Meet Some Of Our PBCers Who Received

 

The Gift Of Life

 

 

 

 

CAROL WALDNER

 

In 1976, in a routine physical, I was told my Alk Phos was elevated.  A series of doctors scratched their respective heads and ordered numerous tests with no definitive diagnosis.  A liver biopsy brought a diagnosis of "granulomitis hepatitis."  The itching started in the eighties. Many more tests and another biopsy still offered no diagnosis other than the above.  In 1990 I jaundiced and sought help at Mt. Sinai in Cleveland. Dr. Tavill was puzzled but started me on Actigal.  Over the years my Alk Phos reached the 1200's and never really came down.  When I moved to Florida in 1991, I was referred to Dr. Spivey at Mayo Clinic in Jax.  He told me he suspected PBC, but my AMA was neg. Now they know that there is a sub group of us who fit that scenario.

 

Other than the wild itching, I was lucky to have few other problems until the fall of 92 when I noticed my eyes turning yellow along with my skin.  At that check up I heard the word "transplant" for the first time and things went downhill fast.  I was evaluated in Feb. 93, listed in March and txed 37 days later at age 72 on Easter Sunday.  My gift of life came from an eleven year old girl.

 

I had a bout of rejection before discharge and was treated with steroids.  Went home on the fifth day after surgery feeling great.  At four months had another rejection episode and this too was treated successfully with steroids.  Other than a bad case of Shingles, I am astoundingly well.  I take Prograf, Fosomax, Nexium and Insulin for Med induced Diabetes. I feel I am in good hands with my tx team at Mayo and my local docs.

 

So here I am at 74 alive and well and grateful for my good fortune!

 

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CONNIE J. WIRTHLIN

 

58 yrs

DIAGNOSIS:  PSC  Oct. 1988:

   No symptoms; increased liver enzymes picked up in CBC for life insurance application

   Diagnosis made thru liver biopsy.

 

August 1997 – October 2003:

Experienced many side effects and condition gradually worsened.  After Hepatic Coma with

Encephalopathy in July 2003, MELD was finally a 7 and was put on Transplant List at University of Colorado Hospital in Denver.  A gastro bleed in Dec. put me at an 11.  Were told I was a good candidate for Live Donor tx but no one in my family was a match.

 

One of my friends, Kris Leonard, came to me with "I am your blood type and I am going to be tested to be your donor".  By the end of February 2004 she was pronounced "qualified Donor".  Scheduled the tx like any other surgery & everything went like clockwork; no problems except Kris and the pain med's didn't get along and it took a few days to find one that didn't make her sick.  She was out of the hospital in 6 days and I was out in 8.  We stayed in 2 apartments in Denver close to the hospital with care givers waiting on us hand and foot.  Twice weekly visits to clinic were required and she was allowed to return to SLC on the 18th of April and I came home 1 May.  (Finally, home alone!!)  Went thru 2 episodes back to back with CMV but pronounced (negative) on the 27th of Aug.  Labs are great and only taking 1.5mg prograf 2xdaily, 81 mg baby aspirin.  Take Prilosec, Pentassa to keep Colitus in dormant state; also Synthroid for minor thyroid.  Doc put me on Valcyte maintenance indefinitely to keep CMV away…

 

I now have a large right lobe for a liver and she has a large left lobe.  She is minus one small bile duct (I have it!!) and she was back to work in 6 wks.  I was back to work as soon as I got home. (Office in home)   The folks at UCH do the most (I think) live donor liver tx's and have a wonderful success rate.  The whole program is great; from the Hepatology doc's, to the surgeons, to the residents, to the nurses and aids. 

 

MAJOR COMMENT:

 

It is just too bad that live donor transplants aren't publicized more than they are.  I know not all people are in a physical condition to receive one but I truly believe more lives would be saved if this type of transplant were more widely known.

 

Kris & Connie

 

 

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DENISE

 

My initial dx by liver bx in 2001 was hepatic failure due to AIH and overlapping PBC.  I had been working in acute care as an RN since 1978, but the fatigue and symptoms and stress from my husband passing away forced me to discontinue work.  I have two children, 17 and 19.  My local hepatologist advised me to see the transplant team at Shands in Gainesville, FL.  I was placed on the UNOS list and my health continued to deteriorate.   A dear family friend who just lost his wife to cancer offered to donate half his liver to me.  He said "I couldn't save my wife, but perhaps I can save you."  What a blessing!!  The tx was done 7/2/02 and my donor was able to return to work within 3 weeks with no complications.  My story was complicated by acute rejection, leakage of bile and fluids at the surgical site, and a blockage in the biliary system.  A stent was placed at ERCP.  3 months later, the stent was removed (by ERCP) and I went into a septic coma for 2 weeks.  I was really doing fine until April this year when my enzymes started rising.  Even after I was placed back on 40 mg prednisone and 100 mg Imuran, they still are rising (I am also on Prograf, CellCept, Ursodiol, insulin for brittle diabetes, betablockers, synthroid  and E-mycin for gastroparesis).  After 2 more ERCP's, my enzymes are normal and I am being weaned from the prednisone.  A stent is in place at the right bile duct where a stricture was found.  Today, both my donor and I feel great.  There IS hope for all those who live with this disease.  May we continue to support each other with love and prayers.

