Liver Disease: Investigating my wife's passing
My wife passed away on Jan 30th 2023.
But, I am trying to understand what happened to her. There is still an investigation going, but she became physically decompesated while they tried to figure things out. Got COVID, RSV, caught a horrible ESBL UTI, eventually passed away after a nurse set an IV wrong on a vancomycin drip, and she got 4 times the max dosage, was toxic and passed from renal failure due to toxic vancomycin.
But the doctors kept arguing on did she have cirrhosis? not have cirrhosis was she in liver failure… it was horrible.
Anyhow while in Las Vegas they did two biopsies, as she had a mass on her liver. Left LFTs were all normal, and her CT showed fat infiltration and a slightly enlarged liver with a cyst compressing the IVC vein. MRI same fatty liver, PET fatty liver. Ultrasound said fatty liver with smooth contour, patent portal vein with proper blood flow. Portal vein pressure normal.
She had a hitial hernia, no varacies but the GI showed gastropathy? a very bad mucus lining. The GI doctor said due to portal hypertension even through the portal pressure was normal. Another doctor was saying the mucus was damaged from the acid reflux of the sliding hitial hernia.
The biopsy of the mass on the left lobe showed fibrosis grade 2, with ballooning. The other biopsy from the nonmass showed normal liver with no issues.
Her billis bounced all over the planet from normal to 2-3 times above normal. Doctor thought it was due to the AKI from the ESBL.
Her Albumin levels would bounce around a lot from normal to below normal.
All her liver panels showed normal, except GGT which was just a point or 2 above normal.
We WBC was high, her RBC low, and her Hemoglobin bounced around a lot, from just below to just normal. Every time they would give her blood or albumin her Billis would jump. She had a slightly enlarged spleen. A test showed she had abnormally high immature red blood cells and a high death rate of red blood cells.
Her INR stayed normally in the .0 to 1 range, but since she was hospital bed bound for nearly 3 months, they had been giving her heparin and her INR climbed for a while maxed out at 2, then dropped back down to 1.
She had a positive hep a hit.
An old Doctor had come in the week before she died and said your wife does not have a sick liver. I do not know how these nuts prognoses decompensated liver disease. She is severely malnourished from not eating proper at the hospital. And we need to put a feeding tube in. But her blood panels are GREAT. He said I suspect since your wife has an auto-immune cant remember the name it affects the thyroid and salivary glands he said it can impact the gallbladder, and imaging shows a lot of sludge and slightly dialted ducts. So I suspect her GGT elevation is due to that.
But on that Thursday she was great, then coded with a mucus plug from pneumonia… was pulling out like a champ, she was on optiflow, and was down to 38% they figured one or two days and she would be back on room air. On Sunday she looked really weak and had trouble talking over the optiflow.
They only had a resident on the floor that night. And she said she will be okay her numbers are good. She is just weak.
I came back Monday morning and she was gone, initially, they said sepsis, then said renal failure from Toxic Vancomycin levels.
But the one doctor keeps saying she had cirrhosis due to gastropathy.
After all that typing can a person have damaged stomach mucus from hypertensive gastropathy? While having normal portal pressure? She did have Grade 4 esophageal erosion with no bleeding.