turning on a dime

[Guest guest]

 At our very first Partners conference one physician , Dr. Trotter, described this as "hitting the wall". He said that things could go rather smoothly for a long time and then suddenly you hit the wall and get to where you need a transplant.He likened it to driving a great old car , small problems that you fix along the way, maintenance and tune ups but then one day it becomes obvious it is time to turn it in.I suppose it depends on what you mean by "turn on a dime". In my case, I went from not too sick, to transplant in about 3 months. I'll post the graph on my MELD score on the website (it's in the photos section). It's obvious that things were gradually getting worse, but when it really started getting bad it shot up really fast. So yes, I had a lot of warning that my liver was getting gradually worse, but three months before my transplant I had no idea that I'd be needing one that soon.'s turn on a dime moment came when he developed his esphogeal varices. His lab work was the same and he had not felt well for a long time but when he started to bleed all waiting was over.Marti 

[Guest guest]

Because the body can function fairly well with only 30% of a normal

liver (living donors often give 60 to 65% leaving them with 40 to 35%

during recovery) nothing much happens during the years it takes to

lose the first 70% or so of our liver capacity. Drugs that are

metabolized in the liver like alcohol or caffeine may take longer to

clear, but systemic functions, i.e. producing albumin and clotting

factors, remain adequate. When we hit the wall, additional damage to

the liver produces corresponding increasingly severe symptoms of

edema, ascites, encephalopathy, bruising and jaundice (not to mention

fatigue, portal hypertension, itching and other ESLD symptoms).

I definitely experienced long periods of relatively stable health

before things started to go bad prior to being transplanted. It is not

like eating poisonous mushrooms and your liver fails within hours, but

the change of pace means that yearly monitoring is insufficient and

must be stepped up to quarterly and then monthly as we approach the

critical point.

Tim R, ltx #3 7/7/07

>

> At our very first Partners conference one physician , Dr. Trotter,

> described this as " hitting the wall " . He said

> that things could go rather smoothly for a long time and then

> suddenly you hit the wall and get to where you need a transplant.

> He likened it to driving a great old car , small problems that you

> fix along the way, maintenance and

> tune ups but then one day it becomes obvious it is time to turn it in.

[Guest guest]

-----Original

Message-----

Because the body can function fairly well with only 30% of a

normal liver (living

donors often give 60 to 65% leaving them with 40 to 35% during recovery) nothing much happens during

the years it takes to lose

the first 70% or so of our liver capacity.

That’s’

what I was trying to say…but should have left it to you…you’re

the best at it! The first e-mail (that

started this discussion) said his LFTs were normal or near normal, and what I

was trying to say was, you’re not going to go from normal to transplant

without plenty of warning (unless some other major problem comes up.) So don’t sit and worry if today is

the day “things will turn on a dime” you’ll know long before,

that things are headed in the wrong direction. Thank Tim for always clarifying things

for us.

With love, Barb in Texas - Together in the Fight, Whatever it Takes!

Son Ken (33) UC 91 - PSC 99 - Tx 6/21 & 6/30/07 @ Baylor in Dallas