Post Transplant-Day 2

What a whirlwind these last few days have been. Nicks surgery went well. It was intense…back there for 12 hours…and they finally finished up in the early hours of Sunday. A lot of sorting of his anatomy but they did it. And they did it well.

Nick was progressing incredibly well on his official day 1 post surgery, yesterday. He was off of his breathing tubes quickly, very alert and even got up to walk. Unreal. He was exhausted but his pain was managed well. He even graduated out of the SICU and moved down to the transplant floor where they will care for him for the remainder of our stay.

Early this morning came some major complications. Nick had severe internal bleeding that gave everyone quite the scare. They rushed him back up to SICU and immediately intubated and scoped him to find where the bleeding was coming from and they uncovered a small tear in the lining of his stomach, likely caused from the cardiac scope they had in him during his surgery. They quickly “stapled” this area back to good through the scope and were able to stop the bleeding before it was too late. The fact that these teams were able to take care of this in the manner and timing that they did is not lost on us. Based on what we’ve been told by the staff here, this situation could have had a very different ending, and I can not tell you how grateful we are right now.

Nick was intubated most of the day today because of the trauma his body went through this morning…he lost an incredible amount of blood. His breathing tube is now out and he’s resting comfortably. His vitals and labs are back in check and he’s feeling ok overall….he’s just completely wiped. He needs sleep and as most of us know that is so hard to do in the hospital..especially in the SICU when they are coming in constantly. But he’s snoring away right now and hopefully tomorrow he will be able to go back down to the transplant floor if he does ok overnight.

And let me just tell you. We all knew Nick was strong. We’ve seen it, well, basically his whole life, but even more elevated over these last ten months. But if you think that’s as strong as he gets, you are so very wrong. The amount this man has been through over these last 4 days is nothing I could have even imagined. But he keeps going. He just rolls with it. He’s as headstrong as ever and I couldn’t be more proud of him. He is kicking absolute ass🧡

While today was taxing, we are thankful he is bouncing back from this quickly and that there have been no other complications thus far . His new liver is doing so well..I just can’t even believe I get to say that. Hoping and praying that this very large, frightening event today is just a bump in the road.

I’m not even going to let myself go down the road of his medical teams. But these people here…every single one. It is an absolute honor and privilege to be in their care. Im going to save the rest for it’s own post someday when this is all behind us..because they deserve 10 billion words of their very own.

Please keep your prayers for Nick and his care teams coming. And if you would be so kind to pray for Nicks donor as well. For her beautiful, selfless soul and for her family who lost her. She is the reason we are in this place of hope right now and it’s such an emotional thing to process.

Your prayers, concern, well wishes, meals, love for our kids and everything in between are carrying us through this, truly. Thank you isn’t enough. We feel you marching with us, sweet friends and family, and we are sending you love xo

Surgery Complete

They finished nick last night around 2am..it was a very long and complicated surgery but they did what they set out to do. He is in the icu now and they just took his breathing tubes out and he’s breathing on his own. He’s pretty out of it but is awake…just very exhausted and in a lot of pain. Overall he’s doing well and as they’d hope thus far🙏🏽🧡

It’s here!

We got the call at 4:45am this morning and Nick went back into transplant just a bit ago. I have so much going on in my head and heart, but the words just aren’t following. I will be sure to keep you updated, but if you have a few extra prayers or positive thoughts to spare we will take them. Nick went back there radiating strength, grace and confidence, per usual, and I couldn’t be more proud and full of hope..bless his beautiful, brave heart. Be in touch…much love xoxo

Officially Listed

Hello all…Hope this note finds you well and coming off of a wonderful Valentine’s Day. Thought I’d share what we know as of now with regard to Nick..

Nick is officially on the transplant list! Can you even believe this?! We’ve been waiting for what feels like an eternity to get to this place…he did it. He has come so incredibly far.

Nick had his treatment procedure yesterday and all went well and as expected. His radiologist was successfully able to cover the remains of that “hot” tumor he treated in the last round and was also able to hit one more small one that hasn’t been a big concern/high on the radar, just for precaution. Now, we just wait and pray for a liver to present itself to us. If we haven’t gotten the call in a month or so we may need to go back in and rescan things/discuss another treatment to keep things at bay but as of right now his radiologist doesn’t see anything else he needs to or could treat at this point. Unbelievably positive news.

