One step back, yet again! Chemo cancelled

Andie,

I am suprised that your Dad’s Onc isn’t letting him have the chemo at this level – unless there is something else going on with his liver. Do you have other liver function test levels you could post such as ALT, AST, ALk Phos, and Albumin? If these are all relatively normal, it would mean that his liver isn’t really in distress and it should be safe to do Chemo. But maybe the Onc is being extra careful.

Also – what antibiotic and dose is your dad taking? If it is Cholangitis, Ciproflaxin 2 X 500mg/daily is the usual treatment. And it is safe to take longer term if needed.

One last question – how long has he had the metal stents in? This was the cause of most of my infections/cholangitis as the tissue (not necessarily tumor) grows through the wire mesh in time and blocks/occludes the stent. By the time I decided I needed to have it looked at (bilirubin went to a high of 2.9), both of my stents were blocked. Wow did I feel better after that was cleaned out. It had been about 8-9 months since they were installed. So – this is something to keep an eye on also.

Lastly – Kathy I’ll look into posting an easy conversion tool for us all to use soon. I just did that match quickly but it is more involved to explain.

Best wishes.

Rick

Yes, the UK standards for bilirubin are different. The “in range” values are between 3 and 17 micromoles per liter, which is quite different from the US at .1-1.3 mg/dl. So, converting the bilirubin of Andie’s Dad to the US lab standards he would be at roughly 5.7mg/dl. At this level, it might even be difficult to detect yellowing in the skin or eyes, especially if it is moving up and accumulating.

It sounds like your Dad is on antibiotics, could this possibly be for Cholangitis? When the bile ducts become infected it is called cholangitis and it almost always raises the value of the bilirubin. I’ve had this occur to me at least 3 times in the last 5 months but to stent issues and each time it has come down within a couple of weeks with antibiotics. Hopefully this is the case with your Dad and within another week he will be back on track. I think I lost 1 week of chemo due to this, which was a welcome break anyways.

Best of luck to you and your Dad, Andie. I hope to hear that his bilirubin levels have come down the next update you give. Sending healing prayers your way!

Rick

Although, not easily understood by a layperson it does describe in detail the function and disfunction derived from elevated bilirubin levels:
http://en.wikipedia.org/wiki/Bilirubin
From what I understand certain medications can increase the levels, amongst other things. Hopefully, someone can come along and give us a good lesson on this.
I have also been told that an elevated bilirubin level may not necessarily be a reason for alarm. The body may simply regulate itself. As we have experienced many times…it becomes a waiting game.
Best to all,
Marion

I don’t understand the bilirubin levels, “Last week they were 45, and this week they are 75. So in one week they have increased by 30.”

My lab sheet says Total Bilirubin reference range is 0.1-1.0, and Direct Bilirubin is 0.0-0.3. It does say mg/dl after these on my lab sheet, so perhaps a different measurement is being used?

I hope someone can explain this to me, because I can’t get into context. I know we all experience things differently, but how could it not darken your urine? It’s got to get out somehow.

Thanks,
Kathy