In My Shoes: Bronchial Artery

Saturday, July 26, 2008

Bronchial Artery

This is an example of an enlarged bronchial artery. This is NOT Fiona's........

Notice the arrows. That is where the bronchial artery is enlarged. Fiona's right bronchial artery is also enlarged 3 times of what it should be. This is the MAJOR CONCERN. They have already embolized part of the bronchial artery (see the star for approximate area) since she was bleeding from there. This artery is very high pressure and very dangerous if it can't be managed.

Now silly us, but I thought there was an AVM at the point of bleed when they embolized her bronchial artery. But that is, in fact, wrong. There wasn't. (Um learned something else yesterday) It was just the bronchial artery itself bleeding. You know, I don't know how much is we misunderstand what they are saying, we thought we knew and didn't ask the right questions, they aren't really telling us what is really happening or we are just crazy but I could swear they told us it was another AVM........um....a little frustrated and feeling like they are not telling us everything. I would rather be told than to find out later there is something far more serious going on. NO ONE ever said this bronchial bleed was any different from the other bleeds. Truly her pulmo nor liver doctor ever made a differentiation between her bleeds. So I guess this is one reason why we were caught off guard with this. And why has it taken UCLA to sound the alert? I don't know why her pulm didn't feel this was critical enough to figure out what is going on and whether she needs part of her lung taken out.

I did ask her pulm doctor yesterday if they can't figure this out, where do we go fromm here. He looked at me a little insulted. He said between him and the UCLA doctor they should be able to come up with some better ideas. "Ok, so if you don't, where do we go?" HAHAHAHA He response was, "Where is there to go?" Well, I'm sure some institution in the US is a leading institution on lung problems. I don't know. I sure as heck am not going to have her lung taken out without someone who KNOWS about this stuff give us advice. This isn't going to be one of their experiments and research papers without a fight. I still just can't make sense of all of this yet and hopefully, I'm praying hard, we don't even have to cross this bridge. This has to be bad dream.

Peggy

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Biliary Atresia

Biliary atresia is a condition in which the ducts that carry bile from the liver to the gallbladder and small intestine are not normal. These ducts can be injured, blocked, or missing. When the ducts that carry bile out of the liver are closed, bile backs up and damages liver tissue. In time the liver can develop scarring or cirrhosis. The gallbladder may also be abnormal or missing. The cause of Biliary Atresia is unknown. It occurs in one infant in every 15,000 live births. It is a serious disease which requires immediate surgical and medical treatment.

Arteriovenous Malformations AVMS

I have been diagnosed with AVMS in my lungs do to my liver disease. These have caused me to have 2 lung bleeds which were very scary. I still have more AVMS and they are causing me breathing problems. Below is an explanation of what the AVMs are and a picture of what is happening in my lungs.

Arteries and veins are part of the human cardiovascular system. Normally, the arteries in the vascular system carry oxygen-rich blood at a relatively high pressure. Structurally, arteries divide and sub-divide repeatedly, eventually forming a sponge-like capillary bed. Blood moves through the capillaries, giving up oxygen and taking up waste products from the surrounding cells. Capillaries successively join together, one upon the other, to form the veins that carry blood away at a relatively low pressure. The heart acts to pump blood from the low pressure veins to the high pressure arteries.
If the capillary bed is thought of as a sponge, then an AVM is the rough equivalent of jamming a tangle of flexible soda straws from artery to vein through that sponge. On arteriogram films AVM formation often resemble a tangle of spaghetti noodles. This tangle of blood vessels forms a relatively direct connection between high pressure arteries and low pressure veins.
The result is a collection of blood vessels with abnormal connections and no capillaries. This collection, often called a nidus, can be extremely fragile and prone to bleeding.