Special Christmas

My wife Medy, my daughter Luna, and I were all set to leave on Dec. 20 for Silicon Valley to spend the Christmas holidays with my daughter Emily, her husband Brett, and our grandson Carter. I had also arranged for Stanford University Medical Center to take a look at Medy to check if her bile problem had indeed been solved.

We had standing instructions from our liver surgeon to rush to Makati Medical Center to have a third operation once Medy developed jaundice. Since she had had no bile leak for a month and a half, I was sure nothing could stop us from going to the US.

The reason for the standing instructions was, of course, bile.

All red blood cells break down after three or four months to be replaced by new cells; this is the body’s way of cleaning our system, something like a biological oil change. When the cells break down, they release a yellow-orange protein called bilirubin. The liver sends the bilirubin through bile to the small intestine for eventual excretion. If bile does not flow to the intestines, the bilirubin stays in the bloodstream and stains the eyes and the skin yellow. That is called jaundice. Since Medy’s original problem was the lack of a way for bile to move from the liver to the small intestine, jaundice was a visible sign that the original problem had not yet been solved.

Towards the end of November, some of Medy’s friends remarked that her eyes seemed a bit yellow, but because I was eager to leave for abroad, I was on denial mode.

On Dec. 3, her friends insisted that she had jaundice. I answered that the only way to find out for sure was to have a doctor see her. We called the liver surgeon to set an appointment. She was out of town and could not do the operation in Makati Medical Center immediately anyway.

We decided to see the hepatologist we had consulted four months earlier at St. Luke’s Medical Center. The moment she saw Medy on Dec. 4, she said, “This can’t wait anymore. We have to operate immediately. The risk of infection is too high.” 

St. Luke’s Medical Center did not earn its reputation of being “a center for world-class healthcare in Asia” by not being proactive. If the race against bile was going to be won, it had to be won quickly. The hepatologist arranged for the operation to be done by one of the best Filipino biliary surgeons, who happened to have a day free in his busy schedule.

This was the third clear sign that God was directing the events. We learned from doctors later that, had we waited longer, Medy would not have made it. It was crucial that we got a free slot in an operating room with excellent doctors attending to her.

On Dec. 5, Medy was admitted into St. Luke’s Medical Center. That night, Emily arrived from the US.

After various tests, Medy had her third operation on Dec. 8. After the four-hour operation, the surgeon explained to us that, instead of merely repairing the earlier Roux-en-Y, he had done another Roux-en-Y with a larger opening, using a different part of the liver. He had removed three remaining tiny stones from the liver. He had moved a portion (the jejunum) of the small intestine close to the skin, to enable non-surgical repairs in case of future need.

“No one among my patients has ever had to use this safety measure,” he assured us, “but it’s better to be safe.” Should the bile stop flowing again to the intestines, Medy need not have another operation. All a doctor has to do is to extract through the port whatever debris may be causing the blockage.

During the seven-month ordeal, with bile unable to leave her liver (called cholestasis, from the same Greek root word as “static”) and scarring liver tissues (called fibrosis), Medy developed secondary biliary cirrhosis. (The term is misleading because it is not cirrhosis, which is chronic liver failure and life-threatening.) Damage to the liver is supposed to be irreversible and may eventually cause cirrhosis (the real thing).

We are not scared even a little bit about the irreversibility, because God has already shown extraordinary care for Medy and is not likely to let up now.

In fact, during our consultation last week, the hepatologist said that Medy’s latest blood tests showed that the biliary cirrhosis may be reversible. That would be another miracle, but who are we not to believe in miracles? In any case, biliary cirrhosis is a condition Medy can live with for a long, long time.

After the operation, Brett and Carter arrived to spend Christmas with us in Alabang. We still had a family celebration, though not in California as we had thought we would. God meant for us to spend the holidays in the Philippines. Christmas in 2008 was truly special for our family. (Final instalment next week.)