Denise

 

Until early 2002, I had no idea that the liver was the only vital organ that could regenerate itself.  My initial thoughts of organ donation brought back images of the old Woody Allen movie Sleeper and the scenes of the cloning process of the nose.  It was 37 years ago when I first met Denise and her family ˆ she was 11 and I was 20.  I bought my first car ˆ a red 1962 VW convertible - from her father, and I painted their family house as a job that summer before going back to college.  I kept in touch with the parents over the years and visited them periodically at their home in Indialantic, FL after moving to Florida myself in 1980.  I never saw Denise over the entire time frame of 1967 to 2001.  It wasn‚t until 2001 that I met her again when I dropped by her parents house and she was there.  I learned that she was sick, but didn‚t know the specifics.  It was months later when I saw her again at her parent‚s house, and realized that she was still sick, but again, I didn‚t know the details.   As I learned more about her illness, I realized that she needed a liver transplant to survive.  We were chatting one day in March 2002 when I told her that I would give her part of my liver. That statement set off a chain of events (medical appointments, physiological exam, website research) that led up to the ninth live liver transplant ever performed at Shands Hospital on July 2, 2002.  I was out of the hospital in 8 days and was back at work part time on the 10th day after the operation and back full time by the 13th day.  I was tired for weeks afterwards, and I have memories of the hospital stay that will be forever etched in my mind∑like the feeling of riding in a toboggan (hospital bed with safety arms up), rock music playing in my head and the morphing of the ceiling tiles in my hospital room when I was coming out of the anesthesia.  But more importantly, I have an abdominal scar that will always be a reminder that I helped someone.  It’s been twenty-seven months since the operation, and I feel terrific.  After several close encounters during that same period, Denise is currently in good health, and enjoying life with her two children.  She also likes plain M&Ms and eats peanut butter sandwiches prior to going to bed, things she didn’t eat previously!!

Victor

 

Denise & Donor Victor

 

 

 

 

DIANA

 

Amsterdam, Netherlands

tx: March 18, 1990

 

Sept. 10, 2005

I was born in Los Angeles 54 years ago (1951). When I was 19 I left college and spent a year traveling around the world with my future husband. We moved to Santa Cruz, CA when we returned.  Our first daughter, Maya, was born in 1977.

 

In 1980 at the age of 28 I noticed my first symptoms of liver disease.

In 1983 I had our second daughter, Haley.

In 1985 we moved to Amsterdam, Netherlands.

In 1989 I was finally diagnosed with PBC and a few months later was put on the transplant list.

 

There were 11 of us on the list at the time and I was the only person with type A blood so I was first in line for my blood type.

 

In 1990, at the age of 38 I had my transplant after being on the transplant list for only a week. It was a very difficult recovery and I spent 5 months hospitalized. Besides having CMV and possible meningitis, I also managed to wind up with a paralyzed leg. I had a year of physical therapy before I could walk without a brace and have been left with permanent nerve damage pain in my lower leg and foot but I can walk and run now.

 

After spending the first year recovering from my transplant it's been pretty smooth sailing. I was weaned off of cyclosporine after 4 years and now only take 9mg. prednisone and 75 mg. imuran daily. I also take Fosamax for osteoporosis, vitamins and something for nerve damage pain. I can't say that I have as much energy as I'd like to have but I have enough. I don't work. I love to travel and my favorite things to do

are snorkel and play tennis.

 

My girls are now 27 and 22. They no longer live at home but I get to see them a lot and I'm happiest when we're all together. I'm so proud of the young ladies they've become and am so grateful that I've been

granted all of these extra years of life. I’m expecting my first grandchild in a few months (mid-Dec. 2005).

 

Life is great!

 

Diana Watson

 

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DIANNE HOWELL

 

I was diagnosed in 1992 though my liver test numbers had been abnormal since 1985. I was finally sent to the liver specialist who figured it out with tests. I had Primary Sclerosing Cholangitis. In 1990 my specialist tentatively diagnosed me with Autoimune Chronic Active Hepatatis or Lupus. I was diagnosed with Lupus in 1991 by my Rheumatologist.  Once an ERCP showed Sclerosing Cholangitis in 1992 the other diagnosis was not discussed though we knew I didn't just have PSC that something else was going on in my liver. Another doctor on the Transplant team added the ACA Hepatitis to my diagnosis and both diseases showed up on my hospital chart.

 

I was transplanted in August 2003 in Vancouver, B.C., Canada.  I am doing very well.  My liver blood test numbers have been normal since just after I left the hospital. I have never had a rejection episode though that doesn't mean I never will.  My Tacrolimus level has been reduced from 7 and 7 at the beginning of April to 4 and 3.5 mostly because of peripheral neuropathy that was reacting to the Tacrolimus. The Neurologist wanted my dose reduced.  The doctor now says my trough level can be reduced to 3.5 so I am hoping to have my Tac level reduced some more.

 

Thought I would add that I have been married for 41 years. I have two children 40 and 38 and three grandchildren 16, 15 and 11. I will be 60 on the 18th of this month. I have 4 cats and a kitten.

 

 

 

 

DONNA BIAS

My name is Donna and I am 56 years old and had my transplant at age 45.  I live along the Ohio River with my husband of 39 years.  We have 3 daughters and 1 son, and 8 grandchildren. 

