Wednesday June 22nd 2011 - And some days just suck

Today sucks. I'm wired different than most people. Bipolar suffers are wired differently than others. We take chances and hang ourselves way out on a limb. We go for broke and fail to see the barriers of normal life. That is why so many bipolar people do such fantastic over the top things. That's why some of our greatest bipolar leaders like Lincoln or Churchill have done the impossible. Its because they fail to recognize impossible.

I'm that way. I can't do anything half way. I'm all in or not. When I'm manic nothing is impossible, but, when I'm depressed, nothing works. Today sucks. It seems like everything is working against me. I do so many positive things. I know that. I do things that other people wouldn't even consider trying. I genuinely think there is nothing I can't do if I apply myself. Of course, that's silly. Everyone has limitations, I just don't recognize mine.

But today, I just feel defeated, frustrated, lonely, and hopeless. On the bright side, I'll probably bounce out of this despair when I cycle up. Just have to hang one until then.

Oh yeah, remember that great idea about the peer to peer financing? It only works if other people care. Even though I sent out info to my friends on facebook and my family and friends via email, no one that I know has even invested $25. So I guess that's what my life is worth. Less than $25. Being bipolar sucks.

Tuesday June 21st 2011 - A better way to fund bariatric surgery!

I thought I was all set, but my financial plan needed the sale of two cemetery plots that I thought I had closed, but, on Father's Day, the elderly couple's grown children told them not to worry about pre-planning. Someone else could buy the plots, but I can't rely on that payment by July 5th when I need to pay the hospital. 

I could use my credit cards or a personal loan, but I decided to try a different route to close my $3000 gap. I have listed my loan request on Prosper.com which facilitates "peer to peer" investments. The idea is that any site registered investor could go to my request and invest as little as $25 or more towards funding my loan request. The collective investments will quickly fund my request in days. 

Unlike Kiva.com micro-loans, peer to peer loans generate a strong return on their investment. It's really a smart way to help out a friend without all the personal crap.

My loan request is for : This loan will be used to... prepay balance of $3,000 from a $16,000 Realize Band surgical procedure on the 5th of July for the surgical procedure on July 11th, 2011. 

To see my loan listing and hopefully invest in my request, go to https://www.prosper.com/invest/listing.aspx?listingID=512627&utm_medium=email&utm_campaign=system_event&utm_source=borrower_listing_created&utm_content=view_listing

June 19th, 2011 - Bipolar panic attack

I really have no idea why this happens other than to say that it is a symptom of my bipolar disorder. About a month ago I had several unexplained panic attacks. They happen the same as today's did.

You'd think I was happy about father's day and the surgery approval. Plus, yesterday I went with my wife and 20 year old son to Breckenridge Colorado to tour the Country Boy Gold Mine. It was awesome. I should post some pictures. I will definitely post on my facebook account. You can become my "friend" if you add a note that you are a lose250 blog reader. I think you can find me as Christopher Sharits (Lakewood Colorado) or by my email address csharits@comcast.net. After the long tour into the bowels of this picaresque rocky mountain we panned for gold. Cheri and Jeff found gold. Well, some flakes.

So anyway, I've had a great weekend and there was no reason to have a panic attack. It happened in the grocery store. I do almost all of the shopping, but today I had my wife with me. It was only a $100 trip and I was finding everything I needed on my list. All was good and then in the laundry soap isle I started to sweat. By the end of the next isle my heart rate shot up and I started to lose my breath. I told my wife we had to hurry and get home because I didn't have any lorazepam with me.

Everything became, well I think I was hyperventilating, so everything looked bright and flashy. I could hardly mask my distress. We got out to the car and I was nearly in tears. My wife tried to talk my off of the ceiling and I got back to the point where I was just hyperventilating. I slowed my breathing and we made it home. I got a huge glass of ice water and took two lorazepam. I sat and tried not to show my emotions because I knew I was irritable and could easily transfer my distress towards someone else who obviously didn't deserve it. I chilled in my bed and fell asleep until dinner. Now I feel better, but I still feel as if I was in a marathon.

Sunday June 19, 2011 - Insurance approval letter

I did a mental cartwheel when I received this letter from my insurance company approving my Realize Band procedure and I thought I might share it.

My favorite sentence is "Based on the information provided to us, we are pleased to authorize your admission for the service(s) list above." Procedure listed above: "Lap place gastr adj device."

