October to November

As usual it has been a while since anything was posted.  We had a good Halloween though the kids refused to stay in their costumes for more than an hour.  Fast forward a month and we were able to have Thanksgiving with Karen's parents and siblings.  The next day Karen wasn't feeling well and recognized it as signs of dehydration setting in so we made a trip to the ER so she could get some I.V. fluids.  She left a few hours later feeling better.

Karen's blood counts have been lower than normal so her chemo treatments have been less than regular.  On Monday (11/30/2015) her oncologist let us know he wanted her to have a colonoscopy (her third this year) to see if a cause of the bleeding and low blood counts could be identified.  The first two weren't able to get very far due to bleeding and the tumor.  The third time was the charm and they were able to get all the way up since the tumor in her colon was removed over the summer.  Nothing significant was found.  That's the short version.  Here is the long version.

Monday she was admitted to the hospital and stayed until Thursday.  The doctors were concerned that doing the colonoscopy on an outpatient basis was too risky and they wanted her admitted in case any complications arose.  They gave her several units of blood and platelets to help with her blood counts.  So far the bleeding has lessened significantly but the underlying cause needs to be resolved before her oncologist believes they can safely resume her chemo treatments.

They believe the cause of the bleeding is hemorrhoids in conjunction with a condition known as portal hypertension.  There is a vein in the liver (the portal vein) that is being constricted.  Since there is another way back to the heart the blood takes the alternate route but in essence causes a traffic jam which increases the blood pressure in her abdomen.  When her hemorrhoids bleed they do so much more than normal due to the increased blood pressure and the reduced ability of her blood to clot.

The normal procedure for taking care of hemorrhoids like these is surgical banding.  However, since these other conditions exist there is good chance that she could bleed to death very quickly if that were attempted.  What they are going to try instead is internally cut off the blood flow to the hemorrhoids.  There is a good chance they can either reduce or eliminate the bleeding completely.  We are hoping to find out this week when or even if that can be tried.

The doctors did mention something called a TIPS procedure which allows the blood flow to bypass the portal vein in the liver.  Possible complications of that are a buildup of toxins in the body since the blood flow would partially bypass the liver and reduce its ability to remove toxins from her blood.  The buildup can cause mental confusion and dementia like symptoms.

As if Karen didn't have enough to deal with, another side effect of portal hypertension is fluid tends to collect up in the legs and abdomen.  She looks like she is pregnant and has even been asked twice when she is expecting.  We told the ER doctor that and he responded that she could have a lot of fun with those comments.

I think that catches you up on what has been happening lately.  This week was already going to be busy for us.  Karen has a PET scan at Huntsman scheduled Thursday and an appointment with the interventional radiologist to go over the results and see how well the Y90 treatments worked.  This is also the doctor that may be able to cut off the internal blood flow to her hemorrhoids.

Karen and I are very grateful that a few people that I work with volunteered to help us with Christmas shopping.  It's a good thing since Karen was not in any shape to be out and about on black Friday.  Some young women from the ward called while Karen was in the hospital to volunteer for a few hours of babysitting on Saturday.  When they called they didn't know Karen was in the hospital or the situation we were in.  With babysitters lined up we were able to go for a drive, just the two of us, and talk.  It was nice to have some free time with her.

Things happen for a reason, we just need to figure out what the reason is.  Sometimes it requires some patience to find the reason but it does come.

I will try to keep the blog updated with what we find this week.

Braden