Tuesday, April 28, 2009

Not such great news

Monday was a bummer. 

We learned that the tumor has indeed spread to encase the portal artery and vein, thus confirming that mom is not a candidate for resection surgery. Two surgeons have reviewed her new scans. I won't speak for everyone in my family, but I think we all felt this was a very real possibility. It's just hard to hear it. 

The other bad news is that mom's external drain is malfunctioning (ie, it's probably plugged or kinked internally). This means that her bile is again building up on the right side of her body, and her heightened bilirubin count proves it. There is nothing we could have done to prevent this. It was always a possibility. She will have another ERCP on Wednesday and they will try to put a stent in on the right side. Remember that she already has one stent in on the left side. The left-side stent appears to be working well. 

Although mom cannot have resection surgery, she is still potentially a candidate for a liver transplant. In fact, the transplant is one reason why doctors have not yet done a real biopsy within the liver to confirm the cancer diagnosis. Having a needle poke in the liver would immediately dismiss her as a transplant candidate. She meets with a transplant team this Thursday to determine if that is a next step. If so, she would likely undergo chemo and be placed on a transplant list, which can mean months of waiting. 

Otherwise, they are trying to schedule an oncology appointment (on Friday) to begin discussing chemo and phototherapy options. She cannot begin either until a biopsy confirms her diagnosis, so the transplant team must first make their determination. 

The secondary key with any treatment will be to keep her bile dispersal under control. It's not easy and prevents mums from walking around or doing anything active and still be comfortable. Nobody likes a big wire going through one's liver. 

No matter how you put it, it looks like we'll be in Rochester for awhile. 

5 comments:

  1. Good Morning Paulette & Greg,

    (and to Mr. Trespasser Cancer, we rebuke you!)

    Indeed, we did not want to hear this news. We revise our thinking, try to get our brains wrapped around a new situation, and continue praying. All works for good when the Lord is in charge.

    We love you. God loves you. Everyone reading the blog loves you. Today is your day of rest. Close your eyes and imagine a foot rub. And Greg, find that bride of yours a piece of french toast.

    The Peace of the Lord be with you this day.

    LOVES & HUGS,
    Susie & Jerry

    PS - excel file coming in your email.

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  2. Good Morning, Paulette and Greg,

    My heart goes out to you ... yesterday must have been disappointing for you all. Down but not out, my friend. I am thankful that you are in Rochester where the best of the best are discussing your case, putting in stents with precision, reviewing tests to determine the best options for your good health, putting the medical ducks in a row [you go there, you there, no, don't try to get out of line, go back to your place, Donald (Donald Duck, you know! Now, I'm on a bunny trail, huh ... or should I say, a duck trail!) and you, Lame, go over there!], analyzing the situation, directing you to rest rather than run [hey, your friends are picking up your marathon miles for you right now, Paulette -- YOU ARE STILL IN THIS RACE BIG TIME], ordering you tasty meals. And I am thankful that Greg is there to spoil you, to hold you, to tuck the covers under your pretty chin, to rub your feet, to push a stray hair back off your forehead.

    God loves you, Paulette. He knows exactly what is going on in your body and in your heart. He will not abandon you; He is right there, too, as real as the men and women in white who are hovering over you and as real as the touch of Greg's strong hand. We are trusting Him to take the loose ends of the past few weeks and tie them all together as only He can to bring hope to your heart and healing to your body. Mary Tyler Moore said it this way: "It's easy to be happy when only wonderful things happen." It's when the race seems all uphill, it's when the rain turns into a downpour on Mile #7, it's when the cup of water accidentally spills all over the pavement, it's then that we have to reach down to something deeper/Someone bigger than ourselves and trust Him completely. I am thankful for the many, many family and friends who are holding up your arms and trusting God with you right this very minute.

    Today's Joke:
    A ventriloquist is onstage, and midway through his performance throws in a series of blonde jokes. Suddenly a blonde stands on her chair and shouts, "I've heard just about enough of your blonde jokes! It's guys like you who keep women like me from being respected."
    Flustered, the ventriloquist begins to apologize.
    To which the blonde interjects, "You stay out of this, mister. I'm talking to the little guy!"

    Encouraging words from Psalm 28:7 -- "The Lord is my strength and my shield; my heart trusts in Him, and I am helped."

    May God hold you close and give you peace. I care about you, Paulette.

    Praying for you with love,
    Joyce

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  3. Hi Paulette and Greg,
    Yesterday a day of frustration, Today a whole new bright day for you both.So glad your together and can rest well today and eat what ever you want plus some.We all have to beleive in the divine prayers of the lord and he's just making us go thro some leap holes to get to the good stuff. We are all with you Paulette each and everyday.I thank God for you. With all my love and prayers Peg

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  4. Good morning to both of you!!! May the lord place a healing hand on you for a complete recovery and may that hand also embrace both of you in his love. The power or prayer is coming to you at this time as we are trying to understand the many mysteries life seems to hold. Kenny and I are thinking of you,Greg, Taryn and Thayne and sending you our thoughts, prayers and support. You have the best around you with family and medical staff. Keep us posted and we are sending our love and prayers.

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  5. Paulette and family,
    I am so sorry to hear your bad news but know that God has a plan and is working to find the best way to handle all of this. Prayers are going on all over Ulysses for you and in your recovery. May God's healing hand be with you as you wait to see what all the doctors find and decide to do. I pray that God comfort each of you and help you each to continue to be strong for each other. Greg take care of Paulette and give her a hug from us. We will continue to pray for better days and better news. We love and miss you.
    Terri & Joe Bill

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