My Liver Disease Journey...

Just to give everyone a gist of what kind of a blog I'm trying to create here, it's basically for people who have been diagnosed with Liver Disease (Cirrhosis, Cancer, etc) and are awaiting a liver transplant. I am sharing my story (like an open book), and keeping this also as a 'journal' for what I am going through due to my illness and my life & past experiences.
My name is Victoria Santiago and in 2007, I was diagnosed as a Cirrhotic at the age of 26 yrs old; I am now 30 yrs old. This blog is for those who know what having liver disease is like; the Dr appt's, the freaking out when Dr's can sometimes be so cold & rude in telling you that you're probably going to die from this disease. I walked into my GI (Gastrointestinal) Dr's office, got a liver biopsy done because I noticed some distention in my belly and my AST, ALT & Alkaline Phosphotase came back irregular, which are all liver enzymes. I walked in to try to find out what the heck was going on, and he assured me a biopsy would give me that answer. For those who have had Liver Biopsy's...I feel your pain! It's awful to lay there on your side having a HUGE needle poked under or in between your ribs TWICE for a liver sample. Well, my results raised more questions than answers. It was determined by the pathologist that I had a transition to Cirrhosis, and was consistent with Chronic Hepatits C. However, my blood work shows, from 3 different lab's, that I was diagnosed with Hepatitis C, but I have no virus, the HCV test always come back as "insufficient or mutated virus" meaning that there is no Hepatitis C virus in my blood; I was even told that I can live a long and happy life without ever having it's effects. So I knew this pathologist made a mistake in that diagnosis, and future Dr's whom are liver specialists concurred. I went through a whole mess of 'liver specialists' for year's, seeking a specialist that would take my insurance, which were few & far between. Long story short (too late!lol), I just started going to Mt. Sinai Recanti/Miller Transplantation Institute about a month ago. I also have Pulmonary Arterial Hypertension (P. A. H) and am seeing both a Pulmonologist & Cardiologist (had to get a Heart Catheterization to determine the condition of the P. A. H earlier this year) and I saw them for the first time on July 11th. I would like for everyone who are or has gone through transplantation to share their stories here for moral support (which helps both you & me, for there is strength in numbers), informative links, websites, and help in obtaining what we need and what is out there for people like us. This is by far the biggest threat I have yet to deal with, and being a rape 'survivor' from the age of 18, a former drug/substance abuser that led to the loss of so much of myself, my dignity and self-respect (currently celebrating my first year in sobriety, makes things even harder, but it is getting better with time), is saying a lot. Fact being, I'm a mother of a beautiful son, a daughter of a caring mother, an aunt to 5 precious girls, and a sister to three brave women. Granted, I've made some awful mistakes that I may pay the ultimate price for, but no one is perfect and no one deserves to go through all of these awful things in life, but to have to go through them and learn nothing...well, that's just not very smart! Believing in God has helped me A LOT and strengthening my relationship with Him has not been easy, but I would be lost without my faith. Even though I have family support, it's hard for them or anyone to understand what kind of pain I'm going through, except those who are going through it, and even then, everyone has their own unique story in their 'path to recovery'. I'm inviting those who wish to share their story, wisdom, and strength with me, on my blog. Thanks for reading & please feel free to share your story with me!

Wednesday, August 31, 2011

More bad news...


Well, I didn't get the medical clearance that I need for my transplant.  The right side of my heart still has a significant amount of hypertension, so I am being put on a medication called 'Letairis', and this Letairis has some serious effects on the liver. 

More itching, which I'm itching like crazy already, and when I do itch, a tiny scab can cause alot of bleeding, so, this is a side effect of Letairis, as well as Jaundice, which is a symptom I've yet to experience, and stomach pains, which I already have dibilitating stomach pains, and heart palpitations, and to me, it just seems like this new medication is going to put an extreme amount of damage on my liver.  I really am at the point where I don't trust any of these Dr's at Mt. Sinai, who like to play god with my life!  This never ends!!

I'm making a decision, and it's entirely up to me to make this decision.  I've been thinking of the 'quality of life' that will be given to me after my transplant, and I don't think I want that quality of life; constantly going to the Dr's, fighting for a chance at survival when I may die anyway, and my attitude towards this has faded overnight, it seems.  I have no more fight in me.  I can't take any more bad news, it's destroying me.  I can't take the fact that these 'Dr's' are like my baby-sitters, and I have to ask permission for anything I do.  And it will never end!!  Life post-transplant isn't going to be any better than the life I'm living now.  I will never be 'healthy' again, I will always be on hard-core medication, having to see these a-hole Dr's on the regular, I just don't think I can do it.

