I received some feedback several weeks ago now from the doc at UPMC who did the last Angiogram, and he told me somethings about how my Hepatic Artery was placed that i didn’t know. If you remember, there is a narrowing in my artery caused by the length of it so my RI values are a bit low. So I asked him about why it was left so long, and what could really be done about it. Rather than rewrite it:

If the narrowing continues to be troublesome and requires further action, what would that be?
If you begin to start showing signs of liver dysfunction (elevated liver enzymes, jaundice, or other problems) you would be brought back to Interventional Radiology and we will attempt a balloon angioplasty. If we get a satisfactory result, we would stop. If we get an unsatisfactory result, we would proceed to intravascular stent placement. Although the sharp angulation can make angioplasty and/or stent placement difficult and with increased risk to the vessel, it can usually be done successfully. Because your liver function was so good at the time of the exam, it did not seem reasonable to undertake a procedure with some degree of potential risk, but very little immediate potential benefit.

Is vascular surgery an option to shorten the length of it? Or would a stent be tried first to see if that is an acceptable corrective measure?
Well, surgery can be done, but this is a sizeable and complicated operation, and one which the surgeons would rather not perform if there is a safer or less invasive option, such as balloon dilatation with or without stent.

It also came to mind as to why the length of the artery was left so long? Could it not have been shortened during the surgery?
It is often difficult to get the length of the artery the perfect length. The surgeon will frequently make the connection of the artery to the most proximal portion of the donor artery using a technique called a Carel patch. This allows for a larger arterial connection, but does often make the whole artery a little longer and slightly prone to kinking. Also, as the liver settles into place after transplant, it is sometimes difficult to predict exactly how the artery is going to sit.

So that’s it in a nutshell. It was good to get this information and he has been great answering my questions quite quickly.

More recently, I have been off and on tired still, and was feeling a bit crappy the last week or so but have gone back to somewhat near normal. It’s still hard to find the energy to get back on the bike, and I have ridden to work once so far this year – and I tell you it was a workout. Makes a guy feel old….

I’m a bit more determined now to get back into some semblance of good shape, so I will be hopefully ridding to work 2 or 3 times a week – and getting in on some of the local rides. We’ll see.

• no screen saver
• turn off monitors after 15 minutes
• set to sleep mode after 60 minutes
• hard drives cycle off after 60 minutes
• Hibernate after 90 minutes. 

I have to give it to Microsoft here though, the sleep mode in Vista is vastly superior to that in XP and I had no trouble coming out of sleep mode the half a dozen times or so I awoke my PC. I turned the screen saver off on this test as well to see if it made any changed in the power draw because I have had my doubts as to whether the screen saver turns off after the monitors turn off, or if it continues to run in the background possibly affecting CPU power usage. After checking the wattage used during sleep with both the screen saver turned on and off – it seemed to make no difference at all.

Another thing I discovered throughout this test was that not all USB devices turn off when your machine is turned off. My keyboard still draws power, and will pass power though it to other devices. I have a small Plasma Ball from Think Geek and while it was plugged into my keyboard the power kept flowing regardless of whether the machine was on or off. This surprised me especial since the keyboards LEDs go dark, and it's plugged into the USB ports on the MoBo, not the PCI Card ports.

Still the best solution is to shut the machine down entirely, and let it draw its 35 watts of power while turned off. For those who want to go a step further, you can get a Smart Strip that will shut off all other devices when the CPU shuts down. It is controlled by a single outlet which shuts the entire strip off when the device plugged into that outlet gets turned off, eliminating excess power drain for devices which should be off. This is great for TVs and home entertainment systems as well. Unfortunately it is still just a power strip which I don't use at home. Once this starts getting into battery backups then I will be more likely to get one for my computer.

Watt meter in hand I unplugged my entire system which is connected to a battery backup, and plugged in my new toy. Here are the results:

 Windows Vista Home Premium (SP 1)

• Spiked to 301 watts during boot (just after log in)
• ran at 279 – 291 watts sitting idle 3-5 minutes after boot
• ran at 182-191 watts while in pseudo sleep mode (monitors off and hard drives off)
• after 24 hours – 4.83 KWH

Windows XP Pro (SP 2)

• spiked to 302 watts during boot (just after the loading screen came up)
• ran at 255 – 265 watts sitting idle 3-5 minutes after boot
• ran at 155 – 165 watts while in pseudo sleep mode (monitors off and hard drives off)
• after 24 hours – 4.53 KWH

Conclusions

If I take these results and factor in the national average for electricity costs of 9.78 cents, then it costs me roughly $175.00 cents a year to run my machine under Vista, and $160.00 under Windows XP. I have both machines set to turn the monitors off after 15 minutes, and cycle the hard drives down after 3 hours of inactivity.

There are a couple of reasons why this surprised me, first being that I have more drives being used under XP with one of my drives not being recognized (since the raid drivers don't work) under Vista. The second being the much expanded power usage controls that Vista has. Being that Vista has the capability to actual control how much of the CPU you use, I would have figured the power draw would be less, but it seems initially that XP handles power better. The biggest difference between the two though is how willing I am to actually allow the computer to go into sleep mode. There is no way I am going to put my XP install in sleep mode, or hibernation – it simply won't come back.

This isn't the truest test either, during both tests I was using my computer normally, but I played no games and didn't have Photoshop open or any of those things, it was only to see what I get for running the whole shebang.

I'm not done yet though, so expect another run at this. I'm going to test my Vista install again only this time set it to sleep after 1 hour. I might also run another set of 24 hours tests where I play some games for a couple hours during the evening, as well as turn of the machine when I go to bed, and before I go to work – which should drop my annual operating costs down to $45.00 or so.

