If Liver Awareness Month is meant, in part, to illustrate the various types and stages of liver disease and treatment, David Roncari is a perfect example of someone that has lived through many of these stages.
The 64-year-old Bloomfield, CT resident, a father of two and grandfather of two, has experienced the struggle against liver disease over many years. His medical history: Hepatitis C (twice), cirrhosis and a liver transplant.
It is because of the transplant and an innovative treatment regimen that David is alive today to share his story with us.
Back in the early 1970s, David, who was born in Connecticut and has always lived there since, could never have imagined the twists and turns his life would take.
David and his wife Gilda, in a recent photo.
After receiving his education, David had started to work for the family’s construction business. On June 1, 1971 he got married and this past year he and Gilda celebrated their 42nd wedding anniversary.
Their daughter Kate was born in 1972, and their son Gabriel (Gabe) was born in 1975.
For David and his family, the first hint of what was to come occurred in 1979. David attempted to donate blood to his dad who, although residing in Connecticut, was in Texas to receive treatment after being diagnosed with leukemia.
“I was told that it couldn’t be used because my liver functions were very high,” David recalls.
He had liver disease? It came as a complete surprise to David because he felt as healthy as ever. There were no telltale symptoms.
In 1983, a liver biopsy revealed that David had stage-3 fibrosis and chronic inactive hepatitis. Fibrosis is caused by inflammation of the liver. The third stage is regarded as being severe, just one stage short of the patient having cirrhosis.
“Back then, it was described as being chronic inactive hepatitis because they didn’t know what hepatitis C was,” David says. “They didn’t have a name for it, so to speak.”
David admits at that time he was drinking pretty heavily. “They told me if I got my drinking under control that my liver would probably heal itself so long as I hadn’t entered into cirrhosis. So I stopped drinking, and I haven’t done so for 30 years.”
As his liver disease was inactive, it didn’t really impact David’s life. In fact, for almost two decades, David enjoyed a wonderful life before liver disease would impact him and his family.
“I created a great life with Gilda, helped to raise Kate and Gabe, and built a successful construction company. Life was good. I enjoyed my two big hobbies – cooking and golf.”
In 1999, he became a grandfather with the birth of Autumn, who is Kate’s daughter.
In 1994, as David’s liver disease remained inactive, he decided to increase the value of his life insurance policy. It was a devastating blow when his application was rejected. For the first time, he learned that his chronic liver disease was caused by hepatitis C.
David says, “I didn’t even know I had hepatitis C before that.”
Still, in spite of knowing that he had hepatitis C, David’s life didn’t change. There were no symptoms. He wasn’t feeling tired. His appetite was good. He remained active.
In May 2000, when David met with Dr. Victor Navarro at Yale-New Haven Hospital for a routine follow-up, an MRI revealed that the third stage fibrosis had progressed to cirrhosis.
A year later, when Dr. Navarro left Yale for research, he referred David to Dr. John Polio at Hartford Hospital. Dr. Polio explained to David that going on a regimen of interferon, for example, would have been a waste of time. His only long-term option was a new liver.
David expresses enormous gratitude toward to Dr. Polio. “He recommended that I get on the transplant list as soon as possible, which I found surprising because at that time I was still not feeling or showing signs of ill- health. I didn’t know it at the time, but it turned out that this advice saved my life.”
In the years that followed, though he was on the transplant list—and despite the presence of hepatitis C and cirrhosis—David continued to feel healthy.
But then, gradually, the symptoms began. They included the retention of water, weight gain and fatigue. David was unable to play golf. Nor was he able to do what brought so much personal satisfaction: cooking.
In November 2005, David was admitted to St. Francis Hospital and Medical Center in Hartford, CT. for an unrelated surgical procedure.
Three days later, a sudden increase in pressure within the portal vein—the vein that carries blood from the digestive organs to the liver—caused esophageal varices, large veins, to rupture. David almost bled to death and he was rushed back to St. Francis Hospital where the staff struggled to halt the bleeding. He underwent a radiological procedure known as TIPS, in which a stent was placed in the middle of his liver to stop the bleeding.
For eight days, David remained strapped down and in an induced coma. Fortunately, when David was brought out of the coma, it had helped to stabilize his condition.
“Although I was very sick after the TIPs procedure, it succeeded in keeping me alive long enough to be blessed with a new liver,” David says. “There’s no doubt if the call from the Hartford Hospital Transplant team hadn’t come on December 20, 2005, with the transplant performed the next day, I wouldn’t be alive today.”
David, who was 57 at the time of the transplant, adds: “By the time I got the transplant, I was in seriously bad shape. I couldn’t walk and I spent most of the time in the hospital. I believe I only had a few days to live if I hadn’t gotten the liver.”
The transplant, performed by Dr. Matthew Brown and Dr. Anne Lally with assistance from the late Dr. David Hull, was successful. David describes it succinctly: “My new liver and I were very compatible.”
