Update 12/30/2010

John is feeling good and the stiffness is going away. his appetite is good also. It is about 3:15 pm and if by tomorrow morning his hematocrit is stable they will let us go home. Thanks again for your prayers.

Update on John S Baker

Hi. I’m Steve Baker, John S Bakers Dad

For the benefit of those interested I decided to use a  Blog site as a central point to update Friends, Relatives, Friends of Relatives, and Brothers and Sisters in the Lord on Johns current Medical condition.

As Part of the disease he was born with, Autosomal  Recessive Polycystic Kidney Disease, come some liver issues. The liver tends to be functional  as far as what it does and the labs for liver function tests tend to prove normal however, the liver on ARPKD Kids tends to be Enlarged, Hardened and Fibrostic. One of the veins going into the liver is the Portal Vein. The portal vein collects blood from the esophagus and stomach area and puts it into the liver for clearing and processing. The liver acts as sort of a filter.  After the blood passes through the liver it goes into a vein called the Hepatic Vein. With Fibrostic liver the blood does not pass through the liver as easily as it should thus causing higher pressure in the portal vein. This condition is called Portal Hypertension. The spleen is also attached to the portal vein. The portal hypertension also causes blood to back up into the spleen thus enlarging the spleen and hoarding Platelets which aid in clotting blood. The portal vein also carries blood from the digestive system organs to the liver. When this condition of Portal Hypertension worsens it can causes Verisies in the esophagus and or stomach that can bleed.

This is basically where John is at this time. His esophagus however is clear. The bleeding is in his stomach.

They currently have a procedure in which using Interventional Radiology they place a stint through the liver substance providing a path for a portion of the blood to get from the Portal Vein to the Hepatic Vein with out passing through the restricted liver tissue thus lowering the portal vein pressure. This in cause will help the spleen decrease in size and not hoard platelets and decrease pressures in the capillary veins in the stomach and esophagus and stop the bleeding.

This is the tentative plan pending Monday discussions with Gastro intestinal team, Liver transplant Surgeon, Intervention Radiologist, and his Nephrologists.

Hi.

Well Monday the 27th we conferred with the appropriate doctors and such on the possibilities of the previously mentioned procedure. They did an ultrasound and a CT scan to review his vascular system and verify the likelihood of using the procedure. After review of the images  Dr Vo the Interventional Radiologist approached us Tuesday morning and we all agreed to do the procedure The Procedure is known as TIPS, an acronym for Transjugular Intrahepatic Portosystemic Shunt. (Caution, Do not try to say this with a mouth full of spaghetti. ) You may want to look at the Architecture of the Liver for more understanding.

John is also NPO ( No food or drink) as that would require blood flow to the digestive system and would enhance bleeding. During routine examinations when ask if he had any pain his only response was “Hunger Pain”

About 3:30 Tuesday afternoon he went into pre-op and then to Surgery about 4:30. The outcome of the procedure is extremely well. Dr Vo is not only top in field but is a nation wide consultant for this procedure and we grateful to be able to access qualified people for these situations.

Following the procedure they put him in I.C.U. for observation till Wednesday morning (today) and then to a regular room. His neck and shoulder is sore from the procedure and they are letting him drink fluids and the eating will come soon.
As of wed the 29th the earliest possible out would be friday the 31st but we will have to see.

We are grateful for the prayers of many friends and family and a God who “is able to do exceeding abundantly above all that we ask or think, according to the power that worketh in us”

We will keep you all posted.

Thanks.