So This Happened...

   I fell several feet off a ladder today. I don't know what hurt worse, the landing on my back, the two by four that kicked me in the stomach or my pride. I was cutting down the neighbors cottonwood tree that is hanging over our fence. For over a year now it has been rubbing across the top of our roof and the siding. About two months ago I told my neighbor that he needed to do something about his tree and that we were worried about roof damage. He said that it was fine with him if we cut down the tree and basically threw it back in to my hands. I had even explained to him that I had some health issues and he seemed very sympathetic. How it ended up that it was up to me to chop his tree down is beyond me. The day I talked to him I was just happy that he was okay with the whole thing, it didn't occur me until a week or two later that he wanted me to take care of the tree myself.
   Yesterday I trimmed some of the branches off the tree so I could rig a line and pull it over with a come-along because it was leaning in the opposite direction. Things didn't go as well as I had planned and it fell a short distance and landed on the corner of the roof. I figured that if Lois tightened the come-along while I pushed up on the tree with a two by four then it would fall quite easily. It did. I just didn't see myself going down with it. I'm not exactly sure what happened, but as near as I can tell the weight of the tree shoved the two by four back at me as I was prying up on it when it cleared the edge of the roof and we all came down. I feel a little sore, but I think fright probably got the best of me.
   Today I had my clinic appointment and the doctor thinks I'm holding up pretty well. He juggled some meds and we spoke about my blood clot. If you recall, I have a blood clot in the portal vein. My question was whether or not the clot would ever break up and leave. He explained to us that it wasn't something they wanted to risk doing right now. Maybe never. The clot is most likely as hard as a cement boulder and they who have to go directly into the site to do anything about it. What usually happens is that blood vessels start forming around it to pump the blood. In the meantime they wanted me on coumadin to help prevent the clot from growing larger and moving into the splenic vein. If the clot moves into the splenic vein then it's game over. They won't transplant. This was some startling news for Lois and I. Something we had never heard before. After the initial shock went away I realized that there was probably no worry at all. They have me on the right medicine and if all goes well I might be transplanted in the next few months anyway.

 Photo by wikipedia commons

   My liver doctor is also the doctor who's did Lois' endoscopy. He talked to her about her CT scan and couldn't understand why everything has been moving so slow. He recommended that we set up an appointment with the doctor who did the surgery and see about getting this taken care of. We stopped on our way out of the hospital and Lois made an appointment for Thursday. Hopefully they will schedule a surgery soon.
   Well, it's late and I should get some sleep. I'm curious how I'll feel in the morning and if I'm going to be licking any wounds. Stay healthy.

The Shape of Things to Come

We had some good news Friday, more or less. My CT scan revealed no lumps or tumors and, amazingly, no ascites -- the excess fluid that I believed all along was sloshing around my stomach. Evidently I just got fat on my own. I suppose having a degrading liver has something to do with that. But the scan did reveal a blood clot located in my hepatic portal vein. More on this in a second.
We first met with the pharmacist who did a run down on all the drugs I am taking. She then informed us that my transplant coordinator wasn't in because she had the day off. I was very disappointed to hear that, because up until now, we have still not had a chance to meet her. My last coordinator left the clinic almost 4 months ago. I was really looking forward to meeting the new nurse who is in charge of my care. That transition has left me feeling a little lost, especially since I had such a good rapport with my last coordinator and now I feel a little lost in the shuffle. And even though I understand that her jumping into a new job and learning the ropes and dealing with the patients who are far sicker than I am, I had at least expected to have some sort of meet and greet in there somewhere.
We later met with a P.A. who seemed rather nice. Lois and I voiced some of our concerns and told her about some of the problems I've been having. After a minute or so she told us about the blood clot. She told us that a clot like this was not uncommon with people who were going through liver failure and that it most likely posed no threat, but that we would have to continue to monitor it and treat it if it started to look like it was going to be a problem. We were also told that this particular clot was unlikely to displace itself and that it would probably just harden and stay where it was.
When the doctor came in we first started talking about my stomach pains and the whole issue of the blood clot kind of got lost on us. Once I started talking about some of the pains I was having and the difficult time I had catching my breath and losing my voice when I talked, that became more of a concern to my doctor than anything else. After I described an area where I got deep chest pains, he decided that I needed another echo bubble cardio-thingamajig. We never talked about the clot. Later I wanted to kick myself, especially after doing a little research on blood clots in the portal vein. Some of the symptoms I read about online described exactly what I was feeling. Elevated liver enzymes, sharp pains beneath the rib cage (exactly what I am feeling) and stomach pains.
I had labs drawn on Friday, so I am anxious to see where my new levels are and see if my MELD score has changed.
But back to the blood clot, the P.A. said that the thing wasn't the type to displace itself, and it shouldn't block the pipe the blood was flowing through. And it's a pretty damn big pipe, it’s as big as the esophagus or the aorta. I’m not sure how she knows it won’t block it.
What makes me madder than hell is that we kind of got lost in all the other topics, when the doctor finally showed up we never went back and talked about the one thing that seemed most important of all, and that was the damned clot.
After it was all said and done, the doctor left us with a series of tests that they are going to run. Another endoscopy, a colonoscopy and the heart thingy. We will see what they find there and they will check my new labs to see if the MELD has changed or if there is anything else that looks out of the ordinary that they might want to think about addressing. When I get my endoscopy I will talk to the surgeon about the blood clot and I am planning to talk with my coordinator later in the week.
The funny thing about it all was that the clot seemed to be the least of anybody’s worries and the P.A. kind of frightened me when her voice started cracking and her face got all flushed at the possibility of admitting me right then and there to see what was going on. But then the doctor came in and said, "Oh, we'll run some test and see where we are."
I preferred his approach a little bit better, even though he did seem a little more concerned with what was happening in my chest than in my stomach. I will get my new MELD score sometime this week. I am hoping for at least a higher number.