Many of you know the procedure this morning in IR was successfully completed. Maggie was given an exterior drain that empties bile into a small bag on her right side. It almost looks like the colostomy she had temporarily in the summer of 2014. Our family has a tendency to joke about serious things and come up with funny names – I think it might be a coping mechanism to make things more familiar or less threatening. Maggie decided to name her drain/bag system “Simone Bile”. She shared this with me earlier and I nearly fell off the sofa laughing. I wish I’d have said it.
She’s feeling good tonight – her discomfort is well controlled with pain meds and she has rested some today.
As we’ve shared, the bile duct is completely obstructed by this tumor. During the procedure today, IR got a better look at the situation. The main artery to the liver and vein from the liver are in close proximity to the bile duct and are in line to become obstructed as they are now showing signs of pressure from the tumor. Obstruction is inevitable if the tumor continues to grow. In choosing a treatment option, the function of the liver has to be considered. Conventional chemotherapy and any clinical trial are too toxic to the liver to try at this time. In incredibly good timing, results from a blood sample taken several weeks ago by the Phase One team came in to Dr. Saleh yesterday. The test looked for all mutations of the cancer circulating to see if any were “actionable” or matched with a known antibody to serve as a treatment. Maggie had one hit in this test. One of the “mab” drugs which are targeted therapies or antibodies is a match. We hope this will be effective in targeting a pathway the cancer cells use to grow and multiply. She is scheduled to get her first infusion of this drug tomorrow with repeating treatments once a week. It may take three treatments before we start to see tumor shrinkage
We now know we were a little naive in thinking about getting Maggie to Over the Edge. She will be staying in the hospital in to next week (most likely) while she gets her first treatment, her liver counts are monitored, and until the liver recovers enough for the drain to be internalized and/or a stent placed. So, I’ll go to Jackson to cover the event. Molly will be there and has stepped up to go over in Maggie’s place. What a great sister!
We are thankful the drain was placed in the nick of time. Maggie’s bilirubin had been steadily rising each day. Phil asked what level represented danger to her system. He was told that starts at 15. This morning before the procedure, her level was 14. We’re praying now for the liver to drain and recover to allow further provision for a working duct, no interference with blood to and from the liver, and for Maggie to recover enough to allow toleration of the most effective treatments – standard and clinical trial.
We are encouraged by the compassionate and dedicated professionals we interact with each day, in every new department as we work our way around – Phase I trial team, ER, ICU, GYNX, IR, and GI. God places special ones in our path. We are blessed.
I am continually amazed by your family’s strong faith. Prayers headed your way.
Melissa, I got off work today and anxiously looked for info about the procedure today!! I am so thankful for the details you give us..and I am really thankful you are SO SMART to understand all this…seriously! I deserve an M.D.!!! You always were my smartest and wisest friend!! 🙂 Oh, how I am praying for these details you have outlined…Maggie is incredibly blessed to have you and Phil and Molly as her family!! And you are blessed to have Maggie as your daughter! I am so thankful that God is IN THE DETAILS! Know you all are very prayed for and loved from Idaho!!
that is supposed to be “YOU deserve an M.D…….NOT ME!!!!!!
Praying. Praying. Praying. Praying. Praising God that the drain is in place and that she had a “hit”.
Praying for Maggie.
PRAYERS CONTINUE!
I pray for the Lord to wrap his arms around each and everyone of you, prayers for healing, prayers for strength??
Thank you for updating….so clearly and precisely. We will pray accordingly!
Prayers for Maggie coming from FBC Shannon, MS.
Praying for continued strength and healing!!! Love and prayers!!!
So thankful this surgery was successful. I will be praying for this new drug to be effective on the tumor.
we continue to pray. Thankful the procedure was successful!
Praying for you all continually. Love your ability to be humorous in stressful situations. God is good and has provided a fun coping mechanism 🙂 that you are allowing each of us to enjoy along the way. Continuing to pray for healing, wisdom, guidance and peace in the journey.
Thank you for keeping us updated. I pray for Maggie’s peace, faith, and continued reliance on God. I’m so thankful for her wit and humor!
Praying for a clear path for the next treatment and liver protection
Continual ?????