Posted tagged ‘inr’

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.

Chopped Liver – And It Stoned Me

May 7, 2011

You may have surmised from the lack of a health report in recent posts that all is going well with my recovery following my Liver Transplant way back in the dim and distant past of almost three months ago. And you would have surmised correctly.

My wound is all but healed. The nurse will make a decision early this week as to whether I will be discharged from their visits – nothing much for them to dress anymore.

Which means that my bile-bag attachment will have been in situ longer than it took my gaping wound to completely heal. It should have been removed after about three weeks.

This is a big week for me in addition to my healing wound I have an appointment on Wednesday to undergo my third attempt at an endoscopy to remove my attachment. I will doubtless be a bit nervous about this event as I certainly don’t want to wake from my drowsy slumber following the endoscopy to find that it is still in place. I have to come off Warfarin from today, go to the hospital on Monday morning for a blood test to see the level of my INR before they decide that I can start my course of Tinzaparin injections prior to the procedure on Wednesday.

Away from my health, I have been with my son at home all week as he has had a bad cold and off school. I’ve taught him how to play Chess and he has taught me Mahjong. And he wanted to read my Chopped Liver blogs going back some days and weeks – of course I didn’t mind doing this, although with some trepidation as I couldn’t remember which, if any of my posts, were for adult eyes only.

Anyway, he really enjoyed them, and laughed in many of the right places too, so at least I have found someone who appreciates my humour. However he did query as to my spelling of the boy’s name Weedy. I said it’s because you’re Wee D. I’m Big D and you’re wee D. So he said, why don’t you spell it “Wee D” then and not Weedy?

Y’know son, I think you’re right – from now on you’re going to be Wee D. Unless I am still writing this when you have grown taller than me, in which case we may have to rethink.

And also, Dad, you shouldn’t start a sentence with “And”. Ok, son – I don’t need to be told how to write a bleedin’ blog, got me? So, get back to your homework – oh, and don’t you start any sentences with “And”.

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.