07/18/2025
***Ainsley update***
06/10/2025
I started writing this on Sunday, 06/08, but I wasn’t able to finish. I’m trying to edit what I wrote previously as I update new information now, so hopefully this all makes sense when I’m done.
Unfortunately, Ainsley landed herself back in the hospital on Saturday. We enjoyed one night together at home on Thursday and one night together in the hotel near the hospital on Friday. Then, Saturday morning, I took Ainsley to the hospital for labs. (These were routine labs while we figure out the right anti-suppressant medication dose, though we won’t typically have Saturday/weekend labs in the future.)
Labs were relatively easy. Of course Ainsley cried, but she quickly recovered and went back to her normal, happy self. The doctor also ordered a urine sample, which meant I had to wait patiently for Ainsley’s p*e to leak out her ureterostomy and catch it in a container. She was on the bathroom changing table for this and SCREAMED the entire time. (Background, a few months ago, she started freaking out during diaper changes if her legs were dangling off the couch. She seems afraid that she’s going to fall and feels extremely insecure.) She also pooped, but I couldn’t change her bc I didn’t have extra diapers in her stroller bag….
Once I got enough urine—they only needed one ml, but I wanted to make sure there was more just in case—we headed down to the car. There, I gave her the anti-suppressant medications as to stick to our very strict schedule. It was hot outside and I was sweaty, but finally we went “home” to the hotel.
Once we got into the hotel room, I changed her diaper. She started to freaking out while laying on the bed (legs NOT dangling) but was comforted with Dad’s arm around her. I sat her up upon finishing her diaper change…and she promptly threw up all over herself. Lovely. (She wasn’t sick, and she didn’t throw up anymore after that. However, her stomach is very sensitive to crying and being jumbled around, and I think going from lying down to sitting up so suddenly was too much for her little tummy to handle.)
After cleaning her up again, I got a call from SCH. It was one of the nephrologists, and he said her creatinine (kidney level) was elevated. When we discharged on Thursday, her level was at .5, which is beautiful for post-transplant. Saturday morning’s labs showed it was 1.3, WAY too high. The nephrologist explained we needed to come in for an ultrasound.
Going back to the hospital for the u/s was a nightmare. The gal at registration was very patient, making phone call after phone call to figure out where to send us. Turns out, Radiology only does inpatient ultrasounds on the weekend, and they thought we were being admitted. I told registration that they was NOT our understanding; nothing was said about an admission. Radiology then said we needed to go to the Emergency Department (ED) if we were doing the u/s outpatient. So I walked all the way to the other side of the hospital and got registered at ED. (Chad and the girls were with me, as we planned to drive back to Olympia together for the rest of the weekend after the u/s. They hung out at the main hospital Starbucks while I proceeded to ED.)
The ED nurses had to place an IV bc Ainsley apparently needed more labs. Her potassium was high at her morning labs and they wanted to re-check it. The second check WAS a bit better, coming down from 6.1 to 5.8. However, anything above 5.5 is too high.
After that, Ainsley got her u/s. It took an hour and she somehow slept through most of it. She cried initially, but Dad comforted her, apparently enough to rest. That was pleased the heck out of me bc it was 2 pm, naptime.
Since her potassium was high, a nurse came in after the u/s to do an EKG.(Elevated potassium can lead to irregular hearth rhythms and issues, which we definitely don’t want.) Ainsley was awake by then and handled the testing well.
The nephrologist whom I spoke on the phone with came in shortly after the EKG. He said the u/s showed fluid in the kidney. His guess was the stent should not have been removed from her ureterostomy on Thursday and she would likely need another one placed. She would need admitted so the team could monitor her labs. Hopefully they would see her creatinine come down after Urology addressed the ureterostomy issue. Before he left, he took a quick look at her EKG results and said everything looked good.
We got a room on the floor shortly after that and an Urology resident eventually came by. He was able to place a temporary catheter into her ureterostomy and p*e immediately came out. They left the catheter in so the kidney could continue draining better. They wanted to see what her labs looked like at midnight.
