Thursday, November 26, 2020

No sense in numbers

Yesterday’s saga continues, a conclusion not in sight.  I got a call from my doctor in the morning, asking to be at the hospital at 11 for the blood test and an ultrasound.  As I had the pump running through my port, the nurse who drew the blood had to do it the old-fashioned way, from a needle in my vein.  This is a much less pleasant experience than having a pin pricked into one’s chest, strange as that sounds.

The ultrasound was quicker than the one I got last September when the cancer was first diagnosed.  This time, there was much less to see.  I’m definitely not pregnant.  That was the first observation.  It caused me some relief.  The second observation concerned my gallbladder, which the certified ultrasounder found hard to pinpoint.  I told him I had shed it last year in an operation that started as a little puncture in my belly and escalated into a cut from my ribcage to my pelvis.  During fasting, the gallbladder can shrink quite a bit, the doctor said, but this makes much more sense.

This was essentially the extent of the ultrasound.  The doctor pointed his sonic head here and there, pushed and poked, but couldn’t find anything that could explain the elevated liver values.  Straying further, the kidneys and the pancreas looked good.  The spleen as well.  I’m somewhat surprised I still have it.  Isn’t that a bit of a useless organ?  There was nothing worrisome at all.  Ultrasound being a low-resolution technique, there’s no guarantee that something evil isn’t lurking undetected.  For this, I’ll get the CT, which remains scheduled for next Thursday.  There was no reason to push it forward.

When I saw my doctor again, half an hour later, he looked perplexed.  To his surprise and also to mine, my liver values were even worse than the day before.  Bilirubin had essentially stayed flat, but the transaminase levels had doubled.  These enzymes make it out of the liver and into the blood only when there is liver cell damage, says Wikipedia.  There’s no evidence for such damage and no clear reason, said the doctor with considerable bafflement.

He kept asking whether I was taking any new medicines or had consumed anything out of the ordinary over the last few weeks.  I have not.  I follow the Waterboy’s advice and don’t do drugs, unless it’s absolutely necessary.  If anything, I’ve stopped a drug, or something masquerading as such.  The last few capsules of coriolus powder have been sitting in their tub for a while now.  I have no intention of restocking them.  To rule out any external influence, the doctor ordered the pump with 5-fluorouracil to be removed.  It was still half full, but it was also the 24th bottle I’ve received (adding up to an impressive 2.5 l of 5-FU solution).  A little bit less won’t make one bit of a difference.

When the nurse removed the pump, she took more blood for yet another test of my liver values, to see the progression is.  This one was only two hours after the previous one.  I’ll give more blood tomorrow morning and will have another consultation with my doctor.  I judge the chances that we’ll learn anything as rather low.

It’s a strange situation to be in.  Every time that I’ve received bad news in the last year and a bit – and there have been plenty – there has always been an explanation.  There’s the cancer, there’s continued growth, there are metastases.  All easy to understand.  Now, there’s nothing.  The numbers aren’t where they should be and no one has the slightest clue why.

I haven’t yet given up on my hypothesis that fasting caused all this commotion.  It could be that it takes a few days after breaking the fast for the numbers to come down.  It would be reassuring to see the growth stop or even revert course tomorrow.  I’ve written the same about my cancer a few posts back, but here I’m more optimistic.  Am I on a double downward spiral, a double helix of doom?  If the values keep rising, my liver might give in.  Does this sound bleak?  Luckily I’m not one to worry unduly about things I have no control over.  It’s going to be ok.

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