My First Stent

Posted 5 January 2016

Friday afternoon, we checked into UCSF emergency, and thus began one of the most tedious, frustrating parts of my ordeal so far.

What sent me into the emergency room was not my symptoms, but the blood test for Alkaline Phosphatase. The normal range is 26-137. Mine was 970, indicating some kind of liver-related trouble.

Here’s a little anatomy lesson, in case your knowledge of your organs is as fuzzy as mine was. The liver produces bile, which gets delivered to the small intestine through the bile duct. Bile is needed in your intestines to digest food, but it does bad things if it gets to other places in your body.

If the bile duct is blocked, then its main component, bilirubin, builds up in the blood. My bilirubin values had been normal, but were now climbing.

After an interminable weekend at UCSF being seen by all sorts of doctors, residents, interns, fellows, nurses, techs, and who knows who else, on Monday I was finally scheduled to have a biliary stent installed.

I was being squeezed in to an already full schedule, so we were on hold — and on npo (nothing by mouth) — for most of the day. Finally, in the late afternoon, the actual procedure was done. Remarkably, it is all done through endoscopy: down the esophagus, through the stomach, and into the small intestine. Then, find the tiny opening into which the bile duct enters the intestine, and place the stent into the duct.

My critical blood values immediately starting going down, and I wasn’t feeling sick like I had been. The long-persistent belly pain was still there, however, partially masked by an ever-increasing dose of oxycodone.

So this particular hospital adventure was addressing a side issue caused by my tumor pressing on things. The stents are supposed to be good for 6-12 weeks, after which they need to be replaced.

The stay at UCSF didn’t help with identifying the cancer or coming up with a treatment plan. I had been waiting for weeks for an appointment with USCF’s cancer specialists, and there had been hope that being in the hospital might get me higher up on their list — but it didn’t.