Topic: Why is the jaundice back?

Can anyone provide insight into what it means when the jaundice returns? Dad has a biliary catheter in, and it is flushed several times a day. The flushings are going fine, but over the last 48-72 hrs. he has turned very jaundice again. The last time the jaundice was this bad, was when he was diagnosed in early Nov. He's undergoing chemo (gemzar) once a week, he feels ok right now, no fever and no advancements in the pain. Just very yellow skin & eyes. Any thoughts?

-Tess

Re: Why is the jaundice back?

Hi Tess,
I would be concerned that the drain is plugged or dislodged. The Drs. should check that out right away. It seems like a lot of people here have Drs. who don't get too concerned about rising bili levels or jaundice but my husbands Drs always jumped right in to find out what was going on. They have never left him waiting ,in fact have even had him admitted at times if that meant things would progress faster. I have always been grateful for that and I think that is a big part of the reason he has done so well. It is very hard on the body to suffer increased bilirubin levels. I hope things get straightened out soon for your Dad. Best wishes. Mary

Re: Why is the jaundice back?

Thanks Mary. We'll follow up with the docs. first thing tomorrow. We've mentioned over the last couple weeks, amongst ourselves, that Dad's coloring didn't look quite right.... then you chalk that up to over scrutenizing... but this AM, there was no denying the jaundice! We'll stay right on it- thanks, & best wishes to you Mary!

-Tess

Re: Why is the jaundice back?

The radiologist indicated that the biliary cath, which serves as the stent of sorts, is not obstructed (following today's scans). Dad's bili levels are back up today, but radiology said he'll have to go follow up with his oncologist - as they can't explain the jaundice.

-Tess

Re: Why is the jaundice back?

Hi Tess,
I'm no expert, since my mother never needed a drain, but the only time she exhibited jaundice was when she had an infection around the tumor (I think it was called cholangitis, I can't believe I've forgotten already). They even said it could be a GOOD sign, that the chemo was killing off parts of the tumor and the dead parts were causing the infection. BUt I guess the doctors would know if your dad had an infection - white blood cell counts and all. Just a thought from my own experience. I hope you find the answers soon.
Joyce M

Re: Why is the jaundice back?

Good morning neighbor,
   I like Joyce M. 's diagnosis - I hope you solve this fast and the yello's all gone. Butch never went thru jaundice (except after the operation), so I don't know myself.


Joyce C.

Re: Why is the jaundice back?

Hello Joyce (squared) & thanks for the notes. Very interesting connection between the cholangitis & effects of chemo on liver. In Dec. Dad had an infection that they believe started in the region of tumor (potentilly with cath) & went to the blood stream. While Docs have indicated chemo is working, based on the CA19 tumor marker, they've not yet been able to determine if the tumor has shrunk at all- this will come with scans on the 17th of Feb. How wonderful to think that the chemo could have such an impact on the beast.

Do you know if it's possible to have decreasing CA-19 numbers and increasing tumor size? Currently the doc argues that the chemo is working based on the CA19 number, but at the end of the day- if the tumor is not shrinking then it can't be removed.... which is the objective.  I guess time will tell.

Best,
Tess

Re: Why is the jaundice back?

Tess,
   I don't believe that I have heard of a case where that number was falling and the tumor was not shrinking -  I hope I/m right!

Joyce

Re: Why is the jaundice back?

Hi, Just wanted to provide an update on how this strange disease reacts.....  While the tumor has not increased in size, the CA19 numbers are back up to over 9,000 and the bilirubin level is back up to 18. There's still no explanation for the extreme jaundice- as they say the cath is working fine. Additionally, the pic line in Dad's arm continues to leak green/yellow. They've provided Dad with a new med to breakdown the bile in the system, but after reading the potential side effects, Mom's not certain if she wants to add that to the mix.

Best,
T