June 17th, 2011 - READY TO GO: Surgery date July 11, 2011 !!!!!!

I just received the call from the surgeon's office! My insurance has authorized the surgery!


Important Dates:

• Meet with Swedish Hospital on July 5th for pre-surgery blood draw and medical review. It will take at least one hour. Apparently, there is a lot of paperwork and review of my doctors notes.
• Meet with Dr. Tillquist (surgeon) after I finish with the hospital on July 5th for final prep. It is at this time that I will pay the hospital $4500 and pre-pay the anesthesiologist $1080 and pre-pay the surgical assistant $270 (for reasons unknown, the assistant must be paid in cash or check).
• SURGERY DATE : JULY 11, 2011 !!!!!!!!!!!!!!!!!!!! I will find out the exact hour next week. It will be in the morning and I should be on my way home before evening!

At this point I have the $4500 in cash as well as the $270. I may have to use my credit card for the $1080, but it is a green light. It is going to actually happen. I'm so excited I could eat an entire cheese cake! (kidding) Actually, now that it is real I am going to hit the gym everyday (starting Monday) and try to lose a good 10 pounds before the surgery. YEA!!!!!!!!!!!!!!!!!! :-))

Thursday June 16th, 2011 - Final cost of Realize Band Surgery

Finally!!! Quick note: Costs in the United States vary according to insurance stipulations and contracted cost controls with the hospital and the surgeon.

As stipulated by my insurance, I had to use a surgeon who has been awarded "Center of Excellence" status. My surgeon, Richard Tillquist with Swedish Hospital in Englewood, Colorado, was awarded this recognition through a history of great patient outcomes from the operation and a clear commitment to comprehensive, high quality bariatric care.

My healthcare insurance is Anthem Blue Cross/ Blue Shield PPO. Our particular plan is on the high end of our choices because we wanted the extra coverage's and smaller deductibles ($1,000 per person). Plus, the pharmacy coverage is great. It is a group policy through my wife's employer and I believe the healthcare insurance premiums cost our family of five about $1,300 a month.

After the hospital did some research, they decided that I qualify for the contractual lesser amount of $9,000 for the surgery. My insurance will pay the hospital $4,500. I will have to pay the hospital an additional $4,500 before the surgery.

The contractual insurance limits my surgeon to $1,800 for his cost which includes the first three post-op appointments. The insurance has $3,000 limit for the surgeon so the remaining $1,200 will go towards additional office appointments. I do not need out of pocket money until the $1,200 is exhausted.

The anesthesiologist costs around $2,000, however, if I pay in advance they will reduce that to $1,080. The only other cost is for the surgeon's assistant. I believe it costs $800, however, if I pay in advance they will reduce that to $270.


In conclusion, due to insurance contracts with the surgeon and the hospital, the total cost of the operation is an astoundingly low $13,350. That's compared to the estimated cost of $17,000 to $20,000 that I found online for the larthoscopic Realize Band surgery. Overall, I am responsible for $5,850 which is lower than I ever imagined.

Now I am waiting for the surgeon's office to call me once they have the final insurance approval. Then I can pick a date for the surgery. I will pick the earliest available appointment.

Saturday June 11th 2011 - How I got fat revisited

I am waiting impatiently for my insurance approval. I should get it this week and then I will schedule the surgery. I can't wait. I am going to workout like I did in the summer of 2009. In the mean time I reflect...

When I was in high school I was at my ideal weight (175 pounds). After graduation in 1983 in Lakewood Colorado, I got a job in warehousing in Hayward California. For the first three years I worked on the swing shift between 5:00pm to 2:30am. I was a forklift order puller. It was a very physically strenuous job and it went way past my bedtime so two significant things occurred. The men of my shift ate like mad men and then turned around and drank gallons of coffee and no doze.

Anyway, this is the point where I started losing control of my metabolism. Binging and then voluntary malnourishment. I worked for that company for seven years and received promotions almost annually. When I left that environment I was a warehouse manager and had not worked a physically strenuous job for at least five years, but I still ate like I did when I was 19 and strong. So eight years after graduation I weighed 245 pounds.

I fought the weight while I worked as General Manager at a different warehousing company in Oakland California and got back down to 235, but then my dad committed suicide and we moved to Buffalo New York and I was not handling his death well. When we left Buffalo to Denver for graduate school in 1998, I weighed 285. When I finished working as CEO of a dot com in 2001 I stressed out and reached 310 or so.

