Hey guys, just thought I'd post an update on the leaking bile & the increased jaundice, as the docs can't explain it. It is suspected it's bile leaking from the pic line, as it cultured negative for infection & is green like bile. Dad is awefully jaundice still & the doc's can't explain it. After numerous reviews, it appears that his biliary catheter, diverting the bile, is in perfect place and doing its job. Per the scans last week, after 3 mo. of gemzar, the tumor has not grown. However this week the CA19 is back up to 9,000 + & the bilirubin level to 14. Dad is not eating much & is so very weak. He's expected to start 5FU via a daily pump infusion & radiation (brachytherapy) next week. I worry about his strength level. He also spiked a fever this week, with terrible chills & confusion. It held out for a couple hours as he refused to go to the ER, then it broke & he was back to normal. It was odd, in that it was his off week for chemo.
As an aside, I contacted a bilirubin toxicity specialist this week to inquire into potential negative implications of jaundice in the system for extended periods of time.... The specialist indicated that the form of bilirubin
that is accumulating in Dad's circulation and is being excreted
in the bile will predominantly be the so-called "direct" or
"conjugated bilirubin", which is not a toxic form of the pigment. He further noted that the toxic form is "indirect" or "unconjugated" bilirubin which is,
in general, a problem only in newborn babies and certain extremely
rare diseases. He says that although the jaundice may be extremely
disconcerting and worrying, one should not worry about toxicity from
the yellow pigment itself. That explanation did provide some relief following some readings on bilirubin toxicity.
Keep us in your thoughts & as always, thanks for sharing your insights.