So really, any day now. Any minute. Any second, our lives could completely change and we could get the call. Two of our dear friends reminded us this morning that today is National Donors Day. You know, I’ve always checked the box to be a donor myself…I’ve always seen the possibility in it and the need for it. But sitting here on the other side of it all, in need of a liver for Nick, makes me truly feel, with every bone in my body, the importance of organ donation and the selflessness of those angels that choose to give so another can live. So today, we honor all of those donors, living or deceased. Whether you have provided a living donation of blood or an organ, whether you’ve humbly witnessed donation through the death of someone close to you, or whether you’ve simply checked the box “yes” to be a deceased donor, you are choosing to give life. You are a gift.

Nick is feeling pretty good today. He’s tired and sore and just kind of run down, as to be expected, but he is in great spirits. He’s physically and mentally so ready to push through all of this. And he’s emotional with gratitude for his radiologist and friend who has gotten him to this place of being able to be listed….and I am too, it’s truly just indescribable. I know we’ve got a lot ahead of us, but we have so much hope right now and there is no doubt we can finish this off.

We have to be in NY for the next week and I’m already missing our patient, brave kiddos like a crazy person. There’s just no way I’d be able to do this without my sister, parents and Nicks mom and husband loving up on the kids…plus our beautiful friends that are swooping them up for hugs and play dates. I’ll never be able to thank each of them enough.

So now, we wait. And we pray; That the right opportunity presents itself to us, whether it be a living or deceased donor. That Nick stays healthy and strong, both mentally and physically. That God continues to bless us with his work through Nicks doctors and medical teams. That our kids feel our deep love for them from afar in these potential weeks and months ahead. And that we remain driven and ready in every way possible for that call-Any day now. Any minute. Or second🧡

I promise to keep you posted. Thank you all for your continued love and prayers…you are one unbelievable army and we feel your strength behind us. So very much love to you Xo

What’s Ahead

Hello! I am going to make this as short and sweet as possible…we’ve been running on no sleep and man that in combination with a rollercoaster of emotions doesn’t make for the best brain function…so I’ll try and spare you:)

Nick has officially been approved by the board to be listed for a liver transplant! He’s checked all of the remaining boxes he needed for approval…his bone and ct scans have both come back showing that the cancer has stayed localized to the liver (and my gracious was that news overwhelmingly beautiful to hear)…and they have successfully treated his tumors to a place where he is considered safe for transplant..his last afp draw was at 336. How absolutely positively incredible. There are a few administrative kinks that need to be worked out and then he will officially be on the list..hopefully in a week or two.

I know what you’re thinking. What’s the timeline here? When will we know when his transplant is? How long will it take for Nick to get a liver? And man wouldn’t I love to be able to answer those questions for you. Really, we are approaching this next step just the same as the last nine months..one day at a time. It could take a few weeks…it could take months. Here’s the tentative plan that could absolutely change at any given point:

Nick will have another very mild treatment on February 14th to keep his afp maintained and the tumors at bay in the event that it takes a while for them to find a liver-and he should be officially listed at that point. But right after that treatment is when it will really get serious. Once Nick is officially listed they will begin working up the candidates that have come forward to be a living donor-this couid take some time. And right after his treatment his surgeon will begin intensely looking for a deceased donor for Nick. His surgeons first choice is still a living donor transplant, if we can find the right donor..but if a healthy deceased liver miraculously falls into our lap, we jump on it. Game time decisions. Our prayers right now are asking that the right opportunity presents itself at the right time.

All that grit, Nickyboy. This is what he has been so silently strong for these last nine months. This is what we have been praying for. The hope in our hearts for hearing this news is what’s kept us moving forward. It’s really going to happen, you guys. And while the most difficult piece of all of this may likely be yet to come on so very many levels, we are confident and ready to just push through. I am just so incredibly proud of Nick🧡

That’s really all I’ve got for now. I’ll be sure to check in with new info. Please keep your beautiful prayers coming and know that we send so much love to you xo

Update

Hello you all. I write to you from JFK airport with some pretty stinking uplifting news….

