GREG

[Guest guest]

Hi Greg, my name is Genny. Welcome to the group but wish you didn't have

to be here. My daughter, Jodi who is 27 has AIH and is on the transplant

list. All of her doctors told us not to do any herbal treatment. They said

you don't know what to mix with all of her meds. This is the opinions of her

doctors so take it as you will.

Take care and God bless.

Genny/Jodi's Mom/FL

[Guest guest]

Hi Greg

I have been taking milk thistle since last July before every meal. I don't know if it has helped, but it hasn't hurt me. I asked my Dr. about it and she said I should try it. I bought a book on herbal medications and they touted milk thistle for the liver. Also, it seems to have no side affects.

There are other herbs also, but I am a little afraid to try anything that could cause side affects.

Anyway, my counts are now down to normal....could be the prednisone and imuran....or maybe the milk thistle helped....who knows. Anyway, I continue to take it before meals.

Elaine

[Guest guest]

Dr Siff wrote:

<Some of the most prolific Western research into the method of

dropping and catching loads has been done by two scientists from

Australia, Drs and Newton. Greg has also sold a large number

of his special bench pressing and load releasing devices ( " inertia impulse "

or impulse loading machines) based upon this same principle. >

Dr Siff, I have heard of Dr 's name before in regards to

interesting strength research. Does anyone have any or know of any online

information about him; or could you point in the direction of where

some of his research may be obtained?

Thanks for your time.

Todd

Mississippi, USA

[Guest guest]

Here is a small collection of articles with Dr Greg as primary author.

Very important is the fact that enhancing training induced adaptations and the

types

of movements such training would tend to facilitate neural and geometric

relationships

Dr. Zenker

Performance Edge Dynamics

Santa Cruz, CA, USA

-----------------------

AJ, GJ, Pryor JF, Eur J Appl Physiol 1994;69(3):250-7

Use of the iso-inertial force mass relationship in the prediction of

dynamic human performance. Centre for Exercise Science and Sport

Management, Southern Cross University, Lismore, NSW, Australia.

the results are explained in part by the neural and mechanical

differences between iso-inertial and isometric muscle actions and

their respective specificity to dynamic physical performance.

GJ, AJ, Walshe A, Eur J Appl Physiol Occup Physiol

1996;73(3-4):346-52

The specificity of strength training: the effect of posture.

There is a paucity of research into the importance of performing

strength training exercises in postures specific to the movements they

are attempting to facilitate. … The results supported the concept that

posture is important in training as those exercises conducted in

similar postures to the training recorded the greatest improvement in

performance. For example, after completion of the training the weight

training subjects significantly increased by approximately 12% the

maximal load lifted in the bench press exercise and the peak torque in

the isokinetic bench press test.

However, performance in the isokinetic horizontal arm adduction test

was not significantly changed. We speculate that the phenomenon of

posture specificity may, at least in part, be caused by the differing

postures altering the neural input to the musculature. The results

stress the importance of selecting exercises in which the posture

closely resembles that of the movements they are attempting to

facilitate. UI: 96375556

GJ, AJ, Walshe AD, Ness K, Res Q Exerc Sport 1996

Dec;67(4):373-9

Stretch shorten cycle performance: detrimental effects of not equating

the natural and movement frequencies.

This study aimed to assess whether the benefits associated with

stretch shorten cycle (SSC) movements required the movement frequency

to be in resonance with the natural frequency of the elastic

structures. Seventeen untrained participants performed SSC and

concentric bench press throws. Further, quasi-static muscular actions

were also performed in which a brief perturbation was applied to the

bar with the resulting damped oscillations providing natural frequency data.

It was observed that prior stretch did not facilitate concentric

performance. Further, there were large significant differences between

the natural frequency of the musculo-tendinous system and the

frequency of the SSC movements. The authors hypothesize that the

failure to achieve resonance contributed to the poor performance

achieved in the SSC actions. UI: 97168885

GJ, AJ, Giorgi A, Can J Appl Physiol 1996

Aug;21(4):301-15

Weight and plyometric training: effects on eccentric and concentric

force production.

The study was performed in an effort to gain greater insights into the

adaptations invoked by plyometric and weight training. Forty-one

previously trained males were randomly allocated in either a control,

plyometric, or weight-training group. The experimental groups trained

for 8 weeks, performing either heavy lifts or dynamic plyometric

exercises. The following test items were performed prior to and at the

completion of the training period: (a) vertical jump, ( a series of

isoinertial concentric and eccentric tests, © push-up tests, and (d)

maximal bench press and squat lifts. Plyometric training significantly

enhanced the rate of eccentric lower body force production.

