The MASH Journey Can Seem Difficult and Frightening at Times: Dave’s Liver Health Journey

Dave Sosa grew up surrounded by music and sports. He remembers a childhood where his mother sang opera, his father introduced him to the classics, like Frank Sinatra, Bing Crosby and Tommy Dorsey, and sports were a family tradition. As an adult, Dave stayed active and engaged, often running the five-mile lake route near his home without a second thought. 

Then one day, near the end of 2012, that active lifestyle took an unexpected turn when Dave was diagnosed with metabolic dysfunction-associated steatohepatitis (MASH), a progressive liver disease that can lead to cirrhosis and liver failure. 

From early signs to advanced disease

Unlike many patients with MASH, Dave experienced symptoms that led to early testing. The first signs appeared in early December, shortly after Dave’s father passed away. Dave had been experiencing persistent back pain, which he attributed to lifting and caring for his elderly father. Following a series of diagnostic tests, his primary care provider (PCP) reviewed a radiology report that indicated probable signs of early-stage liver scarring. This presentation is uncommon, as MASH often progresses silently and is typically detected only after significant liver damage has occurred. 

“My PCP brought me up to speed and referred me to the hepatology department at California Pacific Medical Center (CPMC),” Dave says. “I was quite surprised initially that this was happening, as it was truly surreal.”

The hepatologist at CPMC began a full investigation. Dave had a history of mildly elevated liver function tests, which made it difficult to pinpoint the exact onset of disease. Noting his elevated iron levels, CPMC performed a liver biopsy, which ruled out iron overload as the primary cause. He also began biweekly bloodletting procedures to reduce iron levels and underwent genetic testing for hemochromatosis, for which he discovered he has a carrier gene. 

At first, Dave's liver disease was considered less advanced, with a score of 7. His care team at CPMC hoped to reverse the disease, but further testing confirmed irregularities, scarring and, eventually, cirrhosis—an advanced disease stage likely accelerated by his hemochromatosis.  

Looking for additional insights into his condition, Dave turned to University of California San Francisco Medical Center (UCSF), where specialists conducted a full investigation into the status of his liver, ordering additional blood work and metabolic function tests. Ultimately, his care team recommended a liver transplant. But the road to a new liver was riddled with obstacles. 

As the months progressed and his condition worsened, Dave developed jaundice and experienced gallstone duct blockages that required surgical intervention. “They couldn’t use anesthesia because of my liver disease,” he recalls. “It was a time of great suffering—I had lost all muscle and body fat.”

Dave also developed pneumonia and severe edema, making it nearly impossible to walk. “Both of my legs swelled to the point where my cardiologist estimated they weighed 50 to 60 pounds each,” he says. The prolonged water retention led to lasting cartilage damage and neuropathy pain.

As his health declined, Dave finally received a call from UCSF, where a new liver was waiting for him. He made it to the hospital with help from his brother. “I was of course very scared and had great reservations when the moment to finally go for surgery drew near,” he says. “But I had no choice if I wanted to remain living.”

Rebuilding after adversity  

As a key account executive at Labcorp for over 16 years, Dave has a unique perspective on diagnostics and patient care. His role keeps him informed about new test methodologies, and his health plan coverage through Labcorp covers the monthly lab test analysis.

“Labcorp plays an active role daily in helping me maintain my health,” Dave says. “My management team made me feel totally supported at the time of my transplant and after. They gave me the recovery time I needed to learn how to resume daily life.” 

While the transplant surgery was successful and has reversed the course of his liver disease as his body adapts to his new liver, transplant recovery has brought a multitude of new challenges for Dave. “The hardest part hasn’t been the surgical scars,” he says. “It’s the lingering injuries—neuropathy, bone degradation from edema, and the daily medication and dietary restrictions. It’s like rebuilding after a war.”   
 

A new liver, a new lease on life

Today, Dave is vigilant about his diet, careful not to eat in excess, and continues to stay active despite mobility limitations caused by neuropathy and cartilage degradation from excessive edema during his illness. “I try to maintain a healthy lifestyle and remain as active as possible,” he says. “Even if that’s just walking the lake route I once ran.” 

He avoids alcohol, not just for medical reasons, but out of respect for the donor who gave him a second chance. “I’ve seldom had temptation to indulge given the sacrifice my donor made for me and what I endured.” 

Dave continues to receive monthly care at UCSF, including annual FibroScans of his new liver. He also receives additional care at Stanford to improve foot mobility and hopes to soon return to dancing, one of his lifelong passions.

“The MASH journey can truly seem difficult and frightening at times,” Dave reflects. “But it can lead you to the next phase in care and survival, especially when you have the proper diagnostics, medical care, and dedicated team.”
 

Dave Sosa is an employee of Labcorp. No compensation or remuneration of any kind was paid in connection with this story.