Post Liver Transplant Incisional Hernia

After Transplant some people develop incisional hernias, where the bowel works through a weakened muscle/facia wall at the site of the stitches.

Mike is 3.5 years post transplant. He had his first repaired at about 2 years post TP. It was north of his navel in a Lexus scar. This new one is to the right of the naval, perhaps at the site of the final incision where the drain was removed and stitches closed last.

The Hep and Surgeon looked at in August and thought they would let it be for now as it wasn't causing any real trouble. He was to wear a belly band and keep an eye out for trouble: if it got larger, if he could not pass stool, had pain or fever or was really bothering him, they would fix it with mesh.

During the past week he has had horrible pain radiating across his abdomen. We met with the surgeon today and they scheduled the repair for December 12th. It will be a day surgery but they will keep him overnight if he has any post op complications. During his last few procedures (2 rotator cuffs and the first hernia repair, his BP went nuts and they wound up keeping him to settle that down)...so we will plan to stay in Miami for a day or two...just in case. Merry Christmas, Mike, you get a flat belly again.

His doc has been all over him because he has gained wt quickly after treatment. I think that he has been feeling better (almost normal) and sort of over did it. He lost 90 lbs from the last time he felt well til transplant and has regained 35 of those pounds. The doc says to knock it off. (We are both watching it now...I have a pounds to lose myself.) The extra pounds are not good for the hernia...extra pressure.

We are looking into a new medicine that Mike was prescribed by Dermo. He has a patch of pre-cancerous skin on the top of his head (the top, under baseball cap area). It looks yukky, but his hair still grows so is not unsightly unless you look between the hair. He has used various prescribed potions but it has not resolved. They called it actinic keratosis and this can become basal cell carcinoma and has in several places. He has had 2 squamous ones also.

Earlier this month they prescribed flourouracil 5% cream. In checking the sides of this med, it says severe abdominal cramps can be caused by this cream in rare cases. The dermo says that is when you use this med internally, the pill type. BUT, I was given prograf cream last year for a vaginal rash and it did me in in 30 minutes. I was nauseous a whole day each time I used that cream. So.. external cream can get you!!! I don't care what the doc said.

So, who knows, chicken/egg... He will stop the cream. He will get his bump repaired. We hope it doesn't recur a 3rd time. Or get worse before the 12th. We are to bring him in if has horrible pain again, if it gets hard, or if he has fever.

Hope everyone has a calm American Thanksgiving...I think our Canadian members have already celebrated their Thanksgiving in October (so a belated greeting to you and yours)... Happy week to the rest of you folks.

Hugs,
MamaLama

I like this post transplant discussion. It is very helpful. Thanks for posting about this, Mama.

Themister and I spent a lot of time researching post transplant, post TIPS, risk/reward, quality of life vs quantity of life on both sides. We have had years of cirrhosis to spend time getting facts. Some do not. Some fall swiftly into ESLD and have no idea they have a sick liver when facing urgent need for transplant.

For **David**. One question I have is if a bag of groceries was too heavy, how do you now work as a tile setter? This seems like a labor intensive career that would not work with hernia risk and lifting restrictions. Is one gradually able to lift more weight? I so much appreciate you continuing to help other folks who are on this side of transplant. It is easy when facing transplant, to hear only the good news, not the whole story.

Thanks for the update on Mike's pending repair, Mama Lama. It is really helpful to hear the stories after transplant, not just before. People move on, or move to more liver post-transplant forums, and those facing transplant do not get the info "here" in detail, that many would like to know. Thanks to David and Mama Lama, Lostson and others who post the updates that help others facing this surgery.

A transplant is indeed, life saving. But it is obvious there are many chronic conditions that are part of the game post-transplant. Restrictions to follow, meds to take for a lifetime, complications from surgery for many years...like skin cancer risks, hernia risk, etc.

I have followed several post-transplant life time meds and sides from meds, as well as forever medical tests and appointments. I have read blogs on post transplanted, and see depression also is a big issue for many after transplant. I often wonder if the reality of a changed quality of life is not part of the depression? Any comments on that?

I know Mike has a great caregiver who will see he gets well cared for. Mike will love his flat tummy Christmas gift! You will need a nap for Christmas :) Big Hugs

David, This helps understand the lifting. It is good to hear more of your story like this. I am really glad you can still work at your profession. I bet you are excellent at what you do.

We all have knees, shoulders, go out with age...but it sounds like you can make reasonable changes needed to get it done.

