A trip to Edinburgh

So after being released from Dr Gray's, and after two more blood tests where my ALTs were not really doing very much, a decision was made for me to be admitted to the Royal Infirmary of Edinburgh for a Transjugular Liver Biopsy to be carried out.

My "admittance" to RIE was a joke. I was told to be there for 10am in the morning. On arrival I was told there was no bed for me and they didn't know when there would be one - other than some time that day.

I spent the day getting sorer and sorer and tireder and tireder. The room they put me in to wait was uncomfortable and not appropriate for sleeping. I ended up in the cafe where I could at least lean over the table which was a position which relieved the pain for me. By the time they phoned me at 3.30pm to tell me the doctor wanted to start my admission, I had been in tears several times. The whole situation was ridiculous.

So the doctor says "how are you?" and I burst into tears. Couldn't hold back the frustration and distress I was in. It was awful.

Then she says "I just need to take some blood" and I say "good luck with that one". Bless her, she told me she was pretty good at getting blood so don't worry about it. I said fine, but I'm just saying, its been a bit like getting it out of a stone.....

And then three more holes later, she's managed to get less than 1ml of blood out of me. Handed over to her colleague, who spent a while looking before stabbing and also used a butterfly needle instead of the canula the first one had tried to fit.

Then miracle of miracles, a bed was ready for me. And off I went, exhausted and emotionally drained - again.

The next day, I got my breakfast, and a visit from upon high, aka the consultant, and then I hung around waiting and waiting for my biopsy.

The biopsy itself was interesting. In a transjugular biopsy they insert a long needle into your jugular vein, and feed it down into your liver and remove a piece or two of tissue for analysis. I had to have this instead of a regular liver biopsy because my blood wasn't clotting properly and there was a risk of bleeding. With the transjugular option, any bleeding will be into the vein mainly so its a bit safer. I was awake for the procedure, although sedated and it was just a bit odd. There was a moment when I wasn't sure what was going on when my shoulder hurt a bit, but apparently that was when they actually removed the tissue, as the nerves from the liver are linked to the shoulder. Weird, but not painful or anything.

I made a good recovery and was discharged the next day - although I did have to wait for hours as my bloods weren't playing again.

The results of the biopsy weren't supportive of their diagnosis of Auto Immune Hepatitis. Apparently, my liver was cholestatically inflammed, and there was no scarring or other damage. Apparently with AIH, most people have some scarring by the time they have a biopsy.

So that was quite good. Away I go home, bloods twice per week and see what happens.

At this point my ALTs were around 913 and my bilirubin was still up over 100.