Not really any new information to pass along at the moment.  We do need to send up some extra prayers for Mallory"s kidney numbers to improve and for the doctors to determine exactly what is causing all this.  Lots of different tests are pending, we need a diagnosis.  As we said earlier today it does appear to be some type of virus/infection, we just need it identifed.  Mallory was waking up some today and becoming aggitated and trying to communicate with us. She did write us a few notes also.  We will update again tomorrow after we know more.  Thanks so much for all the kind notes and for the prayers.  The Smiths

Well it’s been a long day here at Emory! Mallory has been resting comfortably all day (she really needed it). So we spoke with the Dr.’s and here’s all they had to say.

She is responding well to the ventilator. They have been able to reduce  the oxygen % from 90 to 50 (Mallorys doing more of the work now). Her kidney numbers have gotten a little better which was good news since they were giving her laics to remove excess fluids. We should know the biopsy results by tomorrow afternoon (keep your fingers crossed). Mallory did test positive for gram negative rod bacteria but they already have her on 3 different antibiotics so she should be covered. They have changed one of the medications that they are using for sedation since it can trigger pancreatitis. Dr. Ram thinks that all of the issues Mallory is having have contributed to the bilirubin being high, the other liver functions are almost (or are) normal which indicates that her liver is still functioning well.  They will still be assessing Mallory day by day to decide when she can be removed from the ventilator. The Dr. did tell us today that if Mallory had her oxygen levels stabilizer she would have died within 24 hours.

Thanks to everyone for ALL the prayers and sweet messages you have left for Mallory and our entire family.

The Smith’s

Mallory"s breathing all day has been very shallow and labored. During the late evening and early morning her oxygen levels were up and down she had a host of nurses and doctors in and out of her room. At about 3 am her oxygen levels got dangerously low and the floor nurses called a "Code" which meant that the crash cart team was summoned to her room. Mallory has been transferred to ICU here at Emory.Since her beathing has not changed they are intubating her (placing a breathing tube down her throat and regulating her oxygen levels). As the Dr."s have told us she can not continue breathing at the rate she has been for the last 24 hours. There are several speculations why but for now they are intubating her and will be giving her lasics to assist in removed excess fluids. Will keep you posted as we know more.Please Please pray hard for our sweet Mallorys recovery.

The Smith family

We wanted to give everyone a update on Mallory’s condition. They have yet to do the live biopsy for several reasons.
They need to start a second IV line and they are unable to do so (her veins are now very fragile). So they have had to call in the PICC team to start a PICC line. Mallory’s arms are all bruised from all the blood draws and blown IV’s.  They have been giving her several blood products this morning including a IV anti-biotic since she started running a fever during the night. They are doing the biopsy procedure different than before, they are going through the jugular vein in her neck (yikes). The procedure will probably be longer but also be safer for her. The more concerning fact is that her bilirubin jumped from 7 to 13 over night (should be less than 1.2 so that is of greater concern now. They are scheduling a ERCP test for tomorrow to check her bile ducts again. All of the above is very concerning to us, Mallory is very upset so we spoke with the liver team outside of the room to ask them the tuff questions. Since we have been so involved with Mallory’s health over the past 4 years we have become very aware of the things that we should be more concerned about. So when we talked with the doctors we pointed out the facts that the only reasons her bilirubin could be going up were from a blockage, inflammation/infection of the liver or the liver has stopped functioning properly. The Dr’s did agree with us but are holding off with any diagnosis until the biopsy and ERCP test are done and the results are known. I guess all those biopsy’s in the past were a good thing so they will know exactly what changes (if any) have occurred. So right now we are praying either of the first two (really don’t want either but if we had to pick any of these, the first two would be the best). The endocrinologist did come in and tell us that her calcium levels are now back to normal however they will continue to monitor them dailygan. I will keep you updated when I have more information. 

