Had two out of three procedures

Okay ... short and sweet.

Met with the surgeon, before the operation.  I asked him if he'd seen the radiology report AND the MRI images.  He had.

Do you have an opinion as to what we're looking at, Doc ??

Yeah.  I think it's cancer.

[Note: at this point, they ALL think it's cancer]

Here's the short part.  Post-op ... the doc says he found nothing, did NOT take a biopsy.  That's it.  He saw no occlusion ... no stricture ... no tumor ... nothing.  It up and disappeared like a fart in the wind.  He did an Endoscopic Ultrasound AND an ERCP.

My bilirubin is down, again, but not to normal, and it COULD be because of the cholestyramine that I'm taking.

My ALT, AST, and Alk Phos are still quite high.

Which points to autoimmune, but ... I am NOT happy that he didn't take a biopsy.  He was asked to, by my primary care GI guy.  Why would you THINK it's cancer, and then not take any kind of tissue sample ??  Why wouldn't you take a brushing (for cell analysis) ... from where you SAW the blockage on the MRI ?

It makes zero sense.

We called the primary care guy.  Left a message.  I'd like to see him ASAP (currently scheduled for Tuesday).  Will probably need to be referred to Immunology.

Cancer would have been a simpler diagnosis, if not "better" or easier.  Autoimmune -- particularly in a complicated patient with a diagnosed immune deficiency -- is not a good thing.

We're all very confused.  I suspect Dr. Hu (my liver guy) isn't going to be happy about this.  It's more likely than not that I'm going to have to undergo a separate liver biopsy ... through the skin ... instead of the whole "While you're IN there" that today would have been.

I dunno' what to say.