Cruisin with the Real"s

Cruisin with the Real"s
Joe and Nancy Grand Cayman 10-07

Loma Linda Medical Center

Loma Linda Medical Center
Where the magic happens........

Sunday, January 27, 2008

new stuff

I will be spending some time today updating and playing with my blog. It was an interesting week with lots to share.

Note the new SUBSCRIBE button on the left.

Friday, January 18, 2008

Oh, this was funny!

The day after I found out I was listed I was sleeping in.. and the phone rings about 9am. Normally I would let the machine pick it up but all of a sudden I was like, SHIT, I need to answer it now! I looked at the caller ID and dang if it didn't say Loma Linda! I thought..........there is nooooooooooooooooooooooooooo, WAY!................. Well, it was the billing dept wanting to talk to me about $$$. LOL.

Good for a laugh though!

Dang it has been soooooooo cold !!!! BRRRRRRRR

This has been a great week. I have been sleeping so well which is unusual. But it has been cold and the bed cozy and warm. My night sweats seemed to be taking a break and just the piece of mind that we made it past that hurdle.

Thanks so much for your comments. I love them and they add so much to the blog. You guys are great!

I wrote a couple of other posts and POOF. They disappeared into oblivion. I will make sure to copy before posting from now on in case blogger decides to eat them up.

With the help of some of my online support group folks I was able to find out how the livers are allocated from UNOS and also how many people with my blood type and MELD score are in our allocation area week by week. It was very interesting. I found out that currently, as of January 11th 2008, (there will be new data posted next Tues.) That in our local So Cal area there are only 5 people in *my group* and one of those is a child who will need a small or partial liver. So depending on if anyone got transplanted in the last week, their MELDS changed or others were added like myself we will see what kind of group I am in next week. I just think it is interesting. It may seem obsessive but I don't like to feel in the dark and with the idea that I could suddenly get a phone call and run to the hospital or it could be a year or more..

But one of 5 in So Cal ?????????? WOW, no wonder the Dr said it might not be long.
Now that is with a MELD score of 26. The group is 25 or higher. So if my meld drops to 24 or below I fall into a new group. I am being tested every Tuesday now so they are keeping very close tabs. This is required for the list. In case you are interested this is the Data site for current candidates and recent transplants by center, region or state.

Back to my week. I have been working on the house a bit, got my nails done, made a trip to the dentist and am going to San Diego tomorrow to have lunch with my Mom.

I am toying with the idea of heading up a fundraiser for the local *DONATE LIFE* Chapter. It is at the end of April in Fullerton, CA. I will let you know some details on that if I decide to do it.
Timing is sort of an issue and I would need some help organizing it. Any takers? If you are interested, e-mail me.

My long list of projects is suddenly feeling the need for urgency and prioritiztion. LOL

Do you all like my new trick of hiding the links?????? I am learning. I have some new blog stuff to try this weekend.

Even though it has been so cold, the weather has just been beautiful. I hope everyone is enjoying it and the beginning of your new year!

Wednesday, January 16, 2008

Sleep Finally

One of the common symptoms is sever fatigue, insommnia and change of sleep patterns. A lot of patients with cirrhosis have trouble sleeping at night but sleep off and on or all day depending on how sick they are.


Before the hospital visit my head could hardly stay upright at around 4pm. Literally. Very weird and I there was nothing I could do about it but lay down.


Lately and for a long time I have had night sweats and they aren't hormone related except that your liver controls, like a lot of other things, your hormones. That and being on diaretics that keep me constantly peeing wake me up frequently at night.


Well, last night I slept like a baby, no sweats, not to many times on the potty and it was great! Not only that but I slept until 11AM... Oh, JOY! I just felt like my body finally relaxed and said PHEW! I had been running pretty hard the past couple of days...up at 6am, out of the house by 8 and not home until 6 or 7. Those are long days for me right now. So I enjoyed the catch up.


Is anyone else out there keeping a blog? I have some questions for you if you are.


Thank you guys for all the great comments and congratulations! Yes, you can congratulate me now.....LOL

Tuesday, January 15, 2008

I AM ON THE LIST, I AM ON THE LIST, I AM ON THE LIST!

I AM ON THE LIST!,I AM ON THE LIST!I AM ON THE LIST!I AM ON THE LIST!I AM ON THE LIST!I AM ON THE LIST! Okay, calm down already! I have been jumping up and down all day! I went this morning to the cardiologist, she said it is a go and said it normally takes about 3 days to type it up and get the confirmation to transplant but I am giving you a piece of paper to carry over yourself! Took a blood test and it is official!

More later. Joe just got home and I want to go jump around with him a bit!

