The Diagnosis

After arriving at the ER, CT scans were immediately ordered.  As I waited, I call our children. Erin headed our ways immediately.  Results began to come back, but due to no fault of the ER general doctor, specifics were vague.   No internal bleeding, baseball sized tumor in his liver, with lesions throughout both lobes, and “spots” on his lungs.  
He would be admitted under the care of Internal Medicine, an Oncologist would be called in and likely a biopsy of the largest mass the next day (Tuesday).  Erin had texted Joe and he swooped in and began carrying some of the load as close family had to be notified sooner versus later. (The first of many provisions by God) A blood transfusion was ordered to try to combat the low hemoglobin count and help with the anemia.

Tuesday, Barry went in and had the biopsy performed in the radiology department. We were grateful that they did not have to open him up completely for that.

Wednesday brought a combination of colonoscopy and endoscopy to check the GI tract for signs of bleeding and/or signs of cancer.  Praise Jesus, those results were clear.  Dr. Park, our oncologist, was very clear- he needed the pathology report to agree with his interpretation of the biopsy findings he himself at examined. We needed to hear the word Cancer from the lab to continue forward.  Additional bloodwork was order to help determine the “type/location” of the initial cancer cells. A Test called CA19-9 was ordered. The top end of normal is somewhere in the 30s, Barry’s was 4000+.  Under circumstances, they would lean towards this being pancreatic cancer. But because the pancreas was clean as far as the CT scan, CA19-9 can also detect liver bile duct cancer. 

Thursday morning, Barry was stopped from ordering breakfast. Pathology had agreed we were dealing with cancer (it feels laughable that we were waiting on them, but insurance and legalities…..).  Barry was scheduled to have a metaphor placed Andreas collarbone To receive infusions and do less painful blood draws. Although there was no real bleeding with this procedure, Barry’s blood count had dropped again and we needed another infusion of blood.

Friday morning, Dr Park arrived and dropped the bombshell- Barry has Cholangiocarcinoma- cancer of the liver bile ducts.  It is rare (~8000 people a year are diagnosed, it’s aggressive (by the time it’s diagnosed, it likely metastasized), and it has a extremely low survival rate- The best chance for sure is to be able to shrink the tumor enough to operate. We were encouraged to consider not only Dr. Parks oncology clinic, but to seek outside resources, such as MD Anderson who have whole departments that specialize in this cancer alone.

We were released from the hospital, Friday afternoon. Now the battle begins…