December 17, 2010

More Bad Blood

Because of my blood disorder, I am on blood thinners to prevent another clot. Last week was my routine monthly PT-INR check for my hematologist. Afterwards we made a few stops so I could get the final stocking stuffers. When we got home, there was already a message from the Dr. This is never a good sign. So I called him back and he told me that my INR was 3.6. I'm usually around 2.1. So this was a big change. He asked me to move my doses around so that I would be taking 9mg 4 day a week and 10mg the other 3 days. And I was scheduled to go back in again in a week. Fast forward to yesterday. Same routine, went in, got my labs done, came home and no message! Woohoo! NOT! Got the call around 4. I'm at 2.8. Still a little higher than my Drs would like. So now we are dropping the 10mgs and going 9mgs all week. And in 7 days, I will be back in there getting stuck again. Thank God I got over my fear of needles when this all first started!
So what does 2.8 and 3.6 mean? I don’t usually explain things because there is a 90% chance Ill screw it up, but here is how it was explained to me.

PT= Prothrombin Time. It is a measure of how quickly blood clots
INR= International Normalized Ratio. Is the standard unit of measuring the PT.

Being on blood thinners means I am monitored closely to make sure that my blood isn’t to thin or thick. The average range of someone not on blood thinners is around 1. I am usually around a 2.1 or 2.3. So anything above 3 is cause for concern. As my blood gets thinner my risks of bleeding get higher. So things like bumps on the head, falls and cuts are much more dangerous. And for those of you that know me, those things are kind of my thing!

My INR also changes my MELD score, which determines my place on the transplant list. As my liver disease advances, my liver has a harder time processing my Vitamin K, there for causing my blood NOT to clot. And that means a higher INR. And a higher MELD.

The last time I got to see my labs, both my bilirubin and creatinine were at 0.6 and my INR was 2.4. This game me a MELD score of 16. When my INR is at 3.6 that bumps my score up to21. But being on blood thinners means that unless there is a change in my bilirubin or creatinine then my MELD wont change much because its being controlled.

So here is to turning yellow from jaundice (bilirubin) and my kidneys giving out (creatinine). I joke about it, but its really what I am waiting around for. Eventually something has to give right?
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  1. Oh girl, I have been yellow and it is NOT fun. I think I was sicker from having acute hepatitis C than I ever was from all the chemo I got to treat my leukemia. (Years later I found out I could have died back then from fulminant hepatic failure.) I know things have to get worse for you to get your liver, but I think that sucks. Hang in there and know that I send healing thoughts your way all the time...

  2. Il semble que vous soyez un expert dans ce domaine, vos remarques sont tres interessantes, merci.

    - Daniel