Dr Baxter's Blog

     The Christmas and New Years Holidays were relaxing but eventful with family getting together and sharing our blessings.  Then on January 3rd, I went in for a check-up and injections according to the protocol of my clinical trial.  My weight was 186 pounds and all was well, especially in light of my clean CT scan from December 18th.

     But as January progressed, I began to realize that my strength and endurance at the gym was slipping a bit, and I began losing weight despite having a solid, even ravenous, appetite.  The radiation-induced colitis was continuing unabated as well, which was still a bit frustrating.  By the last week of January, it was clear that my skin and eyes were beginning to develop a  yellowish cast, a sure sign of jaundice and possible liver trouble.

     When I went in for tests on January 31st, my weight was 169 and my blood bilirubin level (which should be below a value of 1.0) was 6.7.  Other liver function tests were also elevated.  I feared a recurrance of my cancer, but my oncologist felt that, since I had a recent clear CT scan, the likely cause of the jaundice and weight loss was due to an obstructed stent.

     Last March, during my Whipple surgery to remove the cancer, two tiny plastic tubes, or stents, were placed in my common bile duct (which connects the liver to the small intestine) and pancreatic duct (which connects the pancreas to the small intestine).  The surgeon secured these stents in place with a suture that would dissolve in a few weeks after the ducts had healed, thus releasing the stents into the intestinal tract and then out of the body.  But sometimes things don't work out quite like they should.  Both of my stents remained in place in their respective ducts.

     Another CT scan was ordered to be certain that there was no new cancer--there wasn't--and I was anesthetized that afternoon for an endoscopic procedure, including a colonoscopy to evaluate and biopsy the colitis. 

     Modern medicine is a wonderful thing.  In a one-hour procedure, an endoscope was passed through my mouth, into my stomach and intestinal tract, and up into the respective ducts, where the 2 stents were simply plucked from their ducts with minimal fanfare.  The biliary stent was occluded with inspissated bile and even the pancreatic stent showed a partial blockage.  The biopsy of my colon confirmed a resolving focal colitis (fortunately, that is even now beginning to improve).

     Ever the impatient patient, I assumed my recovery would be rapid, but the half-life of blood bilirubin is at least a week, and the improvement has been a bit slow, but certainly steady.  On February 7th, my blood bilirubin was down to to 3.9.  A week later on Valentine's Day, the value was 2.7 and the other liver functions were back in the normal range.  You have to look very closely now under good light to see any jaundice at all.  My weight is now up to 176 pounds.  Karen and I have resumed our daily 3-mile walk with the dogs and I'm back in the gym, albeit at a slightly reduced work load.

     Anyone that has dealt with a chronic illness soons learns that there are speed bumps along the way, most of which can be overcome.  I am very gratefull to my entire medical staff, the oncologist, the surgeon, the gastroenterologist, and their compentent ancillary teams; for the prompt professional approach to the diagnosis and treatment of my potentially-scary hiccup.  To  paraphrase an old saying from Mark Twain:  Rumors of my demise are premature!

     Another CT scan will be scheduled sometime this spring, but it will have to wait until after a two-and-a-half week cruise to Australia and New Zealand that has been on Karen and my bucket list for several years.  I will be sure to update this post as things progress.

     Life is good!     David Baxter     

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 Antoine de Saint Exupery, poet