Monday, January 14, 2008

Monday, Monday......

Had a great day today! I was up early to do some work and get ready to leave early for my trek to LLU to see Ben, the social worker. What wasn't to love. I had a lot of energy, felt good, weather was incredible.

My appt with Ben went well. He said that I don't need to see him again unless I need to talk to him about something.

He wants me to participate in the support groups more often. I have been wanting to do this. They are every week and very well attended by both pre and post Transplantee's. Very informative and supportive. I have planned on attending many but so far whenever I would have on one my agenda sandwiched between other Dr appt's on those days...Well, the Dr's appt's ending up taking more time or they need another test or something and the support group gets bumped.

Did a little window shopping at Victoria Gardens.

Came home and jumped on the computer to check on some client's upcoming cruises then made a yummy, quick dinner of Mahi-Mahi, broccoli, fresh pineapple and some left over potato's.

The mahi-mahi, you have GOT TO TRY... I got it at trader joes in the freezer section. 2 ample pieces were $5.00 and came marinated. I just defrosted them and put them in the oven for 10 minutes...DELISH!

Tomorrow I am back down the hill for the appt I have been waiting for since before Christmas. The Cardiologist. My hope is that he just says everything is a go and doesn't need anything else. We will see.

By the way.....Thank You to all of you who came looking for me when I disappeared a bit to long! I appreciate you all keeping an eye out for me!

I am off to bed.
Have a great day tomorrow and I will let you know what the good Dr says tomorrow night!

Sunday, January 13, 2008

Understanding the MELD score

MELD score. Model for End Stage Liver Disease ..... it's all about the MELD

I got this off a support group I belong to in case you are interested. Basically the MELD score components are Bilirubin---Liver, Creatinine---Kidney function and INR, how well your blood is clotting.

The Meld score is a fair system. It is based on how long the person has to live without having a transplant done. They can tell this by the bilirubin level, creatinine level, and also the INR level.They have, in many places, added the sodium level to this.Bilirubin is converted by the liver into a soluble form and the liver also makes factors to keep the blood clotting which signify the INR level. So they are looking at the function that the liver does. The creatinine is a by product of using our muscles. The kidney normally removes this from the body. If the kidneys are having a problem, then this level will raise in the blood. The sodium is being watched more closely because of patients being put on a low sodium diet basically because of Ascites and edema forming. Sodium is one of the electrolytes of the body that keeps our hearts beating in rhythm. So it is very important.The Meld score starts at 6...these people are pretty well yet and have a long time before a transplant is needed...some even go off the list____the highest is 40...these people are very sick and may need a transplant in a few days otherwise they may go into a coma or become to sick to withstand the surgery. If your tests results show that you are getting better, you will go down the list...as you get sicker, you will go up the list.

People who are on the list, usually have a contact to be sure where they are located on the list.

Lake Arrowhead Resort

I forgot I would give you a review of our brunch up there...

The remodel of the resort turned out very nice and the fine dining restaurant looks lovely.

Christmas Brunch no so much.... I will withhold any reviews of food because I would like to give it another chance during their *normal* dining service.

The food was so-so, but they served it buffet and the service more than sucked.... I also think it was way overpriced.

If you go and try it for dinner, let me know...Oh, they do have a very nice private dining room surrounded by a wine cellar...If you have a large group that would be a nice place for dinner.

Then until Now

After Christmas we all went back to our various corners and we spent a quiet New Years at home this year. The last several years we have made a point to do something special and really celebrate but this year we decided on a quiet one at home.

I have had more Dr's visits including one to the big guy at the transplant center, Dr Mendler. He is my lead Dr in all of this and I haven't seen him since my first appointment and the transplant center a couple of months ago. Basically he told me that I will be listed as soon as he gets clearance from the heart institute. I was under the impression that my case would have to go back before the committee but he said, no. I was ready to be listed as soon as next week if he gets the OK.

Well, Joe was with me for this appointment and we were both excited and apprehensive all at the same time...Let's just say the butterflies came out to say hello.

Dr Mendler is a very quiet Dr. He is very thoughtful, analytical and doesn't talk much. You can tell there is way to much going on in his brain. I have a lot of trust in him and like him you just need to be ready with your questions as he is very busy. Like a lot of specialists he speaks his own language and you need to know some of it to communicate and ask the right things.

He seems pleased with my health otherwise. The cardiac issue seems to be whether or not my heart can withstand the grueling surgery. Some previous stress tests that they put it under seem to still indicate some questions in that regard.

The other issues that are common for cirrhosis patients are:

Ascites: fluid in the abdomen which can get huge like a pregnant belly (seriously...belly button pops out and everything) and would have to be drained.