I was diagnosed with PBC in 1991.  I first went to an urgent care facility for the severe itching and was told I had scabies – ha!  After a couple of weeks of treatment, I called them to say I was still itching.  I was told to do the treatments again.  After a couple more weeks of no relief, I went back to their office and they told me to see a dermatologist.  My family physician had been out of town during this time, but finally was able to see him.  After I told him of the itching, he took one look and told me I was jaundiced and suspected a gallbladder blockage and admitted me to the hospital that day.  By the next day, he had lab results and called in a gastroenterologist.  This doctor did a brief exam and told me I had cancer or cirrhosis of the liver.  After a number of tests and a liver biopsy, PBC was confirmed.  While in the hospital, and on the day of my 25th wedding anniversary, I was told I had 2 years to live.  What a shock when you didn’t even know you were sick – just itching.

Along with the severe itching night and day, my spleen was as large as a football, which was due to the restricted blood flow in the liver forcing the blood into the spleen.  This made it painful to eat very much at one time due to the pressure on my stomach.  Also, the spleen was “eating” up my platelets, which caused severe hemorrhaging every month during my periods.  I had a lot of nose bleeds too.  At one point, my platelet count was so low they were afraid my brain would hemorrhage.  The fatigue was so bad that I would fall asleep sitting at traffic lights.

The gastro doctor gave me a choice of several transplant centers.  I chose the University of Pittsburgh because of the number of successful liver transplants, as well as being within driving range of 5 hours.  I was put on an experimental drug called FK-506, now marketed as Prograf, to see if it would slow down the progression of the disease.

After dealing with the normal PBC disorders, in September 1996, I began experiencing pain near the center of my abdomen – not the right pain which was my liver, and not the left side which was my spleen.  I was admitted to the transplant hospital and found the pain was due to gallstones.  Since my liver numbers were going up, I was asked to stay in the hospital to wait for a liver.  Also, it was the Labor Day weekend and usually an indication of more accidents allowing organs to be available.  I waited one week and they did triple the number of liver transplants that week, but there was no match for me or there were others who needed it more.  On the 7th day I was told I was a backup for a liver.  Later that day I was told the liver was mine because the person it was intended for was too unstable for surgery.  My surgeon told me the liver had arrived late and testing had not been completed, so I was sent to the operating room for the preliminary procedures, anesthesia, incisions under arm and groin, etc., everything except for the major incision to remove the liver.  I later woke up in ICU without the liver because it was too old to transplant by the time the tests were completed.

I was then told another liver was on its way, but did not get it either because the person I was a backup for earlier was now stable enough for the surgery.  On the third day, I was told another liver was on the way.  The liver arrived but was severely lacerated from the retrieval process.  Since it was a young, healthy liver, my surgeon repaired the lacerations and proceeded with the transplant.  There were some lacerated areas that were not detected until all ducts were connected.  The surgeon then did more repair work on the liver and I was packed with an absorbent material due to the excess liver bleeding, and given 20 units of platelets.  Two weeks later I had another surgery to remove a large hematoma near the liver that was causing pain.  This “chopped” liver has worked very well since that time, except for a year after my transplant, my liver numbers started going up.  The liver biopsy was inconclusive as to whether it was rejection or reoccurring PBC so I was treated for both.  During the past 11 years, medications have been fine tuned and gradually the liver numbers have returned to normal.

I went back to work 3 months following my transplant and probably haven’t missed more than 11 days of work in 11 years.  Praise the Lord!

DonnaOhio River

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GLENDA

 

My name is Glenda Rosenbloom. My husband Alan and I live in Wodland Hills, California outside of Los Angeles with our little dog Charlie. I had elevated liver enzymes in 84 with zero symptoms until 99 when I had 5 bleeds from esophogeal varices. They installed a TIPS and the bleeding stopped.  When I was evaluated by UCLA, they decided I had PBC. Prior to that, none of the medical centers could figure it out since I had negative AMA and ANA.

 

I went on UCLA list in May of 99. My sister tried twice to be my donor but was refused both times. After having been on the list for 19 months and having UCLA say it would be another 12-18 months, I decided to look elsewhere. I picked Mayo in Scottsdale which had a new program. They evaluated me and put me on the list 12-00. On March 13, 2001 I got my new liver.

 

I had a rejection episode in Jan of 02 when they switched me to cyclosporine and my body didn't like it. They flooded me with steroids, put me back on Prograf, and I had no more problems.

 

Didn't have another bump until they took me off Pred. They tapered me from 5mg, cutting it 1 mg per month. I was Ok until I hit 3mg and I began to suffer from total exhaustion. I was off Jan of 03 and got some more energy. But I'm still not recovered. I was told it could take 6 to 8 months. I also have recently been having trouble with my joints. They are swollen and sometimes painful. I was told this was because Pred is an anti-inflamatory and this is body's reaction to not having it.

 

I did some research and found if adrenal glands do not function well, you do not have natural cortisone and your body suffers fatigure. Also found that bone marrow will not produce enough white blood cells, if it has a zinc deficiency. So I asked them to test for zinc in April, and sure enough, I was low. So they said just to take an OTC dose once a day.  I got instant energy but then that tapered off. My GI told me, he’s had other patients go off steroids and they have the same problem. It's a matter of time. And I've got that. Plus I'm determined to stay off it.