I know that people care about me, and they want for me to have a long life, but, if this is the kind of life that's going to be in store for me, than...I don't want it.  If this is God's will that I die from this illness, so be it.  I want to enjoy the life I have now and not have to have myself and my entire family constantly worrying about me.

I have some major decisions to make, and I will not make them lightly.  But, I am considering leaving the transplant clinic, eating a healthy diet, and when the time comes that my liver is just too weak to go on, then I want to go on.  I feel like nobody's even bothered to ask me if this 'quality of life' is what I want.  To be forever on SSI, forever disabled, forever seeing these Dr's, and death awaits us all!  Is this really worth it to 'extend my life' for who knows how long, and have my family in constant worry & putting my loved ones in jeopardy for me? I don't want to put others, especially my family, in unneccesary peril and danger to themselves just so I can extend a few yr's on my life!  I would rather enjoy the time I have, now, with my family and son, and when the time comes for me to leave this earth, it comes.  Who am I to interfere with what God has in store for me?

What I guess I'm saying, and I'm sure it's very hard for everyone to understand, but I would like the last yr's of my life to be stress-free, and happy.  I don't want to die on an operating table, or from a massive infection/rejection of a liver.  I want to enjoy what I have now, and cherish these moments.

I don't know, I'm just so sick and tired of these constant, never-ending Dr's appts, tests, being poked and prodded, having to get 'permission' from a Dr in order to do anything! It's not like they seem so adamant on 'saving my life' anyways.  All they're concerned about is, 'Is her insurance going to pay us for this & that?'  It makes me sick to my stomach that these Dr's have the final say on every single thing that I do!  I don't know, I'm just losing all of my bravado and ignorance is definately bliss!

I just feel like this is a never ending cycle that will never stop, and I will be seeing Dr's for the rest of my life, & I'm really not ready for that, I have a deep mistrust of Dr's, and with good reason.  I've been lied to by Dr's before, and I don't see that changing!

Well, I will keep everyone posted, please leave a comment if you have any advice.  Thanks!

Friday, August 26, 2011

Clearing traffic...



Went to Mount Sinai today, I'm going to keep this blog brief...I'm kind of tired talking about this.  So, I went to Mount Sinai, was up very early this morning, and I had my Echocardiogram & Pulmonary Perfusion Imaging test done.  After that, I went to Brooklyn Hospital's Dental Clinic, and they were extremely nice there. 

I saw the Oral Surgeon and the General Dentist.  They took Xrays, and what the Oral Surgeon said was that he's looking at 'the big picture' here, meaning that he doesn't want for me to undergo a platelet transfusion, just to have one tooth pulled.  So, it was a good thing that Sam was with me.  The cost of dental implants are very inexpensive there, due to the fact that it's done by residents who need the experience, and my insurance pays for the hospitalization (which would be a must, for the platelet transfusion, I would be in the hospital for a minimum of 2 days), and the only thing that needs to be paid for is the materials, not the labor.  This is what makes dental implants so expensive is the dentists charge a fortune for the labor.  So, the general consensus is that the other teeth that I have under the 7 tooth bridge are not in good shape either.  Also, I was told that I can, and have enough bone, for 2 implants, minimum, on the bottom, to support my full bottom denture.  The implants would work as 'anchors', and instead of having teeth placed on the abutment, it would be snaps, so the denture that I already have can be modified to accomodate the two 'snaps' that would be connected to my jaw, and the denture can snap into my jaw, making a secure fit that will be much more comfortable than it's been now.  I wouldn't need to use polygrip/fixodent or any of that glue stuff. 

Now, as for the top, I would need approx. 4 implants, and they charge $300 per implant, and I would need a sinus lift, as well as bone grafting.  This is a serious procedure, made even more so by my medical condition.  To get everything that I would need done, would probably cost about $3,500, which, thankfully, my boyfriend said he can pay for.  What's more concerning, is my health and if I will be able to get general anesthisia, which I probably will not, due to my PAH, however, I took those 3 tests today that will determine my medical clearance for my Liver transplant.  Based on the first test I took, the stress test, it was very good.  Meaning, that my lungs are compensating for the damage my liver is causing the rest of my body, and that can only be coming from one source: the heart.  So, hopefully, I will get some good news Monday that will let me know that I did very good on these two tests that I took today, and that I don't need additional medication to make the hypertension levels go down.  If that's the case, then I should also be able to get medical clearance not just for the liver transplant, but for the dental implants, as well.

