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I am currently in Indiana visiting Dad again and am happy to report that he's feeling better. Well, relatively speaking anyway. Dad is still not up for leaving the room due to his many physical symptoms despite my annoying pleadings to get him out for a short bit, but since he's been comfortable enough during this visit to at least sit with me upright in the living room for several hours the last few days, I will take what I can get.

http://www.expedia.com/Indianapolis-Hotels-Candlewood-Suites-Indianapolis-Downtown-Medical-District.h1627340.Hotel-Information

We visited Dad's physician (his GI or gastroenterologist) on Friday practically as soon as I stepped off the plane from New Jersey. His GI was kind enough to make an exception to see us on a Friday: he usually only sees pre-transplant patients on Wednesdays and post-transplant patients on Fridays. Thankfully, there was some flexibility somewhere in this crazy mess (or mishegoss) called waiting for a liver transplant.

Hey, baby, what's your type? A little history of anti-HCV therapy

In the fight against Hepatitis C, there has been some very exciting new developments. I receive daily news updates about all of the activities going on in pharma/biotech in the field, including several [expensive] acquisitions by big pharma just to have access to the new Hepatitis C drugs in development. There are several new classes of therapies that either just were approved or should in the next few years that are considered direct acting antivirals. As usual, it is incredible frustrating that these new drugs *in theory* would benefit my father, however the timing could not be worse as he needed those therapies a few years ago and now it's too late--well, sort of.

Viral life cycle and direct acting antiviral  targets.
http://hepatitiscnewdrugs.blogspot.com/2012/01/direct-acting-antivirals-for-treatment.html



Hepatitis C has been identified for a couple of decades now with plenty of research done towards a cure, however the drugs that came-out in the 1990s were not very effective and came with a lot of side effects as I briefly mention in one of my first posts.

Pause

I certainly do a lot of kvetching. Well, I did title my blog as a fair warning to readers. But, yes, a lot of complaining still. I realize that.

Tonight I left my apartment and noticed a strong smoke smell as soon as I shut my door. My first instinct was that a unit in my building was on fire--that smell was so strong in the hallway with 3 doors and a flight of stairs between me and the street that I assumed it had to be my building. I practically ran outside with my heart racing. I started thinking about where important documents and what treasured items I would take out of the house if I had to run back in to take anything out. As soon as I went through the final door to the street, it was obvious there was a terrible fire brewing--and it was not my building.

A fire is currently still blazing around the corner from my house. It started over three hours ago and there were flames coming out of the building when I first saw it about an hour after Hoboken Police Department was already on the scene. It was such a gut-wrenching site--I stared in shock for a solid 5 minutes. There were 5 fire trucks on the scene and another fire truck was driving down the street from Elizabeth (a town that's really not that close in fire terms) once I started walking away. There were dozens of shocked people staring like me at the horrific site. The smoke burned my nostrils and eyes and I was a block away.

http://hoboken.patch.com/articles/building-evacuated-after-three-alarm-fire-on-washington-street#photo-9149561

I'm Batman!

No matter where I am or what I am doing, I feel like I have an alter ego these days. My (internal dialog) mantra last week was "I'm Batman!" anytime I couldn't rationalize a particular situation.

http://trailers.apple.com/trailers/wb/batman_begins/trailer/


People at work have no idea what's going on with me and my family. I prefer that it stays that way, however it is so odd to have so much going on in my head as well as the daily phone calls, emails, and occasional trips where I'm missing work. I know plenty of colleagues wonder what I'm up to and make (incorrect) assumptions. Part of me wants to tell everyone the whole story--have a little sympathy before more judgements are made about my occasional run down the hall to get into a conference room for a personal call or a missed couple days of work without talking about where I went or why I'm so exhausted and low-energy these days.

Medical Education: Hepatic Encephalopathy

The liver is an amazing organ when it is working properly. It is the largest and heaviest internal organ. According to wikipedia--a fantastic source of medical information, I know, especially to all of the medical and lab professionals out there--it is thought to be responsible for ~500 separate functions in the body. It is important in many types of protein synthesis, all sorts of metabolic cycles (e.g. carbohydrates and lipids), produces blood coagulation factors, stores such substances like vitamin D and iron, and breaks down toxic substances (many of you know that about drinking alcohol, for example).

Bottom line: when you have a failing liver, you will have a lot of different problems to look forward to.

It was clear a few years ago that Dad started to have trouble breaking down toxic substances. Again, Dad never really drank, so this is not an issue about alcohol. Or drugs--he doesn't do that either. The liver plays a key role in converting ammonia to urea. Ammonia (NH3) is the product of oxidative deamidation reactions. The reaction is part of the breakdown process of amino acids (they are the building blocks of proteins, for the non-scientists). To humans, ammonia is toxic even in small amounts. In a healthy person, ammonia is converted to urea via the urea cycle and then excreted from the kidneys. When someone has end-stage liver disease, they could potentially have a build-up of ammonia levels. This is not good.

http://smmhc.adam.com/content.aspx?productId=39&pid=1&gid=000372