6 week check

It was my 6 week check-up yesterday. The good news is that (barring suspicious blood test results – remember they forgot to arrange them before the appointment so there were none to review?) I'm being referred back to the care of Dr Caravan-a-nan. Instead of taking 6 hours out of a day for a 15 minute appointment I can go 15 minutes down the road. The hospital policy is to run checks every 6 months where some NHS trusts or specialist centres check 3-monthly. On T’s suggestion I asked the GP if he would do tumour marker and liver function tests in the 3-monthly gaps between the hospital checks and he said yes, so I’m happy about that.
The not so good news is the liver is cirrhotic. The histology report indicates a Child-Pugh grade of A. In gastroenterology the Child-Pugh score is used to assess the prognosis of cirrhosis. It takes a combination of liver function blood test results, your clotting rate, whether you have ascites (fluid in your abdomen) and whether you have hepatic encephalopathy (confusion caused by an accumulation of toxic substances because the liver can’t remove them). You can be A, B or C with a score of 5-15. I score 5 at the moment so I’m an A. 5’s and 6’s are eligible for resection. Above that and I won’t be eligible if it’s needed in the future. My bilirubin (an increase causes jaundice) and albumin (a protein that helps keep fluid pressures in the body stable) only have to go slightly above or below the norm to attract 2 extra points, a motivation to stay on a healthy diet and keep fit.
I didn’t ask about prognosis. There are too many variables. Hepatitis medication seems to suppress the virus for about 4 years (I don’t need it at the moment). HCC tumours can reoccur as soon as 6 months. Cirrhosis can either stay the same or get worse. If you stay as ‘A’ by year 2 survival rates go from 100% to 85% so a statistician can work that out longer term. I don’t know when my Year One started.
More good news was that on the return journey I felt really hungry. The first time since the surgery. We got a takeaway from our favourite Bay Leaf restaurant and I managed a decent size portion followed by pears and ice cream.