Wednesday, July 1, 2015

God Is Good

God is Good.

I’m sitting in Alec’s I.C.U. room right now as he is getting a good little snooze.  It’s his Birthday today, June 14th, and he is ALIVE.

LIVER TRANPLANT DATE: June 9th-June 10th 2015

Our family will never forget these dates.  I am just going to say it right off the bat, I am pretty sure that I will need some therapy after what we just went through.  I don’t want to relive the trauma that we both experienced, but I know that I need to write down all that transpired, because the Lord was with us. 

I’m not quite sure I can really go into the details of what transpired that day.  Rewriting what we lived through creates a little too much PTSD.  Reliving the trauma and talking about it is completely draining. I would however love to tell all my family members thank you for coming to my aid during his surgery.  Apparently, earlier that morning (before going to the hospital) when I was gagging and sick to my stomach Alec had a little conversation with my Aunt Tori. He told her that while he was in surgery, she needed to get as many of my cousins and family members to come and be with me as a distraction.  He also told her to, “make sure she has some alone time too. She will need that.”  I can’t believe that he was thinking about me while he was the one going into battle.

The date today is now June 30th.    Each time I opened up my computer to write down my thoughts I got too emotional.  I was exhausted.  It was all too recent and fresh to have to relive again. I am happy to say, that while I’m not fully rested, I have enough emotional reserve to begin document our journey. So, here it goes . . .

Monday night, June 8th, 1:00 a.m. in the morning we got a call from our coordinator telling us of a possible liver donor.  This was maybe our 7th offer or 8th offer in both primary and secondary slots.  Due to one reason or another, none of the organs looked right for Alec’s body.  Monday morning, June 8th, around 7-7:30 a.m. we received the follow up phone call that said that its looking like a pretty good chance Alec would be transplanted, and to get to the hospital. 
Miles was asleep, Alec was calm, and I got out of bed and just dry heaved.  My stomach was in knots.  I continued to pace and gag because I was so sick to my stomach.  Reality really hit me hard. My husband is going in to surgery today.  With each transplant surgery, mortality rate goes down.  Third transplants really aren’t common, and therefore not really offered.  The Docs knew that Alec was as strong as they come, and it was his only option.  The odds were against him in all ways possible.  He could live with his diseased liver for how ever many days, months, or years it could provide him, or take a leap of faith and get on that operating table. This meant one step closer to Alec living, or one step closer to dying.  I may not have a husband tomorrow, I thought.  Gag, dry heave, shake, gag. All the while in my extreme nervousness, Alec felt peace.  PEACE! He was a little nervous yes, but overall, he knew he was going to be o.k. This young man’s faith has always been remarkable, and it is what has kept my little family from going completely insane with worry. One of my Aunts put things in perspective. She would tell me to say, we are alive today, so we will be O.K.  (I love it, but I hate it.  Who has to think this way? Ugh, we do). 

We called on our family to come give Alec a priesthood blessing for the healing of the sick before we needed to leave.  His father offered it and it was beautiful. Through Alec, Vince blessed the surgeons to call upon their medical training, to have calm and steady hands, to work together, and to have faith.  He blessed Alec’s body to be strong, including his spirit. IMMEDIATE PEACE FLOODED THE ROOM. All those who were in that room that morning (including myself), cannot deny the witness that we all received that ALL WOULD BE O.K. 

And boy did we need to call on that peace during Alec’s gruesome 28-hour surgery.  (The average liver transplant surgery takes anywhere between 6-12 hours. We were told to plan on 20+ hours due to his 2 previous transplants, scar tissue, etc.) The one thing that Alec had going for him was the fact that he would be asleep during surgery. Not us. His surgery was stressful on all those (far and wide) who knew what was going on. I wonder how many of us forgot to breathe regularly during that day.  

All of the employees on Level 10 (who we have grown close with over the past 7 years) said that while Alec was in surgery there was a quiet hush on their floor.  Everyone was on pins and needles waiting for the next update and the final outcome.

