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29837 tn?1414538248

MELD Score Change

Just received a complete evaluation of my condition from Dr. Robert Gish, the Hepatologist.

Last few years my MELD score was 7, now it's 6. How's that possible? I was under the impression that this disease constantly advances, slowly or quickly.

Another interesting point: Last few years, my ALT and AST readings were in the low to mid 100's. This year, they are both no higher than 83. Normally I would contact the doctor to get this all understood, but there are two factors of why I'm asking here. First, Dr. Gish is extremely busy and very hard to get a hold of. Second, with all the brilliant minds here, I'm sure someone can answer these puzzling readings. Anybody?


25 Responses
87972 tn?1322664839
HI Magnum,

I’m happy to hear the change is for the positive, even as marginal a change as it is. My understanding is that MELD scores are dynamic in nature, and vary from week to week, month to month… I think even those that have been listed for transplant are occasionally removed from the list due to spontaneous improvements, then re-listed at a later date if needed.

Maybe you can attribute it too a good attitude and living well :o)? I don’t know how much weight to apply to liver enzymes in the larger picture, but my little pea brain assumes again that lower is better, huh?

Good stuff, guy. Have you heard anything about Gish moving to San Diego?

29837 tn?1414538248
Far as I know, he's still in the bay area and comes here once a month and wants to see me once a year. I guess that's better than wanting to see me every few months. He also states that the chances of me getting liver cancer in the next year are 3%.

As for weight, I'm glad you asked that my learned friend. He specifically said to keep my weight down. No more Ben & Jerry's (well, I cheat a little) and no more pizza (cheat again). My weight fluctuates between 190-195 at 6'0". He said that's acceptable. The 190 is minus the treats, the 195 is with treats. No math genius needed there.

Now I move on to other things he said are okay. Milk Thistle, Fish Oil with Omega3 daily, Alpha Lipoic Acid, but three times per week instead of daily, and the same applies with an additional 500mg Vitamin C, 2000iu Vitamin D3 daily and get enough sleep, stay away from anger and stress (gotta get rid of my girlfriend), and enjoy life one day at a time.

His capacity for me is evaluative. In other words, my Gastro is the director, Gish is the advisor. I guess I'm in good hands. I was worried there would be bad news, but this all sounds good. Excuse me while I go have a slice of pizza and some Ben & Jerry's. Shhhhh...

Avatar universal
My meld score is at 6 too according to my blood values.  Very good number if you ask me.
446474 tn?1446351282
Hi Magnum!

MELD scores very all the time. Because blood test values vary over time. In this case INR, bilirubin and creatinine. As you can see with your AST and ALT. When MELD reaches higher numbers it is common to have MELD measured for often as this will affect priority on the transplant list..

Lab Test Frequency

    * MELD score greater than or equal to 25; Labs needed every 7 days
    * MELD score 24-19; Labs needed every 30 days
    * MELD score 18-11; Labs needed every 90 days
    * MELD score less than or equal to 10; Labs needed every year

Today I happen to be looking through my copies of my doctor's tests and notes for the last 3 years. My blood test numbers vary constantly. Although I can see the trend over time as more and more values are out of range.

Slice of pizza?! Your killing me!!! If I ate pizza I'd look like I was pregnant with twins in two days (thanks ascites!) from the salt. I'd gain about 10 lbs in fluid. Yuck!

MELD= 6! Your a lucky man indeed! I was at 15 most of the year and now at 18. Sux!

Whatever your doing keep doing it. Just avoid any obvious things that are toxic to the liver. Anesthesia  was what started my decompensation. Many people don't know that anesthesia and liver disease don't mix and with advanced cirrhosis it can cause liver failure. I had cancer so it wasn't like I had a choice to operate or not. No nose jobs, liposuction for me. Shucks!

Stay stable and healthy...and enjoy your pizza!
Avatar universal
I have nothing of substance to add. I agree with Bill and Hector and Trinity.
I only want to say that I am happy to see that you're doing so well. I always like to see enzymes decrease even though I know they can fluctuate.
Stay well Magnum and stay happy.

Good luck,
179856 tn?1333550962
I think it's all the positive thoughts that have been flowing your way from the forum that's what did it :D

Regardless of how I am happy you are doing better and I have to say 190 at 6' and cheating a bit with my pals ben and jerry now that's amazing ;)
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