ERCP - 1/24/12

I'm scheduled to have an ERCP (Endoscopic Retrograde Cholangiopancreatography) on February 7. Until then, I'll be getting a chemo break. My liver is worsening, with the bilirubin continually rising. My oncologist has done about all she can do with the fluid and antibiotic infusions, so she sent me to a gastroenterologist. Since I had to miss my chemo treatments this week because of the poor liver function, she rescheduled me for next week for chemotherapy. Even though my bone and CT scans from Friday were unremarkable (some tumors had shrunk and others had grown), she's declaring me "stable," and I get to remain in the clinical trial. But she can't treat me if the liver continues to fail. I'm sure she'll be disappointed when she finds out that the procedure can't be done before next Tuesday. They did tell me that if there is a cancellation, they will move me up on the schedule. If I have the procedure on February 7, I will have missed a whole three week cycle of chemotherapy. We're in a dilemma.

After my oncologist and the gastroenterologist consulted, looking at scans and liver function, they concluded that a bile duct may be blocked. The ERCP is a procedure that involves inserting a tube through the mouth, down the esophagus, into the duodenum (opening to the intestines), and looking at the liver. A dye will be injected for an x-ray, and a search for any blockage of the bile ducts will be conducted. Since the liver tumors are so extensive, it's a possibility that one of the tumors is causing the blockage. If the gastroenterologist can remove the blockage, a stent will be inserted to keep the duct open. It's a relatively simple procedure if everything goes well. There are risks of bleeding, infections, inflammation to the pancreas, or a perforation to the intestines. The more common side effects after the procedure are a sore throat and stomach pains. It's an out-patient procedure. They will only give me what I call the "happy drug" (for relaxation) and a local anesthesia for the esophagus. If there are no complications, I'll be able to go home on the same day as the procedure.

It's funny how you learn to live with certain things that are going on with your body. I don't even really notice the symptoms of liver failure. My oncologist and I had talked about the dark urine. I thought that I was just dehydrated and continued to drink more water. My skin has been really itchy lately. Until the gastroenterologist asked me about it yesterday, I thought it was just dry skin from the winter weather (although I lotion up regularly). I had a little jaundice when I was admitted to the hospital in December. The whites of my eyes had turned yellow, but they are back to normal now. The nausea, headaches, and dizziness are so common for me, but the gastroenterologist asked me about those symptoms as well because they could indicate liver failure, too. I do have pain on my right side occasionally, but I've become accustomed to having pain. I'm always at a lost for words when my oncologist asks me if I have any new pain, lol.

Well . . . all I can say is that I hope the ERCP gives us some insight on what's been going on with my liver. Let's fix it, and get back to the chemotherapy. We have some tumors to knock out of commission.