Here we go again - ERCP on Monday

Friday's blood tests showed Michelle's bilirubin remains high, so another ERCP is scheduled for Monday January 5 at 1:30 PM. They'll check out the current stent and probably replace it with a new one.

In the December 26 procecure, the replacement stent was only placed across the blockage in the main bile duct, where the cancer was found. Upon further examination, the doctor concluded the site of the upper blockage (the left hepatic duct) which was stented in early December was probably not cancerous and he believed the blockage was cleared and no longer needed to be stented. Given that Michelle's bilirubin levels have increased beyond where they were on 12/23, it seems likely the left hepatic duct is blocked again.

In any event, Dr. Chen also told us that he wants to place a permanent metal stent instead the temporary plastic stents they have been using, since surgery has been ruled out. He had planned to see Michelle again in mid-February and place the stent then. It seems likely that since he's performing another ERCP now that he'll place the metal stent, but we haven't been told one way or the other. The advantage of the metal stent is that it is somewhat larger and less prone to blockages. Plastic stents can last up to 3 months; metal stents can stay in place for 9-12 months or even longer. We're hoping this will mean fewer ERCP procedures so we can focus on fighting the cancer instead of remediating the symptoms.

Michelle's sister Kim left on Friday to return home to California. We found out before she left that her husband Lindsey has painful shingles! He's in quite a bit of pain, but should make a full recovery. It was great to have Kim with us for a week, she was a big help and enabled Bill to work a full week for the first time since November.