Last night I looked in the mirror as I was brushing my teeth, and noticed that I was quite jaundiced, it was easy to tell in the eyes, and then I looked at my skin in places that don't get exposed to sun (which is almost everywhere) and it was yellow there too. I had an appointment lined up with my oncologist this morning anyway, so I called ahead before that to let them know that we would definitely need to do a blood test to check the bilirubin level. Mine has been moving around between 25 and 45 over the last few months. Today it was over 140. The other odd thing is that my platelet count dropped to 25, when it should be over 100. Actually I think 150-300 is normal. Apparently the platelets could be gathering in my spleen - I have no idea why. My other blood levels were ok.
We discussed possible future treatments. I am not really willing to do another heavy round of systemic chemotherapy since the last round was so rough and was only marginally successful, or indeed, it might have done nothing, it might have all been the radiation. So Radiofrequency Ablation might be an option, also he suggested we could try Erlotinib which is ~$3000 a month.
Since my oncologist doesn't know about bile tubes, he suggested I walk over to see my surgeon to ask more about the jaundice. The surgeon was busy in surgery but I got to see one of his residents, who agreed with me that I needed to go to interventional radiology ASAP to get them to do a cholangiogram to see what was going on.
So... back over at interventional radiology again, waiting around a bit, but thankfully they were able to squeeze me in. They did a cholangiogram, changed the stitch and the dressing. The cholangiogram showed that the internal stent was blocked. Again. I was surprised by that since it seemed to be flushing ok. I flush my bile tube every night with 10mL of saline. The radiologist said he has no idea why my bilirubin had suddenly jumped up to 140 - so he sent me back to see my surgeon's resident. So back over to the other building again...
The resident said there could be a number of causes. Ranging from something simple like a gall stone, to the right side of the liver losing function, presumably due to loss of blood flow from being choked off by the tumour, and dying like the left side did some months back. Of course the later scenario would be very bad. I only have one liver.
This Wednesday I am now scheduled to have an ultrasound of my liver and also to do a more detailed blood test to break down the bilirubin measurements to determine the source. Sorry, I don't recall clearly what he said about that. On Thursday I will go in to see my surgeon who doesn't have a clinic but will run up to see me between operations to talk about the results of all of this.
Meanwhile I am jaundiced, and concerned.