The weight-training group primarily enhanced concentric function.

These results were attributed to the specific stresses imposed by the

differing forms of training and are discussed with reference to

methods of enhancing training induced adaptations and the types of

movements such training would tend to facilitate.

AJ, GJ, J Sports Sci 1997 Apr;15(2):191-200

The ability of tests of muscular function to reflect training-induced

changes in performance.

Human Performance Laboratory, NSW Academy of Sport, Sydney, Australia.

The results suggest that tests of muscular function cannot be used to

monitor training-induced changes in performance. Therefore, the

effectiveness of training should be based on changes in performance

rather than changes in test scores of muscle function. UI: 97403480

GJ, Newton RU, AJ, Humphries BJ, Med Sci Sports Exerc

1993 Nov;25(11):1279-86

The optimal training load for the development of dynamic athletic

performance.

This study was performed to determine which of three theoretically

optimal resistance training modalities resulted in the greatest

enhancement in the performance of a series of dynamic athletic

activities. The three training modalities included 1) traditional

weight training, 2) plyometric training, and 3) explosive weight

training at the load that maximized mechanical power output.

Sixty-four previously trained subjects were randomly allocated to four

groups that included the above three training modalities and a control

group. The experimental groups trained for 10 wk performing either

heavy squat lifts, depth jumps, or weighted squat jumps. All subjects

were tested prior to training, after 5 wk of training and at the

completion of the training period.

The test items included 1) 30-m sprint, 2) vertical jumps performed

with and without a countermovement, 3) maximal cycle test, 4)

isokinetic leg extension test, and 5) a maximal isometric test. The

experimental group which trained with the load that maximized

mechanical power achieved the best overall results in enhancing

dynamic athletic performance recording statistically significant (P <

0.05) improvements on most test items and producing statistically

superior results to the two other training modalities on the jumping

and isokinetic tests.

----------------

Dr Siff wrote:

<Some of the most prolific Western research into the method of

dropping and catching loads has been done by two scientists from

Australia, Drs and Newton. Greg has also sold a

large number of his special bench pressing and load releasing devices ( " inertia

impulse " or impulse loading machines) based upon this same principle. >

Todd <todd137@y...> wrote:

<<Dr Siff, I have heard of Dr 's name before in regards to

interesting strength research. Does anyone have any or know of any

online information about him; or could you point in the direction of where

some of his research may be obtained? >>

[Guest guest]

Greg has also contributed a large number of articles to the

Australian Strength and Conditioning Association's " Strength and

Conditioning Coach " magazine. All back issues (about 10 years' worth)

are available through Ian King's website, and they are brilliant!

[Mel Siff: Yes, about 6-7 years ago, Ian King was the editor of this

publication and

Greg and I were among those who served on the Technical Committee

of the Australian Strength and Conditioning Association. Greg contributed

the following interesting articles:

Plyometric Training (Vol1, 1: 3-5)

Resistance Training for the Strength Endurance Athlete Vol 1, 3: 3-6

The Development of Maximal Strength Vol 1, 4: 3-7

The Principles of Strength Training (Parts 1 & 2 - Vol 2, 1 and Vol2, 2)

Effect of Age and Gender on Development of Muscular Function (Vol 3,1)

Unfortunately, these articles do not contain any meaningful discussion or

application of Greg's work with dropping loads, which appear in various

peer-reviewed journals - a Medline search should produce many of

these, as Zenker showed yesterday. ]

Thanks

Mills

Manchester, UK

>

> <<Dr Siff, I have heard of Dr 's name before in regards to

> interesting strength research. Does anyone have any or know of any

> online information about him; or could you point in the direction

of where

> some of his research may be obtained? >>

[Guest guest]

Here are some articles by Dr. :

http://link.springer.de/link/service/journals/00421/bibs/7075004/70750333.htm

http://link.springer.de/link/service/journals/00421/bibs/7075005/70750455.htm

Vern Gambetta also talked about him at:

http://www.momentummedia.com/articles/tc/tc0705/morepowr.htm

Also, Dr. Newton has a website:

http://www.bsu.edu/web/rnewton/

He lists his research articles there.

Vagle

Apache Junction, AZ.

