In the time that has elapsed since my last post-surgery blog in late December, an interesting post-op complication lingers. A few days after surgery, I developed a mild form of jaundice, which has stayed with me these past five weeks.
It’s a medical mystery, currently under review by an array of doctors. We have ruled out pre/post-surgery drug interactions, and a reaction to anesthetic from the two surgeries I’ve had since spring 2010. The only clue as to what is going on with my body is an elevated liver enzyme, without a known cause.
As a recent cancer survivor, I undergo quarterly medical check-ups and blood work, which includes testing for white blood cell counts, cancer markers, hemoglobin levels, liver enzymes, thyroid and bilirubin counts.
In September, October (pre-op prep), and December, all of these levels were normal. Between first noticing jaundice, seeing my doctor the week of Christmas, and then again two weeks ago, one liver enzyme (alkaline phosphatase) climbed to four to eight times the acceptable range. There are no other irregularities with my most recent blood work results.
I have no pain, swelling, or loss of appetite. I am tired, but am still recovering from major surgery. I am somewhat fatigued all the time, as my cancer drug Tamoxifen is a form of chemo, and fatigue is a side effect.
My medical team does not know why this jaundice is occurring, as the symptoms are unusual. My doctors have put on their detective hats, and are trying to solve this medical mystery.
The diagnosis of jaundice is done by the elimination of possible contributing factors. We know that drugs and anesthetic don’t appear to be the problem. I did not have a blood transfusion during the last surgery. Other potential causes could be hepatitis, a blocked bile duct, inflammation, cancer, or an unknown cause. Because of my cancer history, the medical team is being prudent in further testing as breast cancer can return to my other breast, bones, lungs, liver or brain.
Discussions have taken place between my family doctor and surgeons, anesthetists, and my medical oncologist. The oncologist and family doctor have determined that I need to undergo more blood work tests, a CT scan, a bone scan, and a referral to a hepatologist (liver specialist) to see what may be triggering this problem. It feels like the suspicion of cancer and diagnostic screening all over again.
My nurse educator tells me that every time something suspicious arises with my health, the fear of cancer returning is a normal reaction that all cancer survivors go through as part of their journey with this disease. As my surgical oncologist once said, “women with a breast cancer history live the rest of their lives with the feeling of a guillotine hanging over their heads.“
The stress levels are creeping up. This time of anxiety is so familiar. I am on another roller coaster ride in living with a cancer history. I am still off work, and am trying to stay calm and busy with mindless home projects to distract my worried thoughts. It is a difficult topic to talk about…
I am resolved to work through this medical mystery one day at a time and trust that all will be well. I will do so with Strength, Courage, and Determination.