Sierra, Sierra, Sierra!!

I apologize for the tardiness in updating. It has been too long and a little crazy. June 25th Sierra received a 0 on her biopsy. We were ecstatic. That was her first zero in a very long time. At least a year or more. A couple weeks later. She came down with a virus that had her vomiting and diarrhea. After about a week of the two she had an echo cardiogram done to make sure her heart looked alright. The doctors were worried that she wasn't absorbing her medication. Our cardiologist in Boise, ID and the transplant doctors here decided that she should be admitted for IV fluid. She was very dehydrated. She received 2L of fluid over 18 hours and was released from the hospital in Boise.

She bounced back really fast after her IV infusion and was acting better and better every day. On Wednesday, the 14th of July, I noticed that her ankles were HUGE. They were so big the skin was hanging over them and you couldn't see her ankle bones. Her face had been swollen, but the swelling in her face comes and goes. I called California and notified them of the swelling. They called back and told me to get and echo done immediately. Swelling like this is usually an indicator of rejection. After many phone calls the doctors decided to just life flight Sierra out of Baker straight to California. This life flight waiting time was a treat for Sierra, because she was able to have her cousin Ashley to wait with her. Thank you Ashley, you will never know how much that meant to Sierra. We only wish you could have come with us.

They did many tests on her, (i.e. chest x-ray, echo cardiogram, EKG, and labs) which they felt pretty confident in ruling out rejection. However, the doctors were noticing some "rigidity" on her echo. Our doctor in Boise had mentioned the same thing prior to her getting her IV fluids, thus why they ran the fluid in so slowly. What this means is that the pressures in her heart are high, which happens when the heart is not able to fill properly when it is relaxed, because it isn't relaxing all the way. They are throwing words around like Coronary Artery Disease (CAD).

For some reason, one of the complications of transplant is CAD. It is unusual in the adult diagnosis, in that the plaque isn't formed in the arteries from being overweight or a diet high in fat or sodium. The plaque will build in the smallest part of the coronary arteries where they can't do a lot. some times, they are able to put stents in and that helps.

Sierra was placed on a new medication combination last year when she was in rejection. They started seeing the signs of CAD then. The medication combination will do 1 of 3 things. It will either reverse CAD, keep it from worsening, or nothing and the disease will keep advancing. In the latter case, the treatment is to care for the congestive heart failure symptoms that will appear with time as the heart is cheated of its blood supply. All in all, eventually a new transplant will be the only option.

Sierra is receiving another catheterization on Friday to measure her pressures and look at the coronary arteries. As of December, the arteries were unchanged from last July. We are hoping that they have not worsened and she can keep plugging along. We will update as find out more and have an understanding ourselves. Sorry for the lengthy update. A lot has happened.