27-летняя женщина из Новой Зеландии борется с циррозом печени, ставшим следствием алкоголизма

Online exclusive For years, Shannen Findlay thought she was getting healthier. She was losing weight, drinking less and eating better. What she didn’t know was that her liver was already failing. Looking back, I had been sick for a long time. Too sick to sleep and too sick to work. Too sick to feel good, and too young to know that I was truly, terribly sick. Back then, I’d thought of liver disease as a death sentence in old age; the price a person pays for a life that has already been lived. I’m 27 years old, living with cirrhosis of the liver, and I know better now. My best friends and I were spending the final days of a three-week trip in Italy when I felt a horrible tightness in my chest. A pulsating, rhythmic squeeze and pinch right where my heart was. I put it down to the unforgiving Tuscan sun. The cobblestone pathways that made up all the towns and cities we’d traversed were not lenient on feet and, by extension, surely my heart, too. But it wasn’t just my chest or my feet that ached. I woke each morning with puffy cheeks and heavy, drooping eyelids. My thighs and legs ballooned beneath white linen skirts and brightly coloured sundresses. Ten months earlier, I’d left my job in the pursuit of my health to go and live with my cousin. I’d quit drinking (bar a few late-night wines). I’d stopped eating after 6pm (for the most part). I’d started sleeping more and waking up earlier. I’d lost 40kg. Perhaps I wasn’t ready to walk in the Dolomites just yet, but I was taking steps in their direction. By the time I’d returned to Sydney, my breath was laboured, difficult. After one particularly worrying hospital stay, I was sent to my GP’s office where I underwent three days of blood tests, ultrasounds and scans. My doctor delivered terrible news to me in the too-tight patient chair of her office. The conversation was blurry then and even harder to remember now. What I do remember, though, is nodding solemnly, again and again. I do remember holding my breath to stop big, sloppy tears. I do remember stumbling out of my doctor’s office, face pinched and head held high. I’d known, even my haze, that looking down meant crying. I wasn’t nearly ready to cry yet. There were still children climbing on jungle gyms across the road from where I stood. Still elderly milling about with hands behind their backs, walking slow and smiling lazily. I remember in the fading of that very cold, very bad day, pulling out my phone to call my mother and letting a strangled sob fall from my mouth as I told her I had cirrhosis of the liver. I was 26. For a long time afterwards, the diagnosis felt impossible to reconcile. The very word felt ancient: “cirrhosis”. I’d packed it into the same part of my brain where useless facts about tuberculosis and scurvy lived. These words did not belong to me. They meant nothing to me. I am too young to have a rotting, failing liver. And still, I do. Liver disease impacting younger people Doctors are reporting an increase of severe, alcohol-related liver disease in younger patients – particularly women. Researchers note that the faces of the people appearing in liver clinics today look different, younger, from the people they treated 15 years ago. What once might have been considered a death-sentence disease for older men is now being diagnosed more in younger women. Before my diagnosis, had anyone described a typical cirrhosis patient to me, I would not have recognised myself. Perhaps I should have. At my heaviest, I weighed around 230kg. I was a binge drinker, hiding excuses for glasses of wine and decorated cocktails in work deadlines, my friendships, each celebration and every failure, and in all my anxieties and relentless, suffocating ambitions. There is no mystery to why my liver rotted inside my body, overworking itself into eventual failure. The confusion is how I didn’t realise I was sick – extremely sick – much sooner. My diagnosis feels especially significant knowing that liver disease is becoming increasingly common in New Zealand and Australia. Conditions linked to alcohol use and fatty liver disease affect people every year, often driven by factors such as obesity, diabetes and high blood pressure. This condition can go undetected and unaddressed for years, with some people unaware they have liver disease until the damage is already significant. That was me. At 26, I was much younger than the person most people picture when they think of cirrhosis, but the disease impacts other young adults globally. A 2019 Canadian study found that the highest rate of new cirrhosis diagnoses was among people aged 18 to 35, highlighting the growing impact of fatty liver disease. Young women are emerging as a group of growing concern, too. Researchers have found that women can develop cirrhosis after fewer years of drinking and at lower levels of alcohol consumption than men, meaning serious liver