Lymphocytic infiltration in the sinusoids (CAM5.2 stain × 260); E: High power, lymphocytes destroying hepatocytes (CAM5.2 stain × 520); F: Lymphocyte “eating” hepatocytes in a liver parenchyma (troxis necrosis), arrow showing immunological synapses (Electron microscopy × 15000). The patient’s liver function tests peaked 4 d after admission with serum AST level of 1613 U/L, ALT level of 1227 U/L, serum alkaline phosphatase of 268 U/L, serum TB of 10.5 mg/dL, and INR staying at 1.3 I/U.
Her recovery is further slowed by lack of consistent sleep. In addition, she is experiencing huge hormonal upheaval: estrogen and progesterone levels have plummeted, and the lactating hormone levels are rising. It is totally normal for sleep-deprived new mothers to be exhausted, unable to concentrate, and even to suffer some mild memory loss. In addition, the new mother has difficulty adjusting to losing control of her environment and being at her baby's beck and call.
Oops – no harm done hopefully. I have documented everything I have eaten and the time I have had it in a notebook I keep in my kitchen. This is important to do for many reasons -1: So you can total your protein intake and 2: If you have a reaction to a food you can easily pinpoint what may have caused it and 3: it is a good thing to bring to your nutrition appointment to see if there is anything they would like to change.
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