Tuesday, July 26, 2016

Do I Look Yellow to You? - July 26th

Beth’s feet are back to normal (well, except for her kickstand toe).  The swelling was all but gone this morning.  We might have overreacted last night after Googling what swollen feet meant combined with cancer. There were lots of results that mentioned, “end stages of liver cancer”, “liver failure”, “final symptoms”, etc.  Totally freaked us out.  

While swollen feet can be a sign that something cancer related might be in play, it also could just be a side effect of traveling 13 hours in the car on Monday and her not walking around much during those 13 hours (I think she only got out of the car once during the entire trip).  
As we read more posts from our Google search we were a little relieved that there are other symptoms that are usually present in people on the verge of liver failure.  Beth has some of them, but not ALL of them.

Jaundice
One of the liver's many functions is to break down the components of old or disfigured red blood cells. The chemical bilirubin is released by red blood cells and broken down by the liver. If the liver is unable to expel bilirubin or the red blood cells break down at a rate faster than the liver can keep up with, there will be yellowing of the skin, whites of the eyes and the underside of the tongue. When metastases invade normal liver, the decreased number of liver cells are unable to keep up with the metabolism of bilirubin, and it builds up in the blood.
Beth does not have any of these symptoms. Beth did ask my mom and I today - “Hey you guys will keep an eye on my skin and eyes and let me know if I start to turn yellow, right??”

Increased Abdominal Girth
The liver synthesizes many proteins for the blood. Some of the proteins regulate the fluid levels in the body, particularly by keeping fluid in the blood vessels. If the liver fails, these proteins are not made, and fluid leaks out from the blood vessels and into the surrounding tissues. In the case of liver failure from cancer, the decreased number of liver cells cannot synthesize enough proteins, and fluid leaks into the abdomen. Fluid build-up in the abdomen, called ascites, leads to increasing abdominal girth, nausea and vomiting.
Beth abdomen is swollen and very tight and has been very painful.  She has had nausea and vomiting symptoms for a while now.  

Problems with Kidneys or Lungs
The liver plays such a major role in the body that without its proper function, other organs may begin to malfunction. In hepatorenal syndrome, liver failure leads to kidney failure, with increased fluid buildup in the body, weight gain, swelling and decreased urine output. In hepatopulmonary syndrome, dysfunction of the liver causes dysfunction in the lungs, which can leading to breathing complications. These issues may be compounded with cancer if metastases have also spread to the kidneys and lungs further compromising their functions.
I don’t think we are too worried about her kidneys or lungs just yet. Beth for sure is not gaining weight and the swelling seems to only be in the abdomen (aside from the one day of her feet swelling).  

Bleeding Disorders
Other proteins made by the liver work to regulate bleeding. The proteins undergo a series of chemical reactions to stop bleeding once it has started. In the case of liver failure from cancer, the decreased synthesis of these proteins from the invasion of tumor cells makes it harder for the body to stop bleeding. Once bleeding has started, it may take longer to stop the bleed and a transfusion with blood products may be required to replace the missing proteins.
Another symptom Beth has not experienced.

Confusion
Since the liver helps to clean and detoxify the blood, toxins can build up in liver failure with cancer. One toxin that has been linked to confusion, sleepiness, and disorientation during liver failure is ammonia.
No worries here yet either.  Her confusion is mainly caused by her son’s eating habits, Lily’s choice in outfits some days and why on earth would an MVP caliber player (top 2 or 3 player in the league) join forces with one of the best teams in the NBA after losing to them in the playoffs???  Those are her thoughts, not mine.

So, we all feel a little better now that we had time to do a little more reading up.  Still on high alert and praying for increased time though but not freaked out like last night.

Tomorrow we leave Indiana and head back home to Ohio.  As we get closer to our vacation ending I am saddened.  This will probably be the last trip Beth will physically be able to make.  Traveling is just too hard on her. I take that back, we do have a trip to Chicago on Monday for Beth’s regular 3 week check up.  Depending on how she does on that drive we may chose to switch doctors from CTCA to a local doctor to spare her the travel.  Beth is not at all happy about switching doctors to anyone but CTCA.  

Beth not being able to travel anymore also throws a wrinkle into my efforts to help Beth fight cancer emotionally.  Over the last 18 months I have strategically planned trips or vacations for her to look forward to, to set her mind on fighting towards.  After each trip, I would casually put the idea of the next trip that she could focus on getting too.

There is no next trip planned.  I am worried about that.  I am worried about what short term event she is going to look forward to. Maybe I’ll break the news to Ben and tell him I am taking Beth to Cavs Opening Night (Championship Ring Ceremony) this fall. Maybe that will be her next event to look forward to.

2 comments:

Anonymous said...

Oh I'm glad you've put your (and all of our) minds at ease. Keep digging deep. We love you and continue to pray.
I vote you take Beth to opening night. 😉

stalker sarah said...

I'm going to come visit (if she's up to it and of course, I won't stay long or be a burden)! Maybe that will be something small she can look forward to! Or maybe she doesn't want me to come at all! Ha! Also. Def take her to opening night! Prayers are always going up! Love and hugs from Kentucky! 💗