Liver Transplant Recipient
Brian Hough and his family endured more than they could have ever imagined during the year and a half leading up to his liver transplant. Every day another obstacle seemed to occur, yet their faith and determination saw them through the roughest period of their lives.
Brian's liver disease dates back 30 years, when he was diagnosed with hepatitis B after a period of brief illness. He never thought much of the diagnosis and went about his activities as usual. It wasn't until 25 years later when Brian started putting on weight and noticing discoloration in his toes that he sought medical help. "Once I told the doctor I had hepatitis B, a blood test was done showing that I also had hepatitis C and end-stage liver disease," he explains. Brian's doctor referred him to a local gastroenterologist who recommended a liver evaluation at California Pacific Medical Center.
But before Brian's evaluation took place, he was admitted to California Pacific because of a side effect of liver disease called encephalopathy. This condition, caused by high ammonia levels and toxins in the body, is the result of the liver's inability to process toxins appropriately. It leaves patients confused and delusional, and is an indication of end-stage liver failure.
"The liver team put me on medications to control the encephalopathy, but two months later I was back in the hospital, "Brian explains. "During this second stay, I was evaluated for transplantation and listed as a 2B in late December 1999."
Brian experienced several months of improved health in early 2000, but in August, took a turn for the worse. His creatinine levels were rising-a possible sign of kidney failure-and fluids had accumulated around his lungs. Brian was admitted to the ICU in late August while doctors tried to bring down his creatinine. "A few days later, I received a call at 6:30 a.m. and learned that Brian had collapsed in the bathroom during the night and was found unconscious," says his wife Judy. "His ammonia level had increased so much that he went into a coma and only had brain stem activity. At that point, we had to face the fact that if he came out of the coma with significant brain damage, he wouldn't be able to get a transplant."
Judy and their children, Travis and Ashley, kept vigil by Brian's side as his coma persisted. Then, on the fourth day, he awoke. Miraculously, Brian suffered no brain damage, but he remained in a dangerous fight for his life. Because his liver disease had caused so much strain on his kidneys, doctors determined that Brian needed both a liver and kidney transplant to survive. The day after he awoke from his coma, doctors alerted Brian and his family that a liver had become available, but after inspecting it, they cancelled the surgery because it was too small. So they continued to wait, week after week, hoping for a miracle.
As each day passed, Brian's strength depleted and he became more anxious, requiring oxygen to breathe. Then, on September 14th, after a month in the hospital, Brian's liver transplant surgeon, Dr. Osorio, alerted them that they had a liver and kidney to transplant.
The anesthesiologists arrived at Brian's room prior to surgery but after reviewing his charts, became concerned that his blood pressure was too low to undergo the operation. "Dr. Osorio explained the concern to us so we could make a decision," says Judy. "My feeling was if we didn't do the transplant, I'd die anyways, so we might as well go ahead with it," says Brian. "Dr. Osorio agreed and told me he was throwing me a Hail Mary pass and that I'd better make it to the receiving end!"
The team then went into action preparing Brian for his transplant. "We had complete faith in the medical staff," says Judy. "They worked like a finely tuned machine, with each person doing their part. There was a lack of wasted thought and motion, which made us feel very safe with the team's capabilities. All this time while they were prepping him, we stood around his bed like angels-it was surreal."
As Brian was wheeled into surgery, he gave his family two thumbs up, telling them "Let's rock and roll." From then on, they waited nervously, thinking about the risk from the anesthetic and double transplant. Within two hours, they learned that Brian was successfully put under. Twelve hours later, Dr. Osorio came to tell them the transplant was a success.
"Once I awoke from surgery, I was so grateful to be alive that it overshadowed any pain," explains Brian. Judy adds, "He woke up smiling like a cheshire cat-it was one of the happiest days of our lives." Judy was so grateful to have Brian alive that every time she saw Dr. Osorio and his surgeons, she would break into tears.
As his recovery continued, Brian's liver enzyme and bilirubin levels remained high, leading to the discovery of an obstruction in his bile duct. Brian underwent a series of surgeries to remove the obstruction. "I feel so much better mentally and emotionally, but continue to work on physical therapy because the coma did so much physical damage," Brian explains one month following his transplant.
"It's hard to imagine anyone more capable, compassionate and caring than the medical staff at California Pacific," say Brian and Judy. "The team could figure out any challenge and we had complete trust in them. Dr. Osorio would talk with us, eye to eye as we faced tough decisions about surgery, never hurrying us, and always making time to answer all our questions."
When Brian sees his transplant scar, he views it as a reminder of his second birth-a mark showing his determination and will to live. "I used to think such a major scar would be shameful, but now I look at it with pride," he explains. When thinking about other patients waiting for transplantation, Brian and Judy advise: "Just take one day at a time. You can't hold on to things because your condition can change at any moment. So live each day with gratefulness and determination."