Mild Focal Acute Cholangitis

My Gasto, Dr. Em, says he isn't sure it is PBC now, or even PCS (which the name of the "possible" diagnosis is in the PCS description, but apparently not it?). Basically, I am in the "early stages" of inflammation of the bile ducts. My tests/biopsy was sent up to OHSU now to be reviewed and will know more in 2 weeks. As much as I want to know more, understand what exactly IT is, I appreciate that Dr. Em doesn't know and is getting another opinion, instead of bluffing his way through it for more money.

I have all the early symptoms of PBC/PCS (similar symptoms, very different outcomes in the end), and will just follow along w/ the dietary changes most PBCers make. They are common sense changes, low sodium, low fat, healthy & fresh fruits & veggies, drink lots of water, exercise...all the stuff we know we are supposed to do already!

The best outcome would be an infection that isn't showing many symptoms and taking a lot of antibiotics to get rid of it out of my body, and all will be good (hopefully). The worst outcome it seems is being diagnosed w/ one of the above, in which medication will be dolled out to slow damage.

Who knew something could go wrong w/ bile ducts! There are funny names for some too, the sphincter of Oddi, Ampulla Vader...makes you feel the "force" within you, haha.

So, NO CANCER, my ultimate fear! Yeah!

Pre-Liver Biopsy

I have to say, this week has been mostly up, but I have caught myself displacing my anxiety more than a few times. It didn't come out as anixety though, it was morphed into anger, and directed at my loving family. That got me sad, and using more restraint on myself, which is good.

Today, I am working on the more details of making sure the house is better (not best though, things are a bit behind in the organized home front...toddler #4 will do that to a family!); and working at calming myself into a more peaceful mindframe.

I won't lie and say I haven't thought of the 4 outcomes my Gastro Dr. Em might say to me, and think of how I will deal with each blow, and who would be my first call depending on outcome (that is to say, IF I find anything out tomorrow). From what I researched, these are the most likely outcomes, but there are dozens of others too...

1. Everything is fine, just lose the 55 lbs you are carrying around and your health will return to mostly normal, you just have minor damage to your liver that may/may not heal, but your liver enzymes should return to normal.
2. Well, things aren't fine, but they aren't dire either. You have some minor problems that we can work with over time, but are life long since there is no cure for them...self-help, some meds, and if things get worse as you get older, we have some ideas we can work with (PBC or worse, PSC).
3. You have a severe life long disease that we will work closely with (be it NASH or full blown cirrohsis), and eventually you will need a liver transplant in 10-20 yrs.
4. You have cancer. You are not eligable for a liver transplant due to having cancer.

I am working on thinking positive, as I read, hear and even my Dad tells me...think the outcome you want, and you will most likely get it. It is true, we are what we EAT & THINK, and that is why I am in the place I am now.

I am aware that being this overweight is very bad for me, and that exercise and eating differently will save my life. From the time I worked at Burger King when I was 17, until my gallbladder was removed 11 months ago, I ate fast food about 3 times or more, a week (I was 34 at the time, that was HALF OF MY LIFE).

In our home, we don't have a bunch of junk or even soda. Those are special treats that happen on a bday or something (every other month here). We do eat too much pizza and ice cream, even though I am anti-dairy (what a dirty secret that is!). We don't buy cookies, chips (okay, tortilla chips and fresh salsa in fridge isle). We eat a lot of ground beef, cheap & easy to fix for a family of 6, and whole chickens when they are on sale at Roth's for 69cents a lb! What I am saying is that we don't eat like I see some families eat...a lot of crap. But we don't eat as healthy as I would like according to my own standards.

In 24 hours, I will be sedated, sliced open (just a bit) and a needle will pull some of my liver out to test. I pray, pray, pray that I get a second chance at life, and some life sentence doesn't come from this. I keep thinking, maybe I am overreacting...but what if this is even more than I realize it could be?

My Dr. reminds me though, if it were cancer, you would be losing weight...well, I am a steady 190, so that is a good sign!

Hepatic Function Panel- Liver Test Results

ALP- 142 (normal 30-126)
ALT- 69 (normal 4-36)
AST- 47 (normal 8-35)

These are my most recent results, more elevated than the last ones I took about a month ago. At this point, we are looking at PSC (primary biliary cirrhosis), or worse yet PBC (primary scelrosing cholengitis), to which there is no cure for either.

Cancer is a possibility, but not what my gastro is looking for. I am worried enough though with the diagnoses above since they lead to ultimate cirrhosis of the liver and liver transplant for me in 10-20 years (Dr's speculated time frame), and can lead to cancer (especially PBC). My kids will be needing me still!

I have gone to the great lengths of crying myself to sleep over the possibilities- death, funeral, what happens to my family, Mark, my boys, money, etc. It isn't a good place to live & heal from, so I am strongly working on envisioning a positive outcome, while changing my dietary & physical habits as we speak.

I have much to catch up on here, but am taking one day at a time! Biopsy day is in a week and a half, and we will know so much more then (hopefully, otherwise is is MRI time).