>From: " Todd " <todd137@...>

>Reply-Supertraining

>Supertraining

>Subject: Re: Greg

>Date: Thu, 10 May 2001 07:29:37 -0000

>

>Dr Siff wrote:

>

><Some of the most prolific Western research into the method of

>dropping and catching loads has been done by two scientists from

>Australia, Drs and Newton. Greg has also sold a large

>number

>of his special bench pressing and load releasing devices ( " inertia

>impulse "

> or impulse loading machines) based upon this same principle. >

>

>

>Dr Siff, I have heard of Dr 's name before in regards to

>interesting strength research. Does anyone have any or know of any online

>information about him; or could you point in the direction of where

>some of his research may be obtained?

>

>Thanks for your time.

>

>Todd

>Mississippi, USA

>

>

_________________________________________________________________

Get your FREE download of MSN Explorer at http://explorer.msn.com

[Guest guest]

Greg.... vicodin is hydrocodone and Tylenol together..... percocet is

oxycodone

(now highly prized on the street and a real problem) and Tylenol

together.... it seems if one of your doctors doesn`t want you to take

Tylenol ...you are. Actually Tylenol can be tolerated in modest doses

as long as the recommended doses are not exceeded however chronic (long

term ) use of it may also be damaging ?

Both oxycodone and hydrocodone are opiods... semi-synthetic narcotics

similar to codeine, morphine and other opiates.

Hydrocodone is a class 3 narcotic

Oxycodone is class 2.... a little stronger..

As such both can lead to addiction...

I guess the answer to your question really is...... does one or the

other relieve your pain or more importantly is your pain so great that

you need either one....

Each person has different pain thresh-holds I guess.... but I`ve had

teeth pulled and recovered quite nicely without any pain killers.... I

occasionally take Advil

for headache or joint/back relief and once in a while Tylenol but

nothing else.

In all fairness tho.... I`m a recovering alcoholic and stay away from

any addictive substances...

Speaking of Alcohol.... I think that whether or not any of us can have a

drink in our condition depends a lot upon just how much damage our liver

has already sustained....

BTW .... AIH and alcohol may be two different conditions but cirrhosis

is cirrhosis no matter how you get it.

Choose wisely grasshoppers...

Jerry

[Guest guest]

HEY JERRY,

THANKS FOR WRITING.MY CONDITION WAS CAUSED BY ALCOHOL ABUSE. DIFFERENT FROM MOST IN THE NEWSGROUP.I DIDNT KNOW MUCH ABOUT AIH UNTIL I GOT INTO THIS NEWSGROUP BUT IT SOUNDS LIKE PBC IS A LOT WORSE IN MOST CASES.WHAT IS YOU CONDITION AND WHAT CAUSED IT IF YOU DONT MIND ME ASKING.

GREG

[Guest guest]

HEY JERRY,

ANOTHER THING IS THAT I HAVE NOT BEEN ABLE TO SLEEP FOR ALMOST 2 YRS NOW. MAYBE 2 HRS AT A TIME AT THE MOST.VERY FRUSTRATING!!!!! BUT I DONT KNOW WHAT TO DO ABOUT IT,MY GI HASNT OFFERED TO GIVE ME ANYTHING TO HELP.DO YOU HAVE THIS PROBLEM?

GREG

[Guest guest]

Hi Greg

My name is and I am new to the group also. I have end-stage liver disease which they are now telling me could have been alcohol related. It does not make us bad people. Both of my parents were alcholics, mom died in 1995. I have been seeing a social worker as part of the psychsocial background they do on liver transplant recipients and she says I have to attend a few AA meetings even though I have not had a drink for a few years. Anyway, it was nice chating with you. Jerry is a wonderful person and a wealth of information to the group, if he doesn't know it already he'll point you in the right direction. Take care of yourself.

God Bless

in Tustin

Re: [ ] Re: Greg

HEY JERRY, THANKS FOR WRITING.MY CONDITION WAS CAUSED BY ALCOHOL ABUSE. DIFFERENT FROM MOST IN THE NEWSGROUP.I DIDNT KNOW MUCH ABOUT AIH UNTIL I GOT INTO THIS NEWSGROUP BUT IT SOUNDS LIKE PBC IS A LOT WORSE IN MOST CASES.WHAT IS YOU CONDITION AND WHAT CAUSED IT IF YOU DONT MIND ME ASKING. GREG

[Guest guest]

HI Greg, My son Hunt, the AIH kid, just had 4 wisdom teeth pulled. His hepotologist told his tooth DR to give him meprozine. This is a generic for Demerol. They preferred giving this to him than something with morphine or codeine. Not sure why, also they told him to take aleve as needed. His liver numbers are normal now, so that might make a difference.

Rosemary

[Guest guest]

> Are you in FL? I live in GA but my new neuro is in FL. <

Ok...if I had read a little farther, I would have seen where you are at. Sorry

for the interruption.