462. 462! As of Monday, Nicks AFP is down to FOUR HUNDRED SIXTY TWO-the lowest its been! This is absolutely incredible. Nicks afp jumped up to 1600 the day before his last treatment a couple weeks ago…so to see it down to 462 after just two weeks post treatment is very very positive news. Now, we just hope and pray that it stays stable, or even decreases further.

We saw both his interventional radiologist and transplant surgeon today. While we all know that this number means nothing unless we get listed and transplanted…this is an insanely hopeful step down the right path and we are all celebrating this major win. So here’s the lowdown…

As of now, they are planning to have Nick listed for a transplant on Monday the 27th. Their selection meetings are on Mondays and unfortunately they don’t meet next Monday because of MLK day..so we have to wait until the following Monday for him to be approved. A few things need to happen in order for him to be listed that day :

-he needs to have a clean CT scan which he had this morning and passed

-he needs to have a clean bone scan which he will have back home next week

-his next bloodwork (on 1.24) needs to show his afp has remained stable/under 500

If all of this checks out in our favor he will be listed and things will start moving very quickly. There is so much involved in this that I’m not going to go into crazy amount of detail but basically they will start working up the incredibly selfless living donor candidates that came forward-a living donor transplant is his surgeons first choice if we find the right donor-and while that is all happening his surgeon will do everything in his power to find a deceased donor that may work. The problem with a deceased donor is that Nick will not likely get offered a healthy deceased liver for many reasons…so we have to play the game and when the opportunity comes to make a decision, we make the best one. Yes a living donor transplant could be risky for nicks aneurysm-but he feels he can fix it after the transplant-he just feels a very large sense of urgency to get this liver out of Nick before the tumors grow back-it’s a risk vs benefit deal.

We will also evaluate a need for another treatment once we get Nicks bloodwork back in two weeks. The good news is that his IR feels confident on where this afp is being released…so he knows right where he’d go if another treatment is needed.

This is only the potential beginning of a very long, intense road. But it’s a beginning and we are beyond grateful for that. Our heads are spinning with excitement, fear, caution, logistics and so many question marks..but we are blessed to be in a place where we know we can make this work because of all of the support we have. We have made it so far already and we will continue to do whatever we have to do to get to the finish line. Nick is so strong and capable.

And, because I so desperately want you all to join us in prayer and gratitude for Nicks care team, I truly just need to somehow try to help you understand these human beings. Nick and I sit here and try to grasp this piece of it all and it’s just so intense and overwhelmingly emotional to think about. While being told “I’m sorry we can’t help you” by two institutions 9 months ago seemed like the most heartbreaking, devastating, gut wrenching thing in the world…we are now so incredibly clear as to why that happened. We were led to this team at NY Presbyterian/Weill Cornell so intently, for so many reasons. Because they are exceptional at their craft. Because they are well studied and experienced. Because they are risk takers and feel Nicks strength and capability within themselves. Because they can empathize with Nick. But because of the way they’ve stood by us and seen the hope…that’s the piece I will never be able to loose sight of. From accepting Nick as a patient when they knew he was incredibly high risk…to continuing to treat him when it may have felt precarious…to refusing to accept no for an answer when it came to listing Nick. These doctors and their entire teams have felt the worry and celebrated the wins along side us in a way I didn’t know was possible in healthcare. And while I know we have an incredibly long road ahead of us and that we have nothing guaranteed, the safety we feel about what’s ahead is the most comforting thing in the world. And that safety is because we know Nick is in the care of the very best hands and hearts. I just simply want you all to know them so badly….the real estate in my heart for them is indescribably big. So if you would be so kind, your prayers for them would mean so much. Prayers that they continue to see potential in Nick. That they continue to have clarity and precision in their work. And that they know and feel the utter gratitude that we have for them.

So that’s all I have for now. We are feeling pretty high today and that feels amazing. Nick has a little cold, but beyond that he has completely rebounded from his last treatment and is feeling really good. He physically looks so healthy too…what a beautiful sight. We will continue to keep you posted if anything comes up and I will absolutely let you know once we get bloodwork back in a couple weeks or so. In the meantime, please keep your beautiful prayers and light coming….man are we feeling it all 🧡 So much love to you xo

Happy New Year!

Happy 2020 to you all! I hope your holidays were wonderful and that you have been enjoying time doing whatever it is that fills your heart up over these last few weeks!

