We didn’t expect this…. Follow up to ‘Just when we thought we had made it to 5 years’

chemosmoker said:

Medical term search and information...
Marilyn,

Grateful to hear the chemo is holding the cancer at bay for now. As for the liver issues I did some reading. I know that the word Ascites is branded about here allot....and Michael is currently suffering from some from of this right now with that magic vacuum pump he is living with, but here is what I find in researching fluid accumulation around the liver. I hope this might lead you in the right direction? Just hoping to help as I am no doctor!

Here is what I can find:
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Ascites (/əˈsaɪtiːz/ ə-sy-teez, from Greek askites, "baglike")[1] is a gastroenterological term for an accumulation of fluid in the peritoneal cavity. The medical condition is also known as peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum or more archaically as abdominal dropsy. Although most commonly due to cirrhosis and severe liver disease, its presence can portend other significant medical problems.
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And this:

A collection of fluid around the liver (perihepatic fluid) is not specific for any one condition and can be due to a wide number of causes. The fluid could be ascites (an excess of abdominal cavity fluid), blood, urine, chyle (lymphatic system fluid), bile (digestive secretion produced by the liver and stored in the adjacent gallbladder), pancreatic juice (digestive secretion from the pancreas), or pus. With all of these fluid sources, the list of causes may include tumor, obstruction (e.g., bile duct blockage by a gallstone), trauma, autoimmune disease, heart failure, infection, abscess, medication (e.g., Tylenol overdose) or toxin, cirrhosis (liver scarring with dysfunction or failure), etc. Unfortunately, the symptoms you report (headache, ear ache, sore throat, swollen glands, fever, nausea, vomiting, weakness, and loss of appetite) are also nonspecific with countless possible causes. Your doctor and/or one or more specialists (e.g., gastroenterologist, or digestive system specialist) will obtain appropriate labs and imaging studies to confirm the underlying diagnosis for the perihepatic fluid.
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Hope some of this helped?

God bless. I will be watching for more informed posts as well.
Praying for you both,
-Eric

Further developments
Thank you to those folk who read our story and left such kind comments. We have a new update if you are interested.

Thanks Eric for the information. I appreciate your care and effort.

A visit to the oncologist always seems to throw up more questions than answers!
So chemo is not doing anything to whatever is in the liver? And what is the fluid – blood, bile? We were so shocked. We thought things were going well despite Brian feeling crappy with chemo. And there was not going to be a break – the oncologist wanted him to have 6 months worth of chemo.

We continued to feel a little stunned for a while and found it difficult to grasp how severe or dangerous it was or might be due to no real new information. Brian worried that he might have an agonising journey with liver cancer and I feared him not even making it through an aspiration! The mind takes you into places you don’t want to go.
We tried hard to keep going and we usually only allow ourselves ‘wallow’ time immediately after bad news before finding things with which to occupy ourselves. Whether it is fact or not, Brian thought he could ‘feel’ his liver and occasionally became very despondent. We seem to have spent so much of 2011 just waiting. Our plans for a break in November have now appeared in a different form. With Brian off chemo while the liver is being investigated he still has to have a weekly PICC line flush so we aren’t going anywhere!

Anyway, we finally got to meet our liver specialist. I had checked him out online and he seems very competent and well-trained (in the US!) He was very thorough, asking lots of questions to get to know his new patient and wants to chase up every film Brian has ever had in order to have a complete dossier on the computer. (We have had tests at different hospitals) He talks about putting Brian’s case to the surgical team at the Austin Hospital – which also includes our oncologist – for their considered opinion. He is all for doing nothing at the moment as rushing in and draining the fluid may not be the wisest option. So we have an ultrasound next week for confirmation of the fluid type. At the moment he suspects that it is blood and could possible resolve itself and be reabsorbed back into the liver.
We were there for about 30 minutes and managed to discuss lots of things, not the least of which included why the possibility of a ‘debriding’ or ‘debulking’ of the abdomen to remove the peritoneal nodules had not been considered. Although he is not necessarily recommending it, he wants to make sure that we are aware of all possible options before continuing with any treatment. This sounds horribly scary to us as it is not commonly done here! So we left feeling stunned (again!) and not sure what to think. He planned to ring us in a week.

However, next morning he rang us and completely surprised us with new news. He had spoken with our IL surgeon and the oncologist and reviewed the latest CT scan which was now on the computer and allowed a closer, more detailed look. He is now pretty sure that it is fluid other than blood! If there are no symptoms (which there aren’t at the moment) then he suggests leaving it and only draining if there are any issues. He talked about the surgery again and is still not sure of the right answer. He did say that the situation didn’t look alarming though.

Needless to say all of this has resulted in a large sigh of relief from us and a feeling that a load has been lifted from our shoulders. So we wait some more…

Marilyn

(PS. Last night I wrote all of this straight onto the board and somehow hit the wrong button and lost the lot! Just now there was an electricity surge as soon as I had finished typing and my computer went off! I recovered most of this (in Word) but still had to remember what I had written before. I bet it sounded better then! Lesson learned.)