Need some advice

Hello Annie,

Hope your are doing well.Ginger my wife,I believe it was on her third chemo treatment got a blood transfusion.She went in for the chemo and they told her that they where going to give her the treatment but that she had to go to the hospital right after the chemo.She was in the hospital over night, had the transfusion and had a paransentisis. She was in the hospital for one night only.And believe me.It made a big huge difference on her,because she up and Christmas shopping two days after her chemo treatment.Good luck with your brother and Happy new year.

Hi Annie,
My husband has this awful cancer too. He's on Oxaliplatin/5FU combo every 2 weeks. His labs are always fine and chemo proceeds. He seems to be tolerating it well. Your brother may need a change in chemo.  Also, he's had ascites since September and is now having paracentesis every week for 5-6 liters each time. So I would say that ascites does not indicate that the end is near.
Hope all goes well on Weds.  Stay strong.
                 Dianne

Hi,Annie,
I think you should let the medical professional take care of your 46 old brother's situation first;let them to see what kind of medications he should take to increase the "blood count" before using injections to help boost the counts.
First, there are different injections for different conditions. I am not a doctor,but I know about injections in the pharmacy. You did not mention which one(ie; WBC,RBC Platelets,Hb etc.)that had low blood count in any of the messages you wrote on this board. You only mentioned about folic  acid and vitamin B12 prescribed by the doctor and most likely were for anemia .

"fluid in the belly" as you put it ,in general,will not affect that much in the decision making process for the oncologist. Up to 21 liters can be safely removed from the patients in the hospital setting without complications. However most of the amount that removed are much lower than that.

Intrahepatic bile duct cancer(the cancer started in the  bile ducts in side the liver) is what your brother has; it is different from the  liver cancer(ie: in cytology and histology when under the microscope.)

Missing one or two treatments may not make much of the difference in the plans of  oncology treatment. It may help your brothers "blood count" back to normal and can receive the chemotherapy.

Nobody can recommend oral chemotherapy to you except your oncologist; Oral chemotherapy agents and especially the  targeted therapy agents taken by mouth are potent medications( ie; both in effectiveness and side effects) and should not taken them lightly or think of them of  less potent than the IV formulation.

I hope my specific answers to your questions will help both of you and your brother  to develop a more positive attitude toward the treatments and outcome of this diseases.
Finally,I can only speak for myself, positive attitude helps me a lot in dealing with this cancer for the past 44 months; it change my outlook toward my disease  and helps me to start a new journey for the rest of my life. It is no fun,but take the best  that you can have  and prepare for the worse that you cannot control through communication with others and learn about the disease. You will never know what will lies ahead of you,but if you try, I am sure your effort in prolonging your brother's life will not be in vain.

God bless.

Happy New Year!!!

Thank you all so much for the advice.
I realize ultimately its up to his oncologist to determine the correct course for my brothers treatment.  I just wanted some options that possible my sister in law can ask doctor about. 
I did get to see my brother yesterday.  Overall he looks good. The fluid in his belly has really gone down, he's a little thinner than normal but that's to be expected. 
The biggest issue we have is hopelessness and depression.  He stayed in his room a majority of the time I was there.  He cooked a gigantic meal for New Year's Day so I think he must feel somewhat ok.  It's so frustrating that he doesn't take advantage of the time he has now.  When reading the post by Percy I see that he maintains a positive attitude.  And I believe that is key.  Unfortunately I cannot get my brother on the same page.  But I realize that has to come from him.  I can only support him and be strong for him. 
His appointment is today at 815 am California time.  I am saying many prayers that his blood count is high enough for chemo. 

Thanks again.  I keep everyone in my prayers that are dealing with this!!!

Well appointment was successful.  They gave him chemo but a lighter dosage of the combo.  His tumor markers originally started at 4000 but are at 1000. That's something to be grateful for.  Here is the new dilemma.  The doctor was still concerned with his blood levels.  He ordered a test to look into his antibodies??? I have no idea what that is.  Also, if the test comes back with a concern for the doctor he will do a bone marrow biopsy. Since I wasn't at the doctor I don't have the exact name of the disease he thinks it could be.  My sister in law said it started with an M and very long.  I found something online that could be it but again without knowing for certain it makes it hard.  I know many are probably thinking why don't I speak to the doctor or go to appointments?? I absolutely cannot.  When my Mom had CC I wasn't as involved because I was a bit younger and my Mom didn't want me to have to deal with it.  Well I was with her for two appointments.  Each time the news was horrendous and I will never be able to get the look on my Moms face out of my mind.  Therefore I am absolutely terrified and I just can't go.  Either way after talking to my brother he said Doc told him that there wasn't anything that could be done if the blood is bad.
I wanted to update everyone on the status of the appointment and just throw the new dilemma out there to see if anyone might have some experience with this.  This is the only outlet I have.  For tonight I will count my blessings and thank God for allowing chemo today.  Thanks for all the warm wishes hope everyone has a blessed night!