We saw Dr. Heger, and he changed Barbara from Cardizem to a form of Lopressor. Unfortunately, her ankle swelling is only slightly reduced. The ankles are still large and uncomfortable. Since she is no longer in atrial fibrillation, maybe we can quit the heart meds entirely.
Barbara had another ultrasound to check for fluid in the abdomen. Unfortunately, she does have fluid accumulating around the liver. So, we have rescheduled the ERCP procedure this week. We were hoping to avoid this invasive procedure, but to no avail. It is done as an outpatient, and takes an hour and a half, followed by an hour of recovery (she is fully sedated). We are apprehensive, but there doesn't seem to be any other course of action.
Barbara had the ERCP procedure on Tuesday. The doctor found that the bile duct did indeed have a stricture near the area where the fluid was accumulating. He instilled a stent, which runs the entire length of the bile duct from the liver down to the bowel. Barbara was completely out for the procedure, and Michelle and I were invited into the recovery room as soon as Barbara woke. She quickly became more alert, and seemed in better spirits than before the procedure. In fact, she started complaining - and she had plenty to complain about. The doctor wanted her admitted so that he can watch for complications, the main one being pancreatitus, since the duct from the pancreas is disturbed during the operation. Although the ERCP was at Norris, she was to be admitted to Keck, since the draining procedure was scheduled for Wednesday morning at Keck. Well, it took hours for then to arrange a room at Keck, and arrange for an ambulance to take her a half mile to Keck. We had arrived at Norris at 8:30 am, and arrived in the room at Keck at 6:30 pm!
Barbara was restricted from taking anything by mouth for 8 hours before the ERCP. Then she was only allowed clear liquids, but with the confusion of the move, she got nothing. We finally begged some Jello, even though Barbara hates Jello. We knew that she would again be unable to ingest anything for 8 hours before the next procedure.
Since everything was getting screwed up, I decided to go to radiology and make sure that they knew that Barbara was admitted (the original plan was for her to be an out-patient). As I expected, they were completely unaware. The procedure went normally. It was a CAT SCAN guided draining of the remaining fluid which had leaked from the bile duct. The staff in the GI lab were outstanding - they took good care of Barbara, and even gave her some Morphine when the pain got bad.
Once the procedure was done, the doctors ordered Barbara discharged from the hospital. But, like everything else, this took a few hours while the nursing staff denied that the orders had been given. We actually had to call the doctor and get him to call in the orders that he had already given. We were very happy to get home and have Barbara relax in her hospital bed. We noticed that the swelling in her ankles is slightly reduced. She is still having to go easy with food. That's not surprising, given that she went without food for two days, and had a scope down her esophagus, through her stomach, and into her duodenum.
Today, we had a regular visit with Pain Management. Barbara is taking very little pain medication now, so the visit was perfunctory. Barbara's only pain is after eating.
Barbara has been making slow progress. Her ankle swelling is reduced, but not gone completely. Her main problem now is insomnia. She is taking Ambian, but it doesn't seem to work very well. It's hard to maintain a positive outlook when you are sleep deprived.
We see Dr. Heger (cardiologist) and get a PET scan this week.
We enjoyed a nice breakfast at Foxy's, our favorite. It's nice to have things returning to normal.
Barbara had a PET scan last week, and then met with Dr. Lenz. He said that the scan shows only inflamation areas from the surgery. The CA19-9 is down to 44.6, but that is still higher than a "normal" value.
Lenz is surprised at Barbara's difficult recovery from the surgery. If the cancer comes back, he will probably opt for SBRT instead of surgery. SBRT is a directed radiation which affects the tumor on which it is focused, with minimal damage to surrounding tissues. We'll see.
Barbara also saw Dr. Heger, our cardiologist. He says that her EKG looks fine, and he doesn't need to see her for three months. I'm sure glad that we stopped the talk about a pacemaker (by the hospital cardiologist, who seemed to want to "do something", even if it wasn't advisable).
Today we attended Kanan's gymnastic competition. He was up against gymnasts from numerous gyms in Southern California. Kanan was wonderful to watch - so string and smooth in his movements. At the awards ceremony, Kanan was on the stage 6 or 7 times - he placed in the top three of most of his events, and he received third overall for his age category. All of his hard training is paying off. He was glowing - and deserved it.
Barbara is still having trouble sleeping. Dr. Lenz suggested that she try Benedryl, a anti-allergy medicine which has sedative properties. It works sometimes. I've gotten used to Barbara falling asleep on my shoulder when we watch TV.
Last updated on Sunday, 12/14/2014 at 5:00 PM
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