Today's update on Brian

Thankyou so much for your texts, voicemails and phone calls today. It was so nice to get to hear from friends and family who are thinking and praying for Brian.

It was a great trip up here and after a wonderful home cooked lunch from Auntie Doris, we got ready for the appointment. Then we got a call from Bri's nurse saying they were super behind on proceedures and to not come in until atleast 3:30 for labs since all we would be doing would be waiting.

We put the kids down for naps and visited with Doris. Then we took a special trip to our favorite beer spot in the midwest, John's Grocery Store on UI's campus to pick out two yummy six packs to do a tasting with my brother and neighbors ( probably should have waited to make the purchases until after the appointment)....

We got there, Brian did labs and we were meeting THE DOCTOR ( one of the most renowned GI specialists in the country) by 4PM. He did an extensive medical history and pain history, an exam, and talked and talked and talked. By 6:15, we were headed out the door with no real answers but a plan and some real options. We feel good and we feel there is no better place to be than here, at the University of Iowa Medical Center....

He reviewed Brian's ERCP and while Carle said that all his ducts were totally clear, we very clearly saw a large white ball in his common bile duct. It could be an air bubble but it also could be a large stone. "Definately not clear," Dr. said. COuld that be causing the pain? "Absolutely"

He looked at the film of his sphincterotomy and said that they opened only 20% of it and that there could still be dysfunction in the Oddi area and that could be the cause of the pain.

We got his labs back and his liver enzymes were high again. He said that when you have a true biliary attack, your enzymes go really high and the 2-4 days later go back to normal. Well, Tuesday he had one of his worst attacks yet and the high numbers could still be from that. They spike then balance out over and over, truly proving a realy acute dysfunction, THis would be his second spike ( remember how his last ER visit showed high liver counts then 4 days later was normal). The doc said that our next plan of action would be to do blood work on Monday to be sure the numbers go back to normal. Then, we wait for an attack. During an attack, Bri has 2 hours to get to the lab and get more blood drawn. If that shows a spike, then we wait 2-4 days and test again and see if it goes back to normal. if we can prove true biliary dysfunction based on blood levels, insurance would then cover another ERCP. During that ERCP they would go in to the bile duct, see if that little ball was a stone. if it was there, remove it. ALso do extensive testing on the sphincter of the Oddi and evaluate that condition as well. ALso while in there they can see the liver and evaluate that as well.

Brian is fasting right now. TOmorrow morning he goes for more labs. They are doing a glucose and an insulin test just to get a full picture of his levels there since there is diabetes in the family and sometimes liver issues can be early signs of other conditions. ALso, they are doing another Celiac Disease screening. While Sphinter of the Oddi Dysfunction is very rare in men, when it does happen for men, many have Celiac's disease so again, we test ( since Bri's family has that too).

The waiting for an attack plan could be annoying and possibly even long but the doc assures us that if we can weather this storm and get this information, we'll know exactly what route to take. His job is to get the clearest picture and do the least amount of proceedures with the littlest risk involved to get the best results.

While our doctor had some social awkwardnesses and his sense of humor was extremely dry ( and he didn't seem to appreciate Brian and my silly sense of humor), he knew his stuff and he was very specific about what needed to be done and what he would be doing once we had a better picture.

We feel in good hands and very cared for, even if he didn't like Brian's poop jokes or threats of eating a bacon cheese burger and large beer for dinner tonight.

We also got to spend a few hours with my cousins and their kids tonight at dinner and at my aunts house. My cousin Becky is the one who saw this same doctor and has Sphincter of the Oddi Dysfucntion herself. She's been such a blessing to us as she has been a great support and the only one that really understands the pain Brian has been suffering through. Not to mention my kids LOVE her kids and they all got to stay up extra late tonight playing since they only see each other a few times a year.

Brian is supposed to be extra careful with is diet and again, NO BEER for awhile while we deal with this liver stuff but he'll be OK ( he has two beautiful six packs waiting for him)

We are back to waiting but for whatever reason, it doesn't feel so bad. My heart is full of hope again instead of the agony of not knowing and not feeling any committment from health care providers to help us. We have a plan and while the journey ahead could be a long one, we hope that we finally have the right path and feel confident knowing we have care providers who will work with us and not give up.

Keep checking back here! We'll post updates after his labs and such tomorrow and also as we get results from each of his labs ahead.

Thanks for everything. Keep asking how we are doing, keep cracking jokes with us and helping us keep it real, and keep praying for us. We need it and it's working!