 

I'm now 26 months post tx. I've gone on trips, do yoga twice a week, do organ donor events, garden and walk the little dog. Alan and I like to go to movies and plays. Just saw Confidence and Identity which were both good movies.

 

Glenda & Alan

 

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JOANNE CATHCART

 

My transplant was 12/05/03   Two days after Joan Dale's.  . When I was admitted to Lahey I was considered alert and oriented and in no acute distress, (meaning I knew where I was and why I was there.) Otherwise I was basically in an encephalitic stupor.).  My lungs and heart were fine, my belly wasn't swollen from ascites (I had very little ascites) but in my extremities I had extremely edema.            

                      

My last labs were as follows.Alpha- fetaprotein was 7 and normal, white count of 6, hematocrit 27.4, platelets 110,  Creatinine 1.7, (  winthin 30 days it went from 0.6 to the 1.7)Bun was 10,  Albumin was 2.3, AST 355, ALT 175, alkaline phosphatese 98, and total bilirubin was 6.9..   This should give you all a guide as to where you are in the scheme of PBC.      I had been diagnosed with my PBC in 1982.. My edema worsened to the stage that I was actually leaking fluid with bile from my pores. My last ultrasound in 2003 prior to transplant showed I continued to have a small mass in the left lateral segment of my liver ( it stayed the same throughout the past 6 months and I was given ultrasounds monthly to watch it.). Also showed ascites ( not bad) and a patent portal vein (varices).    My overall physical health history was ... portal hypertension, esophageal varices, Dystonia (another very unpleasant neural muscular disease), upper GI bleed from varices in 1995, autoimmine disease Sjogren's syndrome, I at that time had depression for which I was on medication,(Lexapro) anxiety attacks ( wonder why ha ha), increased lipids and last of all asthma.         

                 

My meds were Aldactone 100 MG twice a day and  Lasix both for the edema, Atarax (itching), propranolol for blood pressure (hypertension), Actigall, Advair and Albuteral for the asthma, lactulose for edema and supplements of Q10, basic complete vitamin and a B Complex, Vitamin K, and Primrose Oil for my skin.    I did/do not smoke nor drink alcohol.                                                                                      

 

Finally a suitable don or was found for me.( I have B+ blood type)  The new liver was found to be in extreme good condition but also was very large.   I won't go into the actual transplant procedure. I do know it wasn't a long procedure and it went smoothly. First they put in a chest tube for precaution. Then proceded with the transplant surgery. They then removed my gallbladder which had numerous stones. I had 3 Jackson-Pratt drains and then a biliary stent .  They said they had a hard time closing as the liver was so very large. I gather there was a bit of giggling.  (My liver has changed size and is perfect for my body size.  Livers are smart. ) Went to recovery.  .THEN.things got complicated.  ( and here is where my memory went),  On day three I had a major change in my mental status from a reaction to the Prograff.  They took me off it and replaced it with cyclosporin. They performed a CT scan and MRI of my brain, they were thankfully normal..  I then added neurology and psychiatric services to me daily doctors.(Jeff says they were in my room constantly).  I remained in never land.( my own little world) for quite a long time after that. THEN, I had a right sided pneumothorax, which required a second emergency chest Chest tube (By then the first one had been removed).. This one occurred on post op day 10, when I was sent downstairs to have my lungs drained. (My lung was punctured.so another emergency second chest tube was put in. And off again to SICU (Surgical intensive care unit) Once again I got better and this tube was also removed.  Meanwhile my liver was happy as a clam and doing very well.  My color right after my transplant was normal! Jaundice was gone and the varices was dissolving.  THEN  it was  discovered that I had a bronchial infection  called DACTYLARIA CONSTRICTA. 

 

So I was then also under infectious disease doctors.  I j ust kept adding more and more doctors to my day.  For this I was put on voriconazale and Valcyte.  By Jan 1st my mental status was improving greatly although I still had problems. I was alert and knew where I was then but still "drifted off" to parts unknown.  On day 27 post op I went off to acute rehab for two weeks.  This was probably the hardest part for me emotionally as my husband couldn't stay in my room there as this time I had a roommate.  Prior to that my husband never left my side.he slept in a chair until they found a chair then opened to a bed for him. He did most of the personal care for me.  Bathed me, washed my hair, brushed my teeth .everything as I was unable to do anything at that time from the mental problems side effect of the Prograff.  I remember he would put me in the wheelchair and push me around the hospital when visitors left and took me to the cafeteria for cocoa. Bundled me up with blankets and took me outdoors.  That was wonderful!  In rehab I had to learn to use a walker as my left foot was still the size of a football and was extremely painful.  The nerve endings were sensitive.  I had and still have slight neuropathy., on both feet and hands.  I also learned how to do all sorts of basic things.even to write, and to speak better.  (When I got home I read the dictionary for hours every day) 

 

Finally I got to go home.what a happy day that was for me!  YEAH!   I had no idea what my home looked like, all I remembered was I lived on a mountain top and had lots of land, and three cats waiting at home.  Before I finish here I want to tell you all that Christmas day was the first day I was aware of the world.and that is when my husband gave me a box stuffed with your wonderful cards.  I can't ever tell you just how much that meant to me and how much it helped me to get better. All of you will remain in my heart forever. I continued to heal both physically and mentally. I married one wonderful husband.  Now I am doing very well and am very happy.  Many of you must think I went thru a terrible time.well yes. BUT I have to say I WOULD DO IT AGAIN IN A HEARTBEAT!!!!!!!  I wouldn't even hesitate.  The experience although tough was mind expanding.  I learned so much about life , myself and my friends. 

