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Well I’m writing this post as I sit in the observational unit of the hospital again. As you might have guessed, I came down with yet another fever and they’re trying to figure out what is causing it and what can prevent it from happening again. Here’s a little update on the last week:

TUESDAY
I had another ERCP procedure to remove and replace the stents in my common biliary duct. There were two placed side-by-side during the last ERCP and only one when the doctor got in there. The other one fell out and passed on its own. He removed the existing stent and put in another one successfully. We listened to baby’s heartbeat before and after the procedure and he/she was doing well.

I had no pain or discomfort after the procedure, just a bit of a sore throat, so they sent me on my way after a couple of hours in the hospital. The plan is to replace the stents every 6 weeks for the remainder of my pregnancy and stay on my antibiotics throughout. I didn’t sleep well throughout the night but the remainder of the day was uneventful.

WEDNESDAY
Another pretty uneventful day as I returned to work, continued to take my antibiotics, and just had some sore muscles in my neck from the procedure.

THURSDAY
I had a couple of follow up/check-in appointments scheduled from my last hospitalization. I met with the Infectious Disease doctor I had during my last hospital stay to discuss the plan with antibiotics and she was in agreement to stay on the course of antibiotics I’ve been using since the plan is to continually replace the stents. I scheduled a follow up appointment for 3 months from now.

I then met with my normal Gastroenterologist (doctor who specializes in management of diseases of the gastrointestinal tract and liver) to check-in on how things were going in general since another doctor conducts the ERCPs. Everything went well since I had been feeling good and we discussed the plan or repeat ERCPs and antibiotics.

We also discussed consulting and updating my Hepatology doctors at Rochester Mayo since I haven’t been down to see them since my initial diagnosis in February 2016. Since the PSC symptoms have appeared since and things are obviously progressing, we’d like to keep them up-to-date with my current status. The doctors at Mayo have more PSC patients and are heavily involved in studies and the latest findings with the condition. Additionally, if things continue to progress to the point of transplant, I’ll likely be going through that process at Mayo, so it’s good for them to stay updated and involved in my progression. The hope to go down there at least annually and continue to work with my local doctors as needed.

I scheduled my follow up appointment with the Gastroenterologist for a few months and headed on my way.

As I was getting ready for bed, I began to feel feverish / achy and had chills off and on. The fever never went higher than 100.8 degrees so I decided to sleep it off in case of was lack of sleep from earlier in the week.

FRIDAY
I felt better Friday morning. No fever, just a little tired. I don’t work on Fridays, so my son and I just laid low. We ran a few quick errands and around lunchtime I began to feel tired and feverish. It had jumped back up to 100 or so. I decided to take a nap and after 45 minutes of sleep my fever had jumped up to 101.3. I called the nurse line and they said to go into the ER as usual and that they’d notify my GI doctors.

We found care for our son, my husband came home from work, and we arrived at the ER around 3pm. As usual, they ran bloodwork, conducted a urine test, and sent me for an ultrasound of my organs. By this time I was beginning to experience some nausea but it was manageable. We also heard the baby’s heartbeat and got to see it once again.

They decided to admit me and get me going on IV antibiotics since this is the third instance of fever during pregnancy and I was still on antibiotics this time. The ultrasound came back normal and my liver bloodwork was high (like normal) but not crazy, so nothing appeared to have gone wrong with the ERCP earlier in the week. More blood tests were ordered and antibiotics given for the night

SATURDAY
My fever seemed to be gone by the morning and I was feeling much better.
My white blood cell count came back high and my sodium was low so they decided to run some additional test that we’ve never run before in case something not related to my liver was going on. The doctors wanted to continue to monitor me for at least another day given this.
All the tests came back normal, so once again, the doctors are stumped on what is causing the fevers.

TODAY
Our hope was to be discharged today, but there is no clear solution to prevent these fevers from happening since we don’t know what causes them. After 24 hours my blood cultures did not show anything, but they are usually most telling after 48 hours. The doctors feel more comfortable sending me home with an antibiotic after viewing the 48 hour results to determine what might work best, so here I sit. At least for another day.

Fortunately, we are so blessed with amazing family and friends who have supported us in this journey by praying, watching our son, visiting the hospital, chatting on the phone, and texting to help me from being bored. 

I’ll be sure to give a quick update once I’m discharged and know a little bit more.

