Tuesday, December 23, 2008

One step forward, two back?

OK, time for an update. To recap, I stopped the tetracycline and diflucan on December 3rd, due to unacceptable liver enzymes (ALT 300+), but I remained on the slow ramp up of Buhner herbs, and added some good liver herbs as well.

Liver function
The liver enzymes kept climbing, even off the meds. They topped out a few days ago at AST 195, ALT 540. This is very worrisome considering the "high threshold" for each is around 40. I'm getting my blood tested now twice a week, and a few extra times thrown in. Fortunately my LLMD has been right on top of this, calling me very soon after each test, and discussing possible causes and options.

Problem is, at this point, we're just not sure why the liver is acting this way. I had an abdominal ultrasound a couple of days ago, and it showed nothing abnormal, so no Fatty Liver disease, or anything like that.

I'm starting to notice one of the effects of the liver damage: clotting. Normally when I have blood drawn, there's no bleeding whatsoever afterwards. Now, I have to hold the bit of gauze against the pricked spot for a few minutes to get it to stop bleeding. This is hard to just ignore.

We (me and my LLMD - the blind man and the expert) are hypothesizing that somehow it's the herbs that are messing things up. So, after that last very high reading, I stopped most supplements (and I'm still off all meds), except for Milk Thistle, N Acetyl Cysteine, Flax Oil, Flax Meal, and Probiotic. Within 24 hours of this, the liver AST/ALT dropped from 195/540 to 101/427. Still very high, but quite a drop in one day off the Buhner herbs.

I've been searching the internet, and re-reading Healing Lyme, and there's no mention of these herbs stressing the liver. In fact, the opposite. Can't figure it out, but for now I'll continue on this minimal regimen, testing the blood twice a week. Hopefully there will be a significant, steady downward trend.

I'm seeing a gastroenterologist (liver doc) in early January. Hopefully he'll be able to rule out any other liver issues. If so, we're left with the Buhner herbs, if readings trend down, and if not, perhaps it's the lyme itself. If the latter case, then my LLMD is considering liver-friendly options, such as Ceftin paired with Biaxin. All I know about these at this point is that they're oral abx.

General Symptoms
My symptom chart is still all over the place, up and down. I had a 5 day stretch where I felt pretty good, and I went for a tiny hike one day. Only about 3/4 of a mile, with slight elevation gain. I dressed in my hiking shorts, etc., and used my trekking poles, so it would feel more like a hike than just meandering through the woods. I set a reasonable pace, and it was quite enjoyable. I found myself thinking that I'd do this again tomorrow.

I really should know better by now. The next couple of days I didn't feel so good. Hike-related? Who knows. Perhaps I was just due, as I can't remember the last time I had 5 good days in a row.

Today was a good day, and I'm thinking I should go for another little hike tomorrow. Not sure if I will, though. First, now we have a foot of snow on the ground, which makes walking much more strenuous. And then there's that liver thing. I'm avoiding all toxins, like pain killers and even the smallest amount of alcohol, and I don't want to do anything else to stress it. Do livers get tired from walking?

Oh, one more reason to wait. I don't really need a hike to be followed by the usual few days of extra-extra neuro symptoms just in time for Christmas. My family deserves a break.

So, I guess for now it's just a waiting game, trying to eat fairly well, etc. Eventually I'd like to get back on some meds, but even then it'll require constant monitoring. And if that goes well, perhaps at some point I'll be able to add one Buhner herb back in, perhaps Andrographis. Ramp that up, and see if there are issues.

I'm not sure I'll ever be able to tell precisely what happened here, but I'd be happy if I could eventually get back on the Buhner protocol, even at 1/2 dose.

There, all said. Now I can forget all about this stuff and enjoy the holiday.

Merry Christmas.


Naomi said...

Merry Christmas, Joe!

Hope you got to enjoy the holiday. Sorry this is all so complicated! Seems like it isn't easy for anyone to get over this, but I am impressed with your doctor. It's good you have him on your side.


Joe said...

Hi Naomi,

Merry Christmas!

My Lyme doc is my favorite person these days. I feel so fortunate to have found him.