For cirrhosis patients there has always been a doomsday clock. We all know that there are no treatments and only a transplant can save us. Transplant is on the mind of a lot of us but what do the statistics say?
According to the CDC, from 1999 to 2016 over 460,000 people died from cirrhosis. Even today we do only about 8,000 liver transplants a year. Those transplants are miracles for those who receive them but in a way they are a boutique business as most patients will die with no hope of a transplant. There is a tide of disease building in our society which could crush the liver programs. Consider how the rate of liver disease being reported at hospital admission is climbing
In an ordinary time this is certain disaster and the doomsday clock would have its way. There is, however, another side to that coin.
I want to tell you a bit about the future. In my prior life I was an electrical engineer so technology is built into my world view. I'd like to offer you a glimpse of a better time and the defeat of the doomsday clock. The future will require tenacity but knowledge is power against disease. Before I tell you the good stuff indulge me with a small theft from a favorite poet, Rudyard Kipling.
If you can dream and not make dreams your master,
If you can think and not make thought your aim,
If you can meet with triumph and disaster,
and treat those two imposters just the same.
If you can force your heart and nerve and sinew,
to do their turn long after they are gone,
and so hold on when there is nothing in you
except the will that says to them, hold on.
Yours is the liver that can endure
and what is more, survive to a cure.
Apologies to the master, but we are fortunate to live in a time of possibility. In the past several months I have been privileged to get a glimpse of the near future of liver disease and medicine, and I'd like to share some perspectives with you.
Medical information doubled in the period from 1700 to about 1850. It doubled again by about 1920. Today we are on an information rocket and it is estimated that medical information is doubling about every 73 days and is still accelerating. In the struggles of our day to day lives we can't see or comprehend any of that and clearly information does not translate easily into knowledge. We don't have ways to manage or even anticipate what that all means but if we focus just on our tiny concern of how do we keep our liver cells alive, it has real consequences.
That explosion of information is leading to fundamental understanding of the mechanisms that, left untended, will kill us. Therapies to halt progression and ultimately reverse a lot of damage are on the way. The problems are monumentally complex, but as a technological person I can see that they will yield to solutions. The horizon is not known for sure but we will likely enter a therapy realm in the next 2 to 5 years.
Your job, should you choose to accept it, is to hold on.
In the interim, diet is your friend. You truly are what you eat. Your goal is to make the liver work as little as possible, stop sending it harmful things to do, and reduce the inflammation in your body. How to do that. Here is a link to discussions about diet as one way to think about your job.
For liver patients as a group the doomsday clock is running backward. Whether your personal clock is participating has a lot to do with how you deal with every day