Wednesday, September 05, 2007

The Not-So-Full Full Physical

I make a point of going in for a full physical every year. I go in during the month of November as my birthday is in November and I see a check-up as a twisted birthday present to myself. “Happy Birthday - You're not dead!” Well, a few years ago, I went in for my regular physical and was declared to be totally healthy. My weight, my blood pressure, my lab results - all perfect. I was very glad to hear that I was still in good working order. In December, however, I had a medical examination for a life insurance policy that I was buying for myself. Apparently the “full physical” from my physician was not as “full” as it should have been.

Our life insurance representative called me some time after the life insurance exam and told me that he was sending a nurse to my house to take a second sample of my blood as he thought there may have been a problem with one of the results. He informed me that all of the lab results were normal except for the liver enzymes and that they were very elevated. He said that he thought it could just be a false positive and wanted to re-test me. Heck, I wanted them to re-test me. The second test came back even worse.

So - I went back to my physician with the life insurance exam results in hand. I was told that during my November exam, they did not test my liver function AT ALL. How could they skip a review of my liver function during a full physical?? In the physician's estimation, I was a perfectly healthy 33 year-old woman. They claimed that they don't normally run liver function tests for women in my age group who they deem to be mostly healthy. So my physician finally ran their own liver function test on me and the enzymes were elevated again. I was referred to a specialist. I got a clean bill of health in November and was told in December that my liver was in distress.

My specialist is almost 100% sure that I have autoimmune hepatitis. It's not Hepatitis A, B or C. It's an autoimmune disease not unlike lupus. My immune system is attacking my liver as if it is a foreign object in my body. The only reason the specialist isn't 100% sure of my diagnosis is that, per my last biopsy, there hasn't been enough damage done to my liver yet. I have been going in for blood tests quarterly for the last 5 years as a result and am scheduled for another biopsy in December. I now baby my liver - with the exception of the occasional drink, which has been doctor-approved (seriously).

I tell this story now because my doctor has informed me that after my biopsy in December, he expects that I will be placed on medication - a mix of autoimmune suppressants and steroids. As a result, I need to prepare myself for the weight gain and bloating that can accompany the medication. I managed to gain a little more than 20 pounds in the last five years and have basically been told to get rid of it ASAP. Oh joy.

I thought I was being responsible with my own health by going in for the annual physical. However, if I had just had my annual physical, my condition would not have been detected and I could have been running around drinking alcohol and slugging Tylenol. (OK, so I wouldn't have been horrible to my liver - just not as good). The specialist told me that most people with this condition have no clue that they are sick until they are closer to 50 and they have serious symptoms like jaundice and lethargy. Luckily for me, I had the extra exam from the life insurance company, and am being monitored. I am thankful for that.

I didn't know that a “full” physical wasn't actually “full.” If you don't have any medical complaints, your doctor may not test for things like your liver function. Just a friendly warning to ask exactly what your doctor is and is not testing during your annual physical. If you have specific concerns as a result of family history or otherwise, definitely make sure that they are being addressed.

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