A personal journey through cirrhosis, portal hypertension, medical testing in Banja Luka, and the importance of consistency, determination, and understanding my own health.
Returning to Bosnia With My Health as a Priority
In August 2026, I traveled from the United States to Bosnia and Herzegovina, returning to my hometown of Banja Luka.
This trip was more than a vacation or an opportunity to spend time in a familiar place. It was also an important part of my ongoing health journey.
For the past several years, I have been living with liver cirrhosis, portal hypertension, esophageal varices, and other medical complications. I have experienced multiple hospitalizations, undergone numerous examinations, and learned how unpredictable chronic liver disease can be.
Although my condition has become more stable, I wanted to understand what was happening inside my body rather than relying only on how I felt.
One of my main priorities during my stay in Bosnia was to undergo additional liver testing through MR Klinika in Banja Luka.
I also wanted to investigate digestive problems that had affected my quality of life for many years.
My goal was simple: understand my health, identify potential problems, and continue making informed decisions about my future.
Living With Cirrhosis and Portal Hypertension
Cirrhosis is a chronic condition in which healthy liver tissue is progressively replaced by scar tissue.
As scarring develops, blood has greater difficulty flowing through the liver. This can contribute to portal hypertension, an increase in pressure within the portal venous system.
In my case, portal hypertension has been associated with several complications, including:
- Esophageal varices
- An enlarged spleen
- Low platelet counts
- Portal vein thrombosis
Esophageal varices have been one of the most serious complications of my liver disease.
These enlarged veins develop because blood encounters resistance while traveling through the liver. If they rupture, they can cause potentially life-threatening bleeding.
I have experienced variceal bleeding in the past and have undergone approximately four or five endoscopies, including treatment with banding.
Fortunately, I have not experienced another episode of variceal bleeding during my recent period of regular exercise and improved daily habits.
However, I understand that the absence of bleeding does not mean the underlying portal hypertension has disappeared.
That distinction is important.
Why I Chose MR Klinika in Banja Luka
While preparing for my trip, I researched options for gastroenterology and hepatology care in Banja Luka.
MR Klinika was among the facilities I considered for further evaluation.
My laboratory records confirm that MR Klinika requested an extensive series of tests performed through SanaLab in August 2026.
The purpose was to examine different aspects of my liver health, including liver enzymes, bilirubin, blood counts, clotting measurements, and possible underlying causes of liver disease.
For me, this was an opportunity to obtain another set of objective medical measurements and compare them with my previous testing in the United States.
I believe patients with chronic illnesses benefit from understanding their laboratory results, asking questions, and maintaining organized medical records.
My August 2026 Liver Testing Results
My SanaLab testing took place between August 12 and August 22, 2026.
The results showed a combination of elevated liver enzymes, preserved albumin, abnormal blood counts, and several other findings.
Liver Function and Biochemistry
| Test | My result | Interpretation |
|---|---|---|
| AST | 90 U/L | Elevated |
| ALT | 77 U/L | Elevated |
| Total bilirubin | 22.1 µmol/L | Slightly elevated |
| Direct bilirubin | 2.9 µmol/L | Reported |
| Albumin | 41.7 g/L | Reassuring level |
| GGT | 23 U/L | Within laboratory range |
| Alkaline phosphatase | 27 IU/L | Below laboratory range |
My AST and ALT levels were elevated, indicating ongoing liver-cell injury or irritation.
Elevated liver enzymes do not automatically mean that liver failure is occurring, but they deserve medical evaluation, particularly in someone with established cirrhosis.
My albumin result was encouraging.
Albumin is a protein produced by the liver. It is one of several measurements used to evaluate the liver’s ability to manufacture essential proteins.
A relatively preserved albumin level can be reassuring, although it cannot independently establish how well the entire liver is functioning.
My bilirubin was slightly above the laboratory’s reference range.
Bilirubin is processed by the liver, and elevated levels can occur for several reasons, including impaired liver processing.
Taken together, these results showed that my liver disease required continued monitoring, even though I was feeling physically well.
My Blood Count: An Important Finding
One of the most significant findings involved my platelet count.
| Test | My result |
|---|---|
| Platelets | 28 × 10⁹/L |
| White blood cells | 2.8 × 10⁹/L |
| Hemoglobin | 143 g/L |
| Absolute neutrophils | 1.71 × 10⁹/L |
My platelet count was extremely low.
For people living with cirrhosis and portal hypertension, an enlarged spleen can contribute to low platelet levels by trapping blood cells.
However, platelet counts this low are medically significant and require close clinical attention.
My white blood cell count was also below the laboratory reference range.
On the more encouraging side, my hemoglobin was within the laboratory’s reference interval.
These results reminded me that feeling healthy and having normal laboratory measurements are not always the same thing.
Even when I feel strong, my blood counts require careful monitoring.
Blood Clotting and Additional Liver Testing
My coagulation testing included:
- Prothrombin time: 14.6 seconds
- INR: 1.32
These measurements are relevant when evaluating liver disease, although interpreting them becomes more complicated when anticoagulant medication is involved.
I have a history of portal vein thrombosis and have been prescribed Eliquis (apixaban).
Because of this, bleeding and clotting risks are both important parts of my medical care.
An INR result alone cannot accurately predict bleeding risk in cirrhosis or measure the anticoagulant effect of Eliquis.
Additional testing investigated other possible causes or contributors to liver disease.
These included alpha-1-antitrypsin, ceruloplasmin, copper measurements, autoimmune markers, and viral screening.
