Friday, June 5, 2009

Tommy is still not out of the woods; his liver enzyme numbers continue to climb. The doctors have been going around and around about whether the problem is with gall stones or with the liver itself. (If the problem is with the liver, it's probably far more serious.) Dr. Raj (Tommy's primary-care doctor) said for weeks that he thought it was a bile-duct obstruction. Then, Dr. Portz (the Beebe Hospital emergency-department doctor, who saw Tommy on Memorial Day weekend) said that Tommy had acute gall stone disease and that he should see a surgeon immediately. First thing after the holiday, I took Tommy to see the surgeon, Dr. Tatineni; but after reviewing the countless tests that had been done up to that point--numerous blood-work reports, MRI, X ray, ultrasound, diagnosis from Dr. Portz--Dr. Tatineni said no, Tommy may have gall stones but they're "innocent bystanders" and the problem is with the liver. Dr. Raj and the surgeon then talked, after which Dr. Raj called us to say that he now agreed with the surgeon. The surgeon referred Tommy to Dr. Caruso, the gastroenterologist; but when we got to that appointment, it was actually with Dr. Caruso's nurse-practitioner, Kelly. She ordered more tests, but this was clearly a situation where we needed the specialist, and I insisted that Tommy see Dr. Caruso as soon as possible. So, next Wednesday Tommy will finally see Dr. Caruso, and I'm hoping he will come up with a diagnosis and a plan as soon as possible.
Meanwhile, though, Tommy has no symptoms of stress in his liver or biliary system (no jaundice, elevated temperature, nausea, loss of appetite, etc.)--which is heartening. Yesterday and this morning, he has been right on target with his physical and speech therapy (we have been doing 30 minutes a day of speech therapy to help him get his voice stronger). Please, if you are reading this entry, give a call and talk with Tommy on the phone (late afternoon/early evening is best--302-539-8079). Talking on the phone, not to mention hearing from friends and family, is great therapy for him!