NO REJECTION

News we were praying for.

I wish I could say it smooth sailing now, but when Lauren was in surgery having her biopsy the Dr. found that Lauren has an arteriovenous fistula in her groin area.  When you hear the Dr. trying to explain to you what it is, all I heard was Lauren has something wrong and she might need surgery.  I went numb.   At this point, we spoke with her transplant team yesterday, yes they gave us the great news no rejection, but they also told us the they are contacting a vascular surgeon.  Our first appointment they told us will probably be they will need to do an ultra sound  to see the extent of the fistula.  Then we will know more.  To try to explain what I am talking about:

An arteriovenous (AV) fistula is an abnormal connection between an artery and a vein. Normally, blood flows from your arteries to your capillaries to your veins. Nutrients and oxygen in your blood travel from your capillaries to tissues in your body.

With an arteriovenous fistula, blood flows directly from an artery into a vein, bypassing some capillaries. When this happens, tissues below the bypassed capillaries receive a diminished blood supply.

Causes of arteriovenous fistulas include:  This is how Lauren’s biopsy procedure is done.

Cardiac catheterization. An arteriovenous fistula may develop as a complication of a procedure called cardiac catheterization. During cardiac catheterization, a long, thin tube called a catheter is inserted in an artery or vein in your groin, neck or arm and threaded through your blood vessels to your heart.

If the needle used in the catheterization crosses an artery and vein during your procedure, and the artery is widened (dilated), this can create an arteriovenous fistula. This rarely happens.

Catheterization procedure
The patient lies face up on a table during the catheterization procedure, and is connected to a cardiac monitor . The insertion site is numbed with a local anesthetic, and access to the vein or artery is obtained using a needle. A sheath, a rigid plastic tube that facilitates insertion of catheters and infusion of drugs, is placed in the puncture site. Under fluoroscopic guidance, a guide-wire (a thin wire that guides the catheter insertion) is threaded through a brachial or femoral artery to the heart. The catheter, a flexible or preshaped tube approximately 32–43 in (80–110 cm) long, is then inserted over the wire and threaded to the arterial side of the heart. The patient may experience pressure as the catheter is threaded into the heart. The contrast agent, or dye, used for imaging is then injected so that the physician can view the heart and surrounding vessels. The patient may experience a hot, flushed feeling or slight nausea following injection of the contrast medium. Depending on the type of catheterization (left or right heart) and the area being imaged, different catheters with various shapes and ends are used.

 Hope this picture helps explain.

The procedure usually lasts about two or three hours. If further intervention is necessary, an angioplasty, stent implantation, or other procedure can be performed. At the end of the catheterization, the catheter and sheath are removed, and the puncture site is closed using a sealing device or manual compression to stop the bleeding. One commonly used sealing device is called Perclose, which allows the doctor to sew up the hole in the groin. Other devices use collagen seals to close the hole in the femoral artery.

The femoral blood vessels are important conduits for blood traveling between the heart and lower limb. The femoral artery carries blood to the lower limb while the femoral vein carries blood back to the heart. These structures are common sites for conditions that cause narrowing or blockage of the blood vessels.

This past week-end, I kinda lost it.  The thought of something wrong, living in the hospital again was very overwhelming.  I needed to get my anger out and thank god for my family, I took it out on them.  Mom, Donna and Laureen sorry, but thank you.  Your family is the only ones that you can let loose and know they are there for you.

Will post when we hear more.

Lynne