 Lisa and Mike

Sorry there was no update this morning.  Mallory did have a pretty rough night last night, vomiting again.  The docs came by and said that across the board every thing looks a little better.  They told Mallory she looked better and she did say she felt a little better!!  Her meds have all been changed back to oral from IV, please pray she is able to keep them down.  She was given albumin and lasiks again today and is suppose to start getting IV fluids again but at a slower rate.  She had a pretty good day but did vomit once.  She seems to be a little better today and we will certainly take that.  Mike came down and spent the day here with her and I went home for most of the day, I hate not being here!!  My dear friend Rhonda insisted that she take care of me, so we went to lunch and did a bit of shopping and ended it with a Zaxby"s milkshake.  Mallory"s wonderful friend McKay and her mom visited today and Mallory enjoyed seeing them.  Then tonight our awesome friends Greg and Dana came down and brought dinner and it was wonderful.  Thanks to Rhonda for the fun and also the pajamas and socks she sent to Mallory.   Thanks to McKay and her mom for the visit, flowers, stuffed animal and other fun items for Mallory.  And, thanks to Greg and Dana for the company and wonderful meal!!  We love you all!!  Thanks for checking in and most importantly for the prayers, they are working!!!  Lisa

Dr. Parekh performed the scope today, Mallory has several areas in her esophagus that are inflammed and several areas with ulcers.  He is doing a biopsy on a few spots and we hope to have the results at some point tomorrow.  Once the results are in he will know how to treat the ulcers.  Mallory has been getting constant IV fluids,has received 2 doses of  IV antibiotics and also a dose of IV magnesium as hers was low today.  All her oral meds have remained the same, they are adding another med for reflux.  She is now on a liquid diet and was able to keep down some jello that she ate earlier.  If she is able to keep the liquids down she can probably slowly start eating regular food again.  The chest xray and the abdominal ultrasound were both normal.  Right now she is down getting the MRI.  It has been mentioned that she is somewhat anemic so they might decide to give her a bag of blood.  I handle everything pretty good around here....however the part that freaks me out is seeing the blood hang on that IV pole and go into her....it has always freaked me out!!  But I know it is helping her so I can handle it.  The docs are focusing on her stomach issues for now then we will revisit the Bilirubin issue.  I have expressed to them today that it is time to be more agressive and figure this all out!!  i am ready to see my sweet Mallory feel better again.  I will update again tomorrow, thanks for continuing to pray for Mallory and our family.  Lisa

Hey it"s Mallory.

I have an amazing story to share.

So if you see the previous post you will read about what happened to my toe. Well i could barely walk, and was kind of stressed out because of everything that is hurting and this broken toe added on was just not ok. So i went to bed last night around 930 and had a little conversation with God. I asked Him to heal me, that I needed to be able to walk right now. Then I went to sleep. I woke up around 1030 to use the restroom, and when i got out of bed i started walking normally, with no limp. I looked down, and the giant bruise that was on my foot had faded almost completely. I was almost brought to my knees in awe of our amazing Lord. He had almost instantly answered my prayer. It was just amazing, i was brought to tears! This goes to show the magnitude of the power of prayer. Everyone, right now- whatever it is in your life that is bringing you down- pray about it. right now, just say a quick prayer. we serve one AMAZING God!!

Had to share this with everyone, i am still in amazement.

Hey it"s Mallory. I had labs today and everything is looking good! My bilirubin went to 3.9 which is down from last week! Don"t know yet if i will be able to decrease the prednisone but im crossing my fingers!! I"ll go back next week for labs again and i hope they continue to get better.