There are so many different roles we all play in this thing called, “Alec Rampton needs a liver transplant . . .again.”  I feel that we are much like the solar system, orbiting around this complex situation, all experiencing similar feelings in different degrees. We are all one in our thoughts and prayers however, and that love is power.  Love, is why he is alive. And why I haven’t fallen apart at the seams. I have never been so close to imploding than in that waiting room waiting for the conclusion of my honey. We had to do our best to keep the feeling of peace that we had all felt earlier. That was why I became a recluse for a little bit.  I am terribly sorry if this ever offended any of you.  I was
afraid if I received texts, or phone calls, or saw the concern and worry in people’s eyes that I might doubt the confirmation I felt from the Lord that Alec would make it through surgery and that everything would be fine. It was difficult to keep the peace in the forefront of my mind.  The day went a little like this: Peace, hope, faith, tense, heart wrenching pain, faith, peace, fear, pain, loss, hope, faith, faith, faith, loss, peace, fear, hope, peace, fear, fear, fear, fear, faith, faith, faith, and finally peace. (Are you carsick yet?)

With the help of Alec’s mother Janice, the day of events looked a little something like this:
June 9th, 2015
·      After being there since 10 a.m. the team came to take him into surgery at 5:15. Janice, Vince, Alec and I signed some papers and talked to his anesthesiologist, Dr. Rust. I told him he seemed cool. He was, and he later proved he was the reason for keeping Alec so stable during surgery. 
·      They wheeled him away in his hospital bed after Alec and I gave each other a kiss and fist pumped in the air.  Now down the hall in a different direction I yell, “Rock it Rampton!” I see his fist appear above the bed pumping in response.
·      8:31 pm: they called to tell us the surgery had begun at 7:06 pm. “Everything was good, smooth but very slow.
·      9:36 pm: Dr. Fujita arrived with the donor organ after he had flown to another state to procure it. Alec was on the O.R. table open, with his surgeons trying to get through all of his scar tissue.
·      11:25 pm: He was stable, good, progressing slowly but smoothly.
o   Now is the time that my Dad, Vince, Janice and I try to get a little rest. I brought my own anti-gravity chair so that I could sleep on that instead of some stupid hard chair.  When Dr. Alonso came and saw the set up that I created, she said, “Clearly, this isn’t your first rodeo.”

Midnightish-1:00 am: I manage to roam the halls to see if the hospital beds we passed by earlier were still there. Sure enough, there were about 11.  I can’t imagine 11 people needing surgery at this time of night (ahem, morning), I thought.   I’m sure I can snag one of these mattresses and bring it into the waiting room so I can try to get some sleep. We are in fact paying thousands and thousands of dollars to this place. They can at least put me up for the night, hehe.

Apparently they have had issues with homeless people coming into the waiting room in the wee hours of the morning to spend the night.  So they have been more secure in locking level 2 and checking in. I finally got some sleep in the morning when an employee came in to straighten the room around 6 ish.  Somewhat alarmed, she pointed to sleepy me with a blank expression.  Azure and Ashley (our Nurses that came down to check on us) looked at the lady and sensing what she was about to say interjected with. . ."She's not homeless. We know her."  Haha!
(love these people!)

