The Case of the Unstoppable Itch

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Liver-transplantation expert Roger Jenkins, of Lahey Hospital & Medical Center. / Photo by Ken Richardson

Leslie was visiting her daughter and son-in-law in March 2017 when it started: an intense itching sensation all over her body that couldn’t be quelled. A retired nurse practitioner, she began running through potential causes in her head. Perhaps she was allergic to her daughter’s dog, or maybe the buffalo-skin blanket she’d been curling up with was irritating her skin. She even considered the possibility of lice.

By the time her other daughter’s wedding rolled around the next month, Leslie was scratching herself so violently that she had cuts and bruises all over her skin. To make sure no one noticed the damage to her arms and legs, she wore long, dark-green silk pants and a chiffon poncho to the ceremony. But just because no one could see it didn’t mean it wasn’t there. “It was driving me crazy,” Leslie says.

This wasn’t the first time Leslie had dealt with a challenging medical condition. In 2010, after suffering from abdominal pain on a family cruise to the Panama Canal, she had to have her gallbladder removed laparoscopically. But the ordeal didn’t end there: As a complication of the procedure, she developed a bile leak and had to undergo two more surgeries to have it fixed. She’d been relatively pain-free since then—until the itching began.

At her wit’s end after the wedding, Leslie spent more than a year Ping-Ponging from medical expert to medical expert, all in search of a diagnosis that would help explain her excruciating condition. Her primary-care physician did bloodwork and noted high levels of alkaline phosphatase, which can indicate a liver problem, but didn’t think much of it. At a dermatologist’s office, she received oral steroid medications and creams to relieve the itch. A hematologist ruled out cancer. When a gastroenterologist’s office in Portland, Maine, reviewed her records and suggested she might need a liver transplant due to a chronic disease that damages the bile ducts, Leslie felt like breaking down in tears. Looking at her husband, she said, “I love you and I want to live a long life with you. But I’m not getting a liver transplant.”

By the time she walked into Roger Jenkins’s office at Lahey Hospital & Medical Center in June 2018, Leslie was desperate. But after poring over her records, Jenkins, a liver-transplantation expert, offered a ray of hope: He did not think she needed a new organ.

The doctors who fixed the complications from Leslie’s gallbladder surgery, Jenkins explained, had made a mistake and injured her right hepatic bile duct, which drains bile from the liver. In most patients, the right lobe of the liver would have atrophied, but Leslie’s didn’t—hence why no one had noticed the problem before. Jenkins, though, had recently treated a 21-year-old patient with a similar issue, and knew that Leslie’s itching would likely get better if they removed the right lobe of her liver. So that’s just what he did.

After a lengthy recovery period to allow her liver to regenerate, Leslie is now itch-free and living life to the fullest. In just four months, in fact, she was walking up a hill to reach a castle overlooking the Bavarian countryside. “I knew I was better then,” Leslie says. “I knew I could conquer the world.”

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Source URL: https://www.bostonmagazine.com/health/2020/01/07/roger-jenkins/