Thanks for checking up on me

Mallory

Hello all!  We went to Emory today for Mallory to have labs and a visit with Dr. Ram.  Her liver enzymes were perfect, bilirubin is now 3.9, which is lower than last week!!!!  Everything else was stable and Dr. Ram seems pleased with the ways things are going and he reduced the prednisone again down to 10 mg.  Some of you may remember that horrible shoulder pain that Mallory has dealt with off and on since her first transplant, well it has really been bothering her alot and seems to be getting worse.  The doctors have never really given us a diagnosis for this, they just treated it, although it has been referred to as "referred pain".  Also, the only thing that ever really helped with the pain was having shots directly in the spots where the pain is.  So, Dr. Ram examined her shoulder and decided to get an xray just to make sure they are not missing anything.  We don"t know the results yet but I am sure Dr. Ram will call us if he sees anything.  He did give her a prescription for a muscle relaxer so we will see how that works.  Mallory will have labs again in one week and see Dr. Ram in three weeks.  Thanks for checking in!!  Lisa AKA Nana to Dierks!!

Hello everyone!  Mallory went to Emory today for labs.  Her liver enzymes were completely normal.  Her BR was 4.4 which is slightly down from last week of 4.6, YAY!!!  All her other numbers looked pretty good too.  She will go again on Monday for labs and to see Dr. Ram.  Remember that awful shoulder pain she was having for a while, it seems to be bothering her again so we will discuss this with Dr. Ram.  Maybe they can do the shots like they did a few times at Elgeston as it seemed to really work for her.  She continues to be pretty tired but is slowly tyring to be more active to regain some energy.  We will post again after Emory visit on Monday.  Thanks for checking in!  You know you are here but Mallory doesn"t......please leave her note!!  Lisa AKA Nana

Hey guys, it"s Mallory. I will try to do the update the best I can, however with all the meds I am on my memory is not as sharp so I"ll try not to leave anything out!!

Over the past few weeks I have been having very bad episodes of swollen legs and ankles at the end of each day. Along with this, i was becoming lethargic and always felt sortof "out of it." I had been having difficulty concentrating, had been aching, and over all feeling like crap. After trying to assess this and figure out what could be causing this, my mom realized it all started when i began norvasc ( my blood pressure med) and got worse once they increased the dose. We researched it, and all of these were listed as adverse effects. So i stopped my norvasc and notified Dr Ram. My symptoms seem to be improving now that I am off it, and will just monitor my blood pressure daily.

This morning my dad went with me to Emory for labs and my appointment with Dr Ram. My liver numbers are improving, including the biliubin. It was down to 4.6. Dr Ram seems to think the reason it isn"t normal is because my liver is still recovering from inflammation and it takes the bili longer to come down than the rest of the enzymes. Kidney function looks good, and my blood counts are all good too. I was able to reduce my prednisone a little bit more! Yippee! Dr Ram wants to see labs again next week, and then another appointment with him in clinic the following week. He wants to keep a very close eye on me for a while. He mentioned that the next 3-6 months will be crucial in helping to determine a more clear "prognosis" for me, although it is understood with transplant that you can never be given a true prognosis, because things can change so quickly. Overall it was a very good visit.

I had to come to a tough decision today. With all of my energy and concentration being lost to medicine, it has been extremely difficult to do well in school. Also, given the amount of time needed to put into my health care, it makes it harder for me. I decided I will take the rest of the semester off from school, and use my energy to focus on healing. My health needs to be a priority right now, and unfortunately i cannot juggle classes with everything that my body is going through. My family is extremely supportive and I cannot thank them enough. It can be difficult to admit when you"ve taken on too much, and backing down from a challenge is hard for me to do. So thanks to everyone who is supporting me through this and understanding. I ask that you pray I will start feeling better soon so we can move past this! Thanks for all of my team mal-ites for helping me along in this rough process. Im proud to call you all friends!

Thanks for checking in

Mallory

Mallory went for labs today. Her kidney numbers were good, liver numbers were good except for the bilirubin.  Her Bilirubin is now at 5.2 which is up from last week, not sure what to make of this.  A few extra tests were ordered today but we do not have the results back from them yet.  Mallory has been tired this week, having some stomach issues and not feeling great.  We will wait for the remainder of the test result to come back and to hear from Dr. Ram and will update again when we know more.  Please keep those prayers going, we need some answers!  Thanks and have a good night.  Lisa AKA NANA!!