Going back to lurking again...LOL

[Guest guest]

, Greg has an annual physical exam where he works. I guess they will end up

knowing all. Frown. people react so strangely and unpredictably that we were

hoping this would not come about but it is coming and there's nothing to do but

face it. just don't want to have him lose his job over this.

Nurse was supposed to send us a letter from his doctor but it has not arrived.

I am glad Stefin and bev took my advice and joined this group. i think they will

be wonderful contributors to the group, as they both seem to be willing to help

others when they can, too.

everyone have a good day.

Sue and gidget

[Guest guest]

Hello All,

Boy, my computer goes out on me and look what happens. WOW! Well, I agree

with Gregg on *one* thing. I think that a normal person could have done

exactly what he did. After reading all you emails I can't remember how

exactly the story went, but didn't she steal almost 100,000.00 from him? Then

he found out she was just using him. A normal person could have killed her.

This is one of the few stories that I have heard of that drugs probably

didn't have anything to do with. Anyway, Greg I think you have handled this

whole conversation well considering. Glitter has been through a great deal

and we all have to understand that some times our anger is overwhelming and

we tend to say things that we really shouldn't. It is easy to do, there is

know doubt about it especially when you have been and seen everything that

she has and then to listen to all the damaging effects these drugs have had

on so many. All the pain. It seems we have our own scientific evidence right

here in this group to back our claims of the damaging effects. Greg, can you

tell me why they are so bent on masking the darn symptoms with this garbage

instead of treating the underlying cause. I am still baffled by the current

process.

Connie

[Guest guest]

Hello All,

Boy, my computer goes out on me and look what happens. WOW! Well, I agree

with Gregg on *one* thing. I think that a normal person could have done

exactly what he did. After reading all you emails I can't remember how

exactly the story went, but didn't she steal almost 100,000.00 from him? Then

he found out she was just using him. A normal person could have killed her.

This is one of the few stories that I have heard of that drugs probably

didn't have anything to do with. Anyway, Greg I think you have handled this

whole conversation well considering. Glitter has been through a great deal

and we all have to understand that some times our anger is overwhelming and

we tend to say things that we really shouldn't. It is easy to do, there is

know doubt about it especially when you have been and seen everything that

she has and then to listen to all the damaging effects these drugs have had

on so many. All the pain. It seems we have our own scientific evidence right

here in this group to back our claims of the damaging effects. Greg, can you

tell me why they are so bent on masking the darn symptoms with this garbage

instead of treating the underlying cause. I am still baffled by the current

process.

Connie

[Guest guest]

Hello All,

Boy, my computer goes out on me and look what happens. WOW! Well, I agree

with Gregg on *one* thing. I think that a normal person could have done

exactly what he did. After reading all you emails I can't remember how

exactly the story went, but didn't she steal almost 100,000.00 from him? Then

he found out she was just using him. A normal person could have killed her.

This is one of the few stories that I have heard of that drugs probably

didn't have anything to do with. Anyway, Greg I think you have handled this

whole conversation well considering. Glitter has been through a great deal

and we all have to understand that some times our anger is overwhelming and

we tend to say things that we really shouldn't. It is easy to do, there is

know doubt about it especially when you have been and seen everything that

she has and then to listen to all the damaging effects these drugs have had

on so many. All the pain. It seems we have our own scientific evidence right

here in this group to back our claims of the damaging effects. Greg, can you

tell me why they are so bent on masking the darn symptoms with this garbage

instead of treating the underlying cause. I am still baffled by the current

process.

Connie

[Guest guest]

Hello All,

Boy, my computer goes out on me and look what happens. WOW! Well, I agree

with Gregg on *one* thing. I think that a normal person could have done

exactly what he did. After reading all you emails I can't remember how

exactly the story went, but didn't she steal almost 100,000.00 from him? Then

he found out she was just using him. A normal person could have killed her.

This is one of the few stories that I have heard of that drugs probably

didn't have anything to do with. Anyway, Greg I think you have handled this

whole conversation well considering. Glitter has been through a great deal

and we all have to understand that some times our anger is overwhelming and

we tend to say things that we really shouldn't. It is easy to do, there is

know doubt about it especially when you have been and seen everything that

she has and then to listen to all the damaging effects these drugs have had

on so many. All the pain. It seems we have our own scientific evidence right

here in this group to back our claims of the damaging effects. Greg, can you

tell me why they are so bent on masking the darn symptoms with this garbage

instead of treating the underlying cause. I am still baffled by the current

process.

