Last March I was helping Ryan and our fabulous new employee- Zach move these calves from the little "hutchers" to a larger group pen. Catching our breath after that intense work-out, I noticed that Ryan's color was a little off. Upon closer inspection, (peeling down his eyelids) it was confirmed. He was yellow. Having seen very few grown men with jaundice, I told him that he needed to see the Doctor. Oddly, he agreed.
Fortunately, our Doctors office has after-hours- hours on Mondays. You know, because, Ryan had work to do. Unfortunately, Our Doctor was on a work vacation. We both were disappointed, because we love, love, love our Doctor, but I didn't think he should wait until the following week when she would be back.
Dr. Park was concerned with Ryan's symptoms, (fatigue, upset stomach, obvious elevated bilirubin) and wanted him to have some blood work done.
The results of the blood work on Tuesday prompted the Doctor to order an ultrasound of Ryan's liver, kidneys & gall bladder. Something was causing his liver to not function properly.
Ultrasound on Thursday, more blood work, and back to the Doctor on Friday.
The results of the ultrasound found no issues with his kidneys or gall bladder. Both seemed to be working fine. But, his liver was enlarged. His labs were negative for Hepatitis A, B and C. but his AST and ALT levels were 1200 and 1300. Normal range for AST is 5-40, and ALT is 7-60.
Since Ryan is not an IV drug user, alcoholic, or sexually promiscuous, The Doctor was a little stumped. When the blood work came back with such increased levels, Dr. Park had his nurse schedule an appointment for Ryan with a specialist. For the next Monday.
Dr. Park told Ryan not to miss the appointment with the specialist- it usually takes 2-3 months to get an appointment, not the next business day.
Upon visiting the GI specialist and answering lots more questions, scheduling more appointments and more blood work drawn, Dr. Jain thought Ryan may have Autoimmune Hepatitis. Ryan would need to have a liver biopsy first to confirm the diagnosis.
After hours of waiting- (we were early- go figure.) the procedure was finished and we were in the recovery room for a while. Orange Popsicles eased that waiting.
The results of the biopsy showed some cirrhosis, and the Autoimmune diagnosis was confirmed. Ryan was put on two different medications. Prednisone to quickly get the liver numbers under control, and a "maintenance" drug to maintain the liver function.
Within 4 months, he was off of his Prednisone, and just taking the maintenance medication. Liver labs were withing normal ranges and Ryan felt significantly better.
Flash forward: It took some time for Ryan to feel back to his "normal" self. He still tires easily (maybe because he's 40!) and a few weeks ago he was having some pain in his liver region. We've also noticed that he does not digest some things very well, and if he eats those things (pizza) he'll likely experience some pain.
This disease does not resolve itself, and we expect to deal with it for the rest of his life. We are very blessed that he is feeling better, and that there is medication he can take with very few side effects to keep the disease in check.
For those of you who knew all about this, we appreciate your kind concern and thoughtful prayers!
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