As the gallstones turn

We had our follow-up with the hepatologist yesterday. (And, if like a friend, you have a brief split-second moment of thinking, "Wait, why does Rip need to see an expert in lizards?", you might enjoy this comic.)

The good news is that Rip is just a carrier of alpha anti-trypsin deficiency mutations, just like I am. That means we have reduced enzyme activity as compared to normal people, but there's not much research on the clinical significance of that... so besides the fact that we should endeavor to treat our livers and lungs with extra kindness, there's really not much of a take-home message.

The other good news is that all of Rip's liver tests are back to normal, even the GGT (50)... so his episode last month didn't get to the point where it stressed out his liver too badly.

The bad news is that Rip's gallbladder, which was perfectly clear on all ultrasounds in January, is now filled with stones. So, we're on watch for continued bile plug episodes like the ones we had in early January and mid-February, as well as being cautious on the look out for pancreatitis (which is what happens if the obstruction is further downstream of the pancreas).

We're having another follow-up ultrasound in two months before we go out-of-country on our Exciting Vacation. Right now, it's unclear if the benefits of gallbladder removal (no risk of pancreatitis or pain from gallstones) outweigh the risks (surgery, loss of very cute gallbladder)... so we're waiting some more, but alas, this lovely hepatic drama isn't fully behind us yet.

I dispatched an email to the oracular House-MD-like doctor we saw in January to see if he has any ideas for diagnostic testing, as our hepatologist here just suggested testing him for Cystic Fibrosis mutations, which seems unlikely (our donor tested negative for 97 mutations, I did for 29, so the chance that Rip got messed up CFTR alleles from both of us is pretty slim).

But, in the meantime, we can at least continue to get loads of photos to satisfy Jolly's insatiable craving for "pictures of [Rip] in the HOSTIBLE," which is pretty much all that he thinks anyone should ever use the computer for.