Thursday, January 7, 2010

DAY +217: Ascites Resolved; Liver Resolution in Process

Top Line: abdominal fluid buildup drained; more info/time needed to resolve liver issues

Yesterday Susan had about a gallon of fluid, over 9 pounds, removed from her abdominal area (it was nearly 4 liters, in medical speak, but we're Americans, so we don't do metric). It's a quick way to lose weight but don't try it at home. This has alleviated the extreme discomfort of the ascites, although it has introduced a new, but temporary discomfort of its own as the various organs and innards resettle into their reconfigured space. That will pass, presumably leaving Susan feeling much more comfortable than she has for a while now.

The MRI revealed a partial thrombosis (i.e., clot) in the portal vein into the liver, as well as scarring on the liver. The doctors don't know at this point what caused the scarring. More information needs to be gathered, which will be done via
  1. a liver biopsy,
  2. an analysis of the withdrawn ascites fluid,
  3. and a "chem 20" blood test (a comprehensive metabolic panel of 20 chemical tests performed on serum (the portion of blood without cells).
The usual treatment for the partial thrombosis can either be blood thinners or simply the passage of time to let the body deal with the matter on its own. Susan's team has decided to hold off (by default, adopting the "time" approach for now), pending the information still to be gathered

Susan's overall blood results from Monday were in or close to normal range, including bilirubin for liver function, so there's no medical emergency involved. The ascites fluid analysis is already in the works. Susan will probably have the chem 20 done at NYU and possibly the liver biopsy as well, but her Boston team is OK with her waiting on these until her next DFCI visit in early February (don't know the exact date yet). By the way, the skin problems reported on previously in this blog are also most likely attributable to the liver problem, rather than GVHD as once speculated, so we'll hope for improvement on that score as well once the liver issue has been successfully addressed.

When I get a firm date for the next DFCI visit and/or other significant information, I'll post it, but as I can't anticipate when that will be, you might want to check on the blog periodically. Of course, the next full report will be after the February visit.

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