Monday, March 31, 2008

Arterial Blood Gas

these are Bobby's grandfathers
in the form of red blood cells (click to enlarge)

Bobby started having breathing problems years ago when he was hospitalized for shortness of breath and chest pain in 2003. His primary care doc was not surprised when her office was notified that he had been transported by an ambulance to a local hospital on valentines day. Sharon had been recently diagnosed with a host of problems and was on a wild roller coaster ride, trying to come up with a suitable treatment, and it would be almost a year before she found a good doc, and he got her somewhat stable. Now, after 3 different sleep studies, a pulmonary function test and a shunt study, he has hepatopulmonary syndrome. It is thought to be mild. But there is the key word. Mild. Mild has been the hallmark of this wildride from the git go. Don't ,whatever you do develop a severe case of this stuff or you might die of frustration. Mild is good for now. Mild means he cannot qualify for MELD exception points. The hitch is, that if it becomes worse, he will no longer be a candidate for a transplant, because HPS carries a poor prognosis after it progresses, and it is a progressive condition not dependent on the severity of the underlying disease. That means it can get worse even if the liver disease does not. Because it is thought to be a result of chemicals responsible for dilating blood vessels, it can just keep getting worse and worse. The red blood cells cannot reach the oxygen because the blood vessel is now too big around, and the blood is now going too fast. That is how the doctor explained it. He feels himself suffocating at times, even with his oxygen turned on, and he told De Wippersnapper pulmonologist that he didnt care if they say it's considered mild on paper, he cant breath. His chest pain started to ease a bit after being on the oxygen for a while, thank God, but there are still times he will wake with chest pain. The restaurant up the street, Casa del Rey, has green chili in three heats, Mild, Medium and Hot. Only there, the mild aint so mild either. And mild rhymes with wild, and beguiled.