When your body rejects itself.

This isn’t the first time I’ve talked about bariatric surgery.  I first looked into it in 2008.  I was having my second liver biopsy for AutoImmune Hepatitis (AIH).  Autoimmune Hepatitis is a noncontagious form of hepatitis; basically your body rejects its own liver.  No one knows really why it happens.  It is most common in females age 15-40. My story about how I was diagnosed is below.  what I say, is I just hadn't given it a proper work-out.  I never used to drink that much alcohol until about 2005, that's about when my liver started healing. Weird, but true!

I was diagnosed with AIH in 2003 or 2004.  I was having daily migraines. I went to the doctor for the headaches and when they did blood tests they found that my liver enzymes were way out of whack.  Specifically my AST and my ALT.  They were both up over 200.  Normal levels of AST are 5-40 and ALT 7-56.  They thought because I had been taking a lot of Tylenol for my headaches it was causing my liver to freak out a bit, so I had to not have any Tylenol for a month and come back.  A month goes by and I go back.  Headaches still the same and AST and ALT up over 400.  And my urine is turning a lovely shade of brown. I am scheduled for a liver ultrasound to see what they can see.  They are of course expecting to see a fatty liver, because what else would they expect to see in a 200-220 pound woman.  Nothing shows up. It looks fine.  So off I go to see a specialist.

I go to DHMC where I see a gastro-enterologist who specialized in the liver.  He was dutch.  His name was Dirk Van Leuwin. (Can’t remember the exact spelling of his last name). He suspected I had AIH and had me do more blood tests and scheduled me for a liver biopsy.  There were 2 bloods tests for autoimmune markers.  One was anti-nuclear antibodies, and smooth muscle antibodies.  I tested positive for one and negative for the other.  I don’t remember which now.  For the liver biopsy you are given some happy juice so you don’t really remember it too much, then you spend the day in the hospital on your right side as the liver “heals”.  Unfortunately, I ended up in a great deal of pain and was hospitalized.  

As a result of the AIH I was placed on prednisone.  It took 6 months for my liver enzymes to return to normal. This was called chemical remission.  Once they returned to normal I could then start weaning off the prednisone.  That process took a year.  The prednisone made me gain around 20-25 pounds. I got the fun prednisone moon face.  I was also placed on Imuran, which is an immune suppressant so I was more susceptible to infections.  I did get one once that placed me in the hospital for a few days.  I had to have blood tests every 2 weeks for a very long time.

I saw Dr. Dirk….aka Dr. Dick, for a few years until he moved back to Holland.  One time during a visit he said to me.  You are fat.  Ummm. Yeah I know.  I’m thinking gee dude you’re an asshole.  He says, don’t you want to be a contributing member of society?  I was in tears.  I was working 4 jobs!  4 fucking jobs!  I called and complained about him!  He called and apologized to me, but I never saw him again.  I found a new doctor.  I knew I was fat, but there are better ways to talk to someone about it.

I then started seeing Dr. Tim Gardner.  He opted to do another liver biopsy in 2008, which went much better than the first one.  I had been off all meds for about a year or so at that time.  I am happy to say that I have been in actual remission since about 2007 and they say I should stay that way. 

I asked Dr. Gardner about bariatic surgery and he referred me to the program.  Someone from the program called and talked to me.  At that time my BMI was 39.1 and you needed a BMI of 40. They didn’t consider high cholesterol to be a co-morbidity at that time.  So everything would have to be out of pocket and they told me everything from start to finish would be around $70,000.  Ummmmm not going to happen.  I didn’t even know going out of the country was an option.

I do wish at this point I had pushed harder years ago to have the surgery.  I also wish I had pushed myself harder, and had the will-power to do this on my own.  I can hear people saying, it’s all about moderation, just write down everything you eat, track, track, track.  Work out more, chose better foods.  Trust me I have heard it all.  I’ve done it all and I failed at all of them.  I have been a failure.  I know that. But this time I am going to win!