Hey guys, Its Mal!

Today I went into Emory for labs and to visit with Dr. Ram. They were running so far behind, i had to wait an hour and a half just to get my labs done. Once I got back, my veins did not feel like cooperating so it took three sticks but finally got some blood. It wasnt so bad though, Ericka who works in the lab always keeps me laughing, and her funny jokes put me in a good mood.

I saw Dr Ram and discussed my labs. They are all stable. My bilirubin is still a little high at 4.5 but my other numbers are slightly down. Dr Ram decreased my prednisone a little more, because I am just not doing well on it (emotionally.) If things continue to go well he will continue to decrease it. Also, the results from my bone scan were back. It showed i have Osteopenia which means my bone density is lower than it should be. This is most likely because of the prednisone too, so contributes to why he is really hoping to get me off of it. Overall it was a good visit, and I will go back next week for labs.

Before I left i got my flu shot, so my arm is a little sore from that but not bad at all, im glad i was able to get it since i am on such high immuno suppression!

I want to thank everyone for keeping me in their thoughts and prayers. All the support really helps and please continue to pray... I will need prayers to continue so that i can continue to heal! Hope everyone has a great week!

Mallory

Today is Mallory"s 3 year anniversary of the 2nd transplant, Izzie! We are so very thankful for the donor and are still praying for the family.  If you are not an organ donor you should really think about becoming one, you could save so many lives and be a HERO!!!  Mallory is not feeling well tonight so please if you have a moment send up some extra prayers!  Michael and Angela went today for an ultrasound and IT"S A BOY!!!!!  YAY, we are SO excited!!!  Have a good weekend and look for another update soon!!  Lisa

Hello everyone, just wanted to give an update on what is going on.  Mallory hasn"t felt that great for the past couple of days and she has been having some issues with her kidneys.  So, she emailed Emory and this morning received a call that they wanted her to come in today to have labs and see the doctor.  So we headed down to Emory around lunch time and they were really busy!!  Dr. Ram has ICU duty this week so we were not able to see him, he had Dr. Ford see Mallory.  Her labs were stable and almost the same as they were on Saturday.  Her kidney numbers are still slightly high and so are her liver numbers, Bilirubin is 5.2.  The final results of the biopsy are in and I am really confused about what they are!!  It appears that Mallory has some underlying chronic rejection and possibly some type of auto immune markers.  I am not completely clear what all this means but I will ask Dr. Ram to further explain.  Anyways, the treatment for both of these issues is basically to keep her on high doses of prednisone and try to get things under control and back to normal.  So, she will continue on the current medicine dosages and be seen next Friday the 24th for labs again and also see Dr. Ram at that time, he is still overseeing any and all changes.  Please keep praying for Mallory and we will update again in a few days, pardon any typos....I am tired!!  Lisa

So, we are home!!  Mallory"s Bilirubin went down this morning from 6.4 to 5.6 and other enzymes were about the same as yesterday, almost normal.  She was give some fluids and Dr. Ram made a few medicine changes.  Some of the biopsy results will not be in until later in the week so we will post more once we hear.  Mallory will go in at the end of the week for labs and will be seen in the clinic by Dr. Ram in two weeks.  Please continue praying for Mallory, specifically for her Bilirubin to return to normal and for her itching to stop.  Thanks for checking in on Mallory and be sure to leave her a note tomorrow....it is her BIRTHDAY!!!!!  Lisa, ROLL TIDE!!  PS, The photo below is Mal"s leg, it is from the horrible itching!!

ERCP done. The Dr. said that Mallory"s bile ducts looked great (no blockages). Dr. Ram wants to go ahead and do a biopsy today (so he can hopefully get results today) so we are on our way to clinic. Stay positive and keep praying and I will let you know what going on.

Lisa