5/29/08, still 10 pounds down

Well, I started "soft foods" today, and was thrilled beyond belief to be able to chew a very soft, very moist chicken tenderloin. Who ever thought I could get so excited to eat a piece of skinless boneless chicken??? It felt so good to actually CHEW something! I was able to eat one chicken tender, 1/2 of a hot dog, and about 4 spoonfulls of green beans. I ate way too fast though, because I was so excited to be chewing real food, and it hurt! I had to stop, and I thought I'd just let it go down and then be ready to eat the other half of the hot dog and maybe another piece of chicken. That is to say, I really, really, really WANTED to be able to continue eating, but I sat there for about 3 or 4 minutes and overrode the voice in my head telling me to eat, eat, eat. I decided I was done. Amazing! I know I have a hard road ahead though, shutting up that head hunger voice. It wants me to eat through the uncomfortableness and/or pain and/or full feeling. I know it will be difficult to not to give in, but with this band helping me, I know I can do it.

On another more depressing note, I got bad news when I went for my post-op appointment at the surgeon's office yesterday. My surgeon as a rule does liver biopsies on all gastric surgery patients, and although I thought it was silly, I consented for him to do this while he was in there placing the band. The pathology report came back, and I definitely have what's known as fatty liver disease. Apparently approximately 80% of all morbidly obese people have this. It's when fat cells invade the liver, and the white blood cells then attack them, causing inflammation of the liver. This in and of itself is considered a relatively benign condition, because it does not, they don't THINK, lead to fibrosis or cirrhosis of the liver - or liver damage, per se. However, lucky me, I'm among the less than 20% of people whose fatty liver disease has actually progressed to the stage of fibrosis. This condition is known as NASH - nonalcoholic steatohepatitis. This is a serious condition because in 20% of patients with NASH, it leads to cirrhosis of the liver, which basically means your liver ceases to function. The only cure at that advanced point is to have a liver transfer. I'm only in the fibrosis stage, but the kicker is that there is no known treatment for NASH, nor is there any way to know whether I'll be one of the ones in whom it will continue to progress to cirrhosis, or whether it will resolve with weight loss. I've been researching this online since yesterday. Needless to say I'm extremely upset. I'm not sure what to do about it? My surgeon said that in some patients, just losing a significant amount of weight has been shown to resolve the condition. In others, it doesn't. No rhyme or reason. He did tell me that I shouldn't feel guilty - it has nothing to do with the fat that you eat in your diet. It is not known why NAFL (nonalcoholic fatty liver) and NASH are more prevalent in morbidly obese people - in other words, it isn't necessarily caused by obesity in and of itself, it just happens to be common among people who are obese. Same for people who are insulin resistant, or who have full blown type ii diabetes. I don't have diabetes, but I do have PCOS (polycystic ovarian syndrome) which has an insulin resistant component. There seem to be no clear cut answers to anything about this condition. I'm really confused, and I think I'm going to find a hepatologist (liver specialist) to get his or her opinion. My surgeon wants me to join a clinical trial that he is apparently co-sponsoring, which is looking at the impact of a drug called Urso, which is commonly used to treat gallstones. Apparently they have seen successful reversal of NASH using high doses of Urso. He gave me the name of the project manager coordinating the clinical trial at the hospital, but she hasn't called me back yet. I think I should seek the counsel of a hepatologist before I do anything though. It's just such a vulnerable and disconcerting feeling. I feel like I'm a ticking time bomb. Am I going to wake up in 5 years and find that my liver is failing and need a transplant? That is a very sobering thought. The crazy thing that I keep thinking about is that NASH has absolutely no symptoms, and if I hadn't decided to have the lap band surgery, I never would have had any idea whatsoever that my liver was damaged in any way. And I wouldn't be worrying myself to death over it right now. Sigh.....