As always, thanks for joining me on this roller-coaster of a journey.

~Liver Life to the Fullest

As you may have noticed, I went silent for a short while and haven’t posted since my stent placement in March.  There’s a reason, and that brings us to the “good” portion of the title.  Shortly after I returned home from Arizona, we discovered I was pregnant!

We are extremely excited, but also were also initially filled with fear because I had an MRI and ERCP while I was pregnant but didn’t know it. Fortunately, we were reassured by all my doctors that the tests, procedures, and antibiotics are safe for pregnant women and the baby is growing as it should be. I am due in November around Thanksgiving.

I underwent another ERCP procedure in April to remove the first stent placed. When the doctor removed the stent, the common biliary duct narrowed again so he decided to place two stents side-by-side to open the duct further. I was given antibiotics for 10 days after the procedure to reduce the risk of infection and all went well.

Then comes the “bad” portion of the title. A few days after I finished the antibiotics, I came down with a fever and achiness.  I tried to sleep it off during the night and was still feeling pretty crummy in the morning, so my doctors recommended I head into the ER. The doctors think I was experiencing an infection and decided to give me antibiotics via IV and observe me and baby for a day. After spending one night in the hospital I was sent home with two more weeks of antibiotics and baby was doing well.

Once again, a few days after completing the antibiotics, I came down with a fever and some nausea.  After a quick call to the doctor’s office, back to the ER we went.  They put me on antibiotics via IV again and kept me a couple nights for observation.  I was sent home yesterday after feeling much better.

The plan is to stay on antibiotics until my next ERCP to remove the stents in a couple weeks. The doctors are hopeful the infections will stop once the stents are removed. If I have to have another stent placed, I’ll likely remain on antibiotics for a while to keep the fevers at bay.

For now, baby and I are doing well and we’ll take things one day at a time.

Thanks for joining me on the journey.

~Liver Life to The Fullest          

 

 

I wanted to share a quick update post-ERCP. The procedure went well last week and I am currently writing this post as I vacation and bask in the warm Arizona sun.

The doctor placed one stent in the common biliary duct. The stent was twice the size in diameter compared to the last ERCP I had — meaning the narrowing in the duct was not as small. The procedure was successful and the only short-term side effects were a minor sore throat and sore neck/stomach muscles for a couple days. I have been mainly PSC symptom free for the last couple of weeks, so prayers that it continues that way.

I’m currently taking antibiotics for ten days after the procedure to prevent any infection like last time. Since things have been going well, I decided to continue with my plans for my son and I to visit family in Arizona this week.

The next step in my PSC journey is to have another ERCP in a few weeks to remove the stent and possibly replace it with another larger stent to widen the duct further. That would mean another ERCP at a later time to remove the stent for good.  

If I’ve learned one thing throughout all this, it is to take things one day at a time. For today, I’ll continue to enjoy life in the sun. 🙂

Thanks for joining me on the journey.

~Liver Life to the Fullest

I was hoping I wouldn’t be posting again so soon, but here I am. When I last left you I had been consistently feeling good for a couple of months. Unfortunately, over the last month I’ve experienced PSC symptoms once again off and on.

February actually started off on a good note (or so I thought).  As I’ve mentioned before, I’ve been trying to stick to a gluten free diet to see if it helps alleviate some of the PSC symptoms. After being gluten free for over a month, I decided it was time to see if it made any changes to my routine liver bloodwork. The results came back and they were the best they’ve ever been since being diagnosed (my AST was even in the normal range!).

That same evening, things took a turn for the worse as I ended up experiencing nausea and vomiting throughout the night. I questioned if it was related to the PSC or a stomach bug since my numbers looked so good that same day. Since then, I’ve experienced nausea, upper right quadrant (URQ) pain in my stomach, and itching periodically.

I’ve been trying to identify if there are any triggers or themes with my symptoms and I have a few observations that typically ring true for me.   

OBSERVATIONS:  

• If I eat a larger meal I feel as though my body is not able to process the food fast enough and that is often when I become nauseous. I find it works best to eat smaller meals and snack throughout the day.
• My symptoms mainly occur during the evenings but have not occurred for two consecutive nights. This is good and bad. Good in that I’m able to get through the work day without feeling uncomfortable, but bad in that it’s during the short amount of time I get to spend with my son during the work week. I generally don’t eat dinner during these bouts of nausea and feel better the following day.
  
