First Clinic Appointment

Monday’s Clinic Appointment.  Glad we were in the dark.

So, I wrote this last night and then around 3am Fred got sick again and things changed.  Fred was happy with this, so I am going to go ahead and post it to let you know about yesterday's visit.  We are in the hospital ER floor right now.  Will update in a few.

Fred had his first routine liver clinic appointment at KUMed on Monday.  His clinic appointments back home usually involve a lab draw in the morning, a run-through of current medications and vitals, a chat with his transplant coordinator, Kevin (love him) and a visit from the hepatologist managing his case (especially love Dr. Han and Dr. Saab).  It ends with a plan – which is usually “stay the course.”

I know I mentioned before that we knew his AFPs (Alpha-Fetoprotein [tumor markers] in his bloodwork) had been rising dramatically for months.  I think normal is something like <40 and he was soaring over 1000.  We had worried for almost a year as they kept rising with every blood draw – indicating his cancer was revving up.  But MRI’s could not pinpoint an area of concern (visible tumor) so they could not “treat” it.  We were very …  happy (?)… when they finally discovered a new tumor inside the liver and could treat it with Radio Frequency Ablation (RFA).  Fred had the procedure on 2/25/16 and we were told by UCLA it was a “success.” 

What we didn’t know was …  Fred’s RFA was a “success” because they had good margins treating the entire area of concern.  He had no bleeding. No complications.  MRI immediately post procedure looked good.

What we didn’t know was …  his new (and fabulous) doctor at KUMed had ordered another AFP test this last blood draw (last Wednesday). 

What we didn’t know was … if this AFP test came back as levels still soaring up around 1000 or higher Fred would no longer be considered by KUMed as a candidate for this liver transplant – as it would be an indication that the area of concern inside the liver was not the cause of the rising AFPs.  (Rather, it would be an indication that the cancer revving up was likely outside the liver.) 

What we didn’t know was  … this labwork/clinic appointment was providing the doctor with pivotal information. 

Thank God we had no idea.  I mean it.  Thank you, God!   --  as we (me,  the highest strung person on the planet)  -- have enough to worry about.

What happened was … Fred’s AFPs WERE ASTONISHINGLY LOW GIVEN TIMING OF TREATMENT – 76.5!!! Yippee! 

We were told the good news  -- that they were quickly trending down – an indication that the cancer that was revving up was inside the liver and had been treated successfully.  After confirming that the labs deem Fred to still be a good candidate for transplant, we were told the alternate scenario. (Cue the music:   dum    dum    DUM!)    Well played Dr. Gilroy!  

This visit … ended instead with the good doctor saying: “We have a plan [transplant].  Let’s not deviate from the plan.”

Praise the Lord!