Pre-bronch selfie
Since I last wrote, Jody had his six-month post-transplant bronchoscopy. In case you forget, this is a procedure where he is put to sleep so they can introduce a scope, via his mouth/throat, into the lungs. His lungs are examined and “washed” with saline. Tissue samples are taken to check for rejection. It normally takes about two days until we get the results of this test back.
Like his three-month bronch, this one showed no rejection! Praise the Lord for that! It did however show that he is growing a bacteria called Pseudomonas Aeruginosa. This came as a surprise (to us)… sort of.
Pseudomonas is a bacteria that Jody harbored in his old, CF lungs. Once he got it, it never went away. That’s sort of the thing about Cystic Fibrosis. They have thick, sticky mucous in their lungs and once bacteria gets in there it finds a home in the mucous and is hard, sometimes impossible, to eradicate completely. This bacteria is typically controlled with inhaled and oral antibiotics, however, when it flairs up (becomes more numerous), one experiences symptoms and is said to have a lung infection, or a CF exacerbation. Normally this calls for IV antibiotics to again lower the number of bacteria. Those of you who have been following Jody’s journey before transplant know that he has spent his fair share of time in and out of the hospital fighting these frequent lung infections. In the past it became clear when Jody had an infection because breathing became a little more labored (as his lung function decreased), cough and mucous production increased, and Jody became much more tired. Those were his classic signs that it was time for another hospitalization and IV antibiotics.
We had been warned that it’s not uncommon for some of those old CF bacterias to make their way into the new lungs. It could have been sitting in his trachea (or elsewhere) when the new lungs were placed, and eventually made its way down into the lungs. Actually, we found out that a very small amount of this bacteria showed up on his three-month bronch (which they didn’t tell us at the time), but that it was too small to treat. Now, three months later, it’s grown to a quantity worth treating. We were surprised to hear of this infection because Jody feels great; breathing is good, he has no cough, no mucous, and no drop in energy. He has none of the “classic” signs of an infection that we’ve grown so familiar with identifying. I guess that’s the beauty of new lungs.
In case you’re wondering, this does not mean Jody’s CF has returned. Thankfully, this cannot happen. Jody will never again have Cystic Fibrosis in his lungs. This means that he no longer has that thick, sticky mucous which bacteria love so much. He should be able to get rid of the infection completely (yeah!). He is treating with oral and inhaled (nebulized) antibiotics for three weeks; no IV’s, no hospitalization!
Post-anesthesia and breathing well
Here is a picture of Jody after the bronchoscopy, still a little drowsy from the anesthesia. I share this photo because even though he’s in and out of sleep, you can see on the monitor, if you click on the photo (middle number in blue) that his oxygen saturation is at 99% on room air (no oxygen). Seeing that never gets old!
Aside from the infection, the latest issue we are dealing with is the possibility of Jody haven broken the internal wire holding his sternum (chest) together. Over the last week or two he’s been noticing pain in the center of his chest, that feels shallow, like somethings rubbing. In certain positions he moves he can hear a “popping” sound. These signs point to a fractured internal wire. Next week we have an appointment for a CT scan of his chest which will tell us if our speculation is correct.
Like us, your next question might be, how will they fix that? Honestly, we’re not really sure. When Jody asked his transplant coordinator this question, her response was, “I don’t want to tell you because I don’t want to give you anxiety.” This response produces almost more anxiety because it sounds like the fix for broken wires is pretty ugly. Of course, I imagine the worst; having his transplant incision opened to remove or replace the wires, needing chest tubes, needing the thoracic epidural again, pain issues, etc.. Most likely it won’t be that bad, but it would have been nice for the coordinator to give us a better answer. Who knows, maybe the wires are perfectly intact and there’s another reason for the pain. As always, I’ll keep you updated as we learn more. We appreciate your prayers about the infection and the possible broken wires.
CF Wife 