Dr. Vipulkumar Goyani, 35, a doctor from Surat shares his personal experience of a how a diagnosis of Hepatitis B rapidly changed to needing a liver transplant. And how he changed his lifestyle after the transplant to keep his liver healthy.
Please tell us a bit about your condition
I was diagnosed with Hepatitis B on 13th July 2015 and Hepatitis led to Acute liver failure in September 2015 and my living donor liver transplant was done on 30th September 2015.
What were the early symptoms?
Loss of appetite, bloating and heaviness in abdomen, dark coloured urine were early symptoms
Being a doctor, on finding these symptoms I directly went for blood investigations for jaundice. I believe that I possibly got transmitted with this virus during a pin-prick injury while attending to a patient. Many people are chronic carriers of the virus and are unaware of it.
Please describe your experience of managing your condition.
On being diagnosed with hepatitis B, I was shocked at first. Straight away on very same day, I consulted a Hepatologist (Liver Specialist) in my city. He advised a few investigations to diagnose whether it is an acute Hepatitis B infection or reactivation of an old hepatitis B related illness. The results showed that it was an acute one. I was assured by the Hepatologist about complete recovery from that illness but unfortunately my Hepatitis B infection did not respond to antiviral medicines and by September 2015 I had developed acute liver failure. I was shifted to Global Hospital in Mumbai, where I was admitted and on second day of admission I developed hepatic coma. While I was in coma, my family was advised that I need immediate liver transplant. I was unconscious and so my family had to make this decision on my behalf. My older brother stepped up and decided to donate part of his liver. 4 days later, I was transplanted with a part of his healthy liver.
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What is your present condition?
I’m living a healthy life today. I can do all the routine activities that a normal person can do. I have gone back to practicing medicine as a General Physician.
Do you have a family history of your condition?
No family history of Hepatitis. All my family members have been screened for Hepatitis B and none were found to be positive.
Have you had any related complications from your primary condition?
Yes, my Hepatitis B infection led to liver failure and I had developed Hepatic Encephalopathy (coma). Hepatic coma is when the brain function declines due to build-up of toxins that are not removed by the liver. I was kept on ventilator for 7 days for better management so that my life could be sustained and my vital parameters could be stabilized and doctors could buy time for my liver transplant procedures. Finally I was transplanted on 30th September 2015. 15 days after my surgery, I was discharged and sent home.
What was your course of treatment? What medications are you on currently?
Post-transplant I was started on steroids and immunosuppressant drugs right away. My steroids stopped after 2015 but my immunosuppressants will have to be taken throughout my lifetime. This is because immunosuppressant medicines help reduce chances of organ rejection by my own immune system.
Secondly I need to take Antiviral medicine for Hepatitis B to prevent any chances of reactivation of Hep B virus in my body even though I’m presently HbsAg negative.
Were there any side-effects of the medicines? If yes, how do you manage them?
These medicines have nephrotoxicity and they also cause osteoporosis. To avoid nephrotoxic effects, I drink plenty of water and I have to undergo regular blood investigations so that any damage to my kidneys can be diagnosed immediately. To avoid effects on bones, I take calcium supplements and I have to do strenuous exercise to strengthen my bones.
Did you have to travel outside your city for your medical treatment or consult?
I need to consult my Hepatologist every three months. Fortunately Liver Transplant clinics are held in Surat by Global Hospital of Mumbai once every month, so I do not need to travel outside.
What changes have you made to your lifestyle because of your condition?
I was not doing regular exercise before this illness now I do 15 minutes of running and 15-20 minutes of bicycling every day. I have also developed a habit of eating healthy foods only i.e. foods that are rich in protein and other nutrients and low on fat.
Related: 10 Tips To Make Your Liver Strong Again
How did you mentally/emotionally cope with your condition? Did you see a counselor for support?
I was mentally very strong and was confident to fight against my illness. My family was offered counseling by my doctors.
My family and my in-laws have stood strongly by me during all these hard times. Thanks to my brother, I’m alive today!
My friends used to visit me regularly so that I don’t get bored in the hospital. I shared my diagnosis with them immediately so that I could seek help and guidance if needed.
What were some of the challenges you faced and what is your advice to other patients?
- First challenge I faced during my illness was that well-wishers and visitors give various advice, especially of home remedies whose actions are not proven. To avoid offending them, I was also forced by relatives to try a few of them.
- Secondly few people also tried to convince me of superstitions. So in such conditions you need to have the courage to be straightforward and say no.
- Third challenge was to find the best hospital for liver care. A renowned gastroenterologist in my city suggested the hospital in Mumbai for me.
My advice to patients would be to not take jaundice lightly. Always get full testing done and check for hepatitis infection. Many doctors also sadly treat the jaundice in isolation without undertaking a full investigation.
For patients who have undergone a liver transplant, make sure you focus on clean food and water because consumption of any contamination food source can cause an infection. For transplant patients, this is particularly dangerous because the immune system gets activated to fight this infection and can in turn cause rejection of the transplanted liver too.
There are many patients who don’t go for regular follow ups and adjust the dose of immunosuppresant medicines themselves or abruptly stop such medicines without consulting Transplant Specialists and this may lead to organ rejection. So it’s my humble request to all organ transplanted patients to take their medicines regularly and as per the advice of the Specialist.
Do not stop any medicine without consulting your doctor. I have seen two such individuals who have lost their life because they stopped immunosuppresant medicines without informing their doctor.
How has your diagnosis changed your life perspectives and ambitions?
My diagnosis has changed my life totally. I was a happy-go-lucky type of person with regards to my diet and health care before this episode. Now I am very strict about my diet, health and exercises.