• My body does not seem to be able to process fattier foods like it used to, so I’ve been trying to stay away from red meat and greasy foods when possible.

I have been in touch with my doctor periodically over the past month and we ran my bloodwork again two weeks ago. The results were elevated, but not too high to the point of concern since my symptoms had been intermittent. We were taking a wait and see approach to see if things improved or worsened.

That brings us to earlier this week. I was nauseous and experienced extreme itching throughout the entire day on Thursday so I decided to run my bloodwork. The results came back extremely high (similar to when I had to have a stent put in my bile duct in October 2016). The plan is to have an MRI next week to see if there is another blockage and determine if I need another ERCP procedure to put a stent in.

The good news is I’m feeling much better the last two days, so fingers crossed it stays that way for a while. I’ll keep you posted once I know more from the MRI next week.

As always, thanks for joining me on the journey.

~Liver Life to The Fullest

For those of you binge reading my “backstory” posts, we’ve finally reached where I’m at in my journey today.

Since my hospitalization in October 2016, I’ve been feeling pretty good, but have had a few bouts of symptoms (itching/nausea/fatigue) off and on. There are days when I find myself sitting in meetings at work pushing through the nausea or days that I can’t keep my eyes open due to the insomnia. Here’s a funny list of things PSCers can relate to that you might enjoy and give you a glimpse of my daily life.

With the new mantra to “liver life to the fullest,” I’ve been trying to stay active and discover ways to better manage my symptoms. I continue to play basketball in a weekly league which seems to give me even more energy. I’ve been travelling and continue to make plans for the future to explore new places. In addition, I’ve been testing out a gluten free diet to see if helps alleviate any of my symptoms. It’s still too early to tell, but I have been feeling really good the last month of the new diet so perhaps more to come on that.

I recently met with my Gastro/Heptologist and the biggest thing I took away was that I’m in the very early stages of PSC still. My liver function is still really good and only the ducts are affected at this time. And for those nosy family members reading this, the doctor was also encouraging and hopeful that I can have more kids someday.  😉

Today I feel like PSC is manageable and I can continue to live a full life. Sure, there may be days where I feel crummy and don’t want to get out of bed. That’s just a reminder that we don’t always know what someone is going through, so be nice to one another and provide some encouragement.

Thanks for joining me on this journey.

~Liver Life to the Fullest

Life didn’t change after my diagnosis with Primary Sclerosing Cholangitis (PSC) in February 2016 because I wasn’t having any symptoms and there isn’t anything that can be done to prevent it from progressing. It was a matter of waiting to see when and if the PSC progressed. As you can likely guess by the title of this post, it did.

In September 2016, I started experiencing moderate itching on my legs, arms, back, and stomach. I was done nursing my son, so I decided to give a medication (called Ursodiol) a try because it sometimes helps normalize liver bloodwork and relieve itching in PSC patients. Unfortunately, it did not seem to help and my symptoms became worse.

At times the itching became so intense that I ended up with bruising on my legs from scratching so much. To make matters worse, just as my son was FINALLY sleeping through the entire night, I started experiencing insomnia where I’d be wide awake from 2am-5am and nothing could help me get back to sleep. As you can imagine, this led to extreme fatigue throughout the day.

I knew these were all usual symptoms of PSC and that they might come and go. I had an appointment with my Gastro/Heptologist (PSC doctor) in a few weeks, so I thought I’d just inform her of the developments then. That’s when the nausea set in and I was unable to eat much without feeling miserable.  I decided to check my liver bloodwork and see if I could get in to see the doctor earlier. Sure enough, my liver counts were the highest they’d ever been and my bilirubin levels were elevated as well (which they had never been before).

I stopped taking the Urso and was sent for an MRI to check for any blockages in my liver biliary ducts. The Radiologists discovered a portion of my common bile duct was dilated and then abruptly narrowed. For those of you wondering what the common bile duct is—it’s the portion that moves bile from the liver to the small intestine. A blockage can lead to liver products leaking into the bloodstream, which is why I was experiencing the itchiness.

Since I was feeling pretty crummy at this point, we decided to conduct another endoscopic retrograde cholangiopancreatography (or ERCP) to place a stent in the bile duct to get things flowing properly again. I had the procedure in October 2016 and it went well even though the doctor had to place the smallest stent possible since the duct was so narrow.  I was provided with almost immediate relief and I felt like a new person being able to sleep through the night for the first time in over a year.  The plan was to return in a few weeks for another ERCP to remove the stent to place a larger one and repeat one or two more times.

