Monday, November 24, 2008

The Gift

By Richard P. Holm MD

Like a lot of men who make their way to my internal medicine office, Mark Ekeland came by the urging of his wife. He even put it this way, She told me to make the appointment because Ive been really dragging lately. This is classic guy.

During the examination I felt the liver and to my dismay it came down quite a bit below the rib cage, indicating that it was enlarged. The blood tests indicated bile duct blockage, liver cell destruction, no Hepatitis A, B, or C, and the ultrasound test did not show gallstones or tumor but only a large liver.

After a phone consultation with a gastroenterologist, a liver biopsy was done, which proved a rare liver scaring disease called Primary Biliary Cirrhosis. This kind of cirrhosis has nothing to do with alcohol but rather an immune system gone awry, and predicts a gradual worsening, eventual liver failure, and a premature death.

Over the ensuing ten years I watched as my patients condition worsened. Although never complaining, his muscles wasted, his color turned grey-green, his belly swelled, and he seemed to age right before my eyes. 

One day he came close to death bleeding from varicose veins of the esophagus, and although near the top of the transplant list, he still waited. Since there was such a great demand for organs, it looked like he might not get one in time. 

Then, a relative of his wife offered to be a living donor, an incredible gift of half of her liver. The transplant happened rather soon after, and it was a glorious thing to watch Marks general health come back to him over the next three or four months. 

Now four years later, Mark enjoys and savors every healthy day because of the courage and compassion of his donor, and the miracle of modern medicine. 

Take home message:
The advancement of science has offered remarkable treatments for what used to be terminal conditions;
All of us should do what we can to help those in need of organ transplant. Sign a donor card AND tell your family about your wishes to donate if tragedy should happen;
Living donors, and those willing to donate after brain death provide a gift for a lifetime of marvelous relief from illness and suffering.

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