After that I consistently dieted and lost lots of weight, but then I gained it back as usual. When I got super sick in 2007 I was admitted into the hospital at 456 pounds. In the hospital I lost almost 50 pounds of water weight through IV lasixs. Then I had a serious bipolar episode that lasted for two months and I lost another 50 pounds through literal starvation and reached back to 350. I stayed there for a while and then I went vegan in 2009 and began working out about 20 hours per week and I lost 35 pounds in 8 months. Then I started gaining weight even though I was still vegan. I got discouraged and slid back to regular eating and ballooned to 360. Then I got more discouraged, tried a few trendy diets and gained back enough weight that I know sit back at 400.

I relish the thought of never seeing 400, then 380, then 350, then 300, then 250 once I have lost them. I will not gain the weight back. Some people start stuffing their faces with cheating foods and start gaining weight after a year or so with the lap band. But my weight loss will literally extend my life and make it possible to get a liver transplant. No, I will loss the weight. I will be 190 pounds within two years and I will live everyday thankful to have part of my life back. I can't weight to shop off the normal sized racks.

Wednesday June 8th 2011 - More information on the progress and cost of surgery

Before I bore you with my accounting, I would like to update you on the calendar expectations. My insurance file has been sent to the insurance and Eileen from the surgeons office thinks we could have an approval within a week. Possibly Monday.

Once I have insurance approval I can schedule a date for the surgery. Yea! If my approval comes in quickly, I could have a date as soon as after the Fourth of July. Hopefully before I go on a working vacation in Santa Fe New Mexico. I believe that would be one the week of the 25th or so. Unless there are some unforeseen complications, this should be an outpatient one-day surgery.

Now for the money:

• The insurance splits my benefit of $7500 as $4500 for the hospital and $3000 for the surgeon.
• The hospital requires either $6500. They require this amount to be paid one week before surgery. If they do not need all of the money, I will get a refund. Then again, if things get complicated, I might need all of that money.
• The surgeon has a contracted rate of $1800 so there will be money left in the benefit for the post-surgery appointments (the first three are covered in the initial $1800). They will use the benefit until it is gone and then I will have to pay out of pocket, but the $1200 will go pretty far.
• Since I am paying the anesthesiologist in advance, I will only need $1050.
• Since I am paying the surgical assistant in advance, I will only need $270.

The surgery is total costs  $15,320 USD. After the hospital rebate it could be ultimately $14,000. I am going to need $7,820 by the week before surgery so basically by the end of the month.

I have the 2500 Euro ($3,500) from France and potentially $2,800 from the sale of the two Cemetery plots. Roughly I have $6,300 leaving a difference of  $1,520. If I had to I could put that remainder on a credit card.

Then again, maybe I'll get a surgical loan for $5,000 and stash the extra $1,000 or so in savings.

Bottom line: I can afford this and I am ready for this. I need this. I could potentially have the surgery done by this time next month. One more month of being this weight! If I work as hard as I did when I became vegan and exercised like I was on Biggest Loser, I could have lost as much as 110 pounds by January 1st 2012! And by this time next year, considering a slow down in weight loss, I could have lost as much as 160 pounds in the first year! Then I will only have 50 pounds to my target weight of 190 pounds. That would be awesome. Ideal weight within the next two years!!!

Tuesday June 7th, 2011 - Cousin Vicki's card; finances; and book idea

First, an update on the finances of the bariatric surgery (Realize Band). I don't have all the answers yet, but some of my questions have kind of sort of been addressed. According to the hospital, my insurance has a contracted rate for the hospital fee of either $9,000USD for BMI's of 45 or less and $11,000 for BMI's above 45. She thought I might qualify for the lesser amount, but I seriously doubt a BMI of 59 is "borderline."

My insurance is Anthem Blue Cross Blue Shield and it specifically has a $7,500 weight loss benefit. So, the hospital gets $4,500 and the surgeon gets $3,000.

Lets just deal with the hospital for a moment since I know this variable. Assuming that the hospital's contracted rate with Anthem is $11,000, less the insurance benefit of $4,500, then I need to have $6,500 just for the hospital.