Since everything went smoothly and I was feeling good, we headed to my in-laws to attend a wedding that weekend. The first night there, I woke up in the middle of the night with a fever and vomiting. After a quick call to the nurse help line we decided to head into the local emergency room.

They were able to give me medication to relieve the nausea and I began feeling much better. After numerous scans, bloodwork, and six hours in the ER, they determined it was best that I be admitted to the closest major hospital (which happened to be Rochester Mayo).  The hospital was a 45 minute drive away and they wanted to continue to monitor me, so I was able to experience my first ambulance ride (which seemed a bit excessive since I was feeling much better at this point).

I spent the next two days in the hospital running more bloodwork and receiving IV antibiotics as the doctors tried to identify the type of infection that was causing my fever. It ended up being an infection from bacteria introduced during the ERCP likely not being able to flow out which means I’m susceptible to it occurring again the next time I need another ERCP. I was given oral antibiotics for my infection, so the doctors were able to discharge me rather quickly.

I ended up not needing additional ERCPs because the stent fell out on its own (meaning the duct opened up even wider) and I had been feeling good. Praise God!

Actually experiencing the symptoms of PSC and being hospitalized brought reality as to just how crazy this PSC ride will likely to be. It prompted me to do more research and read other PSCers stories. That’s when I realized there are aren’t many people sharing what the “early stages” of PSC is like. My hope is that I can bring some hope and comfort to others in a similar situations and let you know you’re not alone. We can continue to live life fully and bring good into this world no matter what our circumstances are.

Thanks for joining me on this journey.

~Liver Life to the Fullest

Being diagnosed with an illness or chronic condition can be scary and intimidating, but my diagnosis of Primary Sclerosing Cholangitis (PSC) brought a sense of relief. Well, if I’m being honest, there was also a little fear.  It brought relief because I had a long road of tests, procedures, and doctor visits to finally get answers. So I’ll start at the beginning… (Disclaimer: It’s going to get personal real fast.  🙂 )

In May of 2014 I had been experiencing some abnormal stools and decided to see my primary care doctor to get things checked out. She ordered some bloodwork to see if we could figure out what was going on. The bloodwork showed elevated liver enzymes, so I had an ultrasound to check out my liver, gallbladder, pancreas, and kidneys. Everything appeared normal and the doctors were still unsure of what was causing the elevated numbers, so they decided to have me go in for an MRI. Again, everything appeared normal, so I was referred to a Gastroenterologist for next steps.  

The Gastro decided a colonoscopy was the next course of action, so I was able to experience the fun procedure a little earlier than most (at age 28). The preparation of drinking a gallon of laxatives was definitely the worst part. To top it all off, I was the youngest patient in the waiting room by at least 20 years.

After the procedure, the doctor came into my room to review his findings. He stated that he removed a polyp (which could have turned cancerous if I didn’t have a colonoscopy until the usual recommended age – whew!) and that I have something called Ulcerative Proctitis (a less severe form of Ulcerative Colitis which causes inflammation in the last few inches of the large intestine). He quickly stated that he’d write me a prescription for the Proctitis and that I need to come in for regular colonoscopies every few years. Unfortunately, the doctor appeared to be in a hurry and did not really allow for us to ask many questions before he was out the door. Before he left, he did indicate that the elevated liver enzymes were not caused by the Proctitis, so we were back to square one again.

The good news is the Proctitis medication worked immediately and now I only use it as needed for a few days when a flare up appears.   

I consulted with my Gastro and he thought it would be best to conduct an endoscopic retrograde cholangiopancreatography (or ERCP) next. Most of you are probably wondering what the heck an ERCP is. It’s a procedure where the doctor examines the pancreatic and bile ducts by placing a tube down your throat. If they find a blockage during the procedure they will often place a stent or make an incision to open things up. Once again, the procedure did not reveal a clear diagnosis for me because everything appeared pretty normal during the exam.

I did have my first introduction to PSC at this point when my Gastro casually mentioned that PSC might be a possibility. He indicated some of my liver ducts were a little more pink than usual but it was a small chance since it’s a rare condition and there was not a clear sign during the ERCP. He did not seem worried and felt that there were no more tests we should run at this time. My husband and I wanted to start a family soon and the Gastro fully supported continuing to live my life as normal since everything else appeared fine. At this point we did a little research on PSC but put it at the back of our minds since I had been feeling good and the doctor did not seem concerned.

