10/13/2009 10:17:00 PM
Prescott woman gets rare transplant
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A month after Prescott resident Judy Gustafson's small intestine transplant surgery at University Medical Center in Tucson, she can eat two small meals a day for the first time since April.
Gustafson, 57, said she hadn't eaten a normal meal since April 7 when she fell ill and doctors at Yavapai County Regional Medical Center found her small intestine blocked and dead.
Since then, she's received all her nutrients through an intravenous line, which is called total parenteral nutrition or TPN. People on long-term TPN risk liver failure and infections which are life-threatening, said Dr. Rainer Gruessner, professor and chairman of the University of Arizona department of surgery and vice chief of abdominal transplantation.
"I'm only on TPN every other day now," Gustafson said. "I'm planning to be home for Thanksgiving."
Gustafson, who moved to Prescott in 1992 from Minnesota, said she needs to stay close to University Medical Center for a while longer so doctors can monitor her.
"I'm making progress little by little, but the hard part is being human and being impatient," Gustafson said.
She said she's trying to gain back the weight she's lost since this all began, but "I have no desire for malts or sundaes right now."
Gustafson said she had just finished working at Willow Creek School in Prescott as a substitute teacher on April 7 when she broke out in a cold sweat and lost control of her bowels. She managed to drive home where a neighbor took her to the emergency room at Yavapai Regional Medical Center. There Dr. Jay Crutchfield took her into surgery and found her small intestines were blocked, a life-threatening condition, Gustafson said.
"This usually doesn't happen in adults my age," Gustafson said. She added doctors aren't sure how it developed in her.
The condition is more common in children, and they often require a combination liver and small intestine transplant, said Gruessner, who added that two children are waiting for a transplant in the program.
Dr. Crutchfield gave Gustafson three options: seek help at the Mayo Clinic, go on TPN for the rest of her life, which eventually could destroy her liver, or get a transplant at University Medical Center in Tucson, Gustafson said.
"People need to know this option is available," Gustafson said. "I'm going to get back to my lifestyle before. That's my goal."
Gustafson said she went to University Medical Center in Tucson on April 8. Dr. Gruessner, who helped standardize the intestine transplant procedure, performed surgery on her one day later to get her ready for a transplant.
"They (small intestine transplants) are rare procedures," Dr. Gruessner said. "Nationwide, only 150 have been done. None were done in the Southwest until recently when we performed a sister-to-sister transplant."
The first successful small intestine transplant was performed in 1991, according to the United Network for Organ Sharing.
Gustafson had many complications on the road to the transplant, including an infection of the pancreas, problems getting antibody levels down so Gustasfson's body wouldn't reject a transplant, and finding a small intestine with blood vessels that wouldn't get closed off again, Gruessner said.
Doctors finally found a small intestine from a deceased donor that was a good match, Gruessner said.
"I got a call at 6 a.m. to be at the hospital by 9 a.m., and by 3 o'clock I was in surgery," Gustafson said.
"There were some dark periods of time when I didn't think I'd make it, but by God's grace and the help of my doctors, family and friends, I got through it," Gustafson said.
Gustafson said she is impressed by and thankful for the care she has received at University Medical Center. She also said her three sisters, who are all nurses, have helped her a great deal. Her sister Patty has been by her side helping her since April 8.
"She has family up on the Rim," Gustafson said. "As soon as I get better, she can go back home to them, and I can go back to my home with some help from home health care."
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