Diet adjustments

I've been tracking what I'm eating. The full/uncomfortable feeling has continued. Then I made a conscious effort to up my protein intake.

It's been a struggle to eat much of anything this week. Everything seems to make me feel far too full. Even a garden salad. And there are certain things I've been afraid to eat for fear of making it all worse. Namely, when liver disease patients eat more protein than their livers can handle, toxins like ammonia build up in the bloodstream and go (you guessed it) straight to the brain. Hepatic encephalopathy. It's none too good.

So I've been eating probably less protein than usual this past week. And I don't often get enough as it is. My protein sources are based on what's relatively cheap and what I feel like making. I try to vary it up-- some nuts here, some cheese, some yogurt, beans, an egg now and then, whatever...chicken or shellfish if I'm feeling fancy. But typically I'd say I don't eat more than 40 - 50 g a day, which is low. And often it's even less than that, unless I'm trying.

This afternoon, I decided to aim for a higher protein intake. Something at least in my recommended range.

One vaguely disgusting protein shake later, I actually feel significantly better. And possibly even HUNGRY. No way.

I'm keeping tabs on this protein situation from now on.

I won't put pen to paper, it's a mania

Yup. Manic again. How many more days at this dosage?

No visible weight gain, puffiness or swelling. I don't have a scale so I don't know for sure.

Yesterday I had to force myself to eat periodically. I was not the slightest bit hungry, following breakfast, for the remainder of the day.

There are so many complications and possible interactions that it's hard to make sense of what's going on. What's the prednisone, what's the liver disease, what's just normal fluctuations in energy and appetite?

Maybe I need to assume nothing I'm experiencing right now can be explained away as "normal."

Loss of appetite is a symptom of liver disease, especially near the end. Though I will guess that it isn't too far gone if I'm not experiencing nausea or vomiting. Is that why I'm not hungry?

It can't be that the prednisone isn't kicking in. Because it is, oh it is. Definitely manic and insomniac here. Last week I was taking 2- or 3- hour afternoon naps in addition to a full night's rest: fatigue seems to be the number-one symptom of liver disease.

Within a few days of starting prednisone I feel hopped up all day, stay up half the night, and subsist perfectly well on 5 hours of sleep.

With the loss of appetite has come an utter loss of food cravings. I never seem to want anything. I've always had an insatiable sweet tooth. Now candy and sugar are things I can take or leave. I have no desire to eat. And I love food.

I feel full all the time. Almost uncomfortably so. Usually this would have something to do with swelling, fluid retention, and bloating-- side effects of both prednisone and liver disease. But when I scrutinize myself in the mirror I don't see bloat, at least nothing obvious. My abdomen feels soft, not taut or stretched. I don't know what to make of that.

I'm pretty certain I can feel my spleen. It's enlarged and tender and probably has been for a long time, thanks to complications with my liver. Sometimes I think I can feel my liver at the edges of my ribcage, too.

I have the sensation that my heart is pounding. I feel as if I'm trembling from within. When I put my hand to my chest, my heart rate is steady. Normal. I think. I don't know what to make of that either.

Slightly grandiose thoughts come with the mania, a little. I feel chattier, bolder. I'd love to go on a job interview right now because I'd damn well knock someone's socks off. Maybe literally.

I'm a Maniac, Maniac

Oh wow. Wow.

Day 4 of prednisone and the mania has hit me HARD. 7:42 and I literally leapt out of bed. I do feel like I could do anything.

Oh the rush of thoughts. Oh wow.

Yet the real me is back here somewhere, detached, watching and worrying.

If I had a pogo stick I'd find it and pogo.

The funny/weird thing is that this hits me before I've even had today's dose. Interesting. Interesting.

Already kind of excited about dropping down the dosage next week, to be honest. This is...well, we'll see how today goes, but I'm not sure I like feeling so unrecognizable and so fast and so unmyself.

Though I wasn't exactly myself before this, was I, because my liver is on its last legs, last...lobe? Last something. Fatigue might seem like a more normal state for me, especially by now, but there's no reason it should be preferable...is there?

It Begins

Day 3 of prednisone starts today. I'm on 60 mg-- that's twelve 5 mg tablets-- for the rest of the week.

I think at least one prednisone side effect is beginning to kick in. A friend of mine who'd been on prednisone actually enjoyed it (for the most part) and claimed it made her feel "like she could do anything."

Based on the fact that I went from 0 to 60 on waking today, my heart pounding and an unfamiliar mania surging through me...I may be experiencing that particular side effect as I write this.

I'll admit this is better than the all-day fatigue and naptime I had been experiencing thanks to the autoimmune hepatitis/cirrhosis. AKA, my liver giving out.

But I'm scared of what effects are coming next. Weight gain? Puffy "moon face"? Appetite surges? Mood swings? Acne? Muscle wasting?

Fatigue is another potential side effect, too, and I don't want that needle to start swinging back the other way.

I've been examining my face in the mirror since Monday, on the lookout for the dreaded moonface. I suspect my face might be a trifle rounder today, but I could always be imagining things. It wouldn't be the first time.

No appetite surge yet. For my last few prednisone-free weeks I began to experience a loss of appetite, again from my poor struggling liver, and so far that has continued. I'm so afraid of the prednisone weight gain that I'm almost thankful for that.

Oh, you read that correctly. A part of me would rather experience liver failure than drug-induced weight gain. Blame society's impossible standards and ideals for female beauty. Body image issues coming out full swing.