 

I am strong.  I am a PBCer.

 

Special thanks to Linie, Bobbie D, JoLynne, Marlene R, Janice D., Anne V., Nancy (NDC10), and I am sure I am missiing some of you, but you all know who you are.

Joanne

 

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JOE AMSTERDAM

 

My name is Joe Amsterdam.

I'm 56 and a mid-life career change student rabbi.

I received my tx on January 6, 2005.

 My story goes pretty much like this:

 

 

My experience with PBC was a bit different from some. We were living in southern California at the time. In 1997 or 1998 I visited my PCP for a routine exam and probably requested some medication or other for God knows what.  He ran LFTs because of the requested medication, and when my liver enzyme levels came back significantly higher than normal for some reason (intuition? rare in a PCP these days), he drew blood for an AMA titer.  When it came back positive, he referred me to a local hepatologist, who put me on Actigall and had me submit to a liver biopsy.  The biopsy results were somewhat equivocal, but the AMA titer was not.  Thus, I was diagnosed with PBC.  The only symptom I had at the time was ITCHING!!

 

At the time, I was serving a congregation in Anaheim and commuting weekly to NYC to complete courses needed for ordination. Classes were held M,T,W so I had the bare minimum of time to attempt to counter the effects of jet lag. In the summer of 2000 I secured a student pulpit in Bay Shore, NY (Long Island).  That marked the end of the commuting, but late Stage III and all of Stage IV were around the corner.

 

In the late fall of 2000, I passed out in mid-conversation with a congregant at an oneg Shabbat, no less! (This is a post Friday night Sabbath service social gathering, for those who might not know).  I was hospitalized with hepatomegaly (agonizing), but nothing else.  It was in 2001 that the cirrhosis became noticeably worse and I had a series of 10 bleeds from esophageal varices, about once a month, each of which thankfully occurred at home.  Each bleed required 5 days hospitalization (needed for the octriotide to be effective), and approximately. 2 units of blood per hospital visit.

 

The outpatient endoscopies and variceal banding went on for the better part of the year, until my gastroenterologist advised me that the only thing that was going to save my life in the absence of tx was the insertion of a TIPS (transjugular intrahepatic portosystemic shunt). The TIPS would take the pressure off the portal vein and eliminate the possibility of variceal bleeds, but it would also hasten the onset of hepatic encephalopathy, a devastating prospect to someone whose career required intellect, vocabulary, and language skills (Hebrew and English).  After a couple of revisions to corrected clogging of the stent, the TIPS worked well for over a year, but all the lactulose in the world was not averting the encroaching dementia. In 2003, I left my position and became officially disabled. Ascites came at the very end.  Fatigue and weakness were there all along, but got worse.

 

I'm not sure when I actually was placed on the list at Mt. Sinai Medical Center (MSMC) in NYC, but I remember a MELD score of probably 6 or 8, and feeling worse than the score would reflect.  My score was only 16 three weeks before tx, but must have gotten significantly higher by tx time because I was apparently the highest ranking matching recipient. Based on post op evaluations, I would have been dead before I ever reached the MELD threshold of 25.  This, by the way, is an extremely important issue for PBCers, since our presenting symptoms are frequently at odds with MELD scoring.

 

All I can tell you about my cadaveric donor is that this human being, of blessed memory, was 77 yrs old, but in perfect health.  He died of a sudden stroke, but his liver had been "well maintained."  Talk about serendipity - his liver was turned down (because of age) by another donor center before it was offered to Mt. Sinai and to me.  My younger brother was beginning the living donor evaluation process and we're all grateful that we didn't come to that.

 

So that's my experience.  I can look forward to celebrating my re-birthday on January 6, 2006, but the best part was celebrating my 56th birthday on May 19, 2005.  In December, I had no reason to expect that I would live this long.

 

I have special feelings about everyone involved in the liver tx program at MSMC -- they are all wonderful, caring, compassionate physicians, nurses, and ancillary staff.  All wonderful human beings.  And especially for my donor and his family.  They have blessed me with renewed life.

 

I'm glad I've decided to connect with the PBCers.  My wife, Esther had signed up a couple of years ago, but it's new for me.  It seems as though there is so much work to do, from dealing with support and quality of life issues for PBCers, to getting people to understand the urgency of designating themselves as post-mortem donors.  Two months ago, at a colleague's seminar on end-of-life issues, he stated his position that one should indicate in his or her Advance Medical Directives the desire to be considered as an organ donor.  He gave me about 5 minutes to speak, although I was not on the agenda.  Afterwards, a woman approached us and told me that my story had convinced her to sign her drivers license, and would my wife and I witness her signature. We were thrilled - it was a small but important achievement.

