Pitre a ‘trouper’ while he awaits gallbladder surgery in Minnesota
Jonathan Pitre remains in a Minnesota hospital as doctors strive to prepare him for gallbladder surgery by hiking the number of blood-clotting cells in his body.
Pitre’s gastrointestinal system is struggling to eliminate the waste chemical bilirubin, which has yellowed his eyes and skin and left him nauseous and exhausted.
Bilirubin is a brownish-yellow substance made when the body breaks down old red blood cells.
Doctors believe that the bile ducts of Pitre’s gallbladder are blocked, impairing his body’s ability to effectively remove the chemical from his system.
“He’s so yellow: I call him my little yellow man,” said his mother Tina Boileau in an interview Tuesday. “Even his blisters, any secretion from them is yellow.”
The condition has also made his skin itchy, which is especially problematic for someone with epidermolysis bullosa (EB). The incurable genetic disease makes his skin quick to blister and slow to heal.
“It’s just such a vicious circle,” Boileau said.
Gallbladder problems are a common complication after high-dose chemotherapy, which Pitre endured before his stem cell transplant five months ago. He has been in hospital for all but two days since that transplant, his second.
The transplant has taken root in his bone marrow, but it has been accompanied by bacterial and viral infections and kidney, liver and gallbladder problems.
“He is sicker now than he’s ever been and a lot less tolerant of his pain because of the nausea,” said Boileau. “But he’s such a trouper. He’s trying hard.”
The medical plan now is to remove Pitre’s gallbladder — it’s a small, pouch-like organ that stores bile produced by the nearby liver — as soon as he’s healthy enough to undergo the surgery. It’s also possible that doctors will insert a temporary stent to drain his gallbladder if that’s deemed a safer option.
The latest complicating factor, however, is that Pitre’s platelet levels — the cells help blood to clot and wounds to heal — remain stubbornly low.
He’s receiving transfusions to boost those levels, but that process, too, is complex since Pitre’s immune system has developed antibodies to some of the transfused platelets.
It means the platelets he receives now are being cross-matched to find those that are the most compatible.
There’s no timetable for Pitre’s surgery since the procedure can’t be undertaken until his platelets have reached a level at which they can prevent excessive bleeding.
“This gallbladder needs to come out: It has been the source of many problems for the past three months,” Boileau said, adding: “At one point, Jonathan needs to be able to recover and start feeling better.”
Pitre’s skin has improved since his stem cell transplant and his body has shown no sign of infection for the past two weeks.
The Russell 17-year-old has been in Minnesota for more than a year at the only facility that conducts stem cell transplants for EB patients with no other medical options.
“At this point, people wouldn’t believe me if I explained to them everything that has happened,” said Boileau. “You try to fix one problem and then something else happens. It’s one thing after another, just so many things.”
Boileau has celebrated two September birthdays inside her son’s hospital room at the University of Minnesota Masonic Children’s Hospital.
This year, Pitre gave his mother socks and slippers for her birthday since his fourth-floor room is heavily air-conditioned.