Chad and the Bigs, having been with us in the ED and in her room on the floor, retreated to the hotel room around 9 pm to get some sleep. I stayed with Ainsley. (Earlier in the day, I had gotten a call from RMH. They had a large room available to accommodate our entire family. I had hoped we could move out of the hotel and into the RMH room yesterday, but things quickly became chaotic with ER, u/s, getting an IV place, and eventually getting admitted. I called RMH and told them we’d have to wait until the morning.)
As I wrote the update on Saturday night, the nurse came in Ainsley’s room to connect her to feeds per the team’s order. It seemed a stent would NOT be placed once her stomach was empty. Frustrated, I told the night shift resident nephrologist that we were told a stent would likely be placed if the midnight labs showed an improved creatinine level. The resident didn’t seem to know much. She kept repeating that she was “just the messenger” and that Ainsley was no longer having midnight labs. The team wanted to wait for her regular morning labs and make a plan from there. I had her go back and talk to the team. She came back later, stating they agreed Ainsley could be NPO starting at midnight in case Urology decided to place a stent in the morning.
Sunday morning, Ainsley had a follow-up u/s. Urology came by after reviewing the results and said there wasn’t much change; there was still fluid in the kidney. They wanted to monitor how things went over the next few days. I closed my eyes for a long time when the doctor said that. She quickly said, “It’s up to nephrology if you get discharged. Is that what you’re concerned about?” I said YES.
The attending urologist also said she didn’t think a stent would be better than the catheter. Chad (not yet there) and I disagreed, as her creatinine level shot up immediately after the stent was pulled out. Also, a stent has multiple holes in it, allowing for more urine to come out. The “catheter” the resident placed into her ureterostomy was technically an NG tube (nasal-gastro feeding tube). It had only two holes, which seemed less efficient to us, the non-doctors. Fortunately, one of the nephrology surgeons agreed with us and asked Urology to place a stent.
After having been NPO (no eating/empty stomach) for many hours, the day shift nurse came in to connect Ainsley to feeds. Urology didn’t want to place a stent, so she was OK to eat. Thirty minutes later, the nurse came back in DISCONNECT Ainsley from feeds…. The nephrology surgeon had talked to Urology and advised they place a stent. So feeds stopped again…making her NPO again…. The procedure was scheduled for about 4 pm, and there was one case (child’s procedure) ahead of her.
While all this was going on, Chad was moving everything out of the hotel and into the car. (I had literally unpacked almost everything from the car and found each item’s perfect place in the room). He checked into the RMH for me, basically only dropping off her refrigerated medications into the room’s fridge, and then came back to hospital with Bigs.
Throughout Sunday afternoon, Ainsley’s procedure was pushed back many times. When she finally went downstairs for the stent, it was about 8 pm. She and I got to ride in her bed together bc she was so distressed. When she came out, it was about 9 pm. The procedure went well, though she did experience bronchospasms (the muscles surrounding the lungs' small airways tighten, narrowing the airways). She has a history of this happening during anesthesia, so we used her Albuterol inhaler before she went downstairs. The anesthesiologist also used Albuterol during the procedure.
When I was able to meet Ainsley in recovery, she was resting peacefully. Once it was time, the nurse started trying to wake her up. It started out well, but then she coughed, gagged, and threw up. The nurses suctioned her and got her settled down. The anesthesiologist was there and listened to her lungs to make sure they didn’t get j***y from aspiration. After about 15 extra minutes of monitoring, she and I were transferred from the PACU (post-anesthesia care unit) back to her room together. I got to ride in her bed a second time as she was upset again.
Around 10:30-11:00 pm, I left with the Big Girls to sleep in our new RMH room. Chad stayed with Ainsley. Much to our dismay, that night was a very rough night. Her respirations and heart rate were extremely high, and she also spiked a fever. This combo earned her another transfer to the ICU. Chad got about 20 minutes of sleep that night between all the commotion, transfer, stress, and staring at her vitals monitors while the numbers went crazy.
