“Are you feeling alright?” asked a friend over lunch one day last November.
“Not bad. Just a bit warn,” I answered.
But something lingered. His question was not the typical platitude “How you doin?” He had a reason for his precise question.
“Why do you ask?”
“Your eyes are all yellow. You don’t look very good.”
That was a Friday. The previous Monday morning I noticed my urine was not its usual translucent almost clear color. It was dark and opaque, almost purplish. And it wasn’t a gradual thing that came on over time; it was immediate and profound.
I should say right here I am not a medical professional, but I’m not exactly an uninformed coach potato either. I lead a company dedicated to improving the clinician-patient healthcare experience. We make online and mobile solutions that help people manage chronic health conditions in concert with their doctors. So I keep a pretty close eye on everything going on with my own health. I run, cycle or swim 3 to 7 times a week. I compete in races to improve my endurance and stamina. I play with my blood pressure. I fiddle with my weight. I truly can control my heart rate (at least I believe I can). And I have absolutely no chronic or persistent illnesses. It’s all sort of a hobby for me.
So when I noticed my urine was a color I’d never seen before, I did what any reasonably enlightened guy would do: I ignored it.
“I don’t have time for this. This week is packed,” I thought to myself. “Besides, I don’t feel bad. Let’s give this a few days and see what happens. I made it into an experiment to watch and play with.
But on Friday, with the knowledge that my eyes were visibly yellow, this little curiosity moved to center stage. From the restaurant parking lot I looked up my doctor’s name and phone number using one of our own mobile applications. (“This is interesting. I’ve never used our products for real before.”)
I called my physician’s office with the University of Michigan Health Service, explained my symptoms and asked to see someone right away. The very nice lady on the other end explained that I could not get an appointment so fast, but if I wanted I called again at 9:00 am on Saturday, maybe they could squeeze me in then.
“Again, let me tell you what my symptoms are.” This time I used the word: “jaundice.” “We need to find a way for me to be seen this afternoon.”
“Well. Can you be here in 20 minutes?” It sounded like she didn’t really expect I could.
“On my way. Thank you.”
I waited about 30 minutes in the doctor’s lobby getting work done on my iPhone. When I met with the nice doctor, she made some minor apology for keeping me waiting. “Patients are each taking longer than usual today,” she said.
With a smile I assured her I’d do all I could to make her visit with me as short as possible.
As she tried and failed to see light pass through the vial of my urine she said in an almost contemplative voice “Oh no, no. You’re not a delay. You’re interesting. You’re really interesting. Something is going on in your liver. We just don’t know what.” They drew a blood for a bunch of tests.
It was a rather long weekend. By Monday, my skin had turned completely yellow. Not subtle yellow-ish, but screaming yellow, more than I’d imagined it could. And I felt wasted. Not bad, exactly, just wasted. And as a guy who is nothing short of arrogant about my ability not just to tolerate the cold but to wallow in it, I could not stop shivering. I buried myself in my sleeping bag under the covers on my bed and shivered some more.
The lab results came in mid-day Monday. Three values were the focus: AST (should be about 30) was 1,321. ALT (should be about 30) was 2,243. Total bilirubin (should be between 0.2 and 1.2) was 14.8.
Of course, at that time, I didn’t know the target ranges and had no clue what those values meant. I just knew the values. I texted them to my daughter, Alison, who is a physician in Chicago and who, at that time, was 37 weeks pregnant.
Her response was succinct: “OK. We’ll be there [Ann Arbor] in 6 hours.” That’s all the diagnosis I needed. This wasn’t a hobby any more.
They scheduled me for an ultrasound the next morning at 10:00 am. My wife, daughter and son-in-law all piled into the car to drive the short distance to the University of Michigan Hospital.
By this time we had a short list of possibilities: viral hepatitis (A, B or C), all of which seemed like remote possibilities, auto-immune disease, which sounded more reasonable by the hour, and the elephant in my room: cancer.
