My Liver and I

 I had not fully appreciated how essential my liver is, but it has made clear that I cannot live without it functioning properly.  Liver is the busiest organ in our body, it performs almost 500 functions; primarily, it filters our blood and protects us from poisonous substances like alcohol and drugs.  Because my liver is currently unwell, it is testing my patience.  Since early March, I became a statistic, one in ten thousand.  I was diagnosed with drug-induced hepatitis, or DILI (drug induced acute liver injury).  This not widely known form of hepatitis was triggered by a commonly prescribed antibiotic, Amoxicillin Clavulanate, taken together with Acetaminophen better known as Tylenol (paracetamol), a popular pain reliever.  It was my bad luck!  DILI predominantly affects older people, mostly men. 

Researching for this blog, I was made aware that DILI is becoming more common in the United States, with 20% to 40% of cases linked to the uncontrolled use of dietary supplements and herbal teas.  Many patients ultimately require liver transplants.

Upon my return from a week-long stay in New York City, I felt unwell with a high fever, yellowish eyes, and orange-colored urine. Hepatitis was diagnosed in the hospital; I spent three days in ITU (intensive therapy unit), undergoing two blood tests daily and CT scans.  After leaving the hospital, I had to adjust to a new way of life.  Still, there was a silver lining: the liver is a remarkably resilient organ, uniquely able to regenerate after injury.  However, recovery is slow, and it can take up to six months for liver enzyme levels to return to normal.

                                                   The tree of life: Liver blood vessels

An 83-year-old liver takes more time to heal than a younger one, so I had to do my part—and that, of course, was the hardest bit of the process. Because the liver plays such a central role in the body, adopting a liver-friendly lifestyle requires sustained care. To speed up healing, I had to understand how different foods and medicines might improve my liver condition.  Conversely, it was just as important to identify foods and drugs that could harm the liver.  I went full Google AI mode.  It became an obsession: cell phone in hand, I checked and rechecked before choosing a meal at a restaurant, taking medicine, or going food and grocery shopping.

I lost weight; it is hard to regain weight on low-salt, low-sugar, and fat-free meals. My social life in Rio de Janeiro also suffered; meeting friends over coconut water instead of a caipirinha was not nearly as much fun.  The tasty finger food found in Carioca bistros is usually fried and was also off-limits for me.

For the first time in decades, I flew Air France to Montpellier declining the complimentary glass of champagne.  The outlook for socializing in France, the land of cheese and charcuterie, was just as bleak.  Providentially, French food regulations did offer some help, a colorful graded nutrition indicator is printed on most packaged and tin foods.  This color-coded graded indicator for food stuff is named Nutri-score.  The letter A is associated with dark green; it stands for a more favorable nutrient composition.  Sadly, for a charcuterie and cheese lover, only veggies are classified A for their good nutritional value.  On the opposite side, red with the letter E categorizes highly processed food with lower nutritional value or with high content of saturated fatty acids, excessive salt, high calorie density fat like most cheese, ice cream and charcuterie (cold/cured meat like sausage or pâté). 

After four months of dietary restrictions and countless blood tests, my old liver is slowly getting healthier. I just hope its recovery stays on track—and eventually lets me enjoy a glass of champagne and a nice piece of camembert again, E on Nutri-score!