Either way, I'm getting these dental implants, and I'm getting them done at Brooklyn Hospital.  Mount Sinai has a dentist that they 'exclusively' use, and he charges a fortune!  I'm not going to that dentist, and that's the dentist that my Liver doctor is telling me to go to.  What can this dentist do that Brooklyn Hospital can't?  Well, I've found out that they've made a 'protocol' for people who have blood work like me, so it's a little scheme they got going on, a monopoly, so that I feel like they're trying to force me to see their dentist!  What a load of crap! 

So, I will find out Monday how these tests went, and how much my PAH has improved, and on Sept 8th, I'm setting up a plan on getting all of this dental work done.  Till next time...

Wednesday, August 24, 2011

Damned if I do & damned if I don't...



Holy crap!  This NEVER ends!!  My bridge was rocking back and forth yesterday, these are my front/side 7 teeth (it's all one piece) and it came out, and my worst fear came true.  One of the five shaved down teeth cracked off with it!  I didn't see it as such a big deal at the time, because I'm just thinking, the dentist will pull what little root of tooth is left, and will cut off the last 2 teeth of my 7 tooth bridge and make it into a 5 tooth bridge.  WRONG!!!

Maybe I shouldn't have been honest, but, I feel that with this stuff, honesty is the best policy.  So I went to a local dentist, who was very nice, and I told him that I have such serious health issues (which I was planning on holding back, because I just want the damned tooth out!), and, as expected, he asked for medical clearance to pull the root of the tooth.  I thought I was going to get it, it's just a root of a tooth, no big deal, after all, I've had 19 teeth pulled already, so I know what was coming,  plus, the tooth has(had) a root canal on it, so I don't feel a thing on it, I feel like if I took a pair of plyers, I could pull it out myself!  Well, my Transplant Dr. did sign the paper for clearance, and, sadly, he also faxed over my most recent blood work.  The dentist called once he received the fax, and could have knocked me over with a feather.

He said, with my platelet count being non-existent, along with my White Blood Cells, that there is NO WAY that he would be able to do the extraction.  He explained that I would bleed to death, the bleeding wouldn't stop, since a low platelet count means that I can't coagulate, and a non-existent WBC count means that I can't heal.  So, he gave me the number of the hospital, Brooklyn Hospital, and told me what was going to have to happen.  I would need to see the oral surgeon there, I would need a freakin blood transfusion to pump up the platelet count, then he will extract the lil stub of tooth!  Seems like an awfully lot of crap to go through just to get rid of a tiny root in my mouth!  This disturbs me a great deal.  I've never had a blood transfusion before, and I don't know if I want one.  I know blood gets screened more properly than it did in the past, but I just don't want to have to take those unneccesary risk.  All of that just to pull one lil tooth?!

I'm very depressed from all of this, my bridge is being supported by fixodent as of right now, and I can pull it down at any time.  I can't possibly walk around like this for a month, maybe more!  Who knows how long it will take to pump up my platelet count?!  Then, I'll have to have a damned emergency standby team there?  I feel like I'm losing it!  My dentist, and I can't blame him, cause he seems like a very nice man, and I wouldn't mind seeing him again, especially because he told me a few interesting things today about dental implants, and the bone grafting, and told me that if I get it done at this hospital, where I'm going to tomorrow, all I pay for is the materials for the dental implants, and with the implants, abutment and crown, it will be $900 per tooth.  That's a great price, compared to the $15,000 that other dentists charge, considering if I (and I do) wish to keep what little teeth I have left in my mouth, it would be about $3500, which my boyfriend told me that he can pay for (thank god for that!), and to get the process started, it would be about $1,200 to start the whole process to get the 4 implants that I will need.  However, I will not have any teeth in my head during this time.  My self-esteem has taken enough detramental blows, I just don't thing that I can walk around with no teeth in my head!  Even though I know that I will get a more 'permanent' solution to all these problems, but, even more crutial, is that if I need a damned blood transfusion for a simple extraction, when will I get clearance to do all of this other stuff?!  I don't see it happening anytime soon, so I just need to get this tooth extracted, and the dentist can then shave off the last 2 teeth, make my 7 tooth bridge into a 5 tooth bridge.  My upper partial-denture can be modified to add those 2 teeth, and that my insurance will cover all of it.

