Physician Living with Primary Biliary Cholangitis (PBC) [transcript] [audio]

Guest:  Dr. Jennifer Pate

Presenter: Neal Howard

Guest Bio: Dr. Jennifer Pate is Chief of Psychiatry at Baylor St. Luke’s Medical Center; specializes in caring for the mental health needs of patients with chronic illness. This is important as there are often sensitivities and stigmas associated with having a liver disease, as people often don’t realize that not all liver diseases are related to alcohol consumption, which PBC is not. In addition to treating PBC patients, Dr. Pate also has PBC herself. Dr. Pate also has a disorder called Common Variable Immune Deficiency, the body’s inability to produce antibodies to fight infection. To treat this disorder, she has received life saving infusions every three weeks for the past 30 years. Without an accurate diagnosis and treatment, she would not have survived. Having this disease inspired her to become a doctor herself, counseling others with chronic disease. Dr. Pate is 50 years old and has been practicing for 17 years.

Segment Overview: Dr. Jennifer Pate, who happens to have PBC herself, discusses how she helps patients who have liver disease manage the deep emotional impacts of it and offers advice to others who may miss the signs of the disease. (check their Facebook page – LiveHer Campaign)


Health Professional Radio – A Physician Living with PBC

Transcript

Neal Howard: Welcome to the program. I’m your host Neal Howard here on Health Professional Radio. Thank you for joining us. There’s a Facebook campaign that’s doing a lot to spread the word about a rare but very serious liver disease known as “PBC.”. Here to talk about this disease is Dr. Jennifer Pate, Chief of Psychiatry at Baylor St. Luke’s Medical Center. Welcome to the program and thank you so much for taking the time, Dr. Pate.

Dr. Jennifer Pate: Thank you Neal.

N: First, tell us a little bit about yourself and a little bit more about this liver disease called “PBC.” – what it is and why it’s important that women in particular know about it?

P: So PBC stands for “Primary Biliary Cholangitis.” It’s an autoimmune liver disease that impacts about 1 in 1000 women typically between ages of 30 and 50 and this is an autoimmune disease where in the immune system attacks and destroys the small ducts in the liver. So without treatment, this can progress to scarring, cirrhosis, death or the need for liver transplantation. Luckily, we have two very effective treatments that can often solve the progression. And then we also need to be managing the symptoms that come along with this disease notably itching and fatigue.

N: When was your first encounter with PBC?

P: My first encounter was 18 years ago and that was with my own personal encounter. I had some abnormalities on my blood test. I went to a liver doctor to get it checked out, have the liver biopsy and found out that I too have PBC. Luckily, I have responded quite well to medications and we suspect, my disease has actually improved with treatment.

N: Is a biopsy the only way that you can diagnosed PBC?

P: No. In fact, a biopsy is often not needed. It is typically diagnosed by routine lab monitoring like you may have at your annual physical with your doctor or your well woman checkup.

N: How does this impact you on a psychological level enabling you to help some of your patients who may be dealing with the same thing?

P: I actually consider an asset in my practice because when people come to me and they describe the type of fatigue that they have with PBC, it’s a fatigue that is not improved with napping. It doesn’t improve with a good night sleep. In fact, there’s very little that improved it. I am at an advantage with my patients because I can understand that concept. So I feel like my own disease process has made me a better, more confident and more compassionate physician.

N: Does this condition affect men at all?
P: It does but rarely. There’s some cousin diseases such as Primary Sclerosing Cholangitis that are a little bit more common in men as compared to PBC. Those are autoimmune liver diseases where the immune system attacks the liver.

N: Let’s talk about your involvement in this campaign, this Facebook campaign, the “LiveHer Campaign.”. How long you have been affiliated with this awareness campaign?

P: I have worked with the various entities on LiveHer about one year now, maybe a little bit more than that. I’ve gotten different video educational projects that can be found under myPBC Coach on the internet. The current LiveHer Campaign, spelled LIVEHER is a photography campaign where you can see some beautiful pictures, video tips and also learn more about some patients’ stories. The other thing that we have is livingwithpbc.com that has additional educational information as well as some additional patients’ stories. This is really important to get the word out because being such a rare disease, patients often feel very alone and overwhelmed and it’s really important that we get the word out, that there’s support available and there are effective treatments that can solve disease progression.

N: When you’re speaking with one of your patients and they are dealing with PBC, how do you handle the psychological aspect of having been misdiagnosed. I mean it’s a liver disease and many people say that they have been wrongly I guess judged or even diagnosed having maybe a drinking problem in the past or maybe even currently family and friends don’t understand that sometimes their physician is in error as well.

P: That is so very common. In fact, when I was going through this on my own, I was at the end of my medical training and when I learned that I have cirrhosis, my first comment to my liver doctor was, “I don’t drink.”, and he said, “I know. This has nothing to do with drinking.”. So it’s really important that we get the word out that people with liver disease are not just people with alcohol or substance-abuse issue. And what I like to do is do a really thorough interview and look at how the disease is impacting their quality of life whether it’s fatigue, itching, depression, anxiety, chronic pain issues and I like to be very proactive in managing the symptoms so that the people can be as functional as possible.

N: And how has it affected your personal relationships at home? You say your disease has been a little on the upswing and improving a bit with your ongoing treatment?

P: Yes. It absolutely has and I also struggle with some other serious medical issues as well. A lot of these is learning more about yourself and managing your time in the best way and so my family and friends know that inviting me out to dinner is probably not going to work although they breakfast with you anytime and a lot of times you just have to train your family and friends about what works best for you. And so luckily, I’m very functional and my top priority is doing well for my family and doing the very best I can for my patients.

N: Great. Well, we like to learn some more. Where can we learn more about PBC and also about maybe yourself and Baylor St. Luke’s Medical Center?

P: Sure. So there’s a website called livingwithpbc.com with great resources and patient stories. And then on Facebook, you can go to the bar and just type in “LiveHer.” If you are more interested in my personal story, you can Google, “Jennifer Pate in Fox News.” And you can also go to Baylor St. Luke’s Medical Center and look at the liver transplant program.

N: Thank you, Dr. Pate.

P: Thank you so much Neal. I really appreciate it.

N: You’ve been listening to Health Professional Radio. I’m your host Neal Howard. Transcripts and audio of the program are available at hpr.fm and at healthprofessionalradio.com.au.

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