Stable

E. is stable.  He is doing well.  He's had visitors trickle in and out all day long.  They witnessed various moods and expressions throughout the day ... a little bit of loopiness, some grimaces of pain, a bit of orneriness thrown in for good measure, a dash of normalcy and a whole lot of sleepiness.

The GI doctor came in and did the scope first thing this morning.  They actually brought the procedure to E. rather than bringing E. to the procedure.  They wheeled a big cart with all the equipment right into E.'s room in the ICU and did the endoscopy right there.  Pretty impressive.  I waited in the waiting room, but returned after about 45 minutes.  The doctor explained that he found one bleeding esophageal varice (you might recall that E. was found to have esophageal varices in the endoscopy done on November 1st).  An esophageal varice is an abnormal, enlarged vein (like a varicose vein in the esophagus) that most often occurs in people with serious liver diseases.  They develop when the normal blood flow from the liver is slowed.  The blood then backs up into nearby smaller blood vessels (like those in the esophagus) causing them to swell.  Here's the kicker:  sometimes those esophageal varices can rupture causing LIFE-THREATENING bleeding.  Glad I didn't know that yesterday.  Anyways,  the GI doctor used an elastic band (like a rubber band he said) to tie off the bleeding vein.  Basically the vein gets "strangled" so it can no longer bleed.

The GI doctor said that the stomach and the entire digestive tract was inflamed, swollen and irritated.  There were possibly other areas where bleeding was occurring as well, but he thinks that the esophageal varice was the main one.  E.'s on a host of different medications, including a medication that slows the flow of blood from the organs to the portal vein, which reduces the pressure in the vein.  All this will hopefully stop any internal bleeding that might still be occurring.

While the doctor was in there checking things out, he checked on the stents.  The bile duct stent was still in place and doing the job it was supposed to.  The stent in the pancreas (the one that was put there as a detour and we were hoping would slide out on its own) was still there as well, so the doctor went ahead and removed it.  E. tolerated the procedure well, but was out of it for quite awhile afterward.

E.'s still resistant to take any pain medication, despite cajoling from others.  He often grimaces in pain, but claims "it's not THAT bad."  The nausea seems under control, yet he still has no appetite.  Today, he took a total of two bites of pudding and one sip of soup.  They are going to try to start him on a medication to stimulate his appetite to see if that might do any good.  The nurse thought she might suggest a discharge for tomorrow or the next day, but when I ran into the doctor, she thought she might move him to a regular room tomorrow or the next day.  Either way, he is clearly improving so that is good.

Oh, and on another good note, his bilirubin level today was 3.8!