“OK Mr. Dormer. I need you to hold your breath for a bit. OK?” [Pause] “You can breathe now.” Repeat.
“If you’re having trouble, you can breathe whenever you need, OK? I don’t want you to be too uncomfortable,” said the very nice ultrasound tech. But for me, this was just another game. It was too easy and I was bored.
“I wonder how many of these I can do on the same breath?” I thought. So I played. I think I made her nervous.
That was at 10:00 am Tuesday. I had to stay NPO—Nothing Passed Orally for six hours before the ultrasound. My appointment with the doctors wasn’t until 1:00 pm, so we planned to go out for brunch someplace.
Before we were out of the parking lot, I received a call from the clinic. “Mr. Dormer, we need you to stay NPO for a while longer. The Doctor would like you to have a liver biopsy this afternoon.
This was a difficult moment. We didn’t know what the ultrasound showed, but the logical inference was that it was so bad they decided to go immediately to a liver biopsy. We each separately, in our own little isolated universes, reached the same conclusion: This must be the big C.
My dad died when I was six. (See the “about” section of this blog.) I believe I appreciate each and every day. I have consciously celebrated the day when each of my children passes the age I was when I lost my dad. And while sometimes I get caught up in work or something that throws off the balance for a bit, I still think I live life so that when my time is done, I will be satisfied with my decisions.
But sitting in that car in that parking lot, I had to admit that I had not quite achieved the objective. If I really am in the chute racing towards the big finish line, there are still a few things I need to do or say or show.
About this time, without saying so, Alison texted Joe, our son who lives in Alabama. “Dad is sick. You need to come home now. Today.” He arrived at about 9:00 pm.
As with so many things in life, our logical, evidence-based conclusion was completely off the mark. We simply didn’t have enough information and assumed too much from the little we had. After meeting with the doctors for about 20 minutes, answering the same questions about my sexual preferences and drug use, we were told that my ultrasound was completely clean.
“Then why did you call right when you did to schedule the liver biopsy” we asked or shouted in unison.
“Oh, that. Well, Dr. K is leaving for India tomorrow, so we’d like to have the liver biopsy results before he leaves. We don’t know what is causing this. As for the timing, that was just a coincidence.” Innocent and insignificant coincidence for them, shear panic and desperation for us. There’s a lesson there someplace.
The liver biopsy was another chance to play. They gave me a little IV happy drugs, which is standard. I was fixated on my blood pressure as it changed through the procedure. It was obvious that they thought is it was just the happy medicine causing my fixation, and maybe it was, but what a great time to play with my BP, even if I couldn’t actively control any variables in that setting!
Then I had to lie still for 4 hours in the recovery room watching inane TV. I was bored. Suddenly an alarm went off. I thought “What the hell is that? It must be some poor sucker in the next stall.” Then I realized it was my alarm in my stall. As the nurse bolted in I felt a shot of adrenalin flush through my system. The alarm stopped.
“What was that about?” I asked.
“Oh nothing to worry about. Just your monitors.”
I am supposed to feel better with that answer? I settled down a bit. Soon I figured it had to be my heart rate. Goodie. Another game. My heart rate was 60. I folded my hands, stared at the heart rate monitor and concentrated on images of the forest and happy thoughts. My heart rate began to drop. 55. 52. 50. 48.
Alarm, alarm. Here comes the nurse. 55. The alarm stops. The nurse looks at me. I smile.
53. 51. 47.
The nurse looked at me trying to be stern but was betrayed by her smile. “Stop that.”
“Yes ma’am.” I smiled.
On Thursday we received the pathologist’s report. After all the testing the good news is that I don’t have cancer, auto-immune disease, or any viral infection including hepatitis A, B or C. However, the report says my condition is consistent with exposure to a drug or toxin. Since I don’t take any drugs, and since I’m the only one in the family affected, we began a search of products that only I eat or drink.