I do know that I can pay the anesthesiologist $1,080 in advance and save more than $800. There is someone else that I can pay $280 in advance and save another $600. So, as far as I know I need $1,360 for these other services. The surgeon gets $3,000 from the insurance, but I have no idea what that will cover. It has to include his services and the post surgery appointments so I doubt that $3,000 will cut it. For now let's assume I need $7,860 out of pocket. Due to family financial surprises I will probably only have $6,000 plus $2,000 if I used my credit cards. I'm thinking it would be safe to assume that I will need a medical loan of $5,000 so I can be prepared for any other surprises.

I'll know more by the end of the week. I do know that the surgeon's office is submitting my file to the insurance on Wednesday. I have no idea why it took that long, but at least its in. I don't know how long it takes for insurance approval and then I do not know how far out their surgery schedule is. I'm still hoping for August. I won't need the money until the week before my surgery date. Okay, that's the finances.

Quick note on my book idea: I will be finished with my current fiction novel by this August (see www.NightinPositano.com). I think I am going to write my next book more autobiographical and basically make a book that follows the same trek as I have recorded here since June 2009.

Finally, the card from my cousin Vicky regarding my liver cirrhosis:

"They say what doesn't kill you makes you stronger. Well, what if you didn't sign up for extra-strength training? What if you'd rather catch a break once in awhile? 
At some point you'd think you'd be entitled to a free pass or two. Avoid that crisis. Delete those problems. 
It's not that you're not strong or that you don't have what it takes to get through this. You are, you do, and you will. But you've built enough character already, and it's time for things to lighten up a little!
I know it's not my call, but if I were in charge of life's wheel of fortune, you'd get a free spin. And I'll be right there cheering you on!" (written by Linda Barnes).

Saturday June 4th 2011 - Bariatric impatience like a child

As it stands this morning I still do not know how much my Realize Band surgery is going to cost nor do I have a date for the surgery. I know that I have the patience of a child. Usually I am the opposite of procrastination. I try to react and respond to situations or requests as quickly as possible. If you send me an email, you can expect a reply within 1 to 12 hours depending on my email access. I like to be very prompt with paying bills and especially, being on time for any appointment even if it is social.

So it irks me that I have had to leave three messages with the surgeon's assistant. She's the only one that can tell me my insurance progress. Additionally, the financial lady from the hospital didn't return my call, but she may have a better excuse seeing as she might have just returned from vacation.

Part of my frustration is family finances. I've dropped a good $5000 in my bariatric savings and I keep having to dip into it to pay urgent bills. Take for example my middle son's Jeep. It had some kind of Jeep death wobble and it cost me $500. Then on Monday I have to register my youngest for summer school. He failed US Government which drives me crazy sine I have to advanced degrees in politics. The summer school costs $300. If it's not one thing it's another.

I really shouldn't be stressing. I've always had a knack for pulling money out of my butt when I needed it. Eh, I probably shouldn't take credit. God's always given me just what I need. Usually not more, but He always pulls through when I need it.

I guess it goes back to the unknown. If they tell me I need $10000 on top of my insurances $7500 then I would be fine. I would have a goal and I would reach it. The problem is timing. I do not want to slow the process down. I have another $5000 coming in from Europe this week and it is earmarked for the surgery. I just need to know how much I will need. In the end I could just get a medical loan, but I would like to avoid that if I could.

Thursday June 2nd 2011 - Alternative Pain Management

The liver doctor said that the pain in my enlarged spleen probably wouldn't be reduced even after weight loss. My primary care physician (PCP) gave me some oxycodone, but its fairly addictive so he probably won't refill it more than once or twice. So that leaves me with nothing really. Vicodin has too much Acetaminophen (Tylenol). He did say I could take up to 1mg of Tylenol a day. That won't even touch my pain and I'm not convinced that it won't promote more inflammation.

However, both doctors said that medical marijuana won't hurt me and it would probably be effective. In the State of Colorado medical marijuana is legal with a permit. In order to get a permit all you have to do is go to a doctor that is willing to write an affirmative consultation and then file with the state for certification. Even though the state has been cracking down on the medical marijuana industry, it is still relatively easy to get a permit.

Perhaps if I didn't have three impressionable young men I might consider it, but I do and I don't think its the right thing for me right now. I reserve the right to change my mind. Even if I did use medical marijuana, I wouldn't smoke it. To be honest, I don't like smoking anything. It makes my lungs feel congested. If I ever tried marijuana as pain management, I would use edibles like brownies or... I don't really know what's available, but I've heard that there are a lot of options. Probably my biggest hesitation is the fact that, while it is legal at the state level, it is still a federal crime.

