Tuesday, February 28, 2012

Let's All Say a Prayer for Fatty Liver

Life has been on the crazy side for me lately. I will admit it, I'm over committed. The fact that a lot of those overcommitments are for things I really like, such as the ballet, the theater, yoga, quilting, friends, doesn't change anything. And this is a particularly bad time for me to be over committed, because I'm not feeling well.

It started last October, when one of my many doctors noticed that I had elevated liver enzymes and/or other bad test results for my liver. That started me on a four-month odyssey of going on and off various drugs to see if my test results would improve. The fact that I had several doctors independently trying to do this did not help the situation. In January, my rheumatologist took me off Azathioprine (generic for Immuran, an immune-suppressing drug that keeps my lupus in check).

The consequence of going off my main lupus med is that I have felt like crap pretty much ever since. One of the worst problems is the lupus fatigue. Forget getting a a good, 8-hour night's sleep. I could sleep for 12 hours and I would still be tired. Getting out of bed has become a major problem. I only succeed at all because my joints hurt so much by morning that I have to get up. I have resorted to going back to bed in the middle of the afternoon. I do not mean napping, I mean going to bed. It's depressing and I can't get anything done anymore.

After another round of bad tests in early February, I got sent to a liver specialist. Fortunately, I had one who already knew me. Did you know the docs who do colonoscopies are liver specialists? Me neither, but they are. So I went to see my gastric guy, who ordered many more tests and an ultrasound. I got his conclusions last Tuesday.

The tests identified two possibilities, neither one conclusive. Either I have a tragic liver disease or I'm too fat. This is not a joke. Plan A included me having a liver biopsy, but I've had a variety of biopsies before and know what they're like, so I declined, at least for the time being. Plan B, which assumes that I have what is known as Fatty Liver Disease, is that I must lose twelve pounds in three months and get tested again to see if that fixes the problem. If it does, the dread disease is off the table. Yee-haw for losing weight. The fact that I only have to lose twelve pounds to get out of the "overweight" category does not seem like I should be plagued with a fatty liver, but who am I to argue?

If it is not fatty liver, then it is probably Primary Biliary Cirrhosis, a progressive, auto-immune liver disease with no cure except a liver transplant, which of course is not considered until you are at the dying end of it. You can probably understand why I am rooting for the fatty liver disease. The fact that I have already got more than one auto-immune disease does not make me feel good about this, though. Time will tell.

It would be fair to say I am feeling depressed. Depression plus the lupus fatigue is hard to fight. If it turns out to be PBC, the treatment is the lupus medication which they took me off last month. I see that doc next week and I am hopeful that he will put me back on it now. That would help a lot.

The really bad thing is that I have had to cut out my drinking for the duration. Those of you who know me well are wondering why I say this, because I am scarcely a drinker at all. The thing is, after our trip to Costa Rica, I acquired the very best Costa Rican rum on the market - 20 year-old Centenario. I had taken to enjoying a sip or two over cracked ice a couple times a week, just savoring the delicious rum-ness of it. Sigh, no more fabulous rum for me, at least until I know what is wrong with my liver.

Anyone interested in some good rum? Come on over and I'll give you a wee bit. All you have to do in return is describe it to me while you're sipping it. Let's all hope that I turn out to have fatty liver. I will never complain about dieting again.

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