Happy Holidays and Happy Liver

I used to loathe bloodwork.  That is until it starts to show some marked improvement!

So it is official, the new regime, the new diet, and the new supplements (just a bit of fish oil, CoQ10, and Algae) have all somewhow come together to get my Liver Fucntion Tests down- in some cases by just by 10%.   It is a ten percent that I have earned and that I will take!

Now I need to make it through the holiday season, without the discipline of my trainer for the latter part- and all the cocktail paries and receptions.

Is it okay to list everything that I miss?

• More mince pies than I rightly deserve
• Drambuie w a drop of hot water
• Roast Potato w/ Thyme, Sea Salt, Goose Fat, and Caramelised Onion
• Gluwein
• Rosted Duck (mostly the skin!)
• The litany of homeade sweets
• The Champagne

Oh well, it is okay to have one, or even two, but just keep my head up and push myself.

Not getting results? Kick it up a notch! I had no idea how.

So it has been an interesting weekend for me.   I have had my wifes birthday, and we did some very indulgent things with food and a touch of wine.  Its hard, and I accept that it is just part of the risk that for today I was willing to take.

I am not getting progress on the weight loss

So I reched this plateau where I shed over fourteen pounds/1 Stone from the cardio programme that I have been doing over the past few months.

So what do you do when you go a month and you notice that you are working as hard and not getting the same results?  Well, I guess it is called a plateau.   You can only adjust your metoabolsim in stages.   So the only thing left was to take it up a notch.   For people like me, intelligent though I am, I had no idea how to go about doing that.

Boxing has earned my new respect as a truly hard art form and cardio

So I made an appointment for today at the gym with one og the trainers.    We boxed for 20 minutes.   A Jab, A uppercut, and kidney punch- and then combos.  It is much more of a stenuous workout than I ever imagined.  I was a bit winded at the end- but my trainer was hitting the one.   “C’mon give me a few more” and counting them down.   Fight through the new muscle use in a healthy and safe way.   I always thought boxing a bit brutish, but in some ways I could feel my focus—if only in glimpses—and feel a bit of my own anger getting an outlet.

Then we moved to weight combos for better cardio.   I was weak as a noodle to be honest- but kept at it.  We started with 20K bench press- and then moved to a 8 kilo moving postures.

Then came using the Swiss Ball for balance and working on my core and lats through using the 8 kg weight in a combo set of reps.   Breathing is so important for me- I need to get it right.

Then came the well deserved treat at the end of this hour that I was not sure that I would make it through.  I could feel the self doubt creeping in.  “Its too hard, its too much, my muscles are shaking”.   I got treated to a ten minute assisted stretching session on my limbs to try and keep the lactic acid from building up.   The good news for me was that I have good flexibility for someone my size. 

We are now slated for a series of ten sessions with a goal of increasing the wright losss and muscle mass.  The best thing I can hope for is 2 kilo/4 pounds a month with this new regimen at the start- three times a week for an hour.     Okay- its not much- but with the calorie counting- it will add up- and it should be a bit more.  It should get me off the plateau- I dont have the time.  Its lose the weight of gain a lap-band gastro-surgery.    That is my last resort.

Changing ideas about food

The simple tastes are now lingering longer, as I learn to live for a moment in each bite.

This is new for me.    What happens when you think to yourself you can have as many beautiful and tasty morsels as you like?   For me, I realise now that I did not pause to appreciate the taste long enough in my mouth.  To appreciate the flavours.    With wine, I became adept at carefully testing and tasting and taking note of all the nuances.   With a butter biscuit I now find myself enjoying bite after bite carefully and slowly.   Suddenly the butter biscuit seems so much more complicated than I had previously understood or knew.

Sure, for a fine meal and wine pairing, I could get orgasmic.  The thing that is amazing me is suddenly the simple things- when I change my approach- seem to have complexities and simplicities that I am re-learning in almost a child like way.

Pain, Anger, and Progress

So this week ended with a little bit of Pain, a little more Anger, and some Progress.  

Pain

The pain comes in the form of the liver swelling up a bit and being just generally a bit of a problem this week.   The reason for that is simple and two fold.   The “good” reason is that I am excercising and taking the regimen of supplements that has been recommended.  From Taurine, Algae, C, Milk Thistle and some B-10 we are getting somewhere.   The “bad” part is that I made a choice to indulge on my wife’s birthday.   I slip up, a cock-up, and after only two glasses- where are previously that would not have even phased me- I was a bit looped.  Worse, I angered the liver.  Not smart, not clever, but hey I am human and prone to the occasional temptation.

Anger

Focusing purely on the emotional for a moment- it was a hard week for me.  We are entering the holiday season and cocktails and canapes- and some of my most treasured tastes are coming into season.   I am simultaneously angry- more pissed off- that I cannot have them in the way that I would have previously.    Likewise, I am angry with myself, because I think that I few years agao I swaundered an opportunity to improve myself- after my heart attack- and I did not do it.   I kept on ,after a respectable period, with my eye on my health- but not doing what I could have to improve my current lot.   What if—-that really pisses me off.   There is no one to blame but me- and that is its own form of hell.

Progress

Getting to and maintaining the target heart rate is the most important part of my cardio

For the first time in my life, I have been able to truly exert self-discipline in my private sphere of life and health that I so adeptly could exhibit in my work life.   I know what has to be done.  I am counting caloires, educating myself of food choice, keeping a journal, and more-over keeping to my commitment to myself to go to the gym.   Even finding that when I get deep down, that when I am on that treadmill and the “time and calorie” counter are up- that I want to push through it.   Keeep going.  Just for me.  Just becasue it makes me feel good. 

