I'm Beginning to Hate October

2 years ago in October Jaisal was diagnosed with biliary atresia and had his Kasai.

Last year in October we had Kirk's failed attempt to be Jaisal's liver donor.

This year Jaisal is experiencing some of his highest ever liver function tests and we're trying to figure out why Sir Oliver is not happy.

Not cool October. Not cool.

Here's the story. I had to travel for work two weeks ago and was gone from my little man for almost 6 days. On the day before I was headed home, I finally had a chance to facetime with Kirk and Jaisal. Right away Jaisal's belly looked big to me.

All last week I agonized over whether I was imagining things. Then last weekend I couldn't take it anymore so we took him in for labs. All his main LFTs were up. After talking to his nurse yesterday we decided that Jaisal would have an ultrasound and either a liver biopsy or a PTC to try to diagnose if Jaisal was experiencing blood flow issues, rejection, or biliary strictures.

The ultrasound today showed no blood flow issues and no biliary dilation indicating strictures. The plan is to do a biopsy on Thursday to check for rejection. In my gut, I am still concerned about biliary strictures - ultrasounds are not the greatest for identifying strictures, but the other diagnostic alternative is a CT which involves radiation and sedation for a kid Jaisal's age. I am debating whether to have them do the PTC while Jaisal is under for the biopsy just to rule everything out. We'll see if I win that argument with the doctors or if they convince me out of it tomorrow. I just feel like we've had abnormal lab values (although none as bad as this) for a while now, and I'd rather rule everything out at one time. Only a few studies have looked at this so far, but there is some truth to the fact that children who receive liver transplants at young ages and get an older liver may have a higher incidence of fibrosis in the future (even those kids who become graft tolerant). If we add to those studies the fact that Jaisal's LFTs keep indicating mild liver dysfunction through elevated labs, I start to get concerned about Sir Oliver's long term health.

Anyway, if Thursday shows rejection or biliary strictures, we're likely in the hospital through Saturday. I guess it is about time for us to get to know the new hospital right? I did like the flat screen TVs in the ultrasound room today and it does seem like they have a lot more (and better) channels than at the old building. That's good right?