Liver function tests
Yesterday my doctor told me that I have a lifelong, incurable disease, and I was overjoyed by the result. It was the best possible news.
It all started about six weeks ago, when I had a blood-test taken by the doctor. I was feeling great, and I'm sure most people in my situation would have been out doing something enjoyable, rather than being prodded with a needle in a doctor's surgery. However, I believe in catching problems well before they start. A little blood-work now and again is a great way to spot issues before they turn into more serious problems.
In any case, I hadn't expected my blood tests to show anything abnormal, so I was rather surprised when my results came back with elevated liver enzyme levels (ALT, ALP and GGT). This in itself was no great cause for alarm; I was showing no other signs or symptoms of ill-health, and there are many acute reasons why they could be elevated.
A discussion with the doctor convinced me to give up alcohol for the next month, just to be on the safe side, at which point a second blood-test would be taken. So I went around my business pretty much as normal, although with a few regrets that I couldn't enjoy the occasional beer after work.
My second blood test results were more interesting, and it was ironic that due to an IT problem the surgery only had a partial copy of the results. However from that partial transcript it was clear that my enzyme levels were still elevated, and that I didn't have any of the nastier forms of infectious hepatitis. However we were at a loss as to why my levels were still high.
The doctor scheduled me for a full abdominal ultrasound. The ultrasound machine was one of the coolest toys I had seen in a long time. A small amount of gel, a hand-held sensor, and one can take incredibly detailed images of inside a patient. I spent half the examination gawking at the machine and asking how it worked, as well as discussing how the organs are imaged and measured.
The examining doctor did a very thorough job, with images taken of my spleen, kidneys, gall-bladder, aorta, and of course my liver. Lots and lots of liver images. The result was that every single organ looked completely normal in size, shape, and texture. No signs of disease, no signs of inflammation.
Back to the doctor with my ultrasound results, and what I was expecting to be a perplexing situation for the both of us. However this time my doctor had the full results in front of her, and discovered that I tested positive for Cytomegalovirus, or CMV.
A person living in the USA has between a 50 and 85 percent change of contracting CMV by the age of 40, and I imagine the conditions in Australia are much the same. The virus remains dormant for most of its life, but will occasionally flare up causing flu-like symptoms, particularly when the patient's immune system is weakened. When it does so, it also causes mild, reversible hepatitis. It has no long-term health consequences, and is not considered a serious disease.
Now everything makes sense. I had recently been showing flu-like symptoms near the time of my blood tests, and the elevated enzyme levels without apparent inflammation or damage to the liver is a classic sign of CMV. I'm getting some more bloodwork done to make sure, and should have a conclusive result by next week.
What's interesting about this whole affair is that I've known that I've had CMV for years. I'm a regular blood donor, and CMV is one of the routine tests performed on blood donors. When I showed up positive many years ago I had queried the blood bank about it, and they simply described it as "a type of flu, not something to be concerned about".
If my doctor and the blood bank had actually compared notes, then my CMV status would have been already known, and a test for activated CMV could have been performed immediately, potentially saving me a rather uneasy period where I knew there was some "mystery disease" that was causing problems with my liver. Still, I'm very glad that it looks like I'll be given a clean bill of health.
