Achieving Equilibrium

You know that feeling you get the day after you injure yourself? Imagine that you’re hammering nails, and manage to wing your thumb instead of the nailhead. You don’t do any real damage, but it hurts like hell afterwards. Then the day after, your thumb doesn’t hurt any more, but it still remembers that it was slammed, and the memory of pain still lingers in it, keeping you aware of yesterday’s mishap without actually giving you any throbbing pain. That’s how I feel today.

Which is to say, I’m feeling a bit more up today, but I still feel lingering after-affects of that unpleasant little surprise with the MELD score. I have at least been active in attempting to find out what’s happened, and that seems to be helping. I still don’t understand why my score fell. But it’s only a temporary set-back, and I have to keep things in perspective.

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Warning. Boring medical stuff follows.

Model for End-Stage Liver Disease (MELD) score is really pretty easy to calculate. The Powers-That-Be definitely followed the K.I.S.S. approach when they developed this one. (That’s “Keep It Simple, Stupid” for those of you who travel in politer circles than I do.) It takes three blood test (serum creatinine, bilirubin, and INR) and uses them to calculate the odds that you will die from the disease in the next three months. UNOS claims that since the MELD score was implemented, there has been a decrease of deaths on the liver transplant waiting list, but they made that comment four months into the new system, and I’m not sure if this has continued to be the case.

The actual calculation is this:

MELD score = 10 X (0.957 x loge[creatinine mg/dL] + 0.378 x loge[bilirubin

mg/dL] + 1.120 x loge[INR] + 0.643 X cause of cirrhosis [0 alcohol,

cholestatic; 1 other etiologies])

When I plug my creatinine, bilirubin and INR into this, I come up with a score of 19.5! So color me confused, kids. I’m hoping that Dr. Liver will confirm my calcs, and if/when he does, I’ll call The Big City Hospital and ask them how they arrived at their “17”.

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OK, onto other matters. Still waiting to receive my handicapped placard for my car from the state. It would have come in handy last night, when I had to stop to do some grocery shopping on my way home from work. I had to park in outer Jabbip in the parking lot; by the time I had walked across the store to the lot I was too tire to do much shopping! Ah well, at least I don’t have to use one of those motorized scooter cars yet! THAT would be the final insult.

Without any good segueue whatsoever, I will now jump to my newest food craving. I’m an unapologetic sardine lover. Please note, those of you who are about to say “Yuck” while making barfing noises into your trashcans, that I have never foisted them on anyone else. Indeed, I feel it would be a waste to do so, when I could be enjoying the little fishies myself. I was thrilled to find a no-salt-added sardine brand while spot-shopping last night. The store had three cans left, and I bought all of them. I had a tin today for lunch, with a little mayo on a bed of salad greens. Excellent protein source, only 125 mgs of salt, and *damn* but they were good. I grossed out half the people at my table, but I’m beyond caring. There are so few foods that actually appeal to me now, that I’m eating my fishies and that’s an end to it!

On the work front, it would appear that my days of cruising the web during lunch and breaks are numbered. They announced yesterday that new software is being installed this weekend that will block access to all unauthorized sites on the web, and generate a report if we attempt to access them. Things have certainly changed here in the past three years. I don’t blame my company, but I am going to miss the breaks that the net afforded me. Those of you who may have become accustomed to getting a mid-morning or early afternoon comment from me, I’ll still be leaving comments. They’ll just come (much) later in the day now.