This is just another reminder of how damned sick I am, and how badly I want my health to be better again.  Such simple stuff that I take it for granted, that I think a lot of people take for granted, which is their health!  I always had the naive, childish attitude that I was young and nothing bad can happen to me.  I was never more wrong in my entire life. 

So, this root must get extracted, because if it doesn't, then it will get infected, and all hell will then break lose!  Damned if I do, and damned if I don't!  Till next time...

Tuesday, August 16, 2011

As the world turns...



Things are unraveling not so fast as I thought, or maybe too fast.  I saw my Pulmonologist yesterday and basically, had a few questions that I wanted to clear up.  I wanted to know the reason for all of these 'appointments', and just to make sure we're on the same page, I wanted to be sure that the reason was to get my medical clearance for surgery. 

As with most Dr's, the right hand didn't know what the left hand was doing...no surprise to me.  She had no idea that my Liver Specialist had sent me to her for medical clearance, what the status was for my transplant, or anything like that.  All she knew, is that I was referred to her, as a pre-liver transplant patient, and needed my PAH (Pulmonary Arterial Hypertension) evaluated.  Now, she had all prior info on the heart catheterization that I had done in March, and based on the levels of pressure in my arteries, I was not clear for surgery.  That's when I was going to Belleview and was put on Viagra (Revatio).  It's been 5 months now that I've been taking the Viagra (time sure does fly...) and, these three tests are needed to determine how the Viagra has changed the PAH.  She (when I refer to 'she', I'm referring to my Pulmonologist, BTW) told me that enough time has elapsed to now show on the Echo cardiogram and Pulmonary Perfusion Imaging tests that they should be able to see the full effects that the Viagra has had on my PAH. 

Now, back in March of this year, when I had the heart catheterization done, I was told before undergoing the procedure that if the pressure was too high, that they would put a stent in my heart, right then and there.  They did not.  I asked her why a stent wasn't put in back in March when I had the Catheterization, if the pressures were so high.  She gave me an important answer that I was not aware of: the heart has 4 chambers, 2 on the left, 2 on the right...the only way that a stent can be placed in the arteries is if theirs hypertension in one of those main chambers.  That's not what PAH is.  It's the arteries that go from my heart to my lungs that have hypertension, thus the name, Pulmonary (lungs) Arterial (in the arteries) Hypertension (high pressure).  Makes sense, right?  So, I asked her why didn't a stent get put into the arteries from my heart to my lungs?  She said that's impossible.  The arteries from the heart to the lungs are on a microscopic level, therefor nothing can be placed in such small arteries to make them expand, this has to be done with medication, to treat the PAH.  Which is what I've been on, the Viagra, since my catheterization results.

Now, there is a bright side, as there usually always is (and me being the eternal pessimist, it's hard for me to say that!), and that is the Pulmonary Function test results that I did on the 8th of this month.  Those test results came back GREAT!  Now, the Pulmonary Function Test is to check the lung capacity, check for blockage in any airways, to see how long I can walk without feeling completely winded, and to see if my lungs are expanding like a normal (more healthy) person.  On the overall, I scored a 76%, and someone without health problems, has a score starting at 70% and up.  So, I'm within normal range.  That means a few things.  It means that my liver/spleen, as big as they are, are still allowing my lungs to expand and are not being hindered (yet) by the hugeness of the liver/spleen.  Also, it means that my lungs are making up for the deficit of my liver, which can only come from one source; the heart.  On the walking test, what they do is get your baseline heart rate, have you walk back and forth for 6 minutes, and each minute, they check this little box that I hold that's attached to my index finger, to check the heart rate.  So, my heart rate was at a 'normal' baseline to start off with, which is good, and it fluctuated during the 6 minute walk (which it should, since as you exert energy, it's only natural for the heart to respond), and they measure what's called the 'come down' meaning after the 6 minute walk, you sit down and they see how long it takes for your heart to reach it's beginning 'baseline'.  This can take up to 6 minutes to happen.  For me, it took 2 minutes, which is awesome! She measured for 3 minutes to be sure that it would stay at that rate and it did. 

