October 22, 2007
Dear Family and Friends,
"Together We CAM" is certainly having positive affects as Cam continues to have new hurdles to overcome each hour of every day. Please know that I am doing my best to understand the medical jargon and please forgive me, especially those who understand the proper terminology and spelling, for my ineptness as I'm trying to capture and understand on the fly from people who are very busy.
As Cam's blood has improved in many ways, his bilirubin, due to the probability of his liver and pancreatic ducts obstruction, has continued to alarmingly rise and has caused increased nausea and his inability to hold down solids and liquids. He has been on TPN (total parenteral nutrition) which is the practice of feeding Cam intravenously, bypassing he usual process of eating and digestion for 9 days. TPN is hard on the system on long.
As the bilirubin has skyrocketed we knew there was an obstruction. We found a physician to order a MRCP (Magnetic resonance cholangiopancreatography) which is a medical imaging technique which uses magnetic resonance imaging to visualize the biliary and pancreatic ducts in a non-invasive (outside the body) manner. Compared to an ERCP (Endoscopic retrograde cholangiopancreatography) is a technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of the biliary or pancreatic ductal systems. It is an x-ray examination of the bile ducts which is aided by a video endoscope. Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject dyes into the ducts in the biliary tree and pancreas so they can be seen on x rays.
As we were able to obtain the order to receive an MRCP on Thursday, we thankfully received the results of the exam back that afternoon. The MRCP showed a high grade of bile obstruction, both located in the common bile duct that sends the toxins from the liver and pancreas down into the small intestine. The great news that the MRCP said is, "ERCP and stenting recommended as clinically warranted." Without the availably of a Gastrointestinal Specialist to help in Utah Valley Thursday night and with Cam vomiting without pause, I took him to LDS emergency room praying that they would take him. I know that there are politicals and "turfing" that takes place between hospitals and the two counties, I knew we needed hearts soften because the LDS hospital has access to all the records for Cam. As Heaven soften hearts and with Cam's serious condition he was readily admitted and the head G.I. physician made room for Cam on Friday (even though he was totally booked) to perform an ERCP with a scope that has the ability to push a "stent" into the closed areas of the ducts. The doctor was able to get through the stomach and up through the common bile duct but was NOT able to get around the tumors in the duct. As Cam said, "no surprise because each time I wake up from a procedure at the hospital it has not been good news."
With the failure to stent the bile ducts, the G.I. physician immediately arranged for an Interventionalist Radiologist to insert through the side of his body and place a catheter from the top down through the liver ducts and down through the common bile duct. The GREAT NEWS is that this procedure was successful, placing an internal/external biliary drainage. Meaning the internal catheter drains into his small intestine in a normal way and that the external catheter will expedite the process and we hope to have it "capped off" tomorrow. This was the first time Cam has woken up to some positive news. The bilirubin in 18 hours has dropped from 6.9 to 3.5 and we anticipate it to fall to under 2.5 or lower by morning. 1.5 is normal. He has some infections that will keep him in the hospital a while longer.
If all goes well, Cam will start a recipe of Chemo treatments perhaps as early as Tuesday and the treatment will be once every 21 days with another component of the chemo taken orally or by pump every day. Meanwhile, we will work on his immune system and overall homeostasis between treatments. Cam will have all of our treatments provided every day in Salt Lake and feel blessed to have a group of physicians that will take Cam on and help him have the best possible odds for survival.
Cam meanwhile is in good spirits, although he is fatigued and sick and tired of being sick and tired. He will use this toward working on getting out of this condition as soon as possible.
We are blessed more than we can imagine. Good people/professionals continue to come into our lives at the very moment of needs. We continue to use all resources possible from western, naturopathic, homeopathic and eastern medicine practices.
We are full of gratitude for each and every moment that we have to enjoy this growth experience with Cam. We pray for and expect for full and complete restoration of Cam's health. Many miracles have taken place and many more will be needed.
We are so grateful to have a knowledge and a solid belief that our Father in Heaven is a God of Miracles and we understand that He can take Cam at any moment in all sorts of ways and we also know that he can cure Cam at any moment in all sorts of ways. It is His Will that we revere and accept….after we have done everything we can. We are optimistic and full of hope and will not stop until this journey is over no matter the outcome.
Humbly, with Love and Appreciation for every waking moment,
Dave, Paula, Cam and Family