It’s kind of weird ya know? This is the first time in 4 months and change that I have voluntarily produced sweat on my body through physical exertion – extreme pain does not count, neither do night sweats. It’s weird even saying it – I had to say it out load just to make sure I’m not smokin’ the wacky weed. It felt good this time, and not just exhausting – I have hope.

The next time I am at clinic I need to find out when they will be comfortable with me getting on a bike and riding other than in my basement. Not that I want to rush it; too much, but it would be nice to know. If I had to hazard a guess it will be between 6 and 9 months post transplant.

I am pretty much back to full time and will be getting a release from my Docs next week saying so, so that work knows what’s up. I have been recovering well from the work weeks and haven’t had to cut a day short due to extreme fatigue in 2 weeks. Monday doesn’t count because I was sick.

The other reason I want to know; and most likely the real reason; about my effort levels on the bike is I decided some time ago that I was not going to be one of those Dads. You know, the ones that are too fat and lazy to play with their kids without risk of serious bodily harm to themselves? So I am seriously going to get with the program and get back into shape again. Hell, if Rocky can make a comeback at 50 something, then I can do it at 30 something. Right? F$#%in A!

Thanos seems to be doing very well on his second go round, and looks great after 3 – 4 years – in fact I hope to be doing as well as he. I will have to ask my doc about Dr. Tzakis on my next appt., I guess he worked with Dr. Starzl at some point – I’m not sure on all that though. He sounds like a great guy, and an exemplary surgeon. In that, Thanos and I have a lot in common. Dr. Soltyce (aka Kyle) did an outstanding job shoving my new liver into place, and I have no complaints at all. In fact quite the opposite – I am incredibly grateful to him and the whole liver team at UPMC.

I have been working some where between half, and full time now for a couple weeks and it is wearing me down a bit – and honestly I don’t know if I will make it a full day tomorrow or not. I know it’s lame right? It’s Friday, no one wants to work all day on Friday. That’s not it though. I was beat today. Tired as hell almost all day. Even after my spicy grease-biscuit breakfast, and a gallon of tea. We’ll see. I generally get my second wind around 2:30 or 3 in the afternoon, and today I wasn’t sure if I was going to get it. I spent an above-average amount of time staring at a marginally out-of-focus monitor before I snapped back to it.

I still feel pretty good, and I have been trying to walk more. In fact, if it’s nice again tomorrow I might drag the boys down to the might Tuna and go for a walk along the path. Who knows. They didn’t want to go today – they were having too much fun diggin in the dirt.

I started staying almost a full day at work this week, and I have to say right now I am tired – in fact I was falling asleep in my chair just a few minutes ago. It’s not as hard as I thought it would be starting back almost full time, and I expect within the next 2 weeks I will be back to full time on a regular basis.

I haven’t climbed back on the rollers again, and it’s mostly because I have started working longer and get more tired and don’t really feel like it. If I am being honest, it doesn’t even really appeal to me right now. I can tell my energy is low by dinner as I climb up and down the stairs and they feel like I have been riding a lot – that sort of half-spent spongy feeling you get when you work your legs hard – which in a sense I have been.

Powers of recollection

My memory continues to be a point of frustration as my ability to recall things is getting better, but only very slightly so. What’s funny is that I can easily summon bits of ActionScript and mundane programming details and techno-jargon, but little things like band names, actors names, etc… escape me sometimes completely. I can tell it’s getting better, and I have been purposefully exercising my brain with web related books, blogs, essays and such – just to help with this. Not being able to remember things drives me crazy, almost as much as my son kicking the wall to my office from his bed – it’s like being next to a freakin’ dance club sometimes. Only one that just vibrates with no apparent rhythm.

A lot of things have been getting all over my last nerve lately too – for like, the last 2 weeks or so. I’m not going to go into details as to what those things are, but a lot of them are things that didn’t bother me as much before; or that I possibly never really noticed. I’m not entirely positive on that account, but I can tell about my frustration level – and being somewhat limited in my activities, there is a limit to what I can do to relieve this tension. The cat is a great target for torment, but she doesn’t take it well. She gets upset and hides behind the fridge, and hisses at me. Plus the animal is on the wrong end of smart – so, it’s probably best to leave the poor, mental midget of a fuzz ball be….

Back to work

I have to say, overall I am glad to be back at work. Not because I got bored at home; because I didn’t. It’s more along the lines of I love what I do, developing web sites and web applications is a big part of who I am, and I derive great satisfaction from doing it. After 3 months of being deprived of this, it was time to get back to it. Plus, ya know – I missed bR4x and Jeremy.

In other news

I get to stay home for 6 weeks this time around. So my trips back to the Liver Clinic in Pittsburgh are getting at least a bit more distant. Which as much as I like my coordinator, I sat in clinic last week from 7:30 until almost 2:30 – so I won’t miss going every month. I’m hoping for the next trip they kick me out for a couple three months. That would make me happy. Yes indeed. I did have my laptop and a good book with me, so I was able to entertain myself – but I finished the book and the battery on my laptop went out – so after a bit I was stuck watching soaps on TV. GAH!

The CMV popped back up too, but I am on oral meds this time and the numbers are on the retreat – so that may get the boot again too, which won’t break my heart – I take a pharmacy every day – and it gets a bit old. Those damned Magnesium Oxide pills are uncoated, start to dissolved as soon as they hit your tongue – oh yeah; and they suck!

Next time they are doing another Ultra Sound to make sure my Hepatic Artery RI numbers are still good, and hopefully they get to stay that way – and I don’t have to look at another Angioplasty. I am glad they can do 3 of these, but I don’t really want to push my luck – and honestly it’s not a whole lot of fun.

I just have to remind myself that I am only 3.5 months out from transplant right? It’s good to get back on the bike, even if it is for only a few minutes a couple times a week.

Maybe next time I will be able to go for 10 minutes….