These are all good things.  If I do as well on the Echo and the Pulmonary Function tests, then I will get my medical clearance, and things can more forward.  I was also given two puffs of Ventolin throughout this test, since I was prescribed it, once upon a time, and they wanted to see how big a difference it made.  It did make an impressionable difference, so these are all things the Anesthesiologist will need to know before 'putting me under', so I will be given some Ventolin before I go into surgery. 

Unfortunately, my pessemistic attitude can't help but wonder the other possibilities, and it's more than that.  She told me to sign an authorization for my insurance, to approve (I forgot the name, and hopefully, I won't need to know it!) another medication, in the interest of not wasting more precious time, for more medication that I may need.  These last 2 tests are the most crutial ones.  Because PAH shows it's damage in the heart, moreso than in the lungs, and these last 2 tests are testing my heart.  They will be able to get an idea of my heart function through these tests and see the Viagras full effects.  If those effects are not enough to certify me for clearance, than I will be taking this new medication, and in three months time, I will have to get another heart catheterization done.  I really hope that this doesn't happen, and I feel like it's what's going to happen, since they're already having me sign approval's for more medication, I almost feel like I'm being resigned to this fate.  She didn't know that her 'medical approval' for surgery will be the vital kick-off to start the surgery that I need to prolong my life (I hate saying 'save my life', because no life can be saved, death is inevitable, it can only be prolonged, no matter how old you are, and whether it's prolonged for a minute, or fifty years). 

It all boils down to how well I do on these two tests on the 26th and I'm chewing my fingers to stumps till then!  On a different topic, I have my son staying over right now, and he's been bugging me to watch this new xbox game that he borrowed from his friend, so I'm surprised that I've been able to gather my thoughts for this long!

So, I'll check in (maybe) before the 26th, even though, most likely, when I get these tests done, they won't let me know how well I did on them until the 29th, when I get a phone call from Mt. Sinai probably telling me that they're sending the prescription electronically to my pharmacy!  I hate to sound so pessimistic, but I feel like that's what is going to happen.  Anyways, she's not going to be in on the 29th, which is when I was originally supposed to see her, not yesterday, and she's just left instructions to her PA (Physicians Assistant) on how to handle this when the results come in.  I'm keeping my fingers & toes crossed!  Till next time...

Tuesday, August 9, 2011

And the Chaos begins...



Well, yesterday I went to Mount Sinai for a Pulmonary Function test and it went very good.  I have three tests to take, all to see the status of my Pulmonary Arterial Hypertension.  So, the deal is, once I have 'medical clearance' to undergo surgery, then I can get on the 'active' list, my living-donor-to-be (hopefully!) can get screened, which only takes 2 weeks to do, and the gears can be set in motion as to a date of when my transplant will be.

Now, most people don't have a scheduled 'date' as of when they're going to get their transplant, if they're getting on the 'active' list and have to wait for a cadaver organ. Fortunately, even though the liver is a vital organ, it regenerates, as most of you already know, and half can be taken out of someone, which is called a 'Right Lateral Hepatectomy', meaning that 40% of their liver, in the right lobe, will be removed.  Now, the liver is made up of two lobes, the right and the left.  What I didn't know, is that once someone gets a hepatectomy, and their liver will regenerate, the right lobe that gets removed does not grow back.  What grows, is the left lobe, and it grows to 90% of the right & left lobe combined, so a living donor will only have a left lobe, but a very large one.  And I, will only have a right lobe, but a very large one, as well.  This anomaly does not hinder the function of a 'normal' liver. And when I say 'normal', I mean the one you're born with (a right & left lobe).  Also, for those who become living donors, must get their gallbladder removed, since it's in such close proximity to the right lobe, which isn't really a big deal, I had my gallbladder removed laproscopically in 2006, due to 'sludge' that was accumulating in my gallbladder and causing me pain when I ate. 