 

I have since listed myself as a volunteer with the NY Organ Donor Network and am also looking forward to working with the American Liver Foundation in the near futur

 

To all of us, continued good health and blessing,

 

 

Joseph, Rachel, Rebecca & Esther

 

 

 

 

JUDY BURCH

 

Judy Burch transplanted Dec 30, 2000, University of Alabama Hospital,, Birmingham after 14 years with pbc.

 

I was diagnosed with Primary Biliary Cirrhosis in 1986. I knew no one who had ever heard of this slow progressive disease.  My first symptom was fatigue, which became all consuming by 2000. Thru the years I began to give up many of the things I loved to do.  A lot of other autoimmune diseases popped up: Sjogren's Syndrome, rheumatoid arthritis, severe thinning of my corneas, itching that was relentless, skin problems, and then pneumonia. Slowly, as the liver shuts down, the poisons in you body take over everything including your mind. I could no longer reason, do math, remember phone numbers, names, events, etc. I covered it up pretty well I thought but later I learned that I had not done as good a job as I thought. Days, weeks, months became a blur. I would get up and sit for hours in a daze.  It was like I lived in a fog.  I began to lose muscle tone and all my strength.  Families should be made aware of the mental changes, lack of decision makin g skills and the malaise that comes with advanced liver disease.

 

In January of 2000, my gastroenterologist did another liver biopsy and saw that the disease was causing more damage to my bile ducts. I was suppose to be moved up on the list in March but thrrough a paperwork error, I was not. I got a call on July 9th but had to tell my surgeon to pass because I had pneumonia. It was not until the Sunday after Thanksgiving that we were called again. We waited at the hospital for 14 hours and they had to tell us the liver was no good. Two weeks later, a two-hour wait, and the liver had hepatitis C, so it naturally went to someone else. Christmas came and went, and on December 29th I was put on call and taken off 3 times in one day. That night the phone rang and said for us to come in. We went and they took me to surgery at 4:45 AM. I woke up six hours later in ICU, on a ventilator, but was off it in six hours. I was in my room the next day, and eating solid food the day after that. I came home 6 days after surgery. I have not had any major problems, and can doing anything I want. I learned that recovering from a transplant is nothing to compare with living with pbc.

 

I went to the Transplant Games in Orlando in 2002 and Minnesota in 2004 and pitched the softball, and my husband and I did the 5k walk. The most marvelous thing we did there was to attend the Donor Appreciation Ceremony. I belong to a very active support group and have become friends with recipients and donor families and all the wonderful people in our hospital and organ center. Life has never been better and yes I do tell my story every chance I get to promote organ donation awareness.

 

Three months after my transplant I wrote my donor's family for the first time.  In 2003 I received the call that a letter was in the mail from her daughter.  Mary wrote the most wonderful letter about her Mom/   Allison and I were the same age, 2 children and 2 grandchildren, both married 35 years.  She taught kindergarden and was loved by her students.  I met Allison's younger daughter Molly and her beautiful daughter, Lela on Thanksgiving.  These girls have been so wonderful.  I cherish the pictures they sent me.  Their family is never more than a thought away and in my prayers daily.

 

None of us would be here without the generosity of people who under the most difficult circumstances think of other.

 

No one should die because they didn't get a chance at this marvelous gift.

 

Judy & Granddaughter Anna

 

 

 

 

KIM C.

 

DX 1991.  Active on waiting list at Rush Presb. In Chgo.  Had a call August 1998 a liver available.  Went in at 2a.m. and by 4 a.m. they decided to take a pass on the organ, tainted with Heb B core.

 

Waited 6 more years, barley hanging on, July 8 2004, now registered at Northwestern in Chicago, got the “call.”  Everything was a go.  In hospital from Friday to Sunday.  Went to the “Carriage House” for two weeks.  Had episodes of rejection, which was resolved.

 

Jan 2005 developed CMV.  Had much damage to esophagus, many dilations and currently, AMA was positive, 80+ and back on Actigall, starting the cycle again.  Weekly injections of Procrit and Neupogen.  What a wild ride it has been!  Would I do this again, a definite no.

Total time off work, 7 weeks.

 

 

_____________________________________________________

 

 

Lucy Whitt 

 

 

9/9/05

I was diagnosed in September of 1999. I needed to have my gallbladder removed and the Surgeon found something strange with my liver. He took a piece for biopsy. PBC in stage 4,  I was told.  Liver transplant or I would die. I was very scared confused and no one in the family took it as serious as it was  I did my research on the disease. I was 60 years old at the time and had 60 good years of life. My children are grown. I’m alone - I didn’t want to do this. I didn’t really want to die but I’m just hanging out here. I really didn’t know what to do with being who I am I needed to wait to see what God wanted me to do  so I totally gave it to Him. I was doing well after getting on Actigall and other med’s - I did a liver detox with my chiropractor - so for four years I was doing good  then all of a sudden I got very sick. I called my friend on a Sunday morning in Dec. of 2002 - that I wasn’t going to church. I was too sick. Well she stopped over, called my sister. I went to ER. The family took over after that  - they took shifts. Always someone here with me. They took me to appointments for test I needed - I was very weak, in and out of consciousness  - in and out of the hospital. This started in Dec. 2002. On April 10, 2003 I had my TX. It was 6 months before I came home. My son was here with me when they called and said they had a liver for me to come ASAP. I only remember my son asking me on the way to the hospital what I was thinking. I said I’m trying not to think.  It’s all in God’s hands now. It was a long, tough, wild, crazy trip. The family tell me they were called 5 times that I wasn’t going to make it. When I came home, I felt as thought I had been on another planet. It took me about 5 months to get strength back and started feeling great. I had a set back last January (2005). Back on my feet again, doing great. Had my grandson’s visit with me for a week this summer. We had a great time. I have side effects from the med’s, get tired easily, but I have a life now  where I appreciate all the things people and myself included take for granted. I’m happy for each day I have to spend with my family. I don’t put it off until tomorrow. I have more understanding of what is really important in life. I see all the things that God has done for me and more than ever that He will always be there for me in the future. It took me 64 years to get to this peace that I have with God. I’m glad that it is over with, wouldn’t want to do it again. I’m glad it happen and that I still have some time to be with my family. It was worth it. It‚s hard to believe sometimes that I went through this, like it was a nightmare. I’m proud of myself for being able to have gotten through it  (only with the help of God). I now feel that there is nothing I couldn’t get through? Well maybe? It’s 2 years and 5 months and all is wonderful. One day at a time. I don‚t live like I’m dying (Tim McGraw)  and (Toby Keith)  I’m not as good as I use to be, but still good  -------

