Posted tagged ‘ercp’

Chopped Liver – A Certain Ratio

June 2, 2011

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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Chopped Liver – Wave Of Mutilation

April 28, 2011

Fine day today.

(apart from the fact that my boy beat me at Junior Monopoly – some people do not understand that you shouldn’t bite the hand that feeds you).

Had to go back to hosp for a blood test for the anti-coagulation peeps – just got the results back and the good news is my INR level is back down to a respectable 2.0 – it’s official, I am once again able to cut myself.

No problem for me now!

This may warrant a celebratory wave of mutilation (never quite knew what that song was about – until now!).

I met up with a friend at Belsize and we had cwaffy and then walked slowly – but ever so slightly less painfully than before – up the mighty hill to Hampstead and around the narrow streets of affluence until we arrived at Burgh House for afternoon tea in their beautiful sunny gardens. A bit of a shame their scones (pronounced “scones”, of course) were a bit on the hard side, but it was a welcome rest after the exertions of the climb – it’s not all casual laziness as it might sound, you know – I do have to work for it.

So it’s back on the Warfarin again now at a steady 2mg for a few days when I’ll have to stop it again in preparation for the next Bridging Plan prior to the next attempt at the ERCP to remove my cherished attachment – scheduled for 11th May – not holding my breath on that one.

Can’t wait for the Royal Wedding at Westminster Abbey between William and Kate – actually I couldn’t give a flying one for this event – but if I include this sentence in my blog I can tag the keywords and boost my readership to around an extra 5 million tomorrow alone.

Chopped Liver – Trigger Cut

April 26, 2011

Today is the day after the day before. Regular readers will know that the day before was a bit on the negative side and with lots to discuss at the following day’s clinic appointment.

Well, today is the following day and as I trudged ever so slowly and painfully to the tube station to ride the 4 stops needed to get me to the hospital firstly for my blood tests and subsequently for my clinic appointment.

Things to discuss:- The date for my ERCP to finally remove THAT attachment; the constant pain from my wound; the dosage of my current medication and, finally, the state of my new liver and the arteries transporting the blood to it.

The results. The ERCP has apparently been booked for 2 weeks time.

The doc managed to arrange an impromptu Ultrasound examination for me this very day. So I went down to the department, waited five minutes and was seen by consultants who managed to weave their way around my wound dressing and deduce that all the arteries had blood flowing nicely through them and everything looked exactly as a healthy liver should – and on top of that good news, there was nothing apparent to cause the pain I have been experiencing.

By the way, as you may have picked up from my Tweets, I was very proud of myself for resisting the temptation to ask the Ultrasound consultant if it was a boy or a girl. It was a close call, but I made it.

I did bump into Smiler, my pre-transplant consultant who I rarely see these days. He asked me how things were going. I took the opportunity not to talk about the pros and cons of Blackberrys or i-Phones, but to tell him that I felt great – except for this constant pain in my wound. “Ah yes, you can expect that for the first year or so”. So, there you have it. I have to just grin and bear it for the next few days, weeks or months and stop being, as I suggested some time ago, a wimp.

So all in all – a very successful day.

Till I got home.

I got a call from the Haemophilia Centre. They just received my blood results and they have called me in an emergency, informing me that my INR level has shot up to 6.0. To put this in perspective, last week it was at 1.6. A few weeks ago it had reached 4.9 prompting the cancellation of my first attempt at having an ERCP due to my blood being dangerously thin.

When it is 6.0, the bottom line is simply this – I must NOT cut myself. If I cut myself I must go straight to casualty.

I must stop taking Warfarin for the next couple of days and return to the hospital on Thursday for another blood test.

To say the least, this has put the willies up me (whatever that means – I think it means that this is all a tad on the scary side).

I better make sure I don’t pick my nose!

Chopped liver – Down In The Tube…

April 4, 2011

no not Station at Midnight – just Down in the Tube. T-Tube to be exact.

A recap: About 3 weeks ago I turned up for an endoscopy to remove my attachment – my bag o’ bile – there really is no nice way of describing it – it’s a bag o’ bile. I was really looking forward to having it removed as it was causing me serious discomfort – itchy, painful (especially when the dressing is changed due to one of the stitches), and gunk-oozing. It was also restricting my movement – slowing me down and just generally, y’know getting me down. Not to mention the sheer inconvenience of having it under my clothes and having to empty it all the time.

Anyway, not to worry – it was coming out – 3 weeks ago.

Except, as you know, it didn’t come out – due to my high INR levels – too risky – internal bleeding an’ all that.

So, unfortunately, had to reschedule another endoscopy for a few weeks down the line – till Monday 4th April to be precise. I mentally adjusted myself to this fact – and counted the days down. Listen I have had other, more serious, setbacks recently but have overcome them.

Today is that day. Endoscopy booked for 14:30 – which means no food/drink after 8am.

