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Showing posts with label liver. Show all posts
Showing posts with label liver. Show all posts

Monday, 16 March 2015

Turn your lights down low, I need to see your liver

Once again to the north
I did not expect today to be as difficult to cope with as the last time I was in hospital to have a FibroScan and it wasn’t.
All sorts of tests needs to be done to check on health of the liver, from liver function tests that are derived from blood tests, through the FibroScan to check for liver fibrosis and today, it was the turn of an ultrasound scan of my liver to check for scarring on the liver.
The instructions for today were not to have had any meals for at least 6 hours before the scans, however, because the appointment was in the morning, it meant I was not suffering as much as when I had to do with meals for 2 hours, but the appointment was for the early afternoon.
The pickup talk
After attending one of the many almost pointless talk shop telephone conferences, a forum for the deluge of conversation with the aim of achieving something much longer than if everyone just instinctively and assiduously got on with what they need to do, I got dressed and called UberXL.
The driver arrived and whilst his name looked Turkish, he revealed that he was from Eritrea and there begun a discussion about power crazy leaders whose penchant for war over peace had led to the unnecessary demise of Africans fleeing conflict.
Then, I told him where I was from and where I had lived. When I mentioned the Netherlands, he expressed reservations about how safe Holland was for children because of the Red Light District and the coffee shops.
What we never talk about
First, I gave him some insight into Dutch thinking, the realisation that we are prone to vices and whether legal or not, people will indulge in their needs for sex and drugs, they will also pay for such if they need to. In Holland, the Dutch have provided a ‘safe’ and regulated framework within which prostitution can be practiced and drugs procured legally. He got that.
On the matter of children’s safety, I tried to make a difference between instruction and education, stressing that children need more involved parental education on the realities of life so that children can end up making wise choices.
For instance, I said, if my parents had discussed sex with me and clearly indicated that if I was touched in certain parts of my anatomy, it was wrong and I should come and tell them, it is unlikely I would have silently suffered any child sexual abuse. There are more things effective parent communication on the issues of life and experience that could have been discussed and saved the child the misery of bad choices and worse.
Our different experiences
Parents again sometimes fail to realise that the cultural environment in which they were reared as children and grew up in could be so radically different from that of their wards. Failing to adapt and reconcile might well leave the kids in a somewhat schizophrenic world of home life that has no semblance to street life; their encounters in school, with friends or in social settings. It ends up a disservice to the child and could be damaging in the long-term.
It is no appeal to abandon our traditions, but we cannot recreate little Nigerias, little Eritreas, or little Pakistans abroad and expect them to pass for the new realities of our nostalgic feelings for home than we can pass on to our children. Where we live moves on and where we left has also moved on, we are then caught with fossilised expressions of things that no more exist.
My UberXL driver could begin to see my point, we all reach back to our experiences back home in our childhood and castigate the realities we now exist in because we have refused to integrate at first and then aim to claim cultural superiority of our host cultures, thereby depriving our children of the essential education they need to thrive better than we ever have done here.
Our conversation ended as we drew up to the hospital, each of us having been challenged of the need to take a more liberal view of where we now belong.
The deceptions of receptions
At the main reception, I asked for directions to the X-Ray department, and much as there are many signs to the various departments in the hospital, it is a labyrinthine maze of corridors that taking directions beyond the third left or right turn is bound to get you lost in the morgue.
I found the section reading the signs and submitted my appointment notice to the section receptionist whose fast-talking demeanour completely threw me that I did not get to answer all her questions of name, date of birth and home address. I faltered giving my home address, it was not comfortable.
Then she made a mistake of ticking off the wrong name on the appointments list before properly searching for my appointment and ticking that off.
People like me
I was asked to sit and wait to be called. Most of the seats about 7 abreast per row were in theatre-like formation some 6 rows deep and then the wall to both the right and the front had one long row of seats facing us.
Many of the people occupied the seats in the theatre-like area apart from one middle-aged African woman, from what I could make of her features who sat alone to the right finding spiritual solace in the pages of her bible. Some others had the company of friends or relations as I made to sit amongst the crowd.
Just as I tucked into my bag to retrieve my tablet to make notes of my observations so far, a nurse called out my name. I arrived some 15 minutes before my appointment and was being seen to ahead of schedule.
Quite like yoga
We walked another labyrinth of corridors to the ultrasound equipment room where another nurse was busy on a computer to the foot of the bed. The ultrasound machine was against the wall to the left with the bed between us.
I was asked to take off my coats, pull up my shirt and lie on my back facing up for observation. The nurse then said she had to dim the lights in the room before commencing the ultrasound scans. I quipped in the words of a Bob Marley song, “Turn the lights down low,” to which she said, that was as far as the excitement will get. I remonstrated that she was a spoilsport and we all laughed.
She applied some gel to my stomach having warned me that is was warm, a stark contrast to the gel applied to my sides for the FibroScan that was cold enough to send me into hypothermic shock.
The probe was pressed against my skin and she started taking shots of my liver, from the front, from the right side, from the back and then slightly to the left. I asked if it was kicking, it brought a chuckle to all of us as she answered, it was.
In all this, I was instructed to breathe in, hold my breath, breathe normally and push out my stomach and this went on for almost 15 minutes. I could well have been in yoga classes for all those breathing exercises.
A short story
When we finished, a good deal of gel had smeared my shirt, but it washes off easily, I was told. There was time for an anecdote or short story related to pulling out a yellow plug at the end of the day. It was a short film starring Omar Sharif as a taxi driver taking a passenger to a cosmetic surgery hospital.
They passed by another major hospital that had been closed due to unfortunate circumstances, the case of unexplained deaths that damaged the reputation of a once renowned establishment. People in intensive care were dying overnight and some night doctors were about to be charged, being suspected of murder.
Eventually, they installed video cameras in the intensive care wards and it transpired that at 1:00AM the cleaning lady when into the room with her vacuum cleaner and simply pulled the plug of the life support machine to gain a socket to plug in her vacuum cleaner. The horror!
Hospitals now have tamper-proof plugs for critical equipment or red notices posted that such equipment should never be disconnected.
I left in high spirits after being told again that my liver looks fine, but I will get the full detail from my consultant when we meet at the end of next month. I was home just before noon.