The only thing we could think of is the wonderful Alishan High Mountain Oolong Tea that I received from my Chinese teacher last Christmas. She purchased it in China and brought it to the United States. (For the past several years, I have studied the Chinese language at a local school run by the Chinese community.) The doctors kept asking if I take any herbal supplements, so that also made me think of tea. I don’t drink this wonderful tea every day, but sometimes I drink it several days in a row. I just don’t remember. I can say with certainty that I am the only one who drinks the tea, and it is the only product that only I eat or drink.
Friday evening, my son, Joe, did some research on the Internet looking for a link between Chinese tea and pesticides. Here is a link to a key Greenpeace report he found. It says in December, 2011 and January 2012 they bought 18 samples of common Chinese tea in Beijing and tested them for pesticides. All 18 had traces of at least 3 pesticides.
But here’s where it gets interesting: Of the 18 samples, 11 contained methomyl and endosulfan. Methomyl and endosulfan have been banned by the Chinese government (endosulfan has a global ban). My tea was purchased in China, but was grown in Taiwan, so a ban in China would not have had an effect on my tea. I cross-referenced methomyl and endosulfan with liver and came up with some really, really scary information.
One article about methomyl says “repeated exposure to small amounts of methomyl may cause an unsuspected inhibition of cholinesterase, resulting in flu-like symptoms, such as weakness, lack of appetite, and muscle aches. Cholinesterase-inhibition may persist for two to six weeks. This condition is reversible if exposure is discontinued. Since cholinesterase is increasingly inhibited with each exposure, severe cholinesterase-inhibition symptoms may be produced in a person who has had previous methomyl exposure, while a person without previous exposure may not experience any symptoms at all.”
That would explain why I’ve been drinking it all year with little or no symptoms till all of a sudden it kicked my ass!
The next interesting piece of information came when I researched my brand of tea and cross referenced it to pesticides. My tea manufacturer, or at least a tea manufacturer from the same region as my tea, promotes that they have a patented system for washing the tea to remove pesticides. By that claim, they acknowledge that their teas have been treated with pesticides. Further, research shows that at least one of the pesticides, methomyl, is absorbed by and remains in the plant tissue, which means that “washing it” does not work.
Thank goodness that the liver, along with skin, are the only two organs that rejuvenate. So, they gave me no medications (other than one to control a particular symptom). They projected a 90 to 120 day healing and recovery process.
It is one thing to know on some residual abstract level what the liver does and why it is important. It is quite another to see the immediate consequences of a damaged liver. My hair changed color, from a light blonde to white. My skin peeled like I’d been sun burned, particularly where I sweat. My finger nails were funny. I broke a small piece of a tooth. I have no evidence for causality, but the coincidence is interesting.
For most of the recovery period, I didn’t feel bad, just wasted. Early on, I had about 6 to 8 good hours, 4 hours fighting it, and 12 hours huddled under the covers. Although I tried to stay on top of work, I fell behind. One interesting thing, I completely dropped off all social media—FaceBook, Twitter, blog posts, etc. Only now, well into February, am I anxious to jump back in to the fray.
Last week I ran my first race since before the ordeal, a 4 mile race in Riverview, Michigan. It’s a fun race the weekend before Valentine’s Day through a nice residential community followed by a pancake and sausage breakfast in the elementary school gym. I’ve run it a few times.
I always invite my sons who are still in town to join me, but they never do-until this year. This time, Dan (21) and Willie (13) said “sure dad. Sounds like fun.”
As we drove the hour to the race, I commented that I was surprised that Dan in particular would be up for a race early on Sunday morning in February. He responded “Dad, you said that the liver thing made you appreciate your own mortality. Well, it also made me appreciate your mortality. I don’t want to lose these opportunities to do things with you anymore. We’ll be doing a bunch of stuff together as long as we can.”
I am grateful for having had this experience and for my endless blessings.