Connie

[Guest guest]

DZ, where Greg works will know because he has to give them a list of meds he is

taking. Oh well. it has been postponed till the 18th. his shot on the 31st and

the one tonight are behind us now. Shot six is done. Only 42 more to go as long

as they are working. bloodtests still show red and white blood cellsare doing

fine, so that's a relief. Eye doctor said his eyes are way too dry so he got

drops for that.

Hope everyone is having a good day, night, and weekend.

sue and gidget

[Guest guest]

DZ, where Greg works will know because he has to give them a list of meds he is

taking. Oh well. it has been postponed till the 18th. his shot on the 31st and

the one tonight are behind us now. Shot six is done. Only 42 more to go as long

as they are working. bloodtests still show red and white blood cellsare doing

fine, so that's a relief. Eye doctor said his eyes are way too dry so he got

drops for that.

Hope everyone is having a good day, night, and weekend.

sue and gidget

[Guest guest]

Thanks for replying to my message. I guess I want to believe that Laurie

will be " all better " after the prednisone gets things in check. Laurie is

very tired...sleeping most of the time....it hurts me to see her this way.

I know that hope and faith is are strong and wonderful tools, but I also

want to be realistic with myself. Can I expect her to gain a lot of weight?

This is of no importance to me (as my love for her is truly unconditional),

but Laurie is very upset about the likely weight gain.

Assuming the current dose of Prednisone (20mg twice daily) gets things back

in order, can Laurie look forward to a " normal " life...If so, do these

periods of normality last long.....Since AIH will always be a part of our

lives, can I expect her to have periods of illness and periods of feeling

good? Please forgive all of the questions from this AIH " newbie " , but I

really want to know what I can expect from this disease...both best and

worst case scenarios.

After this round of Prednisone, will Laurie remain on the Imuran and/or

Prednisone forever?...this concerns me as every medication has bad side

affects...and Prednisone and Imuran seem to be very bad in this regard.

After reading many posts, Laurie and I are concerned about the appearance of

other problems like diabetes. We have read posts from members who are no

longer able to work (at least like they once did) and some on

disability...Is this likely in Laurie's so-called " slight-to-moderate " AIH

diagnosis...since it was supposedly " caught early " ?

Laurie has had major health problems in the past that now seem to be

AIH-related...over the past 15 years, she has had 3 miscarriages (before

being blessed with our one daughter), her colon shut down (had to have 80%

of it removed), ovarian cysts caused complete hysterectomy/oophalectomy

(spelling?) a few years ago, Kidney surgery

In a way, it is nice to know what is causing the numerous problems that, at

the time, seemed un-related. However it also makes me wonder if the doctor

made the diagnosis as " early on " as he stated....has she really had AIH for

the past 15 years? If so, this may change the good news into very bad news.

I am scared....scared mostly of the unknown. I REALLY appreciate the help

from others in the group...It is like having a new family!

I wish you all the very best.

Greg is Sidney (Laurie's husband)

Re: [ ] Hi !

> >

> >

> > > Thanks Tony.....

> > >

> > > love jerry

> > >

> > >

> > >

[Guest guest]

Hi Greg,

I am sorry that your wife has been diagnosed with AIH. But, it is often true, that when caught early and treated, you can at least decrease your meds significantly and plan to live a long happy life, with just a little bit more appreciation for each wonderful moment. There are others who have dealt with this type of AIH who will probably be able to answer you better than I but I wanted to say "hi" and rejoice in the news that the AIH is early.

Amy

[Guest guest]

Thank you so very much. We will take your advice on getting test

results...I like the idea of having the info about how good/bad/same and

Laurie does too.

[ ] Greg

Greg...Yes, theres always so many questions when dx. Obviously Im not a

doctor but in thinking about my case, I would say Laurie has had undiagnosed

AIH for a long time. I too had miscarriages, a total hysterectomy and

polycystic ovaries removed....Ive even got 'simple' cysts scattered

throughout my kidneys. Ive had colon surgery but my colon has been left

intact. I couldnt even begin to list all my problems both minor and some

very serious that Im having now and have had over 15 years or so. I refused

at first to go on prednisone, the side effects scared me silly but as I came

close to liver failure, I was told either take them or die. I didnt want to

die. Prednisone is a miracle drug altho it has its downside while we're

taking it. Laurie is on a high dose of pred & twice a day...there will be I

feel quite a lot of weight gain and in places that us women have never

realised we had muscles! scarey, yes, but it will all come off when pred is

stopped, and she must be weaned slowly off it. She needs comfort & support,

you both do, but like I said before it wont be forever....Im as slim as .