 

 

_____________________________________________________

 

 

MABEL

 

Mabel Fisher/Iowa/age 59/Diag 92/TX 04

 

I was living in Southern California and at the age of 46 in 1992 my PBC was diagnosed, like many other cases of PBC, due to a blood test drawn for an entirely non-liver related problem.  I was fortunate that a doctor diagnosed it quickly after he ruled out a mass on my liver which was his first guess.  He had the articles by Dr. Kaplan in his office and gave them to me to read which was my introduction to this disease.  He gave me a grim diagnosis of 6 months to 5 years at the most to survive with my "native liver."   I left him fairly soon because he was not a Hepatologist and friends recommended highly that I go to Mayo Clinic in Scottsdale to meet with a newly transferred Hepatologist who ended up being one of my favorite people in the world as I doctored with him for 10 years.  I am one of the patients for whom Urso (initially I was on Actigall) seemed to have delayed transplantation a lot longer than any of their 'best guesses.'    I had a good quality of life for many years and was fortunate not to have any piggy back or 'sister' diseases or syndromes.   I was listed in October 2000 for a transplant at Mayo Clinic in Scottsdale, and had many kind people in my life offer to be a living donor.  Several went through the testing process and none was found to be eligible to undergo that surgery.  They are on my list of HEROES/ANGELS in my life. 

 

I had progressed to a MELD score (which they didn't even have when I went on the list) of 16 by February of 2004 at which time I had switched transplant centers due to insurance changes.   At that point things seemed to progress at a rapid pace which was unlike the previous 12 years of my disease and in May I had many complications which landed me in the ER and then ICU  at Cedars Sinai in Los Angeles and I went from a 16 to a 32 in 2 days time.  2 days later I was a 35 and after that they didn't give me a MELD score, just said I was "next".  The complications included blood clots, kidney failure, infections and honestly I don't remember what else, but I had 8 specialists besides my liver team, all of whom were caring and skilled and  I felt like each one of them carried me "on their back" to OR.  I just know that on June 16, 2004 they told me I was going comatose and they told my husband it was unlikely I would survive past the weekend.   In a surreal move-like moment a nurse rushed in to tell the nurse attending to me in ICU that the team had been seen getting on the helicopter with the cooler and I was rushed to the OR.  There was a back up patient waiting there too because my situation was tenuous at best. 4 hours later I was out of surgery and 4 days later I was home from the hospital.  My liver numbers are all normal at this time (14 months later) and I have a wonderful quality of life.   Those are the cold hard facts. The part that is not factual but is as much a part of the story as the facts is all the people who went with me on this journey and without whom I would not have made it.  Allow me to mention my Faith here, please because it was always a significant part of my life before PBC and my story just can't be told without thanking my God for the answered prayers and for the peace He gave me each step of the way. Allow me to mention Ted my husband of almost 30 years because he is a Saint and the journey would have not been as much fun without him and I would hardly have made it I don't think without his help, his encouragement and his love.   Allowing me to mention everyone else who was a vital part of this would take pages.  Friends, Family, PBCers ... I could tell story after story of people being there when I needed them. Sometimes with a smile, sometimes with a prayer, sometimes with a hand to hold, a meal delivered, and sometimes with just the right post in the Digest.

 

Thank you for letting me tell my story.  If I could sum it up I would say, each of us is so different even though we have so much in common. And predictions are guesses .. very educated guesses, but just guesses and we shouldn't allow ourselves to let them discourage us or cause us to give up.  Enjoy EVERY day and be kind to those around you.  You never know how a person feels (they may be a person like me who says I feel GREAT even when I don't) and you don't know what they might be going through silently so always give your fellow man the benefit of the doubt.  It will come back to you in many ways.

 

It is wonderful that so many people will never face transplantation with the URSO drugs and the earlier diagnoses and with the "soon to be discovered" cure from Dr. Gershwin and his team, but if you do, remember, it is DOABLE and life is GOOD post transplant.

