As you all probably know, Efrim is going through a liver transplant evaluation at UCLA. This has been a long time coming, and below you can read a quick timeline of his story. But to summarize why I'm making this fund, we have had to travel to UCLA (about 6 hours from our home) once this month already. We are currently here for the second time and will be returning next week for round 3 of appointments. Corey is still in school and about to graduate and I don't have much time off on the books so we have to be home as much as possible. Each of these trips are at least a 2 night stay because I need to be mentally coherent for Efrim's appointments because this disease is robbing him of his mental clarity and I'm the only one able to drive. With my paid time off dwindling quickly (though I continue to earn more but it goes quickly with Efrim's appointments and procedures, thank goodness) and the cost of travel, we could use some help. I know this has been a hell of an 14 months for most everyone, so I'm just putting this out there. We will survive no matter what. We have up until this point and we will continue to as a family. I am so grateful to all the angels we have already encountered who have worked their hardest to get us where we are now. Those who have lended ears, laughs, shared tears and just time and strength with us. Without you all I'm not sure where we'd be. 

Here is his timeline (and if you have any questions about any of this, please feel free to ask ):

08/07/17 - Efrim was diagnosed with Cholangiocarcinoma, bile duct cancer. 

08/23/17 - First surgery to place stents and biopsy the mass. 

Sept 2017 - Biopsies came back "consistent with malignancy"and his case was presented to tumor board. They confirmed the diagnosis. 

Without boring y'all with the specifics, for the next 7 months he underwent 15 rounds of chemo and multiple surgeries. During this time he also was being fed through the port in his chest nightly, had 2 internal stents in his bile ducts and an external drain.  He was able to have the external drain removed and started to eat on his own thus no longer requiring the nightly feedings, in August 2018. 

March 2018 - Went to UCSF for second opinion. They had him tested for an autoimmune disease called IgG4 Cholangitis. His numbers were extremely high and so it was then believed that he did not have cancer, but an extremely rare autoimmune disease. 

For the next year they tried numerous medications to help him. Nothing helped. He still had surgery every couple of months to change it his internal stents. They also did other biopsies throughout this time. Unfortunately by the end of 2019 he had been hospitalized 4 times for about 5 days per stay and his stent changes were becoming necessary every 5-6 weeks and then down to every 3-4 weeks. 

2020 - Efrim now has 3 internal stents that need to be changed every 3-4 weeks. Even changing them that often doesn't keep all the infections at bay. In that year he had 8 pre-scheduled ERCP's with stent changes and 3 more emergency hospital stays. All his hospital stays include ERCP's with stent changes as well. 

So far this year, 2021 he has already had 4 pre-scheduled procedures and has been hospitalized twice.  Here is what his last 6 weeks has and will look like:

04/14/21 - ER visit and 4 day hospital stay with ERCP and stent change surgery.

05/03 through 05/05/21 - First appointments at UCLA for liver transplant evaluation. We met with the transplant coordinator, liver doctor, surgeon, oncologist, psychiatrist, nutritionist, social worker and he had a ton of blood drawn and a CT scan.

05/10/21 - Pre-scheduled ERCP with stent change

05/21/21 (Today) - Back at UCLA for a Lexiscan on his heart. 

05/28/21 (Next Friday) - Back to UCLA for the 3rd time this month for a day of 6 appointments.

06/03/21 - Next scheduled ERCP and stent change. 

Thank you for reading and keeping us in your thoughts and prayers.