Encephalopathy: where the ammonia builds up inside and causes dementia of various degrees from mild confusion to convulsions and comma. Everytime I can't remember where I put my keys I freak a bit.

Varicies: enlarged veins in the throat area that can cause acute and deadly bleeding if ruptured

Kidney Failure: we won't even go there............

Loss of appetite, weight loss and mal nutrition. Doing OK there...in fact, note to self, start watching the ice cream intake!

Those are areas that we are watching for very closely and so far so good. I am on medications to help prevent them but it can get past the point of the meds not stopping what the non-functioning liver can do.

THE GOOD NEWS IS:

Dr Mendler said that once I am listed because of my blood type, body size and my high MELD score...(still 25) that he anticipates a new liver could come my way within 2-3 months. !!!!

Now, that is, if one presents itself and of course no one has control over that. But they are transplanting my blood type at Loma Linda in the mid 20's. (Each transplant center differs depending on how many are listed with different melds and blood type)

BUT, OMG!!!!! Hence the butterflies appearing.....scary and exciting. I didn't know whether to run or jump up and down!

I go see the social worker tomorrow and the cardiologist on Tuesday.

Side note:

People keep asking me when my transplant is *SCHEDULED* Have they NOT watched ER????? and seen the helicopter land and Dr Hotstuff jump out with the igloo with the organ in it??????? Another one that hits me funny everytime I hear it......

Welcome Back!








Well, HAPPY NEW YEAR, everyone!!!

I hope you all enjoyed your Christmas, New Years and various other festivities! Our hope is that you were surrounded by people you love and that you had a wonderful time making good memories. (and that you didn't let the stress get the best of you!)

Thank you, Thank you for all the wonderful cards, photo's and letters! I don't think our mailbox was ever as full as it was this year! We enjoyed each and every one.

I left you on the 21st, right before Christmas and the day before the Fitzgerald Family arrived in their sleigh from the Bay Area. They brought the entire family, including Samantha, their trusty Rhodesion Ridgeback! We made room for everyone and fun was had by all, including the pups. They stayed with us 4 days and it was one of the best Christmas's ever! Everyone chipped in to see that I didn't get too tired. They made me promise to not go overboard and I was a good girl.

A couple of things that we did during thier visit was:

Kim and I finished some last minute shopping for stockings, food and goodies, etc. We had some nice big breakfasts and fussed with the house a bit. (and of course caught up on our girl talk!)

All the boys took a trip down to the big new BASS PRO SHOP down the hill to do guy stuff. It is an amazing store,,,,more of an event or must see, kind of place. Which inspired Johnathon and Joey to go out to an undisclosed location to shoot a few guns, including a newly accuired antique rifle from WW1 that belonged to a grandfather of John's. The young ones stuck to pellet guns out back. That and the ever popular WII................. LOL

Tom brought a cooler full of wonderful fresh, dungenous crab from the north coast down for our Christmas Eve Dinner! Yummmmmmmmmmmmy. It was lovely.

All of us went with our neighbors, the Gilliams, up to Lake Arrowhead for a Christmas brunch after Santa visited us all. We were hoping for a bit more snow. It was plenty cold but not much white stuff. The Gilliams had their entire family together as well, which is nice because daughter, Ellie, has been living in her native England this year.

It was wonderful having a house full of Christmas Spirit!

I'm back!

Sorry for the interruption! Playing with the blog a bit....update to follow!

Friday, December 21, 2007

Our friends Karen and Bob

They wrote this in the comments and I wanted to post it. It made me smile. The thought of the toast from the Dawn Princess on New Years....and the thought of taking my new liver cruising again! LOL...... I think I will think of it like that... I am going to take my new liver here, there and everywhere! Oh, what a life we will have together..... :-)

You got it Nancy! We will send you photos from the Dawn Princess, we promise.Listen carefully on New Year's Eve, and you will hear us toasting you and Joe for a long and happy and healthy life together!!!You take good care so that you will be cruising soon, and cruising with that new liver. Then we will really all celebrate together!! Love,Karen and Bob

Thursday, December 20, 2007

heart institute

Marielena just e-mailed me the appointment news. 1-15-08.

(Thanks Bob and Karen! You guys are great! I want some cruise photo's from you 2 so I can live vicariously)

The Boys Adventure






Here are some photo's from the boys trip. The first one is sailing in St John. Look closely they are on the bow together... 2nd one, in the dining room, 3rd one is the Radiance on the left. She currently sails Alaska, Caribbean, So American, So Pacific. etc... next to her is Liberty of the Seas. The largest cruise ship afloat with her sister Freedom. Sails in the Caribbean. I love the bow lines criss crossing in front of the ships holding them tight to the dock. That was in San Juan. 4th photo is in Key West and the Southern most point in the USA. (double click on the photo to view larger)

what the commitee has to say

They did meet today and did review my case. Apparently everything is good to go except for one LITTLE thing. They were concerned about my heart under the stress of the surgery.