You know you are quite an inspiration to us? You are. Big Hugs

Mike had the pains all day yesterday, with vomiting in the morning...but today he is okay so far...though he just told me he feels like "that pain" is hiding just behind the scenes, looking to make itself known.

He is not Mr. Cranky Pants (yet), so I think he is okay for now. Thanks for asking. I'm sure glad we did holiday grocery shopping last weekend before this started. And since he cooks dinner day to day and I do holidays....he is off duty for now....with planned left overs...until he feels way better. I always make broth from the carcass, so yummy stuff is coming soon. (I do the soups also. And any desserts--rare.)

We have kept our suitcase packed as the next episode we are to go to an emergency room and if he thinks he can stand it we will drive to Miami...if critical we will go locally per TP Coordinator directions.

Next week is Tues, Wed, Thurs in Miami for echo, cardiology consult and clearance, and pre-op with anesthesia. There is always a drama about the anesthesia with Mike's valve stuff...so in the end there will be a cardiac anesthesiologist present at the surgery, or that is the history. With the long drive and horrible traffic we will stay at the hospital rate hotel for the 2 nights.

Hugs,

ML

MamaLama,
By the time you read this I hope you have taken Mike to the ER. Even if he doesn't want to go, it's time.

It sounds miserable for Mike. Since he was seen just 6 days ago by the doc's, and they did not feel emergency surgery was indicated, what did they say to do with this off and on pain? Hernia's are so painful. Mike seems to have it ease up after each attack. I know Mike doesn't want to go the local ER route, and I sure understand that. I think he did that this month, as well. Poor Mike.

It is so darned difficult to know what to do. The surgery is not scheduled until the 12th. I wish they would move it up when you go in for his pre-ops this week. He is now since August with this one. A long time. .....well, I don't need to tell you about that! :) Big Hugs

One day down, two to go :)

Let's hope all checks out ok and Mike gets approval to get this hernia fixed. One foot in front of the other...you know the drill. Big Hugs

Hi,

In Miami for 3 day pre op appointments with Mike and we had quite a surprise today, and not in a good way.

Day 3 has been hijacked, it seems...no anesthesia appointment at Jackson...instead Mike's goes for a cardiac catherization at U Miami across the street.

His cardiologist would not give him cardiac clearance for the hernia because his echocardiogram was NOT GOOD. Evidently his aortic stenosis has advanced quickly in the past months and he will need an aortic valve replacement. they will do the cath tomorrow, evaluate it and schedule him for surgery next week. Mike had planned for one or two days in Miami late next week, but will be 5 days + next week instead. Once he recuperates he can reschedule the hernia repair.

They will use cow tissue for the valve. The cath tomorrow is to look for any OTHER issues...are there emerging blockages thay they should bypass while they have him open, etc.

Mike cant catch a break. It is sure taking a lot of steps to get WELL.

Ho Ho Ho...Merry Christmas at our house. The risks are pretty low...1% don't make it. He is tough. I'm sure it will be okay.

Hugs,

Mama Lama

Oh, I am so sorry for all this unexpected medical news. I hate that aortic stenosis! I am impressed with Mike's strength and courage, and your unwavering support. My thoughts will be with you both.

Hugs,
Schimbare

ML,

Our thoughts and prayers are with you and Mike... I'm glad you were already at the hospital/doc appt. when you got this news!! Timing stinks, but it will be nice to have it taken care of. Then in a few months he can have the hernia surgery and feel like a new man!! :)


I admire both of your strength, you've both been through a lot but I know you guys will make it through this and it will be behind you before you know it!!


I think it should be the caregivers Motto...expect anything at any time because that's the way it works!! We plan things and the next thing you know everything has changed. Sometimes the change is good and I think in this case Mike is where he needs to be instead of miles away from the hospital.

Thinking of you guys this coming week

Kathy and Dennis

How did things go today? Thinking about you both. Big Hugs

I tried to.post.earlier. Have been at cathlab 11 hours. He.is resting after.cath, having bp.monitored, then we can go.home. Maybe by 8. Then 2.5 hour drive home.

No bypass issues, so.just.the valve replacement next.week. Whew.

Hugs,

ML

ML,

Our thoughts and prayers will be with Mike and you this coming week.

I definitely understand the cancelling Christmas part. We are doing the same. With Dennis on treatment it is difficult enough dealing with his needs then dealing with company as well. I really don't like it but it is what it is. We plan on rescheduling Christmas to April. :)

One day at a time that's all we can do!!


Hugs,

Kathy and Dennis