Doctor's own transplant inspires fundraising run

In retrospect, there were signs.

But even to a doctor like Terry Box, who specializes in end-stage liver disease, symptoms are much more difficult to diagnose in yourself. It may have been, at least in part, his extensive medical training that kept him from having a physical exam for nearly 20 years.

"I felt great," said Box, who is a liver transplant doctor at the University of Utah Medical Center. "You assume because you're feeling healthy, everything is OK. You know some medicine, so you assume you would know if something was wrong."

Despite a very active lifestyle that included running and cycling daily, Box was sick. It wasn't until a colleague at a medical conference in 1998 asked a seemingly innocuous question of him that he found out just how sick he really was.

"He just asked me how I was doing," said Box, who works daily with patients whose livers are so diseased or damaged that without transplants they won't survive. "I said, 'I think I am doing OK, but I haven't had a physical exam in about 20 years.' "

His friend offered to do the exam himself.

"He was examining my abdomen and said, 'Your liver is so big, I can't even find the edge of it,' " said Box.

A huge tumor had invaded his liver. After some tests, doctors concluded it was likely benign and that the best course of action was to watch it rather than remove it.

"I was still running and cycling a lot," he said. "I was very active. I had some heartburn. The mass had compressed my gut. But I was basically OK for awhile."

Two years later, he fractured his pelvis in a cycling accident, and X-rays showed the tumor was getting bigger. A year later, his symptoms worsened.

"I was beginning to have a lot of difficulty," he said, admitting he hid his condition from almost everyone. "By the summer of 2002, I went out on a bike ride with some friends. After six blocks, I couldn't keep up with them. At that point, I knew I was in trouble."

The mass had gotten so large, it was forcing his heart to work even harder.

"I had high output heart failure due to the size of the tumor," he said. "I was becoming less and less able to do anything. It was very aggressive but benign."

But in August 2002, Box's doctors decided the tumor was acting more like a malignant growth, and they weren't so sure it was benign. They decided he needed to have a liver transplant right away.

He went on the liver transplant list under a pseudonym.