Sometime in the early morning, Ainsley’s breathing and heart rate returned to normal. The team had already started started Ainsley on prophylactic (preventative) antibiotics in case she had a virus. They had also taken blood to run a viral panel. The results showed she was positive for adenovirus. (While I was frustrated that she caught the virus AGAIN, the team was not concerned and believed she was simply STILL testing positive from the prior infection.) Around 4 am, Ainsley had another u/s. The team wanted to compare before and after the stent was placed. Fortunately, things looked much better! The fluid had drained, and labs later showed her creatinine was back down to .8.
Sunday was Chad’s birthday. While I was grateful we could all be together, that was NOT the ideal way to spend a birthday. Monday was better, but he was pretty exhausted. I, on the other hand, felt well-rested. I got to sleep with Bigs at RMH. We got up and had free breakfast. I took a shower. We unloaded the car together. We made our room our new home away from home. Then we went to the hospital and Chad and I traded places. He was exhausted and needed sleep, and since Ainsley tested positive for adenovirus, Sisters were no longer able to visit.
On Monday, the team monitored her to make sure her kidney labs continued to look better. Chad, the Bigs, and I had all driven up to Seattle together on Friday, so we were all kind of stranded together. Chad didn’t direly need to work on Monday, so we called the girls’ school to let them know they’d miss another day of school. I explained that Ainsley was back in the hospital already and we were all in Seattle together. They’ve been wonderful and understanding and supportive, and I’m so grateful for our little community. Later in the afternoon, Sandie/Mimi drove up so she could bring Chad and the girls back home. She got to see Ainsley briefly, but Ainsley had just woken up from her nap and was a wee bit cranky.
We had hoped Ainsley would be discharge yesterday, but we still hadn’t heard a plan from Urology. Today, TUESDAY, Ainsley’s original transplant urologist came in to speak with me. She wants to leave the stent in for now. In a month, under anesthesia, they can take it out, look at her ureterostomy, and decide whether a new one needs placed or not. If her ureter is straight and the opening is flexible enough, they may leave the stent out. If it still feels narrow when they probe it, they’ll place a new stent. Some kiddos DO need chronic stents, and Ainsley may be one of those kiddos. (Honestly, with as complex as she’s been her entire life, I wouldn’t be surprised if she needs them on a continual basis).
The team wanted to keep Ainsley for another day so that she could finish 48 hours of antibiotics. Then, if her blood cultures didn’t grow anything gross, she could discontinue them. I told them I’d hoped to take her home and asked if we could do anriviorixs at home until we heard whether they could be stopped. Another doctor spoke up and suggested we stop antibiotics at 36 hours. Then she could get one more dose and we could be on our merry way out of the hospital in the afternoon. Fortunately, the team agreed to that! So that is what happened. They gave her one more dose of IV antibiotics )while she napped) and then we skid-addled on outta there!
We DISCHARGED around 3:30 pm this afternoon. Her labs look good. Her kidney levels are happy. Her urine output looks good. She and I went directly to Ronald McDonald House (RMH). I was so excited for her to see the place. Our room is large and cozy, and the whole establishment is VERY family friendly.
We went upstairs to our room first, unloaded some things, got her changed out of her hospital gown, then went downstairs for food. After eating, we got to spend time with a therapy dog named Angus. He was very sweet and very soft! He’ll be back again in two weeks. He must be going on vacation, bc otherwise he’s there every Tuesday. Other doggies come and visit throughout the week. I’m eager to see them all!
After seeing Angus, we went outside to the play area. Ainsley walked (with my assistance), crawled around, and went down the slide a couple times. Once she was finished, we went inside and played with a doll house. Once she was done with that, she played with a Hot Wheels track. Once she was done with that, she played with trains….. Finallt, we retreated to our roll bc Mama was tuckered!!!
Tomorrow we’ll have labs again. We are still trying to find the right balance of her anti-suppressant medication, Tacro. That can be difficult with ALL transplant recipients, so nothing special there. After that, I’m hoping we can go to a couple libraries to return books, and then…RELAX!
I’m so relieved, yet again, to be out of the hospital. It’s been a continuous roller coaster with one thing after another. We have no idea what the rest of the week will hold, but for now…she’s healthy