Gallstones are relatively uncommon in children and are not normally seen as a side effect of cancer or chemotherapy. We will never know what caused Ashtyn to get gallstones. Gallstones are small, stone-like objects that form when the liquid in the gallbladder hardens. Ashtyn’s gallbladder had quite a few stones stored. Stones in the gallbladder don’t necessarily pose a problem until they spill into the duct, get lodged, and block the flow of bile. Ashtyn had gallstones obstructing her common bile duct which caused backup of bile and a bulging duct. Ongoing blockage can damage the liver, the gallbladder, or the pancreas. Blockage can lead to infection as well. Organ damage and infection obviously can be serious problems.
It was clear that the stones needed to be removed from blocking the duct and the gallbladder needed to be taken out to prevent future problems. To remove the gallbladder they used the technique called laparoscopic cholecystectomy. Vigilance would be needed to keep Ashtyn infection free since she has very few infection fighting cells. The biggest feat was for the surgeon to be able to flush the stones that were obstructing the duct. Plans were already in place for Ashtyn to go to University of Utah Hospital or Intermountain Medical Center for another procedure if the surgeons at Primary Children’s Hospital were unable to rid the duct of the stones.
Ashtyn was taken to the operating room at 11 a.m.. Though Jason and I felt calm, Ashtyn was nervous. The anesthesiologist gave her a dose of versed, which helped with anxiety. She was upset that we couldn’t be by her as she fell asleep for surgery. As her bed was being pushed into the operating room, she kept looking back to make sure we were still there. During the two hour surgery Jason and I sat in her room, waiting. The OR nurse called us when the surgery was over and Ashtyn was starting to wake up. We quickly went down to the recovery room. As she was waking up we talked to the two surgeons who operated on her. They informed us that the procedure went very well. The gallbladder was taken out without difficulty. Even more remarkable was that they were able to flush the stones through the duct, clearing it of the blockage. The surgeons explained that they had first attempted to flush the stones without success. The dye used only got more and more backed up. They then moved on and removed the gallbladder without a problem. Afterwards the decision was made to attempt one more time at flushing the stones out of the duct. They inserted more dye and flushed the stones successfully through the duct eliminating the blockage. No more procedures are needed.
The remainder of the day Ashtyn was pretty miserable. The pain was more than anticipated even with regular doses of morphine. She was fairly tearful feeling crummy with incisional pain, shoulder pain, and nausea. With each day the pain will lessen. Chandler, Morgan, and Ethan came to the hospital to visit. Ashtyn didn’t feel well enough to socialize with them, however I was able to read them two picture books and say nightly prayers before they headed home for bed.
Earlier in the morning Ashtyn’s oncologists told us that they were very pleased with which surgeons were on call over the weekend. They were thrilled that one of the best surgeons at Primary Children’s Hospital would be operating on Ashtyn. She is a “high risk” patient and needed the best. During the procedure, I am grateful the surgeons decided to try one last time to clear the stones that were causing the blockage in the duct. The success saved Ashtyn another procedure that would have taken place in a couple days, prolonging recovery and increasing the risk of infection. I am grateful her gallstones were discovered now rather than in a few weeks when she will be battling the bone marrow transplant. The complication of a blocked bile duct during the transplant and facing a surgery more immunocompromised than she currently is would have been a huge risk. Ashtyn could have been much worse off had her liver or gallbladder been infected or if she had gone on too long without medical intervention. God’s tender mercies are obvious.
“Some may count this experience as simply a nice coincidence, but I testify that the tender mercies of the Lord are real and that they do not occur randomly or merely by coincidence. Often, the Lord’s timing of His tender mercies helps us to both discern and acknowledge them.” Elder David A. Bednar