. Tomorrow, it’s the doctors’ job to build a bridge over that construction zone to release the traffic to other highways and streets in form of a TIPS procedure. And they work on the construction by removing the blood clot. The surgeons had to discuss this project for a while to make sure the outcome will be long-lasting with minimal risks involved.

And yes, the team works with medication on my pancreatitis, stomach ulcer, and anemia. Today is day #11, me being in the hospital. I haven’t bled for almost a week now. So, they must have been doing it right.

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Since then, I had two follow-up surgeries, follow-up visits with specialists, an ultrasound, another endoscopy, a colonoscopy, iron IV treatment, new blood thinners, etc. Yep, it never gets dull.

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