At the time of this writing, my spleen is about a 6 on the 1 through 10 pain meter. Not enough to cry out, but still distracting. Maybe its more scary than painful. Every time it hurts like this I know that the blood flow through the liver is slowing enough to bloat and enlarge my spleen. That's scary. I'm afraid of bursting my spleen and needing a splenectomy.

Wednesday June 1st, 2011 - An email to friends and family

Hello Family and friends,

Last week I received the results from my liver biopsy to check on the progress of my nonalcoholic steatohepatitis (Nash). I have stage four grade one liver cirrhosis. Stage four is the highest measure of liver scarring and beyond repair; however, grade one is the second level of inflammation which is good news. 

In general, I feel okay today except the grade one inflammation and subsequent blood flow disruption is just bad enough to cause mild to severe pain in my enlarged spleen and I have chronic swelling of the abdomen and legs. It may also be the cause of my chronically low platelet count. For these I am medicated. I am a bit fatigued and I don't always feel so good, but nothing major. I have to continue seeing my oncologist because my leukemia has not been excluded and the liver disease dramatically increases my cancer risk.

My mission is to stay at grade one as long as possible. In order to do this I must have bariatric surgery (Realize Band). I was already running down the lap-band path so I am just waiting for the final financial requirements and a date for surgery. Hopefully, I will have the surgery this summer. The extreme change in diet that is required for the lap-band surgery pretty much mirrors the requirements of the liver diet. And, of course, I need to continue exercising, but I can't put myself in danger of an abdominal injury. Obviously, I can't ever even take a sip of alcohol which really isn't such a big deal for me. Work isn't a big deal since I am writing from home full time now.

Cheri and I are focusing on the bariatric surgery right now so I can become a better candidate for a transplant when the time comes. In no way am I giving up or flipping out. It's not good news, but it's not the worst news and I can survive this.  

Thanks for your support,
Christopher 

Friday May 27th, 2011 - More Fat Means Less Life

Research from The National Institutes of Health published in the New England Journal of Medicine, reports that your risk of premature death increases 31% with every five-point increase in the body-mass index (BMI).

In real terms this means that...

• A BMI of 25.0 to 29.9 increased death risk by 13%
• A BMI of 30.0 to 34.9 increased death risk by 44%
• A BMI of 35.0 to 39.9 increased death risk by 88%
• A BMI of 40.0 to 49.9 increased death risk by 251%

To calculate your BMI go to http://www.nhlbisupport.com/bmi/

The following conditions significantly increase your risk:

• Fatty liver 
• High blood pressure (hypertension)
• High LDL cholesterol ("bad" cholesterol)
• Low HDL cholesterol ("good" cholesterol)
• High triglycerides
• High blood glucose (sugar) Diabetes
• Family history of premature heart disease
• Physical inactivity
• Cigarette smoking

And, of course, cirrhosis of the liver can be lethal. Actually, it is. So I need a transplant asap.

Thursday May 26th 2011 - Perhaps I am in denial

I try not to think about it. I generally feel okay especially after Dr Goldstein gave me some oxycodone. The pain from my spleen is somewhat mitigated to a level of tolerance. Sometimes you don't realize how much pain you have until its taken away.

So, I have stage four cirrhosis. My liver is basically an irreparable mass of scar tissue. If I understand the grading system, then grade one (0 to 3) then I have some blockage in my liver, but not completely blocked. I believe that grade three is liver failure. The minor blockage would explain why my spleen is enlarged and it could even explain my chronically low platelets. If I sit and think about the dying organ and visualize the damaged liver sitting right here. Right under my skin. Right under my right ribcage. I can touch the spot. When I touch the skin over my spleen, it actually feels bruised.

But, I feel fine. I went to lunch with my friend, went shopping, and wrote on the book and I felt fine. Other than being fat, I feel healthy so it is disquieting to think that my liver is so close to failure. To look at me, you couldn't tell that I was sick. I'm not all crumpled up or pale or yellow. I look fine. So it is weird.

Even though I read my pathology report, it still seems very abstract. I asked my fourteen year old if he was freaked out and he said, "Not really. I mean we've been through the medical scares and hospitalizations so many times I just don't think about it. Besides, you seem fine."

