Friday, April 30, 2010

April 30, 2010 - Days of Our Livers

Hi all,

I have a quick update for you all, or "all ya'all" as they apparently say way down south. First, I am now officially on the transplant list as of April 21. My MELD score going in (on?) was only 7, which is a score that almost any one of you would get based on the 3 blood tests that get you onto the UNOS transplant list. Because of the other factors, e.g., risk of adenoma rupture, risk of malignancy, etc., my surgeon lobbied UNOS to elevate my score so I wouldn't be at the bottom of the list, so to speak. I found out today (yesterday) that he was successful, and my MELD score is now 22. If you're really curious and/or bored, you can read more about all of this on http://www.unos.org/.

I have to give credit to my Auntie Em for the second thing. She wondered if this embolization procedure that I was scheduled to do tomorrow (later today, actually) was truly needed. After playing phone tag with Dr. Awesome Transplant Surgeon, he said that it was up to me, but he agreed with Auntie Em that it was not necessary to have the procedure done. He feels confident that a liver will become available within the next 2 months based on their past patients. He said that if I didn't accept the first liver offered to me, I would likely receive another offer about 2 months later. I have to say, that if I have to go through this (which I basically do, since the other options lead to a much more undesirable demise) it's nice to have the flexibility and be able to more or less choose the most convenient time for all those affected. Thank you again, Auntie Em!

So far, the humor and denial have continued to work well for me, but I admit that when I hung up with the doc, I had an "omg" moment of reality when I realized that this was truly going to happen sooner rather than later.

Lastly, in case you're wondering, I'm not normally awake at this hour, but I woke up around 3:00AM and couldn't get back to sleep so I figured I'd update ya'all until I felt sleepy again. Unfortunately, I'm still rather awake.

Love to all, and to all a good night (morning),
Foie Gras

Wednesday, April 14, 2010

April 14, 2010 - As the Stomach Churns

Hi all,

As you know, we left you with a cliffhanger on the last episode of "As the Stomach Churns." Would Dr. Emboloziation Doc be able to help Foie Gras? Would the insurance company cover what might be a radical procedure? Would the drama ever end? Would Foie Gras lose her insane sense of humor? Well read on, my patient and devoted readers, and get those well-deserved answers.

I had my MRI yesterday and met with Dr. Embolization Doc. The MRI showed that not much has changed since my MRI in December, meaning that the adenomas have not grown or shrunk. This is not a big surprise.

Dr. Embolization Doc told me that he has used the embolization technique on adenomas in the past with success. See more on the process here: http://en.wikipedia.org/wiki/Embolization (It's not a very good article/description, but it provides enough info to get the gist of it). It's done in about an hour under a twilight sedation. I'll be kept overnight just for observation and pain management, although he doesn't expect me to have much pain from this procedure. This will be used on my 3 big (larger than 5cm) adenomas. If the treatment is successful, meaning the adenomas "die," then my chances for developing any cancerous tumors will decrease, since the ones that are larger than 5cm are the ones that have a bigger chance of heading that direction. This is by no means a replacement for the liver transplant. That will still happen, perhaps some time this summer subject to availability. It's just something to do in the interim to lessen my chances for malignancy. Dr. Embolization Doc said that we can repeat the procedure if we find that we have had some success, but not total success. He said that if for some reason I found the procedure to be so painful that I wouldn't want to do it again, that would be fine too - no harm, no foul. Something tells me that I've already experienced more pain in my lifetime at one time or another, so I don't think this procedure will be that bad.

I am scheduled to do this on April 30th around noon. I asked him about whether insurance would cover it and he said that occasionally his P.A. or he himself has had to argue with the insurance companies, but they have always gotten them to agree to pay.

That's all for now. Oh, and I still have my sick/insane sense of humor. I don't think any surgical procedure could take that away from me. :)

Love,
Foie Gras