July 28, 2024 - Sacred Heart Admit
52.5% estimated 3-month mortality!! All I thought about throughout the night was the fact that I was dying and I would not survive without a liver transplant! I couldn’t even comprehend what that meant. It was as if someone flipped a switch in my brain and all I could do was pray! I remember my mom sitting by my bedside begging with me not to give up. I wasn’t giving up, but I couldn’t form any words, I couldn’t explain (and still can’t) the overwhelming flood of emotions I was going through. In that moment, I didn’t know how to live but I knew I didn’t want to die. I wasn’t ready, I had so much more life to live, and it now became the biggest fight of my life!!
I woke up unsure how I was feeling but extremely concerned about liver and kidney failure. Repeat labs indicated slight improvement in kidney function and the full results are as follows:
Temp: 99, Pulse: 93, Resp: 18, O2: 92%, BP: 120/71
White Blood Cells – 13.21 improved from 17.19 (Normal Range 4-11)
Red Blood Cells – 2.15 declined from 3.08 (Normal Range 4.2-5.4)
Hemoglobin – 6.4 declined from 9.1 (Normal Range 12-15.5)
Hematocrit – 19.3 declined from 27.8 (Normal Range 36-48)
RDW-CV – 25.6 improved from 26.3 (Normal Range 11.5-14.5)
Creatinine – 3.23 improved from 4.45 (Normal Range 0.6-1.1) 😳
Bilirubin – 10.1 improved from 11.6 (Normal Range 0.1-1.2) 😳
AST – 150 improved from 224 (Normal Range 8-33) 😳
ALT - 29 improved from 41 (Normal Range 10-65)
Alkaline Phosphatase – 103 improved from 159 (Normal Range 30-130)
Ethanol - 0 (negative for alcohol)
Tylenol - Detectable at 7
CXR showed no acute abnormalities. Liver ultrasound consistent with hepatic steatosis and possible chronic portal venous occlusion. CT abdomen pelvis without contrast showed hepatomegaly (enlarged liver), hepatic steatosis (fatty liver disease), splenomegaly (enlarged spleen).
My case was discussed with Swedish Medical Center hepatology and because my tests came back negative for alcohol but detectable for Tylenol, I was started on N-acetylcysteine. N-acetylcysteine is used by healthcare providers to treat acetaminophen poisoning. Acetaminophen poisoning?! I didn’t even take Acetominophen but here they are treating me for an overdose. . .
I was now diagnosed with Acute Liver Failure, possibly from Orilissa with MASH liver disease and Acute Kidney Failure. MASH is a liver disease characterized by fat accumulation in the liver along with inflammation. It is not directly caused by alcohol but excessive alcohol consumption can significantly worsen the condition. It is, however, strongly linked to metabolic syndrome which includes conditions like obesity, type 2 diabetes, high blood pressure, and abnormal cholesterol levels. It is often asymptomatic in its early stages, so people often don’t realize they have it until significant liver damage has occurred and/or has progressed to cirrhosis or liver cancer.
They would continue to monitor liver and kidney function with repeat labs until transfer to Swedish Medical Center in Seattle and would administer dialysis if kidney function reached critical level. Additionally, they ordered 1 unit PRBCs transfusion (since my hemoglobin levels reached critical levels below 7) and I had confirmed Severe Sepsis but of unknown etiology.
I don’t remember anything from this day. Fear and shock had completely taken over at this stage. My disorientation was evident by the picture above, I thought I was in the hospital for 3 days already but had only been there overnight. Tim had even come to visit but I have absolutely no recollection of it. I am incredibly thankful that my mom moved to Spokane at just the right time. Despite battling her own grief, she was my voice throughout this whole process. She was there to make the important decisions and to make sure I never ever gave up!
She (and I) couldn’t have done it without Tim’s support as well. Although, I didn’t want to put him through this or for him to see me suffering in deteriorating health, he never wavered. He took care of all the important things at home, took care of my babies (the dogs) and made it possible for my mom to be with me at all times. Was it easy? Absolutely, not! But our relationship became stronger, and our love grew greater, and we know that we can survive anything!