disease can appear earlier and with less warning. For Māori, the burden is often even greater National health data consistently shows Māori experience disproportionately high rates of alcohol-related harm. Research commissioned by Health New Zealand found alcohol-attributable mortality rates were roughly twice as high for Māori than non-Māori. As a wāhine Māori, I wasn’t blind to the risk factors. I knew alcohol was taking a toll on our communities, and I knew modern diets looked very different from the food traditions many of our whānau were raised on. It wasn’t until my own diagnosis that those risks became deeply personal. The months after diagnosis were among the hardest of my life. I moved from Sydney back to New Zealand to be with my family. For the first time since I was 16, my bedroom was in my parents’ home. I was no longer independent. My family’s love was suffocating and painful because my failure to protect my precious health meant it was now their burden to carry. My mother monitored me constantly, breaking down pills to swallow between meals and tiny gulps of water. My aunty sat with me for seven hours in hospital so she could question my specialist about the things I didn’t know I needed to ask. My sisters took turns fluffing my pillows and changing my bedsheets. They washed me when I was unable to stand for long periods of time, and carried my fatty, swollen arms around their necks to keep me from falling. My little sister, who I could still remember in a tiny incubator, mouth and nose tied in tubes just hours after being born, slept at my bedside and massaged my legs when I’d wake in the middle of the night, screaming from pain. Things were very scary before it all calmed down. On one occasion, thick fluid leaked through the pores of my swollen legs. I was weeping fluid, my doctor explained; it had nowhere else to go. I’d written about weight-loss surgery four years earlier and told readers it was an inevitability I was preparing for. I also admitted – secretly, to myself – that I wouldn’t go through with it. I wasn’t desperate enough. I hadn’t known how sick I was. During the last year, I’ve spent many hours staring blankly at walls, thinking about what is to come of my life. I’d believed recovery would take a year. I hadn’t understood that recovery mean making a constant series of better decisions every day. I have lost more than 100kg. I’ve gone through periods where I’ve taken my medication dutifully, and not at all. I’ve accepted that I am an alcoholic and that years of binge drinking, compounded by obesity and fatty liver disease, led to an irreversible form of liver damage that I will have to live with until I die, perhaps from the disease itself. I’ve also accepted that surviving this is complicated, neither tragedy nor triumph. Cirrhosis can kill you. The road to death by liver failure is painful and scary, it’s not an easy out. But I can survive and enjoy my life if I keep trying. I can be happy. I can still have a future and I can still plan for it. There is still lots of hope to be had, and I have it. The greatest misconception I had about my disease was that it belonged to the old. The second was that after diagnosis, life ends quickly. I was wrong about both. And increasingly, as younger women find themselves confronting health realities they never imagined possible, I suspect I’m not alone. What is ALD, MASLD and Cirrhosis? Fatty liver disease occurs when excess fat builds up in the liver, either because of heavy alcohol use (alcohol-associated liver disease, or ALD), or because of metabolic factors like obesity, type 2 diabetes, high cholesterol and high blood pressure. This is now known as metabolic dysfunction-associated steatotic liver disease (MASLD). In its early stages, fatty liver disease causes few symptoms, if any. People are typically diagnosed through routine blood tests or scans. While simple fat accumulation can be reversible and are generally curable, the condition can progress silently over many years. For some, and in my case, the excess fat can trigger inflammation, causing liver cells to become damaged. As the liver tries to repair itself, scar tissue forms. With time, this scarring can become widespread and severe, leading to cirrhosis – the advanced stage of liver disease. Cirrhosis permanently alters the makeup of the liver, lowering its ability to execute critical functions like filtering toxins, producing proteins and aiding digestion. Once your liver reaches the cirrhosis stage, there is no chance of repairing or growing new cells to replace the damaged ones. Cirrhosis cannot be cured or fixed, but it can be managed so there is no further damage to the liver. This is achieved with medication, complete abstinence from alcohol, a reduced intake of salt, eating well, losing weight and avoiding infections, among other lifestyle changes. A liver transplant is possible when the damage becomes threatening, but it may not be necessary until old age.