Friday, December 9, 2011

Alkaline Phosphatase

The alk-phos is a liver enzyme measuring the health of bile ducts in the liver.  At the moment, mine is very high and that leads to intense skin itching.  It is "itching from the inside" which still makes me want to scratch.  So I am awake waiting for the itch pill Meg prescribed to kick in, and trying not to scratch my skin raw.
Jean-Paul Marat saw himself as a friend of the people, he was a doctor of medicine and a physicist, and above all he was editor of the news-sheet Ami du peuple. He suffered from a skin disease and had to perform his business for the revolution in a soothing bath.



Today we saw Dr. R. who discussed my elevated alk-phos.  He showed a graph of the level versus time. The level was sky high and rising rapidly the first day or so post transplant.  Since then it has been coming down slowly but steadily.  Dr. R. said that was good, because if it hadn't I "would have been toast".  He used those exact words, and they are words that are hard to forget.  Dr. R. is very quick and all business and does not hold back.  It was clear he was not worried at the moment, and Meg and I left the office calmly.  (Until it is normal and stays there a few weeks, this will still keep us on the edge of our seats.)

I remember the first full post op day in the ICU.  Meg looked at me with grave concern and said my numbers were still very high. I clarified-- "you don't want to know, high".  "Yes." She said the doctors thought that they would come down once the initial trauma to the graft was over.  I dozed and she sat by my bedside by the window.  She was back-lit by the window so I could not see her face.  She spent the day tapping into her cell phone.  What was going on in her mind?  I am sure that she was thinking about all the things she knew could go wrong, working through the specifics of my case, assessing the risks and trying to gauge the odds.  And I am sure she was praying in her head, although I don't know what that really means.  (I certainly would have been disturbed if she stood next to my bed davvening all day!)  She is cool and collected under this stress.  She has an excellent medical mind, one that impresses all the docs.  None of this I knew when I fell for her so many years ago.  I am so grateful to her for being their to watch over me,  watching me as my best medical advisor and as the girl I first fell in love with.

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