Tentative liver improvement

Over the last two weeks, I have seen improvement in my liver markers.  The alkaline phosphatase has improved from 2000 two weeks ago to 1400 last week and then 1100 this week.  The ALT and AST markers have also improved and are now sitting right in the normal range.  I also had a liver biopsy earlier this week to see if we could identify anything else amiss an it came back only showing that I have carcinoid cancer.

There is good and bad in these results.  The good is that I don't have autoimmune hepatitis and I don't have hereditary hemocromatosis so we don't need to worry about those anymore.  The bad is we still don't really understand why my liver numbers are misbehaving so badly.  The MRI I had three months ago showed just 20% liver involvement but there is always the possibility of tumors that just aren't showing up on that scan.

We also don't know why it has been coming down.  For the last two weeks (and next week as well), I have been running with TPN without lipids which is basically just glucose along with amino acids (protein).  At 1450 calories per day, this is a slow starvation and I obviously can't continue this way for terribly long.  They did find some high levels of trace elements in my system and have removed some of those from the TPN but we just don't know what change is making things better.  Are the TPN changes even affecting what is going on? 

I have been taking a new medicine called urodoil which is primarily given to help clean up gall stones or sludge but I don't have a gall bladder and my bile ducts are clear.  I have eliminated almost all the supplements I have been taking as well which cannot continue in the long run because of my kidney disease.  Is the new medicine helping or is the lack of supplements helping?  How do you know without starting or stopping as appropriate and risking the numbers going back up again?

So, what do we do now?  I wish I knew.  I haven't spoken with Dr. Boudreaux (biopsy results will be faxed down there tomorrow) and know he will want to see continued improvement.  He was also of the opinion that my cancer was not taking over the liver but what can you say at this point?  How do you really know without opening up and taking a peek?

So, onwards we go with a continuation of the uncertainty.  Cancer is waiting for the current results.  Waiting for the next time you get tests.  Waiting till you can start a new phase of treatment.  Waiting, Waiting, Waiting.  I just want to know what to expect and what to plan for but all this uncertainty is clouding the crystal ball.