June 10th, 2015
·      3:19 am: No one can sleep. I called, they called, still stable.
·      6:06 am: Janice Rampton  (J.R.) text messaged her children back and forth to relay the updates we had been receiving- “11 hours in. We’ve had periodic updates through the night that he’s very stable and doing well, but they are having to be so careful in removing the old liver.  About 2 hours ago, they said the old liver had been clamped off and they were carefully mining for the portal vein millimeter by millimeter.  We took that to mean that they hadn’t had to crack his chest this time, but we aren’t positive.”
·      7:19am: (J.R.) “I spoke too soon, they are waiting for the thoracic surgeon to come in and open his chest so they can finish taking out the old liver.”
·      9:35 am: (J.R.) “ Extra prayers!! This is critical.  They are struggling to get this liver out and there is a 1 in 5 chance that they may not succeed.  They are very concerned.  Extra prayers, please.”
·      12:29 pm: I hadn’t heard an update for a while so I called. They called back: They are working millimeter by millimeter. It’s time consuming. They work. He bleeds. They have to cauterize and wait for bleeding to stop. Then continue on millimeter by millimeter.
·      1:40 pm: Lynette (O.R. nurse) calls to check in. She asks me if she can do anything for me.  I ask her to give him a kiss on his forehead.
·      2:26 pm: I called
·      2:49 pm: They call back. Lynette gave him a kiss on the forehead like I asked.  She came into the waiting room to tell me this with a big hug before she left for the day.
·      3:21pm: We need to start blood flow to the new liver, because we are against the clock now with the donor organ being viable.
·      4:07 pm: Dr. Rust (his awesome anesthesiologist) came in and said Alec was stable.  “The surgery is very, very, very, hard, and he’s nowhere near out of the woods.”  He went to pick his son up from the airport from serving a mission.  We would have had him 2 hours less if his son’s plane were on time.  But it wasn’t. It was delayed.  Another little miracle to keep Dr. Rust on Alec’s case for 2 more hours.
·      4:07-6:33 pm:  Dr. Van der Werf came in to the waiting room to talk with us. I saw fear and concern in his eyes. I later find out from someone that he had to take a minute to collect himself before he was going to tell Alec’s family that the odds were against him.  He kept looking at the floor.  I asked if I could come in to the O.R. to just give him a kiss or touch his head.  The answer was no. I said o.k. After Van der Werf left, we later got a call informing us that Dr. Fujita and Dr. Alonso were working on Alec’s liver while Dr. Van der Werf and another surgeon were working on prepping the vessels of the donor liver.   The idea was to try and get the donor organ partially hooked up to Alec so it had a blood source.
·      6:33 pm: They finally got his liver out!
·      8:47 pm: (J.R.) “They hooked everything up, did an ultrasound and found the blood flow wasn’t what they wanted.  They took it back out, redid some of the vascular structure, flushed it (to remove the blood clots and are putting it back in.  Stable. Found blood clots in the organ. Upon treating this they discovered a flap that acted like a heart valve, which blocked the flow of blood into the liver.
·      I couldn’t take the stress. At certain times I was sure I was about to have a massive heart attack at 30 years old.  I wanted to get out of that hospital waiting room.  I couldn’t take the florescent lights any longer.  I was going to scream if I didn’t see new scenery fast. Just finish this already! I thought.  One way or another, but just finish it!  I might explode!
 Azure, one of our nurses and now a dear friend, took me up to T10 (the level Alec and I became familiar with due to his many hospital stays over the past 7 years).  With permission, they blocked off a room where I could just get into a hospital bed and try and rest.  I was a wreck. I was crying and crying.  I asked Azure to come and snuggle with me.  We just cried. Sweet Azure.  She still had to work so I was left all alone.  I called my mom from the waiting room to come upstairs to be with me.  If you can believe it, I think I slept for 20 minutes.  My mom ran home to get my meds.  While she was gone, I almost had a heart attack I am sure of it! Over the intercom a voice said, “Trauma Alert, Level 2, Trauma alert, Level 2.” (Alec was on that level) “Please, oh please, don’t let that be Alec.”  As I exit my room in sheer panic (which happens to be the scary room that I have never liked and have always requested a different room if it has ever been assigned to Alec . . . a whole other story.  But in this case couldn’t care less) Azure comes booking around the corner.  “When I heard that over the intercom I knew you would freak out.  It’s not for him so don’t worry.”  We walk back to my room and lay down again in total angst.  Crap! I missed a call from the transplant nurse.  I call back. 10:50 pm: “He’s out of surgery, the surgeons will come talk to you.”

Azure and I ran fast downstairs to the waiting room.  “He’s out of surgery,” I tell his parents.  Right then, Dr. Diane Alonso comes around the corner.  The first words out of her mouth were, “He’s Alive.”  Clearly emotional but extremely professional, she began explaining their 28 hour operation.
(This is Dr. Diane Alonso, one of Alec's transplant surgeons. She's kind of a big deal!)