They are still concerned about the low oxygenation of my heart. Called

Ischaemic Heart Disease (IHD), otherwise known as Coronary Artery Disease, is a condition that affects the supply of blood to the heart.

As the heart is the pump that supplies oxygenated blood to the various vital organs, any defect in the heart immediately affects the supply of oxygen to the vital organs like the brain, kidneys, liver etc.

Well, you get the idea. They want me to meet with the cardiac team at the heart institute so they can review my tests and records.

It sounds to me like they are just being cautious which I am grateful for. They don't want anything to go wrong when they open me up for the world to see and tear my guts out.... I guess they would like my heart to keep beating so they have time to play Dr with the rest of my insides. I think that is a good idea. So, check away!

From what Judith said that is all they are asking for so I guess I passed all the other requirements. Social, Psych, Alcohol, Financial, Dental, OB, My hairdresser, the guy at Starbucks said it was okay with him...........Pulmonary, etc. etc. etc.

I have found a couple of local transplant support groups and am looking forward to meeting them soon.

For those of you traveling this weekend, Be Safe, take your time and patience along with you and have a very Merry Christmas!

Oh, I accomplished something today I have been putting off....Shoveling and discinfecting Joey's room.....!!!!!!!!!!!!! You people with teens and above know what I mean!

Wednesday, December 19, 2007

hahahahaha

Need a laugh...watch this!

Michelle sent me this...worth a minute...... http://weblogs.newsday.com/news/opinion/walthandelsman/blog/2007/11/animation_baby_boomers.html

Christmas is right around the corner

Unfortunately, I did not escape this cold thing. It has kind of wiped me out, energy wise etc but otherwise all is good here. I made a killer soup over the weekend. We had fires and stayed warm.

I did go down and have my last pre-committee appt with the Pulmunologist and got official clearance from him for surgery. He said that both my heart and lungs had shown great improvement. My pulmonary pressures had to be under 50 for surgery and they were 35. My leaky mitral heart valve was hardly evident any more. All my vessels and arteries are totally clear. My heart is functioning very well.

They told me that things were bad when they were running tests while I was hospitalized a few months ago because of the acute and serious nature of what my liver was doing to my body. Basically, over working the other organs, the pressures were up and they weren't happy.

I am so thankful for my dedication to fitness off and on throughout the years and particularly the recent ones.... I was thinking the other day that it was only about 3-4 years ago that I was in great shape and thinking of competing in Body Building shows and developing tossing around some business ideas in that direction. My Dr's have NOT been happy that I used Phen-fen for a short while or the Ephedra that I took for quite awhile with the supplements for leaning out during weight loss.

Soooooooooo, off to committee we go! I spoke with Judith, my TP coordinator today to see if they were going to meet tomorrow and her answer was *I hope so*. She said they have it planned for every Thursday but she doesn't know if they meet or not until she shows up on Friday.


Christmas:

Joey will be home tomorrow for the rest of the holiday. Our friends, Tom, Kim and their sons, John and Logan will be here Sat night. So, I have a lot to do in the next couple of days. I told everyone we were doing a very low key Christmas but we still need a house ready for company, meals planned, food in the house and the house ready for Santa to arrive.

We will be spending Christmas Day up in Lake Arrowhead with the Fitzgerald's and the Gilliam's. There will be a dozen of us dining together. Hopefully a little snow and a wonderful afternoon of food and friendship without the dishes up at LA Resort, a newly remodeled hotel up in the local mountains. Here is a link for you locals. Looks like they have done a beautiful job remodeling and if the Chef is as good as the menu's sound the food should be great. I will give you my review after we try it.
www.laresort.com It looks as though they have some good local specials for a weekend or mid week get away and a nice spa also.

(Odd things that didn't use to happen. My Dr asked me what I had planned for the holidays and I told him about Arrowhead thinking he would be happy I wasn't cooking and his response was. You might feel uncomfortable with elevations at the Lake and to pay attention to my body and come down from the mountain right away if I felt faint or had a tight chest, trouble breathing, etc.)

Anyway, on to the few days we all have left before the big day. Try and relax some, smell the Christmas Trees and have a cup of hot chocolate.

