A lot of people write about the past year as each one ends. We will see lots of retrospectives citing problems and triumphs, observations about what was and what might have been.
Those are helpful to many but since I'm not young and I am a cirrhosis patient, tomorrow is what matters to me. I'm pleased to be among the un-dead but a brighter future is what interests me more than the past. I sometimes steal things from Kipling
If you can dream and not make dreams your master
If you think and not make thoughts your aim
If you can meet with triumph and disaster
and treat those two imposters just the same
Yours is the earth and everything that's in it.
The community served by the foundation, my community, is that of the unwell and those soon to be unwell. It is those who currently struggle with chronic and progressive disease and more importantly those who are not yet ill. Liver disease is one of the problems that is anathema to physicians. With no treatments available the argument is that raising alarm may do more harm than good and waiting for symptoms to treat becomes the default.
This new year, 2020, may be a contentious one. It is possible that the FDA may approve the first drug to treat advanced fibrosis due to NASH. This would be very good news as it confirms the potential to actually treat liver disease. Blue skies ahead perhaps, but like most things, it is important to read the fine print.
We are very happy to see this progress, but I worry that expectations will get too high in the patient community. So many people are desperate for some kind of help that news of progress could bring more hope than is justified. I'm not suggesting that this is not really good news, but perspective is critical.
Seeing clearly, that is the goal served by knowledge, so what should you understand about the potential new therapy? Think of a toddler learning to walk. These are the first few steps in that journey. There will be many small steps before we have truly effective treatments. The current class of drugs have limited goals. This is a very complex problem and there will not be a silver bullet to save your life.
As we wait for the science and approval system to mature it is important, if you are a patient or may become one (all of you actually), to understand that the state of the art today is measured against diet and exercise. The very best drug in the near term hopes to be as good for you as eating a healthy diet.
This is important. As you look to the future of therapy remember that you could achieve the same results by making food your medicine. The medical details of liver chemistry are vastly complex. Most docs don't really understand it and as a patient you cannot. However, you can have a strategy. When you eat, choose a menu that causes your liver to do as little work as possible. We have a lot of information on the website so here is a link that can get you started.
fattyliverfoundation.org/na...
You can think of it simply, as don't eat anything white.
Broadly speaking that means limit salt, sugar, refined flour and starchy vegetables. Increase your unsaturated fats and lower the saturated fats. Learn to like non-starchy vegetables and get some exercise.
Easy Peasy and it doesn't cost thousands of dollars a pill.
Wayne Eskridge
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