Waiting……

Hi,
I think things in General should be ok for your husband based on the 2 lab work you post. Do been to worry too much.
However, some how the hydration and electrolytes balance pop up in my mind.
Therefore ,the following discussion is more for that purpose whether than your husband in general.

Besides the total bilirubin is high 2.8 but may be affected by the chemotherapy; the ablumin is a bit low but your total protein is normal. the others like AST,ALT and ALK phosphatase are relatively normal for a CCA patient.Does your husband have diarrhea problem? how many times if so? then hydration will need to be addressed; if not ,I will still ask the doctor what to do .
I quoted from an article about fluids balance in our body.so it may help in understanding the fluids balance importance. This is out of my experience and research range; I may actually go too deep on this subject this time;However, I think is important to know how to manage the hydration status while have ascites etc.
the quote is below from
http://www.nursingcenter.com/lnc/static?pageid=720126

“Albumin is produced by the liver. Among its many functions are its ability to maintain intravascular oncotic pressure. To facilitate movement of fluid throughout the body, facilitate transportation of substances, and act as a free-radical scavenger. Levels of albumin depend on wellness or disease state of the body.When it comes to hepatic disease, acute hepatitis, or cirrhosis, albumin levels do not correlate well with the severity, prognosis, or level of total hepatic function.3 The parenchymal damage or loss has to be severe to affect the liver’s ability to synthesize albumin. The mechanisms responsible for the decreased albumin levels seen in most cases of hepatocellular disease include increased immunoglobulin levels; third-space loss (extravasation into the extravascular space); and direct inhibition of synthesis by toxins.”
God bless.

Brenda, I am glad Kenny is going to talk to someone. There was a gentleman who was a CC transplant after me and has an amazing story to share. believe his name was Mike(??) and he will inspire Kenny.
Your MELD score is good but not high enough to get to top of list, but the higher the MELD score that means you are in major liver failure, which you don’t want but… it is kinda of catch-22. Dr. Chapman is very aggressive in constantly applying for more points, I believe I started at 26 and ended up at 32 in a 5 month period. Your blood type determines which list you are on. I was B+ so I had a shorter list, but then you have a few less blood types to receive organs from, it is all catch-22!! Dr. Jeffrey Crippin is my liver doctor and another kind, down to earth good man, who is so approachable and easy to talk to, you will love him. Barnes was so good to me and they always managed to get everything approved, you are in good hands.
Good luck Monday and please call if you need a friend or directions in St. Louis, MO. (It is going to be real cold!!) (618-567-3247)
Lots of prayers and HOPE-Cathy

Say, Celebrity! Congratulations on the start of your 5th year !!! You are truly a survivor and thriver!

Hi Brenda, to help clarify labs. The CBC you posted tells us the White cell count (which fight infection) which is boarderline low but the absoluted neutrophil count is 2.5 which are premature white cells to gorw up to mature WBC and they are adequate. The only realy low lab is Platelets (they clot the blood) so there can be bloody noses, gums, and bruising. You really need the BMP or CMP to detect dehydration,and ofcourse as mentioned above the liver enzymes should be done, CA19/9 Tumor Marker, and possiby Ammonia level. This level gos up with increasing liver damage and the symptoms are confusion, disorientation, sleeping more, etc. It can be corrected so it might not hurt to get a baseline. Hope that helps. Keep asking questions as we all learn from each other, Janet

Hi, Brenda,

For the health condition as your husband, the CBC panel looks relatively normal;

Due to the diarrhea may be a problem, I think your husband has a hydration problem and needs doctor’s attention at this point.the Hct is lower than normal based on the lab;but since he has acsites ,therefore you need to ask doctor what to do with regard to this problem. .since I believe the fluids is not in the right place even there may be a lot in ascites.. ( Please remember, I am only a patient ,like your husband,I am not a doctor; this is the time to ask the doctor whether your husband is hydrated enough and how to deal with the ascites at the same time.
WBC,RBC among others are low but not too bad;remember your husband is sick ,so we cannot expect everything is within the normal range of a healthy person. The platelets (PLT) is too low for chemotherapy (ie:<75,000/100,000).
However, the BMP you did not mention is more important(ie:AST,ALT,ALK Phosphous,albumin ,BUN/Creatinine ) for CCA.

God bless.

Hi,
Let’s wait till the next scan result to see what else the doctors can do. If all the tumors are dead, then you may not need to worry about the CCA but only the cirrhosis and ascites. Otherwise, systemic chemotherapy or targeted therapy or clinical trails may be appropriate as well as doing nothing is also a choice too.

God bless.