In October 2014 my mother Geraldine passed away after a very brief and completely unexpected battle with late-stage NASH. She was only 62 years old and had only been diagnosed with NASH six weeks prior to passing. Like most people, my family and I had never even heard of the disease that took her from us. She was a gregarious woman, a prolific cook who was known as the matriarch of our extended family. She constantly struggled with weight after having her three kids, and became heavier in her later years, but was never what any of us considered to be THAT overweight. Sure, she had minor health concerns as most 62 year olds do, but we never were aware of anything wrong with her liver. Until, as many similar stories about NASH go, it was too late.
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I have been told that as long as my NAsH doesn’t progress to fibrosis there is nothing to be concerned about ... ‚everyone over 50 has it‘...
Of course I knew that doctor's statement was not true and have been trying my utmost not to allow NAFLD/NASH to progress therefore, this story is a shocker!!
Three months ago, the Dr conducting my Fibroscan said that he had never seen a liver like mine before which didn’t have fibrosis, he said I was very lucky ... am I?
Just to clarify, and this is a common problem, NASH means that NAFLD has progressed from just having a benign load of fat in the liver to damage being done. It starts with inflammation and progresses to fibrosis which can become cirrhosis if not stopped. Lots of people have NAFLD which indicates fat but no fibrosis so there is a lack of precision in the doctor's comment. If you don't have fibrosis you likely have a fatty liver and may be at a very early stage of NASH. It is a difficult distinction to make because the boundary between the two conditions is not precise so we often use the names somewhat interchangeably which causes people a lot of concern.
Thanks, I understand what I have which includes significant Inflammation of my liver.
I am T2DM with HbA1c <6 (goal is to remain under 7) which verifies that my carbohydrate intake over a 3 month period is normal. I suffer with longterm significant hypertension with resultant heart/lung disease and multiple autoimmune conditions . This has resulted in a plethora of necessary oral medications over the years which no doubt has contributed to my liver disease.
I attend a gymnastics class weekly and am a member of two dog walking groups as well as the usual daily dog walking activities. My activity tracker verifies that despite my arthritis, I walk a minimum of 12,000 steps daily. Nevertheless, my liver disease is progressing and therefore this real life story you presented in your post frightens the life out of me.
You are dealing with a complex situation. The difference between you and the woman in the article is that she had no idea that she had a problem until very late stage cirrhosis. One of the challenges we have is how silent it can be in some people. You are aware and working to deal with it so quite different and with your monitoring it won't sneak up on you. Sounds like you are doing the right kinds of things to minimize the problem. It is hard with multiple issues to deal with but knowledge and determination are your best tools.
This is so sad. I am not sure why we dont have public service announcements to educate the public about this silent disease. I was in my 50s when diagnosed but now know symptoms were there many years before. Public education and informed general practitioners are critical as i see it.
That is key mission of the Foundation. A goal is to tell the patient story and get medicine to engage with the disease earlier, before people get sick. Here is a little video explanation.
NASH is largely asymptomatic until it is too late. My impression is that the progression varies significantly from person to person. My mother was diagnosed with NAFLD decades before she died of a stroke at the age of 86. Apparently her doctor did not think a fatty liver to be a big deal so neither did my mother and he continued to prescribe large doses of Tylenol and Ibuprofen for her arthritis pain with no thought to her liver health. Other people are diagnosed at a young age and battle the disease for years. It is all so individual.
That is one of the challenges. While all roads lead to cirrhosis there are many paths and they often overlap. The damage is the result of multiple insults to the liver cells which kill them in the end. It used to be that liver fat was considered to be benign and no one worried about it. There was truth in that because the fat itself is not toxic but when it reaches a point where the function of the cell is compromised by fat globules problems occur and a fat laden cell is more easily killed by other toxins for example. Our modern society has cocked the pistol of cirrhosis and pointed it at our liver through diet and all of the chemicals we encounter so the entire process of becoming ill has changed over the past several decades.
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