Dr. Wheeler, the internist, told us more about Mark's bile duct procedure, ERCP (Endoscopic Retrograde Cholangio-Pancreatography--that's a mouthful!) The stricture in the bile duct made it difficult for the surgeon to reach the blockage. After placing the first stent at the obstruction, he tried unsuccessfully to place another further down, as he was concerned that one stent would not be enough to allow drainage. The duct is soft tissue, and if he pushed too hard, he could puncture the duct, causing bile to leak into the tissue, which would cause REAL pain.
Mark's bilirubin numbers continue trending downward. Initially, it was 11 times the normal amount, and this morning it was down to 8. It's slow, but at least the stent is allowing the bile to gradually escape. Mark is still quite yellow, but other indicators are positive (i.e., a little lighter urine and darker stools -- in case you really want to know. Sorry, maybe that's TMI)
The pancreas was likely irritated by the stent placement, but was that the only reason? Interestingly, Mark has had pancreatic-type symptoms for quite some time. He has complained of pain in his upper abdomen, especially after eating. In hindsight, we recognize that eating rich foods increased his pain. Even when Mark was in the hospital for his IL-2 treatments, and the oncologist would ask where his pain was, he would point to the same location in his belly. They seemed baffled because the tumor in his liver was on his right side. At that time, we didn't know about the tumor near the pancreas.
Yesterday, Dr. Wheeler couldn't give us any indication of how long this hospital stay would be. Some patients heal in days, while others are weeks or even months. As soon as Mark can tolerate mild foods and water, take all of his medications orally, and have manageable pain, he can go home. Mark has been on a clear liquid diet for the past two days, and the pain has decreased significantly. Twice today, he went 6 hours between his 10 mg. dose of Oxycodone. He hasn't been able to do that in weeks. This morning, Dr. Wheeler was impressed that Mark had eaten cream of wheat for breakfast without subsequent pain. He indicated that Mark could be discharged as early as Monday. Dr. Wheeler allowed Mark to have a non-restricted dinner, so he had pasta and sauce. That didn't set as well, so he had to have Oxy in 4 hours. Even so, the pain was not as intense.
Could it be that it's not the actual tumor causing the increased pain? It seems more likely that it's pancreatitis, although the tumor near the pancreas could be causing the inflammation of the pancreas. It's all a big puzzle, but more pieces seem to be falling into place.
The difference in the way Mark feels today versus Friday night is amazing! Today, he talked more, checked emails, did some texting, listened to Church and General Conference talks, and hardly slept at all. That's a significant difference from even yesterday. This is fantastic news!
All of your prayers and loving support are making a difference! Thank-you!!!
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