I finally talked to the internal medicine specialist and thought i'd update everyone. We're still in wait-and-see mode but he was glad to see the enzymes coming down, though he'd rather they moved more quickly. Those enzymes have a pretty short half life so could drop very quickly - disappointing that they didn't drop more significantly (but they did drop). Also, Gael's bilirubin is back up a little, which is concerning as well. It started at 4.3, then dropped to normal, then went back to 1.1 and tuesday was at 1.5 (.9 is the top of the normal range). The good news is that she still feels good. I'm picking up a medication today that might or might not help (Actigall), and we'll repeat the blood work on tuesday. If the numbers aren't dropping we'll have to consider getting more aggressive and doing a surgical biopsy. Unfortunately, Gael's not the best candidate for surgery with compromised liver function - the liver needs to be able to handle clearing the anesthetic agents from her body.
So that's the latest...
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