It’s exactly four weeks since I last consumed even a millilitre of wine, and that includes on a flight to Cape Town where Laurent Perrier Grand Siecle, at £120 a bottle, was flowing freeing in First. Those who know me might pause for reflection, with a soupcon of disbelief. 30-plus years of drinking tends to shackle you to certain trains of thought from your nearest and dearest. A nicely chilled Sauvignon Blanc or a berry-rich 15% Shiraz are engrained against my name. Plus LPGS, of course, when reward flights come up trumps. But societal attitudes change. So does the notion of what constitutes sensible drinking behaviour. Enter the ELF test: not some checklist to establish the provenance of a little creature with pointed ears and poor dentition, but the ‘Enhanced Liver Fibrosis’ test, as developed by some clever folk at Siemens. But more on that later.
I’d been considering arranging a Fibroscan for some time, just to confirm that my liver was coping fine metabolising a weekly consumption of 40 units plus. Fibroscan uses ultrasound to measure how a low-frequency pressure wave propagates through the liver: the stiffer the liver, the faster the wave travels. So, in a normal, soft liver it moves slowly, while in a stiffer, fibrotic liver, the impulse is transmitted faster. The TV programme, ‘Drinkers Like Me’, featuring the broadcaster Adrian Chiles, showed him having a Fibroscan and scoring a high reading – not cirrhotic but clearly heading for it. This made sobering viewing and nagged at me to follow suit. I’d come through it with flying colours, of course, as he drank far more than I did … usually … the rather glaring exception being holidays, particularly in South Africa where drinkable wine and bottled water have similar price tags.
Searches for Fibroscan anywhere other than the London private sector proved fruitless. £450 a pop was hardly cheap. Kent was a complete non starter for anything so state-of-the-art. See my GP? Forget it. I wouldn’t even qualify for a consultation, let along a referral to The London Clinic in Harley Street. My LFTs (liver function tests) have been low normal for years and my BMI of 19.5 puts me well out of risk of an obesity-related, non-alcoholic fatty liver. But the advantage of the internet is that Google searches can turn up things you’ve never heard of: in other words, the ELF test. And the only chemical pathology lab that performs it routinely in the UK is The Doctors Laboratory.
The ELF test is ingenious. It takes three molecules or ‘biomarkers’ that are found in the blood when a liver undergoes fibrotic change, which, when correlated, give a score ranging from 4.0 (essentially no fibrosis) to 16.0 (cirrhosis).
This scale is comparable to the one used by Fibroscan and both are equally validated against the gold standard of the dreaded liver biopsy. Another search revealed that there was one online blood test company – Blue Horizon Medical – offering the ELF test for £199. Still expensive, but a click on PayPal took care of the monetary pain. A few days later, a pack with a gold-top specimen tube and a Vacutainer kit arrived in our postbox. The following day, the specimen was on the way to the lab. Henry is an excellent phlebotomist.
The date 30/04/19 is when the email from Blue Horizon Medical dropped into my inbox. I scarcely gave it a glance until I saw the number “9.37”:
And then there were the terse comments from the pay-per-report GP who didn’t know me from Adam – or my clinical details:
It was certainly a hell of a wake-up call.
And I decided right there and then to stop drinking.