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       #Post#: 19--------------------------------------------------
       Pittsburgh (trip #5)
   DIR By: hlsypin
       Date: May 14, 2017, 10:36 pm
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       May 2, 2017
       Update on Blake. Have you heard of scans/tests that "light up
       like Christmas trees"? Well, we experienced it today. During
       Blake's ultrasound, the pictures were literally lit up in red
       dots, indicating pain and inflammation. The sad truth is that
       Blake has been in pain for so long, that he doesn't realize what
       its like to be pain free and has accepted it. If I ask him if
       he's in pain, he shrugs and says "I don't know" because he
       honestly doesn't! He just knows that he doesn't feel "right".
       Dr. Srinath ordered more blood work today, but they are most
       likely going to order another endoscopic ultrasound. They want
       to recheck Blake's gall bladder for stones/sludge. If either are
       present, they will plan to remove the gall bladder. This would
       be the reason for the pancreatitis flare ups. If they're not
       present, then they will try another medication (steroid regime)
       to hopefully reduce the inflammation of the gall bladder. The
       absence of stones or sludge would mean that the gall bladder
       inflammation is being caused by the Ulcerative Colitis.
       My question was "What reason would there be NOT to remove the
       gall bladder, if that's what is causing the issue? The reason is
       because if they remove it, there's an increased chance that the
       UC would attack Blakes liver at an increased rate.
       Right now, his liver is functioning normally and is responding
       well to the medication for his Primary Sclerosing Cholangitis.
       This is actually great news! Dr. McKeirnan informed us today
       that he was actually very surprised at how well Blake responded
       to the medication. His Cholangitis was advanced and there was
       initial doubt that it would be treated as easily as it was. This
       is why they don't want to do anything that could effect the
       liver, if they can avoid it.
       We were also instructed to call the office at CHP any time Blake
       does complain of pain that would indicate a possible
       pancreatitis flare up. They want to be the ones handling the
       treatment so that they can monitor his diseases as well.
       Although Hamot does a great job treating the pancreatitis, they
       are not specialists in handling Blake's diseases as a whole.
       I also questioned Blakes extreme tiredness. Both doctors
       reminded me "Although he doesn't complain on pain, he is still
       sick. He's still fighting 2 diseases. This is expected. The goal
       is to find an exact reason for the repeated pancreatitis flare
       ups so that we can get him on the road to normalcy."
       Follow up is in 2-3 months.
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