Platelets: No one has any idea why my platelets suddenly dropped to 25. One idea is that the spleen is eating them, in which case I might need to have my spleen removed. However my spleen has been enlarged for weeks, so it doesn't fit in with the observation that they suddenly dropped this week.
Bilirubin: I was told yesterday was that my bilirubin might be high because of the left side of my liver going through some death rattle or some sort. This was guessed at by my surgeon's resident because the ultrasound that I did yesterday mentioned again that the left side of my liver was blocked off. But, it has been that way for months, so I am sceptical that that is the problem. My feeling is that the radiologist is wrong. I think the tube has been pulled out by an inch or more. The black line that should be flush with the skin is now pulled out - the nurse noticed this first, and this is causing the bilirubin/jaundice problem - especially if it moved the internal stent too. This time, I had the same radiologist who did the tube change from hell, so I don't trust him at all, frankly.
One piece of good news is that blood test I did yesterday showed the liver function indicators are still ok, so the right side of my liver is not dying. Not yet. The other thing was that my bilirubin dropped from 136 to 126 - from Monday to Tuesday... naturally, no one knows why.
Future Cancer Treatment: - more guessing. Since cholangiocarinoma is basically unresponsive to treatment, this is all guesswork somewhat. Looking at studies, they all show mediocre gains, but never big reductions in tumour size. Currently, I am leaning towards Erlotinib (Tarceva®) because it doesn't harm the blood levels (there are other side effects), although since Gemcitabine is so commonly used to fight Cholangio, I feel like I should try it, even though it is systemic and I had such a rough time last time with all that systemic chemo. I really don't want to go though that again. I still need to see my surgeon to discuss - well, everything, but one thing would be Radiofrequency Ablation. I need to sort out my more immediate problems first, however.
So, I need to talk about the rest of what the hell is going on with me with my surgeon. One very troubling and annoying development is that my whole liver is in pain. The painquite intentse sometimes, it migrates out to my ribs (the nearest nerves I suppose) and I have to increase my morphine dose to combat it. My surgeon has a clinic on Friday, so I will try to endure everything until then. If things get worse, I will call/go in, of course.
