On 3/14/2008
Maurice wrote:
Hi Leaonard..
All the best of thoughts and prayers to your wife and yourself.
It's Maurice here - again - from Toronto. Found out today that they have removed the external tubes/cathader from my brother...I noticed you are not in favour of this..And, never heard of them doing an internal drainage - other than the original stent. He now has infection around the incision.
What do you think of this...I'm thinking...where does the bile go....if it's not draining out of the body...Doesn't make sense to me to have the tubes removed..
What do you think.
As always appreicate your responses.
best regards,
Maurice
Hello Maurice,
I noticed you picked up on my message to Bayla...that's find because most of these situations are almost about the same horrible issues.
Thank you for the warm comments regarding my wife and myself.
In your last message I read form you was that the doctor inserted an internal stent not a external stent.
Well, first of all you are correct about how I feel about external bile catheter drains. Let me say one more thing about the external drain catheter. I think some of you think the only purpose of this type of catheter is to only drain bile out of the liver into an external collection bag...that's not the total purpose. In my wifes case, she has two (2) external catheters inserted into her liver. One tube is a #8 and the other is a #10. They both are inserted into two separate existing ducts in the liver. At the upper end of the tubes is an area of approximately 2" to 3" long with small hole in it. Picture a lawn watering hose with all those pin holes. The bile drain/stent tubes in my wifes liver are very similar. The purpose of these tubes is to allow the bile to flow out of the two existing ducts and directed into those holes, down the tube that's also inserted into the new common bile duct (small intestine) and down into the digestive system. The only time my wife uncaps the external caps is to flush the catheter's, this is why she has no bile and or blood infections. We flush once every day. This keeps the upper portion of the inserted tubes (stent) free from clogging. That has been my wifes life saver.
Sorry for inserting all this info, I just wanted you to understand the external drain tube purpose...I've read a lot of messages on the cancer board that indicates a lot of folks have the wrong impression of the external drain tubes. By the way, you should only need to drain for 30 minutes each day. Now there are times when the bile turns dark green and a fever surfaces. I that case the draining procedure needs to be handled in a different way.
But back to your comment about the doctors removing the external drain tubes/catheter. Okay assuming he had an external catheter and now it's removed. And I am assuming he still has the internal stent. I am a little confused, but lets go with those assumption. First of all if your brother has the internal stent and it is not functioning it most likely is clogged, he has a problem. If that's the case and they removed the external drain catheter, your brother has a bigger problem. I hope they are not giving up on him.
You mentioned he has an infection at the incision. I'm assuming you mean the entery site where the catheter enter's the body. Allow me...This dressing must be cleaned everyday. In my wifes case...Wash your hands first, cloves are not necessary. I remove the dressing everyday. With Q-Tips dipped in Hyhrogen Peroxide wipe around the tube entry site. You will see white foam surfacing because of the bile in the entry site area. wipe the entry hole clean with another Q-tip. Take a 2x2 gauze pad and cover the entry site. Then take a wide (the IR department furnishes me with this special tape) tape and cover the gauze pad. If you or some one else does this everyday your brother will not get an infection at the entry site. I have been doing this for my wife for 4 years and she has never had an infection at the entry site.
Maurice...you bring up a very important question, "where does all the bile go" Lets assume there are no internal stents or if there are they are clogged, no external drain catheter and the existing ducts are clogged...sounds like you have a 747 in a crash mode at 700 miles an hour. If this is the scenario, your brother is in trouble. Where does all the bile go...well it backs up into the liver and into the body. Your brother's eye's and skin will turn yellow, his urine will turn dark orange and his stools will be an ash color...as you can imagine, all this is not good. I can't believe his doctors are allowing all this to happen, unless they have a hidden agenda that you and/or your brother don't know.
Maurice, Keep questioning the doctor's or at least tell them to lay it all out on the table, so there are no surprises.
Goo Luck...sorry for the long message.
Leonard