The Good and The Bad

Good news.
I did not play paintball with my company. My hands were shaking and I was full of adrenaline but I didn't do it. I used to be a tourney player and would have just dominated with my own marker (gun) and gear; every game someone would ask me to be on their team. Oh well. I knew the owner of the indoor field from my time playing back then and it was good to catch up. He let me put on a shirt and ref. I took it slow out there.

SIDENOTE: In the following information, I am telling you this as I learn it. I think that we as individuals are more concerned about our health than any doctor who deals with dozens or hundreds of people on a daily basis and work on a reactive rather than preventative or active care plan. I have firmly believed that if a patient is not; hot, broken, red or swollen, a doctor has as much a guess as you do, except they see and hear the trends in their region and can order tests. As such the internet is a great way to inform yourself on test results and symptoms but I do not think that it can be used to self-diagnose.

I got my latest labs back and my blood looks normal. The one area of concern is my eGFR which is simply listed below normal. This is a test to determine kidney damage.

Bad News.
Out of nowhere my liver test came back horrible. In the hospital I did have acute kidney (renal) failure and liver failure but the doctors were much more concerned about the kidney issue. On the results I just got back for my liver it shows two high liver markers, ALT and AST, in my blood. Someone hand wrote discharged numbers next to the current ones.

The limits for AST are 0-45, I was discharged at 87 and one week later I am 86.

The limits for ALT are 0-55, I was discharged at 41 but one week later I am 275.

I have clipped the following (from HERE) for explanation

ALT and AST are enzymes made in the liver. They are also known as transaminases. The liver uses these enzymes to metabolize amino acids and to make proteins. When liver cells are damaged or dying, ALT and AST leak into the bloodstream. Many different things can cause liver enzymes to rise above normal levels, including:

• Viral hepatitis
• Excessive alcohol intake/Alcoholic liver disease
• Liver inflammation from medications and certain herbs,
• Auto-immune hepatitis - a condition where a person's immune system mistakes the liver for an invader and attacks it,
• Fatty liver- fat build -up in liver cells, called steatohepatitis when the fatty liver is inflamed
• Inherited liver diseases
• Liver tumors
• Heart failure

ALT (also called alanine aminotransferase or SGPT) is found in the liver only. High levels of ALT in the bloodstream mean that there may be liver inflammation and/or damage. This test cannot predict liver damage or disease progression. It is simply a direct measurement of the amount of ALT in the person's bloodstream at the time of the test. The normal range of ALT levels is between 5 IU/L to 60 IU/L (International Units per Liter). ALT levels in people with HCV often rise and fall over time, so additional testing such as HCV RNA, HCV genotyping and a liver biopsy may be needed to help determine the cause and extent of liver damage.

AST (also called aspartate aminotransferase or SGOT) is found in other organs besides the liver. High AST levels in the bloodstream can be a sign of liver trouble. AST testing measures the level of AST in a person's bloodstream at a given time. The normal range for AST levels in the bloodstream are 5 IU/L to 43 IU/L. Like ALT levels, AST levels in people with HCV often vary over time and can't be used to forecast disease progression or specifically measure liver damage.

I am directed to give another blood sample next week. They are also going to screen me for hepatitis. Words like that one and dialysis are common words that I read and see all the time but until this month couldn't tell you the how, or why, or what about them. I'm learning as you do.


Adding a Terrible Ugly

I just got off the phone with Big John while writing this post. His brother Dan, multiple IM finisher, including IMAZ this month, lives in San Diego and trains with the SD Tri team. He bailed on his team OW workout this morning due to some drinking last night. His normal OW swim partner, Dave, decided to pair up with a first time OW team mate when he was attacked and killed by a Great White shark a few hours ago. Everyones head is spinning over this, especially the woman he was assisting who was right next to him. When you hear it on the news, know that he was a triathlete who was helping a team mate overcome a fear.