Angie & Jim

Daily Updateby Jim

We’ve been visited by both the liver team and the lung team today.  The liver people said that there are some abnormalities on her liver that they want to keep an eye on, but nothing especially dangerous that they think could be causing the current symptoms.  They said they want to have her come back in about 3 months so they can check on her liver and make sure it isn’t getting worse.

The lung people came by and wanted to know all about her most concerning symptom: sitting upright dramatically lowers her saturations.  We did the experiment again so they would watch and they listened to her lungs and asked many questions.  They have a preliminary theory, and they talked about seeing this symptom in others.  That was somewhat encouraging that they have seen this before and know what typically needs to be done.  They were very hesitant to pass a diagnosis without discussing further with the cardiology doctors, but they were talking about a shunt in the lungs.  What happens (I think) is that blood exchanges improperly and so it is mixing in the lungs and thus not getting enough oxygen to the rest of her body.  The fact that she drops when she sits up would suggest that the shunt is in the lower part of her lungs or diaphragm, which gets more blood-flow when sitting up.  While laying down, that part doesn’t get used as much, thus keeping her saturation levels higher.  Seems like a reasonable explanation to me.

They didn’t say much more about it, or what is typically done for it.  They also said if the shunts are few in number and large enough, they can surgically repair them, but if there are many little ones, it is more difficult.  That was about as specific as they got.  They alluded to some tests they can do to verify more certainly if there are shunts — more accurate than just sitting up in bed.  I’ll let you know when we have more news.

Thanks for the love and support!