Wednesday, 4 March 2015

From measuring liver stiffness to stiffneckedness

Probed from the side
Please pull up your shirt, lie with your back on the bed, then have one arm down your side and the other up and folded with your lower arm under your head and hand down the middle of your back as much as you can stretch.
I was arched like this for just over 10 minutes when a cold gel was applied to my right ribcage and then a pulsing probe pressed again the gap between my ribs to take measurements, 10 of which were successful out of 14.
In another age, this would have been a more intrusive and uncomfortable invasive procedure requiring a biopsy of my liver.
Another amazing gadget
The liver is a big deal in human anatomy and it is presumed to perform close to 500 functions, its critical need within the body cannot be overestimated and yet we abuse it with excess and other vices. It is quite resilient, but it can only do so much.
My visit to the hospital was for a FibroScan, a non-invasive means of measuring liver fibrosis or stiffness. The FibroScan [Wikipedia] is new technology and extensive study indicates it is literally as good as having a liver biopsy whilst covering more area of analysis than a biopsy will offer.
In the end, the only discomfort I had was in the application of the cold gel and the stretching, I did consider having a conversation whilst being probed, but I thought the better of it.
Comfortable and comforted
The letter fixing this appointment is better worded than the original one that invited me to attend a clinic and I was not to have taken any food for at least two hours before the FibroScan. This compared to when I had an ultrasound scan of my liver to check for scarring some 19 months ago which required I had not ingested anything for almost 6 hours.
At the end of the session, I asked the nurse for a basic opinion and she said things looked good, I also asked for explanations of the readings before she wrote them down for me to conduct further research.
Within a healthy range
When I checked the kPa reading against the Liver Fibrosis card; for my condition and health, I found that I was well within the green range, which for me means, any considered deterioration in my liver function can be arrested and even reversed with the right treatment.
The kPa (kilopascal) which is 1,000 pascals is a multiple of the International Standard of Units measurement for pressure.
Before going for these tests, I was not sure of what to expect, but I am happy that on moving my treatment to another hospital, they are keen on learning things first-hand than relying on the aging reports from my other medical interventions.
Now looking forward to the next appointment. Meanwhile, you wonder if there is an instrument for measuring stiffneckedness or headstrongness.


Friday, 20 September 2013

Hospital: Hepatic scrutiny

Situation to woman
I could remember the day I had a deep biopsy almost 4 years ago when the consultant dermatologist asked one of his understudies to probe the fungating cancer tumours in the ball of my foot and the second toe of my left foot.
The pain was already unbearable and otherworldly as the woman flooded my foot with injections of Lidocaine to no effect. After seven shots, I could still feel the raw pain of cancer, excruciating beyond what words could describe, but the biopsy had to be done.
So I laid on the gurney, a nurse holding one hand as if I was enacting a sketch of a woman in labour, she asked me to take deep breaths, though I did not have to push, I did ask for an epidural but none was offered.
In the end, I had some tissue folded into a big pad and put that between my jaws for the firmest bite force I could muster and gave in to the worst of the biopsy, which ended after 10 minutes.
Situation to ponder
I was in pain for another hour after that, it was one of the worst experiences I ever had in my life, but it was necessary to ascertain the type of cancer I had for them to determine the course of treatment.
Today, I was to have another experience that could easily have been happening to the other gender as I wondered aloud if it would be healthy and speculated about its gender, then remembered we do not gestate.
Before I knew it, someone was congratulating my wife and I; that left me in a rather tight corner before I stuttered my thanks and moved on swiftly ere I had to divulge too much about my warped thinking and complicated relationship arrangements or the lack of them.
Situation of liver
I was to have an ultrasound liver scan, and I really was not expecting a foetus to be kicking and grimacing in my belly.
Preparations for that meant drinking lots of water to have a full bladder and no food for at least 6 hours before the scan. I find water tasteless that I only got half of the two litres I was supposed to drink into my system.
I registered, and within minutes, the sonographer called my name, took me into a consulting room and then asked me to take my shirt off, sag my trousers before lying on the bed.
She applied some jelly to my belly and used the probe to rub it all over the exposed parts of my abdomen before I had to take a series of long deep breaths that I held for almost a minute before I was allowed to breathe normally again.
Situation is good
I could not see the scans as they allow women to see the ultrasound scans of their life foetuses, however, we did come up with the idea of projecting the scans onto the ceiling to keep patients entertained but that might not be possible under the NHS.
Turning onto my side, my arms raised above my head, she did more scans until she declared that my liver looks fine. Over time, I will continue to have blood tests and possible biannual scans – great relief and thankfulness, one cannot afford another major event for this day.