Josh’s Story

Site created on February 14, 2024

I have thought about how to begin our first Caring Bridge post a dozen different ways and no cohesive or adequate words come to mind. And yet, this post will be long and will be my best attempt to communicate where we are, how we got here, and by the Lord’s grace, where we hope to be at the end of what we have been assured will be a long, hard journey. 




This past August, Josh went for routine bloodwork prior to his yearly physical exam. The lab work came back with all of his liver numbers elevated. He got off of all his medications and did more lab work and discovered that Josh had contracted Hepatitis A while on a fishing trip in South America in late June. Therefore, the elevated liver enzymes were attributed to the Hep A. After three months and a negative Hep A test later, his liver numbers were in normal range. Josh resumed his medications and was scheduled to check his liver numbers again in January. 




That brings us to January 23rd when Josh went in to do lab work to recheck his liver function as a follow up requested by his primary care physician (PCP). Unfortunately, his liver numbers were elevated again, but his bilirubin was normal. Also notable is that Josh felt fine and had felt fine since October. He went back to his GI doctor and they ran a battery of blood tests, but nothing significant was revealed and everyone was more than perplexed. Josh’s PCP had him come back for lab work to retest the liver function on February 5th, and by this point, he was beginning to be symptomatic of liver disease. We were not surprised when his doctor called on February 6th that his liver numbers were even higher and now his bilirubin was elevated for the first time. 




It was decided at that point that Josh should go to the emergency room at Grandview where we ended up staying for four days. They did bloodwork and a CT scan of Josh’s abdomen that first night we were in the ER. The bloodwork showed that Josh’s bilirubin was 10 where it had been a 1 on January 25th, and by this point, he had the jaundice to show for it. The next morning (Feb. 7th), the GI team who had reviewed the CT told us very matter of factly that there was a mass in Josh’s bile ducts “suggestive” of cholangiocarcinoma (bile duct cancer). The news was abrupt and shocking, and quick research showed that this type of cancer was rare and difficult to treat, all of which we have come to realize all too well. 




While at Grandview, they did an endoscopy to biopsy the tumor and to put a stent in his bile ducts to get the bile flowing properly. They were able to stent the right side of the liver, but they were unable to stent the left side because the tumor was completely blocking that side. So we prayed that the right side would do the heavy lifting of moving the bile through his body and bringing his bilirubin down. Right after Josh returned from the endoscopy, they took him for a chest CT to see if the tumor had spread. Thankfully, there was no sign of metastasizing. 




We were released from Grandview hospital on Friday, February 9th. We immediately went from Grandview to UAB where all treatment will be conducted going forward and where our very good friend and radiation oncologist, Sam Marcrom, had paved the way for us to receive immediate care. That afternoon Josh had another CT scan of Josh’s chest, abdomen and pelvis. Again, we were grateful that the results showed that the tumor is contained and had not spread to lymph nodes or other organs. 




Appointments began this past Tuesday where we met with Sam’s associate, Dr. Pfister, who is a radiation oncologist specializing in GI. Dr. Pfister and Sam discussed a combination of radiation and chemo that would be the first step in treatment to reduce the size of the tumor. This treatment would be daily radiation and chemo (likely oral chemo, but will confirm at our appointment next Tuesday with the medical oncologist) five days a week for five weeks. It is our hope that radiation and chemo could start as soon as two weeks. 




We will pursue radiation and chemo regardless, but we thought we had two potential options for surgery to remove the tumor after radiation/chemo: 1) resection (surgery to cut it out) or 2) total liver transplant. Today we met with Dr. Rose, who is a surgical oncologist specializing in GI to discuss the two options. Again, we were beyond grateful that Sam was able to be with us at that appointment because we were not prepared to hear the news that Dr. Rose had to share. 




Due to the complexity of the tumor and its position compressing the artery and vein coming into the liver, Dr. Rose informed us that surgery to cut out the tumor was not an option. Even if it was an option, he said there would be a possibility that the cancer would return. This was hard news to receive because it left only one option - a total liver transplant. 




A liver transplant is no sure thing. I spent several hours on the phone today with a Transplant Coordinator learning more about the process than I knew existed. There is an exhaustive qualifying process to become eligible for a liver transplant. On the face, Josh seems like an excellent candidate and all of the doctors have said so as well. This evaluation process will take at least several weeks. God willing, Josh is approved for the national transplant list, and from there we wait to be matched. We have no idea how long that process will be or if we will be matched, but our hope is not in a donor match; our hope is firmly placed in Christ alone. 




So we wait knowing that God is faithful and good. We believe that God’s ways are perfect and we trust Him with the whole weight of our lives. Josh has said so many times over the past week that he has never felt the peace and presence of the Holy Spirit as he does right now. We know that God has gone before us. He has already provided for us in innumerable ways, and we pray that He does more than we can ask or imagine because He is able (Ephesians 3:20)!




We are immensely grateful for your prayers and encouragement and ask you to join us in praying Psalm 91, which has become our banner and our earnest plea:




“Because he holds fast to me in love, I will deliver him;

I will protect him, because he knows my name.

When he calls to me, I will answer him; 

I will be with him in trouble;

I will rescue him and honor him.

With LONG LIFE I will satisfy him and show him my salvation.”

Newest Update

Journal entry by Whitney Reidinger

So much has happened over the last 24 hours, and although I promised to write more about how God has astonished us with His provisions big and small, it will have to wait. We made it to Rochester, MN, for our week of evaluations, tests and appointments at Mayo Clinic. One thing that cannot wait to be told is that, if we had been discharged from the hospital today, as originally planned, there would be absolutely no way we would have made it here today. Josh did not waltz out of that hospital by any means. Six days in the MICU has taken his body down, and he is struggling to recover strength, stamina and mobility. Again, God was so kind and gracious to give us extra time to prepare for this trip, which was still no small feat still, and spend time with our kids before heading out for the next six days.

I honestly don't know what tomorrow will hold, but I know it will be hard. We begin at 7:00 AM and have six appointments/tests ending at 5:00 PM. And that is just for Monday. It is a daunting schedule for someone in Josh's condition. I don't know how he's going to walk, or quite frankly, stay awake for the duration of the day. I know that sounds dramatic, and in a sense, it is. Josh's body is in a dramatically different state than even a week ago. Not only does he desperately need a new liver, but he needs complete healing from these infections, which will probably require 4-6 weeks of prolonged antibiotics. Additionally, his body is battling swelling and severe weakness from the inactivity of being in the ICU for a week. 

I detail all of this to ask that you pray earnestly for supernatural strength to get through tomorrow, especially for Josh for obvious reasons, but I am in need, as well. I know I don't have to qualify my request, and I rest in Philippians 4:19, "My God will supply every need of yours according to His riches in glory in Christ Jesus." Aside from the physical needs to get through the day, we will have important conversations with transplant infectious diseases - that was added onto Monday in light of his recent hospitalization for infection (again) - and a transplant surgeon, who is the director of the transplant center. These appointments can feel weighty because we obviously want to qualify for a living donor transplant, and we know there are some cards stacked against us. Actively fighting infection with prolonged antibiotics is one of them. But as we prayed tonight, Josh's life does not rest in these doctors' hands or their decisions. No, our lives are secure in the Father's hands and we need not fear. Our bold prayer - and we ask you to join us - is that God would make a way for a new liver for Josh. We see great possibility that it could be here at Mayo through a living donor transplant, but ultimately, we trust God. Our hope is in God. All our expectations are on God. When you taste and see how very good He is, even if the answer is "no", we can rest secure in His love for us. It is enough. It will always be enough. 
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