Whew, my ankles are itching like crazy! I fear that they will start to bleed, or worse, swell up again. I'm scratching so much, they're scabs formed and I can't scratch those, because then I'll start to bleed like a stuffed pig!  I see my ankles everyday, but I do think they are swelling a little bit.  It's not just my ankles, though, I'm itching all over, it's driving me mad!  Anyways, I take the two remaining tests for medical clearance on the 26th of this month, and those are the two test I fear I won't do so good in.  It's an Echocardiogram and a CAT Scan of my heart.  When I had the Heart Catheterization done about 6 months ago, it didn't look good, or that was the impression I got from the Dr.'s.  So, after I get these two tests done on the 26th, I see the Pulmonologist on the 28th, and she will look at the results of all three tests and determine if I'm fit for surgery.  If she determines that I'm fit for surgery, and gives me medical clearance on the 28th, I will then see my Hepatologist shortly thereafter and I will be put on the 'active' list.  Once that happens, my living donor can be screened.  She will have to go to Mount Sinai for two days.  Day one is screening on blood type (which I know is compatible), going over any previous medical history (and this person has no prior medical history, which is more than I think a lot of people can say!), and an EKG, and blood work to rule out any diseases that would make her unfit as a candidate.  Once that is done, and everything comes back good, then she'll have to go in for Day two of screening, which is more intense things, such as MRI, Ultrasound of the liver, CAT Scan of the liver, viewing the arteries of her liver to see if they would line up correctly with mine, and this all takes two weeks.  She also would be speaking to a counselor that would be assigned to her, to ensure that she's doing this on her own free will, not being  coerced in any way, and that she's aware of the risks, and that she's doing this voluntarily.  That's the part that I'm most afraid of.  I've tried to educate her as much as possible to make sure that she's fully aware of what she's getting herself into, and if these are risks she's willing to take.  Now, she's family and I will always love her, regardless.  However, I'd be lying if I said that I knew she was a match, then decided that the risks were too great for her and for that reason, she decides not to go through the procedure, which I'm sure happens at the clinic a lot.  This is why it's pertinent not to put all my eggs in one basket, so to speak.  Another family member has offered to be screened, if, for any reason, this does not happen with the first person getting screened, but she's had prior liver problems, and I don't think she'll be able to donate.  I spoke to my Dr. about it, and he said she'd have to get a liver biopsy done first.  It's also my job, as the recipient, that the donor be fully informed of what they're getting themselves into, and be prepared for it.  I feel like, if anything, I'm discouraging people from wanting to be my donor.  I just feel like I don't want anybody to risk themselves for me.  I know I can't keep thinking this way, it's just negative thoughts, but, in a way, it's also the truth.  Mount Sinai has done many successful living donor transplants, and the chance of things going wrong for the donor are slim.  This is why a potential candidate must get heavily screened, to ensure that the procedure will go well for them.  This is not something that should be rushed, whatsoever.  It's strange that I'm discouraging people to get screened just because I'm the only one who's benefiting from this...certainly not the donor!  It's not going to be easy for me, though, and I know this.  I just feel like, if anything goes wrong with me during the transplant, I would hate to leave that burden on the person who risked their lives for me...all in vain.  People do die during transplantation, it's not that rare an occurrence.  In the booklet "What Every Living Donor Needs to Know!" says in the 'psychosocial effects' section is "Would you be able to accept that the recipient may die during surgery?  Not only do you have to deal with the grief of losing that person, but you have to focus on your healing, as well."  Now, these were some really tough things to read and think about, being that the 'recipient' is me!

I guess these are just things that they have to let the living donor know, but I must stay positive and pray that when my day for the transplant comes, I will be waking from the procedure!  I can't think any other way.  But, before I go into surgery, there will be a room for all friends & family of mine to wait in, and I would like to speak to them before I go in.  I can only imagine what kind of a talk I will have with everyone who would be there.  I know it will be in my head that these may be the last words that I say to my loved ones.  The operation is 6-12 hr's, and a Dr. will come out periodically to let my family know how the surgery is going.  And I expect most of my family to be there, as well, to keep abreast of what's going on.  All I ask, is that I wake up to lots of flowers in my recovery room!  I would like that a lot!  To wake up and smell fresh flowers all around me, inspiring me with the scent of life!

Till this point, I've been very impatient on getting this transplant over with, but now that it may be so near, I feel like things are happening so fast!  But I also feel like it's taking forever, it's hard to explain.  I've been living with Cirrhosis for 4, almost 5 years now, and it's only gotten worse over that period of time.  It'll be such a relief to know that once I get my transplant, I will no longer have this accursed Cirrhosis!

Well, that's all for now, I will write to let you all know how the two tests go on August 26th.  Till next time...