In December of 2014, we were blessed to find out I was pregnant and expecting a baby in August.  I continued to run my liver bloodwork to keep an eye on things. During the course of my pregnancy, all of my liver enzymes normalized.  I ended up consulting with a new Gastro during my pregnancy and she indicated that they often see this in pregnant women with autoimmune diseases and that she’d like to figure out what’s going on after I had the baby.

The rest of the pregnancy continued to go smoothly and in August 2015 I gave birth to an amazing little boy. As suspected, my liver blood work jumped back up and I was sent in for another MRI and biopsy in November 2015. Once again, I had my doctor stumped since everything came back normal. We decided the next step was to go see a specialist at Rochester Mayo to get answers.

After more blood work and scans, we headed to Mayo in February 2016. During my initial consultation it was suspected that I had PSC. They wanted to run some more blood tests (p-ANCA and c-ANCA) to confirm and have me consult with an additional doctor the following day. The test results came back positive for PSC so I was officially diagnosed.

Not much changed after the diagnosis for me. There is a medication (Ursodiol) that sometimes helps lower liver enzymes of PSC patients, but since I was still nursing my son we decided to wait on trying it.

Even though there is no cure for PSC at this time, all the doctors I’ve worked with have been extremely optimistic that I can live a full life. I decided then that I will live my life to the fullest no matter what gets thrown my way.

Thanks for joining me on this journey.

~Liver Life to the Fullest

Like most people, I had no idea what Primary Sclerosing Cholangitis was until a doctor informed me I might have it, but he wasn’t quite sure (more on this and my diagnosis in the next post). I want to spend a few minutes sharing what PSC is to help answer some of the common questions.

PSC is a rare chronic liver condition that predominantly affects older men – I guess I like to break the mold. Essentially the bile ducts inside and outside the liver become inflamed which leads to scarring, narrowing of the ducts and eventually blockages. This damages the liver which can potentially lead to liver failure and the need to have a transplant.

Cause
There is no known cause of PSC at this time but it is often found in individuals with Ulcerative Colitis. (My journey actually started with a diagnosis of Ulcerative Proctitis which is a less severe form of UC.)

And no – PSC is not caused by drinking alcohol. My family and friends reading this are smiling because they know how little alcohol I drank pre-diagnosis that it’s a joke.  🙂

Symptoms
Common symptoms of PSC include itching, fatigue, nausea, vomiting, insomnia, abnormal stool/urine, etc.  I had not been experiencing any of these symptom upon my diagnosis and until September 2016.

Cure
Unfortunately, there is no cure for PSC at this time, but there are medications and surgical options to help alleviate symptoms if needed. One of those surgeries can involve having a stent inserted in the bile ducts to provide relief. However, even if you can manage the symptoms, PSC can sometimes continue to damage the liver to the point where a transplant is needed.  And even if you get a transplant, it’s possible PSC can recur. The good news is there are some great trials being conducted currently and a number of doctors are hopeful a cure can be found.

Dietary Restrictions
There are currently no dietary restrictions suggested for PSC patients. However, there have been a variety of one-off success stories of dietary changes that have lead to improvement in symptoms and slowing progression of the disease. I’m currently testing out a gluten free diet to see if that helps with some of my recurring symptoms. My thought is that it can’t hurt to try.

When people find out I have a liver condition, the most common question I get is, “Can you drink alcohol?”  It’s typically recommended that anyone with a liver condition shouldn’t drink alcohol, so I don’t.  A number of my doctors have indicated that a drink on a special occasion wouldn’t hurt, but why risk it if I don’t need to?

Summary
If I’ve confused you or you want to learn more, here’s a two-minute PSC overview video I found helpful and a PSC website to get you started.

 

That’s PSC. For those of you stressing out thinking that I need a liver transplant ASAP – don’t worry!  I’m in the very early stages of PSC and my liver is still healthy. The condition generally progresses slowly and in some cases, not at all.  The good news is, many PSC patients live long healthy lives with PSC and/or post-liver transplant.

While living with PSC may really stink at times, it isn’t anything I can’t handle because I know God is in control.

Thanks for joining me on this journey.

~Liver Life to the Fullest