David doesn’t know anything about the donor, but he is quick to acknowledge that his good fortune derived from the loss of another family’s loved one. He wrote a letter to thank to them, which was forwarded by the organ procurement organization. So far, David hasn’t heard back from them.
In a strange turn of events, the surgical procedure in 2005 that unexpectedly sped up the need for a transplant uncovered yet another potential danger that could have ended David’s life.
“When they took out my liver, they found a 5 centimeter tumor, which they couldn’t pick up on an MRI or CT scan,” David recalls.
“So, ironically, if I hadn’t gone for the procedure, and if the varices hadn’t ruptured, I might not have needed a transplant immediately, and the tumor might have gotten larger and could well have killed me.”
Despite the transplant’s successful outcome, after a while an infection forced David to return to the hospital to have abdominal muscles removed. David remained hospitalized for another two months. He was unable to eat and it caused a dramatic loss of weight. It also put a great deal of extra pressure on his family.
But, finally, David came through and recovered well. It was evident how much progress he was making when he went back for check-ups every six months.
However, doctors had warned him that, for many patients, hepatitis C returns after a few years. So, not unexpectedly, it did so in David’s case, in 2011.
The timing of his treatment turned out to be propitious. In May 2011, the FDA approved two drugs in the first new class of drugs for hepatitis C in 10 years.
It approved boceprevir and telaprevir.
Previously available medications for hepatitis C (interferon and ribavirin) had low cure rates for patients, but if used with one of these two new drugs as a 3-drug combination, the FDA stated there would be a higher chance of successful treatment.
So, at Yale-New Haven Hospital, David was enrolled in the ground-breaking combination treatment of interferon, ribavirin and boceprevir.
David admits that the 11-month treatment, from March 2012 to February 2013, was accompanied by some serious side-effects. “It affected my red blood cells and I had no energy. I struggled for oxygen. Luckily, I worked from home; otherwise, I would have had to take a leave of absence.
“The good news is the treatment worked. In June (2013) it was confirmed that after six months, my hepatitis C is undetectable, which means I am clear of the disease.”
“It’s all positive, it’s all good,” David says.
David, on a recent Saturday evening, prepares an appetizer and main course for Gilda and guests.
David says he is thrilled that one again he is able to put on his chef’s apron and have a good time in the kitchen preparing meals.
With a great deal of enthusiasm, he says, “Something that pleases me the most is entertaining people with my cooking.”
Being of Italian descent, it’s not surprising that he tends to favor Italian cuisine.
As Gilda works downtown and his office is home-based, David cooks all the meals. And, when it comes to his culinary talents, Gilda is his biggest fan!
We asked David to share one of his own recipes with us: How to make sausage soup. Click here to view or download David's tasty recipe.
In addition to cooking, once in a while gets to play golf again. Asked whether he is a good golfer, he replies: “I used to be a decent player.”
A very happy Roncari family: (Back row, l. to r.) Gilda and David with their son Gabe, daughter Kate and Chris, her fiancé. (Front row, l. to r.) David and Gilda’s granddaughter, Autumn; grandson, Gabriel Louis, and daughter-in-law, Allyson.
How does David feel after receiving a life-saving liver transplant and treatment that has cleared him of hepatitis C?
“I’m incredibly blessed to be alive and have the ability with Gilda to be a part of my family’s lives. Every day is special to me. I can never possibly give back what has been given to me.”
Without the liver transplant and the other treatment he received, David would not have met his grandson, Gabriel Louis.
Actually, David does give back. He is on the board of the American Liver Foundation Connecticut Division.
David also speaks at many of the “Treatment Choices Initiative” (TCI) education program programs presented in Connecticut by the American Liver Foundation.
Moreover, he and Gilda hold an annual “Gift of Life” party at their home every December to thank all those who stood by him during the difficult times and to celebrate his recovery.
At this event, they give guests the opportunity to donate to the American Liver Foundation. This past December (2012) was the seventh get-together. To date, they have raised more than $33,000.
David’s grandchildren, quite naturally, are the source of much joy. His granddaughter, Autumn, is now 14. And if David hadn’t had his life saved, he wouldn’t have gotten to meet his youngest grandchild, 18-month-old Gabriel Louis.
An Organ Donor Advocate
At the 12th Annual Flavors event on April 9, 2013 hosted by the American Liver Foundation Connecticut Division, David was the Fund-a-Need speaker.
During his speech, David expressed his firm conviction that everyone should sign up to be an organ donor. He pulled out his driver’s license, and said, “If you don’t have ‘organ donor’ on your license cards, you’ve got to go have that changed. It’s simple to do. You can save a life. My life was saved because someone was willing to donate their organs.”
Thinking back at all he went through, particularly because October is Liver Awareness Month, David sums up his life and death struggle this way: “Everything was important to me, the doctors and the care I received. The love and support of my family and friends.”
“But,” he adds, “most important, it was the donor. Nothing else could have happened without the liver being donated.”
The video was produced by JMS Communications.