Good night, sleep tight...................................................................................

interesting and inspiring story

Hi all. Sorry to be remiss about posting. I could say I was soooooooooooo, busy with Christmas preparation....but that wouldn't be exactly true... I will write more here later tonight. Right now I need to go to target and get dinner started but I wanted to share and interesting story that I am sure will touch you and you will probably feel compelled to share it with someone you know. Here is the link.

http://www.butyoudontlooksick.com/the_spoon_theory

Talk to you later tonight! Stay warm.

Thursday, December 13, 2007

meeting with the surgeon..................

Yesterday, Joe and I were on the road to the hospital by 7am and got home about 6pm. Long day of appt's and we had some company last night. They went well but I am catching a cold and the day made me tired. Anyway, over all it was a good and interesting day.

We had an appt with Dr Franco, one of 4 surgeons that make up the liver transplant surgery team at Loma Linda. We barely caught him as he was being called to another transplant. 3rd one in 2 days. Joe and I had already had a discussion wondering, since it is such a long and complicated surgery, how much of it the surgeon actually does. Do they switch off mid stream. Does he make the initial incisions and remove the patients original liver along with attaching the new one (makes me think of installing as a good word... :-)

I know that sometimes when the liver arrives and the Dr's assess it, if something isn't right the surgery is off. We asked how often this happens and he said not often as they actually go evaluate the organ of the donor first and do the harvesting themselves. When UNOS calls and makes an offer of a liver to our Dr's. If it matches one of their patients the surgeons actually fly out to harvest the donor's organ and bring it back to Loma Linda and the surgery proceeds from there. 2 of the 4 Dr's are usually involved, sometimes 3. Who actually would be performing my surgery could be any of the 4 depending on who is on duty when *MY* organ offer becomes available. With a 8-12 hour surgery that makes for a very long day...He said sometimes 36 hours. Plus he sees new patients and after surgery follows all his patients post surgery. Who ever performs my surgery will by my *new* Dr post surgery before being returned to Dr Mendler. An entire NEW team will take care of me post surgery.

Other things come into play that I hadn't heard of or considered regarding matching the organ to the patient. I knew about the blood type and size of the organ. The size of the liver can't be to big or to small for the person receiving it which makes sense. The other things they consider are the age and general health of the patient. He said for someone like myself who is fairly young, in fairly good health, (at this point the rest of the things that will eventually start to happen to me, I won't list them but they are nasty and I would rather avoid them if I can) and has a smallish body, they will look for a smaller, younger liver in good health that can sustain me many years. Well, I like that!!!!

In other patients that may be very ill and in the very end stages of liver failure they might use an organ that isn't so *perfect* as they need to get one in fast or the patient will surely die.

He said he thinks I am a good candidate for the transplant. We like him, he answered all the questions we had at the time before he ran out to catch his helicopter...

Oh, we asked how far the organs come from to Loma Linda. He said mainly the Los Angeles Basin and that Loma Linda, Cedar Sinai and UCLA get their offers first then the organs are offered to more outlying area's.

Then onto the anesthesiologist. We didn't really meet with *the man/woman* just the dept as they were gathering data from Cardiology and Pulmonary to get clearance for me to go under.

I passed. Barely. My heart is getting better apparently. My lung function is still a bit compromised.

We made a stop at the transplant unit. I do that every time I am down there since staying there. I stop by to see how my ex-room mate is doing. She is still waiting for a liver and has been in the hospital quite awhile.



I lost my voice yesterday. Got up this morning and took some cough med that my nurse said was okay...well, it immediately wiped me out and I went back to bed and slept until 2.

Joe goes back to work tomorrow and we just found out that our friends Kim, Tom and family will be coming down Christmas. :-)

Tuesday, December 11, 2007

meeting with the Surgeon - NOT TODAY

Joe and I went down to meet with the surgeon today, arrived early and waited about 1.5 hours as he was running late. I am not complaining because out of all the appt's that I have had and LLMC I haven't waited much at all. They all run a pretty tight ship regarding the appt's and I have been impressed. But then, well his asst came out and said "Mrs Real, we need to reschedule your appt. The Dr needs to go do a transplant". So, what do you say, but OK, good luck and when should I come back.

So, we had lunch and are home...We are going to try and fit him in tomorrow between 2 other Dr's.

Thursdays Transplant Committee is cancelled so no list this week. I think now that the holidays are in full swing things will slow down as the various Dr's and necessary decision people take time off.

I feel good so all is well.

Welcome to Kelly and Doug on the blog...That was a very nice introduction. Sounds like you are enjoying the snow and the holidays. It is so nice that all your family is so close by!

Hugs, Have a cup of Christmas Cocoa for me!