Learning the Lingo
When I mark children's writing, I often see attempts at using ambitious vocabulary, which sadly do not quite suit the context. The missed bus is devastating or the petrifying loss of a water bottle. This happens because they know they are synonyms for everyday words but they are not sure of the exact meaning or implied intensity. I realise I was like this with many medical terms.
If you had asked me what chronic means, I would have said really bad. So being told I had a chronic liver condition made me panic. But no, chronic means that it is long lasting, or even life-long with this condition. It doesn't have to be life-threatening.
Similarly, if I had had to describe cirrhosis I would probably have conjured up a picture of something like a large gherkin in the shape of a triangle drawn by a four year old and pickled in alcohol. The shape is fairly accurate, as is the lumpy surface but there is no pickling in sight, because cirrhosis is not necessarily caused by an excess of alcohol. So here is a quick layman's guide to some of the terms used.
The liver: One of the body's largest organs with an important role in the digestion process and general care of your whole body. It stores vitamins and minerals, it helps fight infections, it produces chemicals to help your body break down food into useful stuff and it deals with the bad stuff your body doesn't like. So if your liver isn't working properly, you have to really watch what you eat and drink, because your sick old liver can't get rid of toxins like it used to.
Hepatitis: Inflammation of the liver, usually caused by a virus or infection. Most are not chronic and people usually recover from them over the period of time. For a full alphabetical guide see here: British Liver Trust - Hepatitis and other liver conditions.
Autoimmune Hepatitis: The black sheep of the family. With this one there's no virus, no travel to exotic places, no drug misadventures and no binge drinking. Instead it is caused by your own miserable anti-bodies attacking your poor liver, so it's a bit like punching yourself in the face with knuckle dusters on. No one really knows what causes it, but autoimmune diseases (which include things like type 1 diabetes, Crohn's, asthma and eczema) tend to run in families, and there is some evidence that there is a correlation between lots of stress and AIH.
Fibrosis: This word makes me think of a liver covered in carpet fluff, but the reality is much more gruesome. I saw it in week 1 of the FutureLearn liver disease course and I am still reeling. A healthy liver can repair itself, quite amazingly. But a sick liver just digs itself in deeper when it tries to sort out the damage. When inflamed liver cells die, fibrous scar tissue grows. Like all scar tissue, it is thicker and harder and doesn't really do what healthy tissue does, like scabs on knees which don't stretch and hurt when you kneel on them. It gets in between the healthy tissue in a string bag type of structure, so the healthy bits can no longer work together. Like girls coming along with skipping ropes in the middle of your football game, it stops the team work, you can't pass the ball. And unless something is done to halt the damage, the little pockets of healthy liver eventually give up. It's been ruined like a liver sandcastle sabotaged by a sea of fibrous tissue.
Cirrhosis: When fibrosis gets really bad. People can actually live for years with cirrhosis as long as they are very careful, but you might at some point get put on a liver transplant list if the doctors think your liver might pack up completely. You cannot live without a liver.
Bilirubin: One of the many chemicals of the liver function and what makes a liver sick person's wee go dark brown and skin and eyes turn yellow (jaundice).
Things known by a series of 3 letters: There are lots of these in liver medicine - ALTs, AFTs, LTFs' GGT, SMA (not the baby milk), POT (no, not that either), FER. An LFT (Liver function test) will produce lots of numbers against these acronyms. They all relate to chemicals and enzymes produced by or processed in the liver. For most below 50 is good, above 500 is a worry and over 1,000 is alarming. What to know more? click here: https://www.britishlivertrust.org.uk/liver-information/tests-and-screening/liver-function-tests/
This glossary could go on forever, as with each new jewel of knowledge comes more jargon but I think this is enough for one day. Don't you?
If you had asked me what chronic means, I would have said really bad. So being told I had a chronic liver condition made me panic. But no, chronic means that it is long lasting, or even life-long with this condition. It doesn't have to be life-threatening.
Similarly, if I had had to describe cirrhosis I would probably have conjured up a picture of something like a large gherkin in the shape of a triangle drawn by a four year old and pickled in alcohol. The shape is fairly accurate, as is the lumpy surface but there is no pickling in sight, because cirrhosis is not necessarily caused by an excess of alcohol. So here is a quick layman's guide to some of the terms used.
The liver: One of the body's largest organs with an important role in the digestion process and general care of your whole body. It stores vitamins and minerals, it helps fight infections, it produces chemicals to help your body break down food into useful stuff and it deals with the bad stuff your body doesn't like. So if your liver isn't working properly, you have to really watch what you eat and drink, because your sick old liver can't get rid of toxins like it used to.
Hepatitis: Inflammation of the liver, usually caused by a virus or infection. Most are not chronic and people usually recover from them over the period of time. For a full alphabetical guide see here: British Liver Trust - Hepatitis and other liver conditions.
Autoimmune Hepatitis: The black sheep of the family. With this one there's no virus, no travel to exotic places, no drug misadventures and no binge drinking. Instead it is caused by your own miserable anti-bodies attacking your poor liver, so it's a bit like punching yourself in the face with knuckle dusters on. No one really knows what causes it, but autoimmune diseases (which include things like type 1 diabetes, Crohn's, asthma and eczema) tend to run in families, and there is some evidence that there is a correlation between lots of stress and AIH.
Fibrosis: This word makes me think of a liver covered in carpet fluff, but the reality is much more gruesome. I saw it in week 1 of the FutureLearn liver disease course and I am still reeling. A healthy liver can repair itself, quite amazingly. But a sick liver just digs itself in deeper when it tries to sort out the damage. When inflamed liver cells die, fibrous scar tissue grows. Like all scar tissue, it is thicker and harder and doesn't really do what healthy tissue does, like scabs on knees which don't stretch and hurt when you kneel on them. It gets in between the healthy tissue in a string bag type of structure, so the healthy bits can no longer work together. Like girls coming along with skipping ropes in the middle of your football game, it stops the team work, you can't pass the ball. And unless something is done to halt the damage, the little pockets of healthy liver eventually give up. It's been ruined like a liver sandcastle sabotaged by a sea of fibrous tissue.
Cirrhosis: When fibrosis gets really bad. People can actually live for years with cirrhosis as long as they are very careful, but you might at some point get put on a liver transplant list if the doctors think your liver might pack up completely. You cannot live without a liver.
Bilirubin: One of the many chemicals of the liver function and what makes a liver sick person's wee go dark brown and skin and eyes turn yellow (jaundice).
Things known by a series of 3 letters: There are lots of these in liver medicine - ALTs, AFTs, LTFs' GGT, SMA (not the baby milk), POT (no, not that either), FER. An LFT (Liver function test) will produce lots of numbers against these acronyms. They all relate to chemicals and enzymes produced by or processed in the liver. For most below 50 is good, above 500 is a worry and over 1,000 is alarming. What to know more? click here: https://www.britishlivertrust.org.uk/liver-information/tests-and-screening/liver-function-tests/
This glossary could go on forever, as with each new jewel of knowledge comes more jargon but I think this is enough for one day. Don't you?
I'm really enjoying your writing.
ReplyDeleteI'm framing AIH for myself as "No one really knows what causes it...yet".
Thank you Kathryn. Please feel free to respond with any comments or add your own experiences.
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