Re-entry, part 1

Well hello, it has been a while. Sometimes life throws you curveballs, and I’ve been arcing through one for months now. I’m now in an airplane with Jila, my 6-year-old daughter, flying home to Albuquerque after a 7-week stay in Cincinnati. Her eyes are white, her cheeks are puffy, and she’s hungry.

When we left Albuquerque on Thanksgiving morning, she was yellow and sluggish, suffering from a second spike of hepatitis (inflammation of the liver) and resulting jaundice since June 2012. That episode had mostly resolved on its own without any medication or medical intervention, but had not completely gone away.

It all started out of nowhere on a normal summer day last June when I noticed Jila’s eyes looked yellow. She had virtually no other symptoms, but I emailed our family doctor just to be safe. His response was that yellow eyes can indicate hepatitis, which he explained meant liver inflammation, and asked if she had had dark urine, diarrhea, stomach pain or bad breath. Gulp…indeed I had noticed these symptoms in Jila in the previous week. The doc told us to go in for a blood test and explained a bunch of stuff about hepatitis to me.

First, he explained that hepatitis simply means inflammation of the liver. In itself, the term “hepatitis” doesn’t explain why the liver is inflamed. That’s where A, B, C and other viruses come in: Hepatitis A is caused by the hepatitis A virus. Hepatitis B is caused by the hepatitis B virus. And so on. My doc explained there are lots of other viruses that also can cause liver inflammation such as Epstein-Barr (the virus that causes mononucleosis), cytomegalovirus (CMV), parvovirus and others. When kids pick up hepatitis it’s usually the hep A virus since that virus can be food-borne. Other types of like the hep B and C viruses tend to be harder to transmit (think, shared needles or sex), so they’re not usually seen in kids. My doc explained hepatitis A pretty much always clears on its own with no complications so there shouldn’t be much to worry about.

Well, Jila’s blood tests showed she did indeed have acute liver inflammation. Liver inflammation is measured with a test for the enzymes Aspartate transaminase (AST) and Alanine transaminase (ALT), which in a healthy liver should remain actually in the liver and are mostly not present in the bloodstream. When the liver becomes inflamed these enzymes are released into the blood. Normal AST/ALT levels should roughly be below 40/60; Jila’s were 1400/1200.

The fact that she was yellow meant she had developed jaundice: a condition involving a buildup of bilirubin in the blood, because the liver’s ability metabolize and excrete the bilirubin had become impaired. Normal bilirubin levels shouldn’t exceed 1.2; Jila’s were at about 8 at that first blood test and climbed as high as 12 in the next week. My doc explained that jaundice typically indicates a more severe progression of hepatitis, so my concern and anxiety were sky-high at this point.

But here’s the kicker: Jila tested negative for hepatitis A. She also tested negative for B, C, and every typical virus that causes hepatitis. Thus began our medical mystery.

OK, the captain has just announced we have started our descent into Dallas. I’ll pick up where I left off on my next flight.

Continue reading Re-entry, part 2.