“I couldn’t be happier to be alive and home and have my family here with me, as stressful as the last year has been mentally, emotionally, physically, and financially.”
Darin Koehler grew up in Colorado and has always been an avid outdoorswoman. She loves to run, hike, walk with her dogs, and do anything else that involves being outside.
She also loves to spend time with family, including her five grandchildren, who range in ages from 25 to 1.
Yet Darin’s life was turned upside down after she went into liver failure following a severe reaction to a medication in May 2022. The outdoor activities she always loved began to wear her out. She started experiencing confusion, her eyes were jaundiced, and she noticed that her urine was brown.
She was taken to the local hospital, where doctors informed her family that she had just days to live. Darin was evaluated for a transplant and added to the transplant waiting list. She received a liver transplant just a few days later.
Even though her liver transplant was successful, she developed several intestinal conditions, including intestinal ischemia, short gut syndrome, and an enterocutaneous fistula. She would eventually need advanced care, which led her to the UPMC Gastrointestinal Rehabilitation and Transplant Program in Pittsburgh, Pa.
The Path to the UPMC Gastrointestinal Rehabilitation and Transplant Program
Darin spent 11 months in the hospital after her liver transplant. She had many complications and conditions in that span of time, requiring more than 20 surgeries.
She had intestinal ischemia, which is when blood flow to the intestines decreases. This was caused by a VP shunt she had implanted in 2013 to treat idiopathic intracranial hypertension, a spinal condition that increases pressure around the brain. The tubing from the VP shunt wrapped around her intestines, which caused the decreased blood flow.
During her liver transplant in June 2022, Darin’s doctors noticed that her bowel was very inflamed. Her care team in Colorado needed to remove much of her bowel to proceed with the transplant. She developed short bowel syndrome, which means she didn’t have enough small intestine for her body to absorb nutrients from food properly.
She also developed enterocutaneous fistulas, which are abnormal passages between the small intestine and the skin. This causes stomach contents to drain out of an opening in the skin.
Her liver transplant team knew she needed specialized care that few centers in the United States can provide. The team let her know that of the few centers available, the UPMC Gastrointestinal Rehabilitation and Transplant Program was the best choice for her.
Maintaining Her Active Spirit Across the Country
Darin was taken to UPMC by medical jet in May 2023. Despite her poor health and being in the hospital for almost a year when she arrived at UPMC, she never lost her active spirit.
At first, following her liver transplant, it was difficult for her to get out of bed and walk. She started by walking one lap around the hospital floor in Colorado, which was a large oval.
“I would grab my IV poll and put on my slippers, and I’d go out in the hallway and walk around the hospital floor,” Darin says. “Eighteen laps was a mile – I started out just being able to do one lap, and I ended up walking about three miles a day by the time I was transferred to UPMC.”
She continued this routine in Pittsburgh with her mom by her side. “She’d come to the hospital every single day and we’d walk about a mile and a half in the morning and then another mile and a half in the afternoon.”
When she arrived at Pittsburgh, the team began total parenteral nutrition (TPN) to help improve her strength before she could receive more advanced care. TPN is a form of therapy for people who can’t absorb nutrients from food that’s eaten by mouth. After five weeks of TPN, she went from weighing 104 lbs. to 126 lbs.
The team was able to build her strength up enough to perform the intestinal care Darin required, which involved repairing several parts of her small and large intestines.
She started physical therapy soon after, during which the team worked with her to sit and stand up. She made progress every day and could eventually start walking again. “I was only in the hospital for two weeks after my treatment, and then I stayed in the Family House for a week,” Darin says.
UPMC partners with Family House, a non-profit organization, to provide affordable housing for patients and their family members who travel to Pittsburgh for their medical care. Transportation to the hospital and other supportive resources are also offered.
Darin was able to go home in August 2023, 14 months after first entering the hospital in Colorado. She developed sepsis soon after returning home and required treatment at her local hospital. Her local care team treated the condition, and she returned home a few days later.
Grateful to Be Home
Darin is home recovering from her conditions and is able to walk outside every day with her husband and dogs. Her journey has been mentally, physically, emotionally, and financially challenging, yet she’s grateful for her family and care teams.
“My family is the best,” Darin says. “My mom, husband, daughter, son, and daughter-in-law have been there every step of the way. Without them, I don’t know where I’d be.”
She’s also thankful for the care she received at UPMC.
“Everyone was incredible. The team was incredible – everyone would give me all the time in the world if I needed it, answer questions, and get me what I needed. They tried to accommodate me the best they could.”
Darin’s treatment and results may not be representative of all similar cases.