All running on time – I am duly called in, read the risks (1 in 500 result in death – 1 in 500???? What the heck does that mean? For every 500 endoscopies they do around the country, one person doesn’t make it through? That must be easily one a week – it’s an epidemic!), given my obligatory cannula, had my throat sprayed with vile anaesthetic, had the wretch-inducing tube (with attached Swiss Army knife) stuck down and then – ahhh… blissfully off to sleep.

To sleep.

Perchance to dream.

To dream about life without that feckin’ attachment.

Some chance.

I awake from my slumber to find that following multiple attempts they could not reach the point where my tube is attached – and they had to abandon ship.

A new attempt is schedule for another month down the line.

Another month.

And then what? Same again? Same risks (I’ll have done 500 all on my own by the end – yikes) and what chance the same conclusion?

Look, I know, it’s just another hurdle to overcome. It’s an inconvenience – no more, no less.

I am still doing fine – all things considered – and assuming they can locate the tube sometime in the future, I will look back on this as… actually I may even have forgotten about it.

Chopped Liver – Bloody Well Right

April 3, 2011

Have to confess I haven’t heard that song since I was a schoolboy. I think I even thought it was a bit risky (risk-ay) and hid it from my parents – my little secret having a record with a swear word on it. I’d be interested in hearing the Crime of the Century album in its entirety again – I know Supertramp became a hideous radio-friendly safe AOR American-audience type sell-out bunch of sheisters who made gazillions – but I have a recollection that this early effort of theirs was pretty good – but I was very young and had no taste (unlike now – where I am very old and have no taste).

Anyway I use the title for the blood connection. Tomorrow is my scheduled ERCP to finally (hopefully) remove my attachment. Last time out, pop-pickers, you may remember they aborted the mission due to my INR blood levels being way too high – so to prepare myself for tomorrow I have been on a plan – a bridging plan – to try and ensure my clotting levels are right for the procedure.

I stopped Warfarin last Wednesday. Went 3 days of abstension followed by 2 days of Heparin injections leading up to tomorrow.

As of this weekend – well yesterday my wound was so painful I couldn’t even go on my pathetically short walk – I tried it – but turned back. The nausea was still there, but maybe slightly easier.

Today – much better. Went on my longer walk – felt good. The nausea again was slightly easier – though not gone completely.

Anyway, endoscopy tomorrow. I think maybe even @drobeirne may be doing it. If he is I must remember to tell him that the district nurse has spotted a couple of transparent stitches on my wound that perhaps should have dissolved but haven’t – and quite how she spotted them if they are indeed transparent I’ll never know – anyway maybe @drobeirne is reading this so he’ll know anyway.

Oh I do so hate the bit when they stick the tube down – must try and remember @sawbofeller method – something like sticking the 3rd finger of left hand inside the right ear, crossing legs 3 times and shouting Whoputthebompinthebompshoobompshoobomp as loud as possible.

Chopped Liver – When The Healing Has Begun

March 18, 2011

My chest feels tight. Last night it was painful – I even had to resort to taking Paracetamol – the first painkillers I have taken for weeks – but I was really struggling. It gave me a good night’s sleep.

I guess this is the healing process kicking in. I’ve had my wound checked out – the hideous-looking sharkbite-esque scar is apparently looking very good. But it feels tight.

I am also getting short sharp back spasms whenever I lie down – captivating throbbing pain for about a minute before it subsides. My diagnosis for that is – too long spent lying or sitting around during the hospital weeks – I dunno why these doctors bother going to school – I can diagnose just like that.

Of course I may be wrong.

The good news is that the antibiotics I am taking for the CMV virus I was diagnosed with last week are working. The virus is now well under control and following a good blood result next Tuesday I should be able to stop taking those pills.

That leaves the plan to enable me to undergo a rescheduled ERCP to remove my bile-bag – this will involve stopping Warfarin and replacing it with Heparin – by injection.

I am making good progress. It’s just that sometimes I feel that when I take two steps forward – I stumble one step back – but the net result is still forward. So that’s all good.

Chopped Liver – C.R.E.E.P

March 17, 2011

Well I like that title – even though probably only @drobeirne and @markEChaCha will get it.

Y’see today was E.R.C.P. day.

E.R.C.P.

This is a long tube thing pushed down the throat that has a camera and a Swiss Army knife on the end. They don’t know what they might find when the probe down so they need to equal themselves with all the features of said knife – just in case (though I can’t imagine they have a need for the toothpick).

So this morning I was Nil By Mouth as I made my to the ‘ossy where they took my blood and fitted a cannula (that please you gore-mongers?) and I waited till they got the results before being admitted I’m to start the procedure.

You usually gag when the tube is inserted so I had prepared a particularly funny gag!

But then the doc who was go perform the procedure came up to me and announced that after checking my bloods they found that my clotting levels were at too dangerous a level – so performing the ERCP would create a high risk of internal bleeding and that under no circumstances at all would they even think about risking it.

So operation aborted. Bile bag still in situ – for another couple of weeks or so – and another day where I have learned just how sensitive the complete makeup of the body is – everything has to be spot on otherwise potential great dangers lurks.