Jokingly, he asked me if I had a bucket list. To which I responded no. I've always thought that if someone was critical then they should go see the world or go to strip clubs or rob banks. I don't know. Live like there is no tomorrow because there isn't, but now that I am sort of there, I really just want to live everyday with my family and friends. If I died next week I wouldn't have any regrets. I've lived a nice life. I've traveled the world and I have experienced far more than the average Joe. I've been rich; I've been poor. I have no desire to jump out of planes or bridges with a bungee cord. No; if this is it, then I want to spend it with my family.

Of course I'm not going anywhere soon. I just meant hypothetically. I plan on doing whatever it takes to stay alive and well. I'll have the Realize Band surgery and get thin so I don't wreck the next liver. I hope I get the liver of a playboy bunny. Owe, that might be yucky. All joking aside, I can't possibly be dying because I feel too alive. And I'm happy today. It was a good day and I think its going to be a nice weekend. I hope I get to see Hangover II.

I have to stay healthy because I have way too much to do in the next few years and I want to see my boys marry and give my little beautiful granddaughters. Grandson's will be cool too, but I've always wanted a little girl to spoil.

Was this post too weird? Probably. I'm a bit... I don't know. I'm a bit something. I don't want to die, but I'm really not afraid of it. I just don't want to leave my family behind. And I promised my mother-in-law that I would go back to church. I never really left, but I'll go. I don't think you could be on too many prayer chains and I do believe in prayer. Gotta go cook dinner. Lemon skinless chicken and my favorite salad with dehydrated cherry's, blue cheese chunks, spinach, a tangy sweet dressing and almonds. Yumm. Plus I picked up a fresh loaf of whole wheat bread. Oddly enough, my appetite has gone down. Maybe it was the hypnotherapy??? 

I guess if you sit and think about dying then you would just go crazy and who wants to live like that. Unless I am truly  

Wednesday May 25th, 2011 - Stage four cirrhosis of the liver

I have mentioned many times that I have been told that I have nonalcoholic steatohepatitis (NASH), but the only way to tell if it has progressed to a critical stage is to do a liver biopsy. They have biopsied every organ and bone in my body hunting for cancer. My leukemic symptoms include chronically low platelets, swelling, and an enlarged spleen. Coincidentally those are the same symptoms for advanced liver disease. Now I don't know whether I have leukemia or not, but I do know for sure that I have stage 4 grade one cirrhosis of the liver. There is no stage 5. This is it. Ironically my late father was an alcoholic and he died at 50 with a healthy liver.

While there is no cure for stage four and it is not repairable except by transplant, I am going to continue my trek towards the gastric realize band procedure. If I am to extend my life, then I must lose all of my excess body fat immediately. At the very least it will make me healthier for a transplant. I received the bad news on Monday evening. I tried to schedule a follow up and I don't think the scheduler understood the critical nature of the follow up so she made an appointment without talking to me for June 21. Like I'm going to wait that long. Hellz no!

The dietary changes dictated by the bariatric surgery include many of the same elements as a liver friendly diet. But, I will still have to add more to that. For one thing, I have to call all of my providers to double check the safety of my current meds and I can never ever take Tylenol or even sip a drink of wine, beer, or any alcoholic beverage. I can never take Vicodin. I'm supposed to lay off red meat, processed foods, and other stuff I have yet to learn about. I am going to go to a new nutritionist as soon as possible. 

The following is the technical definition of NASH and cirrhosis: 

Nonalcoholic steatohepatitis or NASH is a common, often “silent” liver disease. It resembles alcoholic liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH is fat in the liver, along with inflammation and damage. Most people with NASH feel well and are not aware that they have a liver problem. Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly.

Cirrhosis is a slowly progressing disease in which healthy liver tissue is replaced with scar tissue, eventually preventing the liver from functioning properly. The scar tissue blocks the flow of blood through the liver and slows the processing of nutrients, hormones, drugs, and naturally produced toxins. It also slows the production of proteins and other substances made by the liver.

According to the National Institutes of Health, cirrhosis is the 12th leading cause of death by disease.

Other than fatigue and pain in my spleen, I don't have any of the severe visible symptoms, but I will eventually. I hope that I can get on a transplant list now before I reach critical. Obviously, my family is upset, but I don't think they understand the seriousness of the situation. For now, it's life as usual.