There is no way for us to completely understand the creative anatomy they invented to “re-plumb” his body (thank you Janice for the thought process).  Because she is so good at remembering important details, I am going to slide the computer over to her now. Hit it Janice:

With an intro like that, the pressure is on. The thing that I remember most is the fact that it truly sounded like an out-of-the-ordinary creative process. At one point, when things were under the greatest time restraint, they called in another surgeon so that Dr. Alonso and Dr. Fujita were working on Alec to continue the removal of the old liver and Dr. Van der Werf and another surgeon were working to create the lengthened vascular structure to connect to Alec’s systems. Dr. Fujita, knowing that space inside Alec was tight and knowing they would have a difficult time reconnecting things, was able to take additional length of “plumbing” from the donor. This gave them the ability to lengthen connections and create “jump grafts” from the liver to Alec. Because they couldn’t disconnect the older liver without the risk of sudden bleed out, they had to (as we understand it) create and connect the new portal vein above where the original portal vein entered. Dr. Alonso also had to make other vascular connections below the kidneys, which are normally done above the kidneys. She also talked about taking the vena cava and instead of its connection being a standard end-to-end suture, the ends were laid side-by-side and connected. The more she described the unusual connections they had created, the more I saw him as a well-loved patchwork quilt that all of them had worked on. After all of the intricate connections were completed, they released the clamps and watched as the liver began to be infused with Alec’s blood. Almost immediately it began to swell indicating some sort of blockage. They thought it might resolve, but it continued to get worse. The only choice they had was to re-clamp and remove the liver again. (That was the phone call we received at 8:45ish. They removed it, flushed it thoroughly, discovered a small flap of tissue that was acting as a block within one of the veins, removed that tissue and then reconnected everything. Once again, they removed the clamps and waited. Immediately, blood flowed as it should and everything looked good. The main concern was that the donor liver had been out for just over 24 hours. Would it function the way God had designed or had it been tampered with beyond repair. Time would tell. 

Thank you Janice! It sure is nice to have you around!  After Dr. Alonso explains everything to us, she asks us if we have any questions. "Um, can I see him right now?"  She said it would take about an hour, hour and a half to get him all cleaned up and settled in the I.C.U. for all of us to see him. But because she's cool she took me right then and there.  Hand in hand, arm in arm, hug in hug, we walked together to see this beautiful miracle called Alec.  We go to the O.R. to find that he had already been moved up to Shock Trauma. Sidenote: I can't tell you how incredible Dr. Alsonso is.  All of the surgeons and team really.  But when you talk to Alonso once, you love her.  If we were in the school yard picking teams as captains (remember how painful that experience was? Either for you, or for the kid that always got picked last. . .torture) you would pick her first.  She may be a tiny little thing but she is one tough cookie.  Besides that,  I'd actually hate to go against her.  I want that woman in my corner at all times! And I am so glad she has always been in Alec's corner.

I entered his ICU room.  A beautiful feeling of purity and peace filled his room. I KNOW that there were angels in there.  I had prayed for them.  I had felt them.  I had asked that an angel would be with Alec through his surgery.  I asked Heavenly Father to have angels touch and be responsible for every organ in his body, that they might protect it.  His room for the next several days was heavenly. Everyone who walked in there felt it.  (Thank you Heavenly Father).

Alec already looked better than when he first went into surgery.  The transformation is that fast.  He has been neon yellow the past several months, and just a short while after putting a healthy organ in his body,  the change was quite noticeable.  There were about 15 people in his room receiving updates and instruction from Alonso.  They all stared at me, curious of what my reaction might be.  This is the third time I have seen my husband hooked up to everything you could possibly be hooked up.   He was covered with a blanket when I weaved my way through the sea of people caring for him. I stood at the head of his bed, leaned over, and gave him a kiss. Everyone was still working on getting their part done, and so the drape that was covering him came off just a bit that I got to see his chest and abdomen.  The nurse, noticing that the drape fell down a little, looked at me to see my reaction and covered the area.  I said, "It's ok, I can handle it.  I want to be here, and I don't want to be in the way.  So keep doing what you have to do." Although I have seen Alec immediately after each transplant, I have never see his chest and abdomen cavity open.  Yup, open.  After such a long and invasive operation, his entire body was too swollen to be sewn back up (he ended up having 3 more surgeries in a week and a half timeline to close him). He had been medically serand-wrapped (I have no idea how to spell that word and I am too lazy to get out of bed to go to my kitchen to find out).  I couldn't see into his body, but enough to witness that everything was exposed. Because they had to crack open his chest again, I could sense the closeness of his heart beat.  You are not suppose to be able to see your chest thumping that hard.  It was so beautiful and fascinating.  I gazed down to his abdomen.  How on earth are they going to close him.  It looks like he needs a skin transplant now in order to cover his organs! I thought.  Crazy, crazy, stuff.  I took a moment to thank each and every person that had helped pre-operation and post.  They worked their rear-ends off to give me the chance to see Alec one more time, and I made sure they knew I was grateful that they fought to keep him alive.  The next few days would be critical.  They weren't able to get an ultrasound after the second try of hooking it up because he was open.  So he wasn't out of the woods by a long shot.  This night in the ICU would prove if there was any good blood flow to and from the liver because there was no other way to tell.  I asked Vince and my dad to give Alec a blessing and to bless his liver.  Like a tender prayer that Alec's sister, Micah had offered earlier during a critical point in his surgery, they too blessed this new liver to not only survive, but thrive.  And so it has.  Simply put, a miracle.  Everyone in the operating room said prayers all during the surgery.  A nurse called me with an update and asked if I had any questions or needed anything.  I said, "just say a prayer."  She replied, "Do you think we haven't?  Every person in that room has offered a prayer.  We've said about 97!!"  Another person came to me and said, "That was the first time I've prayed in 5 years."  Powerful, powerful stuff people.