I have also found a great new tool to warm up with- Something called a “PowerPlate” which helps me challenge my warm-ups before the cardio.  More on that later.

So- the big news is that I kept the calories below 2000 everyday this week.   I have hit my targets.  That is enough for this week.   Just for now- I am okay and a bit proud of myself.

The Angy Liver and it’s host start a journey

Hello and welcome to the Angry Liver- a blog about one man who is adjusting his life around a new diagnosis of Non-Alcholic Fatty Liver Disease (NAFLD) and advancing fibrosis.  

It is obviously not as serious disease as many people cope with every day.  I am doing this more for myself- and perhaps to let anyone else going through the same thing to know that they are not alone.

So why the name Angry Liver?

My liver was angry with me, and clearly letting me know.  Eventually, I became angry with it as well.  Then I realised that I had reached a good place.  Being angry about changing your life is okay. 

"Life is a banquet, and most poor fools are starving"

My Bacchanalian propensities would have to change if I wanted to live longer than my parents- who both died at 58.  That is a little less than 20 years from now.

I realised that as I was going through the past few months of coping with all the required life changes, I was going through the normal process of greif.  I was in denial between the blood-tests and the liver biopsy, I was trying to bargain my way out of a negative outcome, and at last I arrived at anger. 

So what is the big deal?

Sometimes in life you find yourself at the proverbial cross-roads.   For me, it was giving up a rich lifestyle of fine food, fine drink, and fine travel which had been a carefully cultivated goal of my life.   Or, I could continue on as I was and willfully reduce my life expectancy.   For the first time in my life, I made a on the spot choice.  I would change.

One of my greatest personal passsions in life is wine.  From spending time collecting, enjoying, and sharing wine with friends and even having it become a small part of my job- suddenly I felt I was going from 100 MPH to 0.  No more wine.   No more drink. It felt like no more passion.

I have faced worse, and many other people deal with worse everyday.    I have lived through cancer, and lived through a heart attack.   While I am only in my late thirties, I had a somewhat tough start in my younger years when it came to health.    I finally felt like life was going well, and things were right were I wanted it to be.

So what is the long term of this blog?

To just give me a place to put my thoughts- and to help me look back and realise that I am making progress.    If some of you would like to come along for the ride, you are welcome.    If you have NAFLD or Fatty Liver Disease yourself and would like to talk or contribute please do.

So for now- welcome to the Angry Liver.

How it all started

Scared to death

So today was the biopsy.    I am scared, and a bit apprehensive.   I almost dont want to know.  We have talked with the specialist, and we have three outcomes.  It could be cirrhosis of the liver, it could be fibrosis, or it could be just the same elevated enzymes from fatty infiltrate that apparently I have always had.   

The idea that my liver might have a few years left scares me the most.    I know that I have enjoyed my food and wine, and sometimes to excess.   I can’t help but be angry at myself- I did this.   I cannot help but be angry at my genes, at my liver.

One score and a few years ago…

I had cancer.   It was one of those things you learn to live with.   I had a liver biopsy then, due to the sheer amount of chemotherapy and radiation that I was exposed to during my treatment.

So, the good news was that I had a baseline biopsy to work from

The biospy (then-and-now)

So, this is how it's done- well at least the text book version

It was interesting to contrast the difference between the liver bipsy I first had and the one I had a few months ago.

The old one required a long transducer- like a long wire- that was inserted in the liver through a needle and liver core samples were taken.  It was a bit more invasive, and a bit more dangerous than the new procedure.

The new method was excellent, but I had an unfortunate complication.  My brachail nerver was irritated due to the approach that we had to use becasue of the size of my stomach.    So, I had this horrible stabbing pain develop between my collarbone and my shoulder.   It was painful, but not the worst thing I ever exprerience.

So for tonight, I stay in the hospital and graciously accept the pain meds and the kind care on offer.   God I need them at the moment.

Laying out the options

So, with two tense months of test behind me- we have come to some conclusions.

Test No. 1- Liver Function

Was just the standard blood tests, which we repeated twice.   Depending on if you are in the US or UK it often just called a Liver Panel or a Liver Function Test (LFT). 

My liver enzymes had been chronically elevated most of my life, through many different weights and circumstances- but we never really had much reason to find the source once we ruled out the major issues.   Generally speaking it was easier to blame the chemo. 

So, I saw my first specialist in years- a Consultant who is one of the UK’s top experts.  

Test No. 2 Enhances Liver Fibrosis Serum Test

So my new consultant decided that to go straight to a Liver biospy it was safer to try a relatively new test called  Enhanced Liver Fibrosis (ELF) test, the first CE-marked, standardized non-invasive blood test for assessing the status of liver fibrosis.  It was invented by Siemens Medical Solutions Diagnostics in 2007.   It was a good test- but the catch is that it takes up to 4 weeks to complete the test!   So four nervous weeks of waiting.

In the meantime we started to think of what else could have gone wrong.   My new consultant never accepted the premise that it was just the chemo.   He also was brutal about my total BMI being a signifigant risk factor.   So I had to start to address this as well.

Test No. 3- Well thats the Biopsy.   So off we go.

At this point I dont know whether I am more sad, confused, angry, or all of them at once.   I think I am really scared that my lifestyle may have been the cause of all of this- but yet there is a part of me that says I could have been screwed no matter what.  Either way, I am accountable for today.   From today, I have to do the things to make myself better- even though there are no gurantees that I will improve.   

That is the thing with liver issues.   Unless you have serious Cirrhosis, there is no true, literal, linear progression that you can follow to predict where you will be.   You may not be able to predict it- but you know that you can try to change the outcome.