There are a lot of side effects, like diabetes, but it doesnt mean Laurie

will get them. Im not diabetic and Ive been on large doses of pred....the

important thing to remember is to get Laurie well, even if it takes a little

time, so she can have her 'life' back again and start having a normal life

again. She must have suffered from fatigue for years but now the good news

is that it can be treated now shes dx.

There's one bit of advice I will give you and that is almost ensure you

receive a copy of LFT results. I did this at the beginning because initially

I would come home and start asking " what did the doctor mean when he said

things were looking quite good/bad/same? I spent hours torturing myself over

his words. After a couple of weeks, I got all my results of everything that

I had done, so I could see for myself how well or bad I was doing. It

empowered me in a situation which was rapidly getting out of my control. I

even made a graph. Remember all this is my experience only.

Love Jan

Sorry this is so long

[Guest guest]

We really dont have concrete answers for any of your questions. I can only talk about my experience. I never gained the "moon-face" . The early high doses gave me so much energy. I was on medical leave from work - and back home in Atlanta. (I teach in Montana) I went to the gym - sometimes twice. I think that helped alot. If she has binge eating, identify those foods that can be binge foods without causing much weight gain. And, watch the sugar levels. Dont move into diabetes like I did. Does Lauire have diabetes on either side of her family?

When I got sick with AIH before I was finally diagnosed. I went from 225lbs down to 165 lbs. They maybe why I didnt balloon up. I just got back to my weight.

My doctor has told me that he has not seen anyone respond to prednisone as well as I have. My first week I was at 40mg - two weeks later - 30mg - two weeks later - 20 - then 10 - then 7.5 - and then 5. I was at 5mg until the diabetes and they raised my prednisone up to 7.5 - where I am at now.

Expect irritability - and maybe even snapping at you. Know it is not her - it is the drug. Sounds like she has already gone through her share of health problems. Hopefully this can turn things around. You have to keep up the hope for her when she is down. DOnt be afraid to ask questions. Doctors run you in and out like a convenience store. We are here to help and support one another.

Where is Sidney?? We have a SIdney, Montana!!!

[Guest guest]

Greg,

First, I want to commend you for obviously being such a loving, concerned husband. Laurie is very lucky (as am I) to have such a great guy! I am also very new to AIH. I had a liver biopsy on Dec 27th and got the results (and the shock of my life) on Jan 6th. You ask a lot of the same questions I have either asked or at least thought about. Understand that since I am so new to this, many of my answers will be based on what I've been told or read rather than actually based on personal experience. Understand also that I have other health issues, as do many of the members of this group. In my case, sometimes I'm not sure if things going on are from AIH or some of my other problems (systemic lupus, pancreatitis, diabetes). For me, the liver biopsy came after several months of having my liver enzymes basically 'all over the place' (my rheumy's words). The first time that my liver enzymes were elevated was March 2002. Well, let me take that back. My liver enzymes were elevated a few times back in 2000 when I had pancreatitis but when the pancreatitis problems got better, my liver enzymes were normal. Anyway, in March 2002, I was feeling very healthy. Both my pcp and my GI said not to worry about the liver enzymes as it was no big deal. In mid july I ended up in the hospital with pancreatitis again after about 18 months of having no problems. From that point on, my liver enzymes have been anywhere from normal (once or twice) to almost 800 and just about every number in between! My doctors kept looking toward the pancreas/bile duct for the cause of the elevated liver enzymes. They began talking about doing a liver biopsy in August but my GI was so sure that there were adhesions blocking my bile duct causing the pancreatitis and elevated liver enzymes. I had surgery Dec 9th to repair a large incisional hernia (where my left ovary was removed in Feb 01) and to look for adhesions. There were no adhesions anywhere around my pancreas or bile duct. My liver enzymes, GGT, and alk phos were elevated the day of the surgery. Two days after the surgery, the resident working with my GI told me that the GI was going to do an ERCP to remove the stent that had been put in my bile duct in Aug and a liver biopsy in a couple of weeks. As I said earlier, the biopsy was done on Dec 27th. I honestly expected it to show absolutely nothing wrong with my liver! It ended up showing stage 3 fibrosis.

