Things have not improved at all. I vomited blood this morning. I drank too much fluid too quickly at breakfast which caused the urge to vomit, but then there was fresh blood in it - like the night I came into emerg here. My platelets managed to hit 20 a few days ago, and I was optimistic, but they are now back down again. My bilirubin keeps going up, and I keep getting more and more jaundiced.
My surgeon visited and suggested a few things. One is that I should transfer down to the main hospital where he is where my oncologist is, so that people who know my history can be involved in my care. He said that the worst case scenario here is that my liver itself is failing at the cellular level, in which case I could be close to catastrophic liver failure. The other major risk is that might I start to bleed uncontrollably. So, because of those possibilities, he agreed with the medical team here who suggested that I need to have a "family meeting". I didn't really understand what that meant until he explained it to me. I thought it was a kind of group meeting just to make sure all the teams were on the same page for what is going on with me, but he said it was more to draw lines as to at what point I would want to be still kept alive if something catastrophic happens. Thus the involvement of both the docs in charge of me, and my family.
By the way, we haven't heard back from my original surgeon in Vancouver yet, but the 2nd opinion here (from the more adventuresome surgeon) was also that the tumours can not be removed, given all the aforementioned reasons. Essentially nothing on that front has changed much since March, if anything it is worse now.
So tonight I am NPO (nothing to eat or drink) because tomorrow I might have a scope again to look at the bleed in my stomach, and I will definitely have another cholangiogram to check what is going on with the tube.
