Re: Doctor suspects cancer sending for ERCP and brushings & Question for Group

[Guest guest]

Hang in there Nichole. I'm sending extra energy your way.Lee> Is it possible to take an incomplete in one of the courses if you> absolutely have to? It would be awful to postpone graduation but if> you have to?Hi Martha,I actually considered this but says that I had better not do this because I better graduate in May and have all A's. He is really proud of me for getting my MBA. I. 

[Guest guest]

Nichole,

What you must be going through. is right about the MBA if you

can pull off the A's and the graduation without knocking yourself out.

I don't know about real-time pathology for ERCPs, so I can't help

there. The path report usually takes several days, and I guess it

would depend on what techniques they will use to look at the cells. As

for hospitalization, if my endoscopist places a stent or does a

sphincterotomy, he keeps people overnight for observation. If

has not had a sphincterotomy (Sphincter of Oddi, where the common bile

duct drains into the small intestine from liver and pancreas), then

they will probably do one to place a stent. If he's had one in the

past and they don't place a stent, then he probably won't be, but you

should plan to be near the hospital in case he gets a fever or pain

that could be pancreatitis. On my last ERCP he dilated but didn't

stent, and I'd had a previous sphincterotomy that was sufficient to

allow the baby endoscope into the duct, so I wasn't hospitalized

overnight. The sphincterotomy is not necessary for routine ERCPs

because they just inject contrast, but I think if they dilate or stent

it is necessary. My last thought is to go to the center where the

endoscopist is most experienced; this leads to fewer complications.

The MRCP is complementary to the ERCP in some ways because ERCP can

only see the near end of a stricture- a dominant stricture won't allow

the dye up further into the liver. MRCP will allow them to get a

larger view of the whole liver. MRCP showed that my left lobe was

atrophied, while ERCP just showed a truncated bilary tree. Make SURE

the radiologist knows to look for cholangiocarcinoma if they do the

ERCP. The point I want to make is that even if ERCP brushings come

back normal, and all his symptoms seem to be due to PSC progression,

it still can help to look with MRCP. Sometimes cancer cells don't shed

into the duct because the cancer is embedded in scar tissue. I know

this sounds scary, but it's really hard to prove a negative, and this

is what you really want to do.

Of course I know nothing about the situation, but it seems like you

are wise in thinking that Melody's guardian should be local, because

if you can't care for her, the situation is going to be temporary, and

kids adjust better if there is continuity. I'm sure your other friends

will come back and say yes, but they are probably just uncomfortable

with the thought that anything might happen to you, their good

friends. I have asked my sister the same thing and she took ages to

think it over, though I know she adores Zephie.

Best wishes, we are hoping for the best,

Martha (MA)

> Just wish me luck getting through the next little while.