I started taking 20 mg of prednisone daily on Jan 8th. After just 2 1/2 weeks on prednisone, my liver enzymes were near normal. They were checked again last week and both the AST and ALT were normal. I have already begun tapering down the prednisone. Yesterday it was reduced to 17.5 mg daily and we will continue to reduce it by 2.5 mg daily every two weeks until we get it down to 10 mg a day in April (provided my liver enzymes stay normal or near normal). For me, within a week of going on prednisone I felt better than I had felt in months. However, a couple of weeks later I started back having some days that I just didn't feel well. More than anything I've just been exhausted. It seems that I have good days and bad days. Last week was rather rough. I only made it to work one day last week. However, yesterday and today have been pretty good. Additionally, I have felt just kind of 'out of sorts'. It's kind of like my brain doesn't want to work right. Hard to explain, but I think it may be from the prednisone. Of course, my hubby might tell you my brain never works right!

I certainly understand Laurie's concern over the weight gain. When the GI doc told me that the treatment for AIH is prednisone and imuran, my first thought was "i'm not taking prednisone. I don't care if I die, I won't take prednisone and gain back the weight I've lost!" That thought lasted all of 5 seconds and the tiny logical part of my brain kicked in. I realized that I most certainly would take prednisone if it meant that I'll be alive longer! I have many people who both love and need me and to do anything less would be utterly selfish. However, realizing that I may have to be on prednisone for the rest of my life was very upsetting for me. At this point, I have definitely been one of the lucky ones as far as prednisone goes. I was started at a lower dose than most. I'm really not sure why they didn't start me at a higher dose since my biopsy revealed more damage than others who have been put on both a higher dose of prednisone and on imuran. However, since the liver enzymes responded so well to only 20 mg of prednisone, it must have been enough for me. I have not gained any weight on prednisone at this point. In fact, I've lost two pounds since starting it. However, part of that may be that instead of increasing my appetite, the prednisone has killed my appetite for the most part. Also, I was already on 20 mg of lasix a day for problems with fluid retention. I'm sure the lasix has prevented a lot of the fluid retention that prednisone can cause. As for the diabetes, that actually began back in October and is most likely a result of the pancreatitis or simply because I inherited it since my mom is a diabetic. The prednisone has made it more difficult to keep my blood sugar stable but it didn't actually cause diabetes in my case. The prednisone also raised my blood pressure enough that I had to go back on a low dose of BP medicine. I'm taking 25 mg daily of atenolol (a beta blocker). However, I had been on pretty high doses of two different BP meds for several years prior to losing weight. The prednisone has caused a metallic taste in the back of my throat and also nausea - neither of these are all the time, but they are bothersome.

I assume that as the inflammation in my liver gets better, I will begin having more and more good days. From what I have read, it takes about 3 to 6 months after the liver enzymes are normal or near normal for the inflammation in the liver to get better. somebody correct me on this if I'm wrong!

As for working, I had already put in paperwork for a disability retirement before I found out about the AIH. However, from July to December, I was in the hospital over 15 times with pancreatitis. I think that if I only had to deal with AIH, I might be able to continue working full time, but I don't know that for sure. It is my guess that it can vary greatly from one person to the next, as with most chronic illnesses.

As for being 'caught early', according to my rheumy in my case the AIH probably didn't begin around the time my liver enzymes were first elevated in March 2002. My guess would be that regardless of how long Laurie has had the AIH, the fact that the biopsy revealed 'slight to moderate' AIH would mean that her chances of being able to prevent it from progressing would be very good.

Were Laurie's miscarriages in the first trimester of pregnancy? Has she ever been tested for antiphospholipid antibody syndrome? If she has either the lupus anticoagulant or the anticardiolipin antibodies, they cause an increased chance of miscarriage as well as blood clots, strokes, and heart disease. However, once detected, putting a patient on coumadin lowers the risk drastically. By the way, you don't have to have lupus to have either of these antibodies in your blood. However, 50% of people with lupus do have one or both of them.

I think one of the worst things about AIH (or any other chronic illness for that matter) is just not knowing what the future holds. It is scary for both the person with AIH and their family. I do honestly believe that I will be able to live a fairly normal life in spite of the AIH. I think that I will have good days and bad days. The people who care about me may have to understand that I might have to cancel plans at the last minute because I am having a bad day. I am fortunate to have a very loving, supportive husband, daughters, and other family and friends.

I recently ordered a book about coping with prednisone. It was both scary and reassuring at the same time. I wish I'd had when I first began taking the prednisone so I would have been a little better prepared. The name of the book is "Coping with Prednisone - It may work miracles, but how do you handle the side effects?"

Hang in there and know that both you and Laurie are in my prayers.

