Hi folks! Hope everyone is well. I have two updates on Marye from the past week or so. Thanksgiving week came in with a bang as Marye was suffering from pretty serious nausea and vomiting after her last chemo (the week before Turkey Day.) She spent Saturday and Sunday in bed, not feeling well at all. By Monday, she had had enough of laying around and wanted to go grocery shopping. But as soon as I got her into the sunlight, I could see that she was completely jaundiced. I mean, she was doing her best impersonation of a pumpkin pie. That's the best way to describe her color. I don't know if the jaundice just came up on Monday, or that I hadn't noticed it at home under the yellow lights in the house. Anyway, we had company coming and Thanksgiving dinner to plan, so we went into the grocery store. Thanks to my Star Trek-like communicator (smart phone), I was able to shoot off an email to her oncologist right away with this new development. In the meantime, we filled a shopping cart full of food, although we hadn't gotten to the turkey, yet. Twenty minutes later, Marye was sick enough that she just needed to go home. I left the (full) cart in the aisle and took Marye home, planning on zipping right back to the store to pick up where I left off, and hoping that the milk I had in the cart hadn't spoiled too much.
By this time, though, Dr. Riley responded that if Marye was really jaundiced, she needed to get her blood drawn. Right now. Of course. So, the kid at the Meijer was forced to restock all of my groceries as I had effectively abandoned them and took Marye downtown to the cancer clinic. An hour later, we got the results of the blood work, and, as expected, her bilirubin was really elevated at 6.9 (normal is <1.0). A few calls to Dr. Vitale's office, and we were ready to head to Norton Hospital for an emergency ERCP. This was a good thing, since I wasn't sure that the doctor would even be available, with the approaching holiday and all. In short, Marye's stent was blocked, thus the elevated bilirubin. We were really lucky to get the ERCP done when we did, since that condition does not get better with time. Had we waited another day (or six), she could have easily been down with another septic infection from the stent. The ERCP went smoothly and I got her home that night around 11:30 pm.
It took a few days for the bilirubin and jaundice to clear, but she did start feeling somewhat better. It actually took longer than I expected, but it did start to clear up by the weekend. Our company came, and we had a nice holiday. Marye was a trouper, too. She did many of the side dishes for Thanksgiving. Good thing, too, since I haven't figured out those peas and onions, yet.
Since she was pretty shaky last week, we decided to hold off on the chemo. So, that was today. She got her blood drawn and eventually did get the treatment. However, Dr. Riley was not thrilled with the blood work since Marye's liver is not functioning well. I'm not sure of the physiology of it, but the enzymes and the bilirubin were all pretty high. The bilirubin is down from 6.9 to 1.9. That's an improvement from last week, but still a concern. The onc thinks that her liver is still recovering from the irritation last week. I can buy that. She bumped back next week's chemo to the following week and we'll check her labs again on Thursday. As of this writing, Marye is having some nausea that we (again) are attributing to the chemo today. We'll see. She's not jaundiced and I'll check her in the sunlight tomorrow to keep an eye on that. She's had ERCPs in the past that did not go well or caused infection, so I know what to look for and won't hesitate to bring her downtown if she gets any fever or anything.
Moving forward, we're just watching her liver and hoping that it settles down after last week's shenanigans, and she should be back on a regular chemo schedule in the weeks after that. The ERCP that was scheduled for Dec. 17 is no longer necessary. Otherwise, things are just moving along.
