Sorry we're just now getting out an update, we were waiting for official report from Dr. A who was waiting on pathology reports. May be more information than you want to know, but some wanted details and I only wanted to do one mass e-mail.
Findings from endoscopy and colonoscopy:
1. Severe erosive esophagitis from the upper esophagus to the lower esophagus – no evidence of fungal infection or viral infection. Biopsies consistent with severe esophagitis related to reflux of gastric acid. (Dr. A remarked his esophagus is worse than on last study and looks like raw hamburger meat...YIKES!)
2. Significant amount of retained fluid in the stomach consistent with gastroparesis (paralyzed stomach or poor gastric motility)
3. Moderately sized hiatal hernia – allows more reflux from stomach into esophagus
4. Small ulcer in stomach with nearby polyp. Biopsies reveal acute and chronic gastritis – inflammation of the gastric lining without evidence of bacterial or viral infection.
5. The pylorus (valve between stomach and duodenum) thickness as noted on Upper GI, was likely related to nearby ulcer.
6. The small intestine lining look healthy with normal looking villi (finger like projections). The beginning of the duodenum as it leaves the stomach had an abnormal configuration due to previous surgery and scars but not significantly blocked.
7. The small intestine appeared to move but there was reflux of digestive juices from dilated portions of the small bowel. Biopsies from the small intestine were normal without evidence of infection or inflammation
8. Altered folds in the colon on the left side of the abdomen, likely related to scars, possibly from previous drains in that area while transverse section has sharp angles (zig zag effect) making more prone to blockage.
9. Dilated superficial veins in the colon in the right side of the abdomen related to extensive previous surgeries and scarring that altered the route of blood return from the colon to the inferior vena cava. Nothing to do about but be aware; due to blood thinner therapy, if any rectal bleeding occurs seek medical attention immediately.
10. Small polyp in the ascending colon in the right side of the abdomen. This polyp was a tubular adenoma. Not cancerous but if left in, could develop into cancer in 5-10 years. Therefore, need repeat routine colonoscopy in 5 years.
Plan:
1. Continue Nexium twice daily for acid suppression
2. Trying to get answers about using Misoprostol to help protect the stomach and assist with GI motility; greatest concern is the effect on kidney function. In other people, it would be less of a concern, but with only one kidney, concerns for possible detrimental effects are raised. One nephrologist said no concern, another said don’t use, another said he had never thought about it. Not reassuring, so still polling colleagues
3. Continue Metoclopramide for now but increase dosing to more frequent use to increase GI motility and hopefully lessen reflux/vomiting.
4. Another option is Erythromycin. An old antibiotic that would make everybody nauseous, now use it at lower doses to spur stomach motility. Inexpensive but dosed like metoclopramide – 4x/day.
On a better note; we've kept quite busy the last couple of weeks with lots of time spent with family. We had a great 4th of July spent at the lake. Since Ron had to be off the blood thinner for 5 days preceding EGD/Colonoscopy, he was able to really enjoy his time there. He rode the jet ski and played a little water volleyball. It was so good to see him have fun! It totally wore him out for several days, but he says it was well worth it. Unfortunately, he started back on the blood thinner Wednesday so play time is over.
Last weekend we enjoyed more fun with family in town. We were so excited to get tickets to the Friday night Ranger game (yippee for $10 ticket nights...complete with fireworks!) but with all the rain we had, the game was delayed until 9:30 PM. We took advantage of the delay by inviting the family to our house for homemade ice cream and a hilarious time playing MadGab. We did go out to watch the game in it's entirity (until 1:30 AM) only to find they cancelled the fireworks, announcing it after the game was over!
Saturday, the guys golfed and the girls enjoyed spending the day with our sweet Mila and Ella while Stacee and Ryan both worked. Ron was able to sleep in a little and then meet up with the guys for lunch while I grocery shopped and caught up on some household items before all joining up for dinner and an evening visit with Mom and Dad Nordell.
It's always good to have the family around, something we've too often taken for granted over the years. We are incredibly blessed to have such supportive, encouraging family members and the opportunity to see the majority of them throughout the last month has indeed been a treat.
Alot of information to take in. Ron was disappointed they didn't find something that they could "fix". Please continue to pray for wise discernment as to treatment; as well as complete healing, along with patience and hope as we wait!
Much love, Christie
"He is a wise man who does not grieve for the things which he has not but rejoices for those which he has." Epictetus
"Godliness with contentment is great gain." I Timothy 6:6
"But I trust in Your unfailing love; my heart rejoices in Your salvation. I will sing to the Lord, for He has been good to me." Psalm 13:5-6
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