W

[Guest guest]

Greg,

I think Jan's advice is good. How long has Laurie been on the prednisone? I'm sure you said but I forgot. Because my biopsy revealed more damage than some of the others in the group, (stage 3 fibrosis - bridging portal-portal) I was first concerned that my doctor started me on a lower dose of prednisone than most and didn't put me on imuran at all. However, I guess she knew what she was doing because 2 1/2 weeks after beginning only 20 mg prednisone daily my liver enzymes were near normal. They were checked a week ago and were normal. I'm now tapering the prednisone down. I don't think they will put me on Imuran at all because I have a history of pancreatitis and Imuran can cause pancreatitis. My rheumy has also said she doesn't want me on any more prednisone than is absolutely necessary as prednisone also has a risk of causing pancreatitis. However, my GI says the risk of pancreatitis from prednisone is VERY slight, even in someone with a history of pancreatitis.

I can't imagine how being on 40 mg of prednisone a day would make me feel as 20 mg a day was bad enough! However, for me, I had a period of feeling great for a couple of weeks after being on the prednisone for just a few days.

How high were Laurie's liver enzymes at the time they diagnosed her with AIH? Maybe part of the reason they started me on a lower dose was because my liver enzymes didn't just go up and stay up. Mine ranged from normal (a time or two in the last several months) to almost 800 on December 5th. I began prednisone on Jan 8th. On Jan 11th, my AST was 337 (normal is 10-30) and my ALT (normal is 10-36) was 177. On Jan 25th, (2 1/2 weeks after beginning prednisone) my AST was 22 and ALT was 41.

Both my GI and my rheumy were absolutely thrilled that my liver enzymes came down so quickly. Because of my history of pancreatitis, my labs are checked pretty often since I keep having attacks of severe right upper quadrant abdominal pain. They have to do blood work when the episodes are severe and last longer than a couple hours, just to make sure it is not an attack of acute pancreatitis severe enough to warrant keeping me in the hospital on IV fluids with nothing to eat or drink. My liver enzymes were checked again on Jan 29th, AST was 43, ALT was 63. On Feb 6th, AST was 30, ALT was 56. On Feb 19th, they didn't tell me the numbers, but said both the AST and ALT were normal.

I may not be a typical case and I may also be in a state of false security. Maybe my liver is still being damaged even more despite the AST and ALT looking so good. I guess time will tell.

If the prednisone is making her nauseated, you might ask the doctors to prescribe phenergan. Also, I found some lollipops designed for pregnant women that are a great help with the nausea. They are called preggie pops. They come in different flavors but I like the ginger best. They end up costing about 45 cents (with shipping) each if you order the largest quantitiy. The web site is www.preggiepop.com. They only take about 3-4 days to arrive after you order them. Sometimes they work better than phenergan. However, sometimes absolutely nothing helps with the nausea.

I was already on lasix 20 mg a day because I've had problems with fluid retention, which, by the way, the doctors totally blamed on obesity. Guess what, losing 100 lbs did VERY little to reduce my problems with fluid retention. Even before prednisone, without lasix my hands would swell to the point that my rings would get stuck. With the lasix, my rings are loose enough that they will fly off my fingers when my hands get cold if I am not careful. Anyway, I think the lasix is part of the reason I've not had major problems with fluid retention from the prednisone. Of course, I was only half the dose that Laurie is taking, so I'm sure that made a big difference, too. I don't know if adding lasix to the mix to help with some of the fluid retention is a good idea, but maybe you could just ask the doctor.

Also, I didn't even think about checking my blood pressure until I had been on prednisone for about 3 weeks. I should have been checking it from the beginning since I had pretty severe hypertension prior to losing 100 lbs. Prior to prednisone, my BP was often running a little low - normal for me was around 100/60. The first time I checked my BP after going on prednisone it was about 140/89. After just a few days of monitoring my BP and seeing that it was only going higher (very slowly but a touch higher each day), my pcp put me back on a low dose of BP med (atenolol 25 mg). Adding the BP med brought my BP back to the normal range. I checked it just now and it was 114/77. I may be extra paranoid about BP since I have a family history of strokes, heart attacks, blood clots, heart disease and I have a clotting disorder.

I am certainly not a doctor and am very new to AIH. I know different doctors often do things differently, but I certainly think it is within your rights to have Laurie's doctors explain things, such as

why do they want her on 40 mg of prednisone daily?

how long do they intend to keep her on that dose?

when do they plan on checking her liver enzymes again?

I hope I don't come across as a know it all, since I certainly do not know nearly as much as I feel I should about AIH and the liver. I just wanted to share my personal experience thus far.

W