Clearly, scientific studies, research, and data indicates a certain time frame where the donor organ is still viable. His was out for about 23-24 hours. Everyone was unsure of the outcome.  It's not supposed to work as it has.  It just doesn't happen. It is supposed to have dead tissue.  His doesn't.  After several biopsies, ultra sounds, lab work, etc. his liver function showed no stress.  I promised Dr Alonso that if she did her part, Alec would do his, and the Lord would do the rest.  Alec has been blessed with a very strong body.  It is amazing what his body has been through.  He promised me before surgery that he wasn't going anywhere and boy was he right.  He shouldn't have made it.  Anyone else in that situation Im sure wouldn't have the same outcome.  He is a fighter.  He is a warrior.  He is a champion, and he is alive.

The transplant team at IMC is phenomenal.  The surgeons are geniuses.  I know that we would have a very different outcome if he went anywhere else.  There is so much love shared between the Docs and us.  We are all a family.  We are so grateful for the relationships and bonds that have been created with each and every person at IMC.

God is Good.  Miracles do happen.  It couldn't happen though with out his donor.  To the donor family: Thank you for sharing your loved one with us.  We could not be more thankful for their incredibly strong liver that continued to function despite the time and odds against survival. But it did, it survived and is thriving. Alec's donor must have been really active and healthy in order to have such a great organ.  We thank you for that.  We are saddened for your loss, we really are.  We are on a completely different end than you.  We are humbled, and hope you know that we will respect this gift that was given.  We will be able to grow our family because of it.  We will honor your loved one by living a happy, healthy, positive life.  That is the only way we know how to repay you.  That, and to be organ donors ourselves.  It says so much about a person's heart.  Thank you for raising someone that was willing to donate and save lives.  That is a hero.  With my husbands strong body and your loved one's strong liver I just know that together, it will produce a long and happy life. We feel it. Thank you and God bless!

Become an organ donor.  We are in desperate need. Alec is beyond blessed to not only receive 1 but 3 transplants.  People die waiting for one.  We know that many don't have the success that we have had. We are sensitive to this fact.  We do not take this gift lightly.  We will do our best to spread awareness so that there are more organs available in ones time of need.

Welp,  this post was long. I had to write it down.  Alec needs to know just what went on while he was sleeping.  And now, at 2:34 in the a.m. I need to get some sleep.

Love you all!  Hope to see you tomorrow for the 5k, 10k fundraiser that our dear friend Geoff Gough and crew have organized.  It's the trail head right by Hogle Zoo. Just park in the parking lot east of the Zoo. You'll find it.  6:45 registration, 7:00 pm start time.

Peace and Love! We are so grateful for this experience (don't ever want to go through it again) as it has taught us and refined us in many ways.  What I am grateful for the most is love.  Alec's faith and strength has reached and taught so many people. Because of that we have received so many blessings and love from all of you.  The world really is a great place filled with love.  It has been incredible to be the recipients to this love.  Thank you. Somehow, someway we hope you are able to sense the gratitude and love we want to give back.  Couldn't have made it with out all of you cheerleaders.  XOXO