Today was endoscopy day, or EDG day.  With PSC (primary sclerosing cholangitis) comes progressive inflammation and scarring of the bile ducts, yielding cirrhosis, or low liver function.  The uncontrollable scarring causes redirection of blood flow and bile and produces a phenomenon called portal hypertension.  In these cases, most of the liver’s enormous volume of blood gets shunted out the portal vein since the other veins and channels are blocked.  The result is high blood pressure through the vein (since its normally dependent on many other veins and channels as well).  The high portal blood pressure yields esophageal varices (large “balloons” of blood that collect in the esophagus with lack of a place to go), a rerouting of blood in the chambers of the heart, and so much more.

In sum, I’ve had portal hypertension for years, and my doctor monitors it by doing at-least annual endoscopies.  She goes in through my throat while I’m in general anesthesia, and whenever she sees one of these high-pressure varices, or “balloon bubbles,” she puts a tiny, tiny rubber band around it – which later falls off on its own -leaving the balloon nothing but a dead clot to fall away.  The procedure is emminent because of the risk of the varices.  At any moment in time, a single varice could rupture since the volume is just that great.  A patient with ruptured varices would likely hemorrhage before reaching the hospital.  

Then, the oncologist wanted a colonoscopy performed today, too, just to make sure the tumor in the liver isn’t anywhere else, so my own doctor performed that as well.  That part is honestly no big deal.  The worst part is the throat and chest pain after the EDG, and anytime she bands varices, there is a throbbing pain that just won’t stop.  Thankfully, she didn’t see any varices to band today (they have to meet certain criteria to be “bandable”), but there is still a lot of pain from the breathing tube, mouth opener, scopes, and all the bumping around in there.

And so I sit here and sip apple juice and graham crackers, thankful she didn’t find any real varices today.  I’m also thankful my mom was with me, my best friend stopped by (but I was asleep), and Jonathan spent a few hours watching TV on the couch.  (Don’t ask me what we watched – I was out!)

And thanks to you who have been pouring in the cards and sweet gifts… my mailbox hasn’t been empty all week, and I cannot express how much your love means to me.

Until next time…

Today was bittersweet because even though my pediatric GI of over a dozen years, Dr. Hupertz, is still overseeing my case, she had to send me to adults just for the nature of what my disease is turning into.  She’s almost been a second mom to me, and she’s helped me through far more than liver things.  She’s in the first picture with me, and in the second picture is Penny, the OR nurse who isalways there!  I like her because she lets me sneak my glasses into the OR and then keeps track of them and makes sure they’re on when I am awake.  She’s a rule-bender, but she’s a sweetheart, and you know she’s been doing this job forever.  She’s an angel.

So today was my last day, ever, in peds, and that in itself is so scary.  


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