 

Hugs & Smiles,

 

Mabel Fisher/Iowa/age 59/Diag 92/TX 04

 

Mabel & Ted

 

 

 

 

MARY WILLIAMSON

 

I was diagnosed with PBC in 1992.   I went to the doctor because of the non-stop itching, mainly on my arms.  He sent me to a specialist, who did a biopsy and put me on Actigall.  Everything went pretty well until early 2000 and then it started getting worse.  In July, 2000, my doctor told me I needed a transplant, which was too bad because New Mexico had just cancelled their transplant program a week earlier.

 

My husband did some checking and found out about the Mayo Clinic in Scottsdale, AZ.  He contacted them and they told us what we needed to do to be accepted.  We gathered all our information and went there in August of 2000 for the week-long testing program.  I was accepted into their program on 8/24/00 and was officially put on the 'list".  As with all PBC folks, my health got worse as time went on.  We had to fly to Phoenix every week so that they could drain my abdomin (yuk) and do additional blood work.

 

I went in to see my local doctor in Albuquerque who was working with Mayo on my labs and treatment the middle of October.  He was alarmed by the results and immediately called Mayo while he was having them faxed over to them.  As expected, my kidneys were shutting down and I needed to be in the hospital.  We drove to Phoenix the next day, November 1st. (We could not fly because there was a huge Nascar race going on and no flights were available.)

 

I was checked in and I don't really remember a whole lot after that.  I was put on dialysis, taking more enulose (sp?) than I ever want to again, along with whatever else they were doing.

 

I received my liver on November 5th. at around 3 or 4:00 in the afternoon.  The doctors were thrilled at how fast it began working and were very happy with the results.  The first thing I remember when I woke up was that I didn't itch anymore.

 

I had a heart attack 2 days later, because everything started backing up.  They were ready for it and got all the fluid drained from my lungs and everything settled down after that.  I had an episode of rejection about a week after the transplant.  My blood type was A+ and my donor was O.  The problem was that not only was my body rejecting the liver, the liver was rejecting my body.  The doctors at Mayo contacted their partners in Rochester who had had similar problems.  They solved the rejection issue with three 1,000 mg shots of prednisone, given on 3 consecutive nights and by giving me infusions of type O blood.

 

Other than that, everything went as smooth as you could expect.  It was a long miserable experience, including what they called a "prednisone psychosis" (sp?) episode caused by the large doses of the steroids.  That was fun.  I was sure that the nurses were trying to kill me so they could take the rest of my organs and sell them.  (The movie "Coma" kept running through my totally confused brain.)  Of course, I was way out there - and recovered back to the land of the "normal".

 

I was back in Albuquerque and at work by January 15th. and have very few problems since.  I did have one episode of either rejection or the "dreaded return of PBC" in October, 2002.  I was given more steriods and blood infusions of type O and that seemed to settle everything down again.  They were not sure which event occured and it doesn't really matter to me.  I was put back on URSO to help slow down the progress, if that is what happened.

 

I am very happy now.  I have 2 grown children, both in college, a wonderful husband who was a great care-giver, and work full time.  I throw down my pills each day and thank everyone who was involved in saving my life. 

 

____________________________________________________________

 

 

MELISSA

 

My name is Melissa Andreoli, and I had a liver transplant on December 12, 2003. I was 53 years old. In 1994, I had a pancreatitis attack and was rushed to the emergency room. Several months later I had another attack and after many tests, I needed my gallbladder removed. A few months later, I continued to have pain, and my doctor sent me to The Indiana University Medical Center in Indianapolis for an ERCP. The ERCP opened a blockage in the commom bile duct leading from the liver, but also reavealed a chronic disease called Primary Sclerosing Cholangitis. The doctor told me that this disease would eventually lead to a liver transplant. Every year an ERCP was done to remove blockages. I was also put on actigall. In the spring of 2003, I started losing weight, my urine was dark brown, my eyes were turning yellow and I was itching uncontrollably. I had a standing appt. in 3 weeks, and so I waited for that appt. That was not the best decision I have ever made. My doctor scheduled an ERCP and it revealed not only a blockage in the main bile duct leading from the liver but also in the major bile ducts inside the liver.

 

The ERCP was unable to remove the blockage in the liver. So the radiologist then had to try and remove the blockages by inserting 2 wires from the outside into the liver at the blocked bile duct.The first attempt in May was unsuccessful so 2 draining tubes were inserted. After a couple of weeks another attempt was made and this time only one blockage was able to be removed. By this time I had dropped approx. 50 lbs and after several more weeks, a last attempt was made on the reamaining blockage. The last attempt was a success but I still had the drain tubes in case another blockage occurred. Stents were placed in the blockage area but one of them was of a harder material and was so painful just to move my body. This area in which the tubes were placed needed cleaned, bandaged and syringed with saline solution twice a day. After I started to get some strength back I sought a second opinion at the University of Illinois in Chicago. They assured me that I was in extremely good care at the IU Medical Center in Indianapolis.

 

My only option in Chicago was to have a live donor tx. I chose to stay at Indianapolis. My doctor there continued to see a decline in my liver function and I was placed on the donor list on November 12, 2003. The only information I have on my donor is that he was an 8 year old boy from Arizona. My surgery went well; I did not need any blood transfusions during surgery. I am grateful that my donor's family gave me a second chance.

 

It’s been 1 year, 9 months and I am feeling GOOD!

 

Melissa i