Praise God, Tyson was able to come home this afternoon. There are still some unanswered questions but we are trusting God's timing with those answers. All of the various teams at SickKids were confident that he's doing well and can go home. They've also done their due diligence in trying to get to the bottom of what brought on the hematemesis in the first place. When blood appears like that, it can be a sign of all kinds of other serious issues like internal bleeding, stomach ulcers, liver disease and the list goes on. Tyson hasn't had any pain in the stomach or other organs, the vomiting stopped soon after a dose of IV gravol, and his O2 saturations improved quickly with oxygen therapy. They also ran a ton of labs to look for signs of other underlying concerns and came up with nothing.
Tyson had heart and liver MRIs at SickKids last week, and there is some worsening in liver stiffness, which is how they measure the degree of his Fontan Associated Liver Disease. A lot of you have been asking how his liver fits into the picture. When the surgeons replumbed his heart during his last open heart surgery in 2010, his new Fontan circulation (though life-saving!) often creates a challenge for the liver. The blood flow basically bypasses the right ventricle which causes increased pressure in the central veins, especially those draining into the liver. Chronic venous congestion, reduced blood flow, and the body's response to the new Fontan circulation can lead to a range of liver problems, from mild fibrosis to potentially serious complications like portal hypertension and liver cancer. This is why it was so important that someone review the report from his liver MRI before sending Tyson home. We wanted to make sure that the hematemesis wasn't a symptom of a declining liver. His cardiologist was not available yesterday to meet with us in person, but she was consulted and she was happy with the course of action taken by the other doctors. I have asked for her to call me next week sometime so we can go over whether or not the MRI report is something to sound alarm bells over or if we're still playing the "watch and wait" game.
Tyson is doing really well and was very ready to go home. We are going to be pretty protective of him over the next few weeks while he makes a full recovery. He's on antibiotics in case this was a result of a bacteria, as his bloodwork showed an increase in neutrophils which means bacterial infection somewhere in his body. And we are going to really focus on nutrition, hydration, and rebuilding the gut microbiome over the next few months. We really don't want a replay of this to happen again, and especially not the week before his brother's wedding.
That's the update for today. Please continue to pray that Tyson can make a full recovery and that his heart and liver can continue to function well.