Just here with an update on Nick. We returned yesterday from NYC…he had his treatment procedure on Monday. The procedure went very well itself. As you might remember, there was an area in the pet scan that very visibly lit up red, unlike any other area on Nicks liver. His IR went in on Monday and confirmed a very large tumor, roughly around 6cm. Everyone is scratching their heads at how this wasn’t seen on any of Nicks scans. We sat down with his IR and thoroughly reviewed all of the scans…and all we can gather is that this large tumor was either attached to or overlapping with the second largest tumor that was treated a few months ago. We learned it’s incredibly rare for this order of events to happen..for the scans not to show a tumor..yet a pet scan light up red..and his IR to actually confirm and locate a tumor in the area lighting up…and we are thanking our lucky stars for this rarity. His IR was able to target this tumor and ensure that about 90% of the treatment beads made it into this tumor. He also targeted a small one on his route…because he had the ability to get to it and enough beads to do it along the way.

All in all, this is incredibly hopeful news. We truly couldn’t ask for anything more out of the treatment..the doctor had so much clarity on where to go and such success in getting the beads where he needed them. We are just so so hopeful for this tumor to be the one that is releasing all of the afp..and praying that it responds to this treatment.

Nick will have bloodwork in two weeks. This isn’t a ton of time to let the treatment work..but hopefully we may see some sort of change in his afp. A few days later we are scheduled to be back in NY for meetings and tests. We had a long chat with both his surgeon and IR and there are basically three ways this could all go:

1-this treatment could bring his afp down below 500 or right around there…at that point they would start pushing hard and getting the process going to list Nick for a transplant

2-they see his afp drop a tiny bit…at that point we wait another couple of weeks to test again or potentially do scans and schedule another treatment to get this tumor again

3-they see a rise in his afp…at which point we sit down to discuss other options. If his afp doesn’t drop after this treatment, his doctors aren’t confident that this local regional treatment could benefit him any longer. We would need to talk systemic options..and it sounds like it would be immunotherapy. While it isn’t statistically the most successful with dropping down an afp in a situation like Nicks, they all feel like it would be worth a shot and that we’d have to try something. We will cross this bridge if we get there.

As you know…we are relentlessly praying for option 1. We have a few weeks to wait until we have any sort of answer at all..or even any leads to an answer…so we just have to try to focus on the favorable possibilities at this point. While some of the options are sounding a bit scary, there is so incredibly much that could go right here. Patience…we are trying so hard to stay patient.

I’m not going to candy coat it, Nick isn’t feeling great. He had his procedure on Monday and has spent most of the time since then in bed. He’s absolutely exhausted..he’s had bouts of nausea, headaches and is having some pains. We are holding onto the fact that the pains could be tissue and tumor death. He’s in very good spirits, considering, and he gets up once in a while for a game of cards with the kids or to hang out with us or have a meal. He says it’s not unbearable, but bless his heart I know he just isn’t feeling well. It sounds like the first three days could be the worst of it..so hopefully he will turn a corner in a day or two. We will just keep pumping him full of nutrients and rest and will have him back to normal in no time…I’m so sure of it.

We will take any and all light, positivity and prayers you have to offer on Nicks behalf, friends. For healing and a speedy recovery from this treatment, for positive answers and clarity in a few weeks, and for our hearts to remain patient and positive.

Although Nick wasn’t in great shape, we managed to have a wonderful chat on NYE. We both agree that while this past year was incredibly challenging, the amount of good that came out of it is something to write home about. We are firm believers that kindness is contagious and we are certain that all of the kindness we received in 2019 has been spread throughout the universe and is still going strong…what a remarkable feeling. The prayers. The meals. The donations. The rides and extra hugs for our kids. The childcare. The overnights. The shoulders to cry on and the hands that picked us up off the floor. In five, ten, fifteen years from now, when we look back on 2019, I’m so positive that what will stand out the most wont be the heartbreak, the fear or the challenge we’ve experienced this past year, it will be how much more rich and blessed our lives became. For so many reasons; because of the unconditional, vulnerable, raw experience of love it gifted our marriage, because of our beautiful, patient, resilient children, because of the way our hearts and faith in God have grown, and because of your unbelievable support. We are incredibly confident that 2020 will be our year and going into it with you by our sides is something we promise to never take for granted 🧡

As always…I’ll be in touch. So much love to you all xo