Chopped Liver – A Certain Ratio

Not been much to report lately, hence my lack of posts. But here’s where we are healthwise.

All pretty good. The main issue I have is a curious one. Y’see for many years I have had a very low platelet count. Platelets are part of the blood that enables clotting – so it would logically stand that the fewer the quantity of platelets in the blood, the thinner the blood, and so the less chance of clotting (and the more chance of bleeding to death from a minor cut, natch).

So, with that in mind, how was it that I needed a liver transplant due to a blood clot in the portal vein?

Answers on a postcard, please.

But, what this means is that, having been prone to a blood clot in the portal vein, the docs don’t want a situation to arise again that precipitates another blood clot (I don’t really want it either). So, I am prescribed Warfarin – to thin my blood. I say to thin my blood – here’s how they measure it.

A normal person (if such a thing exists) has an INR of 1. Firstly, what does INR mean? Is it some sort elongated medical term only known by its acronym? Well, sort of. Bizarrely (to me) it stands for Internationally Normalized Ratio. Let’s stick to INR.

So, most people are 1. That’s the level. The plateau. But my INR needs to be nearer 2 for the docs to be happy. What does 2 mean? It means simply, that it would take twice as long for my blood to clot as a normal 1.

Nothing to worry about there then.

Now, some weeks ago, you may remember I was due to have an ERCP procedure, but they called it off at the last minute due to my INR being at 4.9 (therefore it would take me almost 5 times as long to clot as normal – not recommend for a surgical procedure). I have even been up to the dizzy heights of 6.0 recently – when I was told, that if I cut myself even slightly I should rush to casualty. Curiously the dosage of Warfarin I was taking at that time was 2Mg and 3Mg alternate days.

Now, I am taking 4mg a day – and I am struggling to get above a level of 1.5. It all seems a bit illogical to me. A bit hit and miss. But I mention this merely to try and appease the Goremongers, who must have been bored out of their minds lately, and to simply explain to you that my liver is doing fine (I call it MY liver now – decided I am not giving this one back) and that this is my main problem right now.

Ok, doing a bit of work now, before gearing my self up for a week away in a cottage in the South Coast with B and Wee D.

Btw, for completists, A Certain Ratio, the punk-ish band of the late 70’s took their name from a lyric in an ENO song called The True Wheel from his album, Taking Tiger Mountain (By Strategy). Of course.

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6 Comments on “Chopped Liver – A Certain Ratio”

  1. Adam Says:

    Um ACR? Punkish? FUNK band dear boy… Also Tony Wilsons favourite muse… I always associate them with the 80s, bad hair cuts and anti Thatcher marches… Anyway thats enough train spotting for one day. Am back now so if you are around for a coffee would be lovely to see you. Am gonna make it my business to play cards in the next couple of weeks also so let me know your movements…

    • davidkallin Says:

      Punk. Funk. (Junk?) Come on, what’s one letter between friends?
      My movements are… a little loose, sometimes I feel theyre a bit…. oh hang on, you don’t mean those movements – you mean my Movements – ah, now then, next week not so good, but would be happy to try fix up a game mid June – aft or eve. Perhaps we could make private arrangements rather than involving the whole world – you never know, they might all want to come. My Mobile number is 07123 123987.
      (not really)

  2. Sunil Ravji Says:

    It’s good to hear that your doing well. The doctors have decided to stop my Warfarin too. It’s good hear that your well enough to go away, I’ve been given the all clear to go to the Maldives in October, thought i’d treat Tina after all she’s been through… n I need a break from all this too. Ummm what else… I’ve started work from last week but only doing 4 hours a day n after 7 weeks I’ll be back to full time if I feel well enough.

    I’ve also decided to do bike ride event next year from London to Southend to rise money for the Liver Department. I’ve started training VERY slowly already, I’m sure I’ll be fit enough by next year. You are ofcourse more then welcome to join me if you feel well enough. I won’t be doing it on my own as I have about 7-8 other people doing it with me so far.

    I’ll keep reading your posts n update you with me soon, it would be good to see you n catch up, hopefully I’ll bump into you on a clinic day.

    • davidkallin Says:

      Hi Sunil – good to hear you doing so well. I dont think I’ll be coming off the Warfarin at all. As my condition included a blood clot in the portal vein, the docs are concerned that I dont develop a similar clot with the new liver – so they will want to keep my blood thinner than the norm. In principle I’d love to join you on the bike ride – though I havent ridden a bike for nearly 30 years. Leave me to ponder that one…

      I have my stent-removal ERCP scheduled for next Wednesday – but not scheduled for clinic until 5th July. Be good to see you soon, keep in touch.

  3. Fiona Says:

    I was told via a hepatitis forum, that for some people a low platelet count is because your spleen is catching too many platelets. Hence an enlarged spleen is often checked for when diagnosing liver problems. Not sure how that equates with clotting, but it could explain why platelets are permanently low.

    • davidkallin Says:

      Indeed Fiona, for years my platelet count has been around the 20 mark (average for a bloke is between 140-300). I once had a bone marrow biopsy and it was found that I was producing a normal amount of pllatelets but, as you say, my spleen was munching them for breakfast, lunch and dinner and never releasing them, hence my low count and enlarged spleen. So enlarged that Smiler used to get his student doctors to examine me as a bit of a test to see if they would identify the spleen and likely cause of its size. However, since my transplant, my spleen is not so enlarged and my platelet count has currently increased to a massive 50 – some way to go, I guess, but its better than 20.


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