Wednesday, May 16, 2012

28- MELD Score

Spring 2012

This story represents present day, now, the past four days.  No time warp at the moment.

Although a MELD score has been mentioned to me repeatedly since I became ill, I had not researched it until today.  From my earliest memories at MUSC my sister-in-law was the most adamant about learning this number.  In hindsight, I believe I haven't looked it up because I have been afraid.

On Friday, May 11, I returned to MUSC to get an update on the status of my health.  Ever since this all began, my prognosis has been very frightening.  I remember hearing phrases like "end-stage" or end of life, yet I ignored them as much as possible.  I wanted nothing of any talk of negativity or my lack of days remaining.

MELD, or Model for End-stage Liver Disease is a system based on the risk, or probability of death, within 3 months, if the patient does not receive a transplant.  The possible value range is between six, and forty.  Six is less ill, while forty is gravely ill.

The survival rate for any one who receives a liver transplant is 90% after the first year.  A patient with a score of 15 has an 85% chance of one year survival without a transplant.  With that, there is a better chance of survival with a transplant than without.  If a patient is graded a score of 19, overall- health typically deteriorates.  Any score 25 and up will have the greatest risk of death, with or without a transplant.

In November of 2011, my score was 23.  This would explain a lot of the negative prognosis, and preparations for death.  I had a 35% chance of dying within the first 90 days.  These chances vary whether or not you have a shunt installed.  A shunt is inserted into your abdomen to drain off excess fluid.  I never had a shunt, but I was drained with needles repeatedly.  It was presumed that my future would involve at least monthly draining.

To the point, my specialist rang me this afternoon to tell me the results of my blood work.  I came back with a score of 9.  Nine means that my 90 day outlook for death is less than 1.5%.  Even if I ever need a transplant, it would be at least ten to fifteen years from now.  The doctor said that because he couldn't say that I would never need a transplant.

I do not have excess fluid on my abdomen anymore.  Friday was the first time since October that a doctor has mashed on my belly and told me that its all muscle.  He even told me to come off of one of my diuretics. 

Added to my new perception of the world is sobriety.  This new-found gift has been here the whole time, and I was not taking part.  A lot of my favorite moments in life have always involved many drinks, but I don't miss the drink.  Gone are the days are drinking to suppress guilt.  The guilt of not getting things done because I was drinking.
The Circle.
I call it the downward spiral.

Now that I am free from that despair, it would be doubly worse if I were to go back.
This is what drives me.  Some say that I am still floating on the alcoholics nine month pink cloud, and then the game is over.  We fall back.

I disagree.

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