Several of these results were within their laboratory reference ranges or negative.
My hepatitis B surface antigen and hepatitis C antibody screening were negative.
Some autoimmune screening tests were still listed as pending in the copies of the reports available to me.
These investigations were valuable because cirrhosis is not a single disease with one universal cause.
Understanding why liver damage occurred is an important part of managing it.
Investigating My Long-Term Digestive Problems
Liver disease was not my only concern during this trip.
For approximately 20 years, I have experienced recurring digestive symptoms.
These have included abdominal discomfort, urgency to use the bathroom, intermittent loose stools, bloating, and changes in stool consistency.
The discomfort frequently occurs below my belly button and often improves after a bowel movement.
Certain foods appear to aggravate these symptoms, particularly some sugary or fatty foods.
During my time in Bosnia, I wanted to investigate these problems rather than continue guessing about their cause.
I considered several possibilities, including food intolerance, intestinal inflammation, irritable bowel syndrome, and small intestinal bacterial overgrowth.
These were possibilities to investigate, not confirmed diagnoses.
My Digestive Testing at Medicover in Banja Luka
On August 31, 2026, I underwent additional testing through Medicover Diagnostics in Banja Luka.
The investigations included pancreatic elastase, fecal calprotectin, and celiac disease screening.
The final report, issued September 14, 2026, provided an important missing result.
My Confirmed Digestive Test Results
| Test | My result | Interpretation |
|---|---|---|
| Pancreatic elastase | 380 µg/g | Normal |
| Fecal calprotectin | 91.7 µg/g | Mildly elevated |
| Tissue transglutaminase IgA | 5.6 U/mL | Negative |
| Total IgA | 3.75 g/L | Within laboratory range |
Pancreatic Elastase: A Reassuring Result
One of the most important tests I wanted to complete was the fecal pancreatic elastase test.
This test evaluates pancreatic exocrine function by measuring elastase in stool.
The pancreas produces digestive enzymes that help break down food and allow the body to absorb nutrients.
Insufficient pancreatic enzyme production can cause symptoms such as diarrhea, bloating, fatty stools, and poor nutrient absorption.
Because I had experienced digestive problems for approximately two decades, I wanted to investigate whether pancreatic enzyme deficiency might be contributing.
My result was 380 µg/g.
Medicover’s reference interval identifies results above 200 µg/g as normal.
This was reassuring.
It suggested that significant pancreatic digestive enzyme insufficiency was less likely to be responsible for my symptoms.
However, a normal pancreatic elastase result does not exclude every pancreatic or gastrointestinal disorder, and it does not establish the cause of my long-standing digestive problems.
For me, this was still an important step forward.
It helped narrow the possibilities and provided another piece of objective medical information.
Fecal Calprotectin: Mildly Elevated
My fecal calprotectin result was 91.7 µg/g.
The laboratory classified values between 50 and 200 µg/g as mildly elevated.
Calprotectin is a marker associated with inflammation in the intestines.
An elevated result can occur for several reasons and does not independently establish a diagnosis such as Crohn’s disease or ulcerative colitis.
This finding indicated that additional clinical interpretation or follow-up might be appropriate.
Celiac Disease Screening
My tissue transglutaminase IgA result was 5.6 U/mL, which was negative according to the laboratory’s reference range.
My total IgA was 3.75 g/L, within the reported range.
These findings were reassuring regarding celiac disease, although no single laboratory test answers every digestive question.
Overall, my testing showed normal pancreatic elastase, negative celiac screening, and mildly elevated fecal calprotectin.
That gave me a more focused understanding of which digestive explanations were less likely and which questions still required attention.
Exercise Became a Major Part of My Life
One of the most meaningful changes I have made has been maintaining regular physical activity.
I have a history of a heart attack, which occurred approximately three years ago.
That experience, combined with my liver disease, changed how I think about fitness.
I no longer view exercise as a competition to see how hard I can push my body.
Instead, I focus on consistency.
My usual routine includes 30 minutes of stationary cycling, walking, and regular gym activity.
I have also enjoyed longer outdoor bicycle rides, sometimes covering 40–60 miles or more.
During particularly active periods, I have walked more than 20,000 steps in a day.
I prefer moderate, repeatable activity over maximum-intensity interval training.
My Typical Cycling Session
My recent stationary cycling measurements have been:
- Duration: 30 minutes
- Average heart rate: approximately 107 beats per minute
- Maximum heart rate: approximately 118 beats per minute
- Effort: comfortable enough to maintain a conversation
- After exercise: generally feeling energetic and well
I take carvedilol, a medication that reduces heart rate and is also used to lower portal pressure in appropriate patients.
Because carvedilol changes how the heart responds to exercise, standard heart-rate training formulas may not accurately represent my exertion.
I manually adjusted my Apple Watch heart-rate zones and chose approximately 118 beats per minute as a personal precaution.
However, I recognize that this is not a medically validated limit for preventing complications of portal hypertension.
Heart rate and portal venous pressure are not interchangeable measurements.
My preference remains to exercise consistently without deliberately pushing toward maximum effort.
What My Cardiologist Told Me
I also communicated with my cardiologist in the United States about my physical activity.
In a message dated May 20, my cardiologist acknowledged my exercise achievements and the fact that I had maintained my routine without reported problems.
He considered it reasonable to continue my established level of activity.
However, he advised against increasing the intensity or volume beyond what I was already doing.
That guidance reinforced an important principle for me.
More exercise is not automatically better.
For someone with a history of heart disease and significant liver complications, the goal should be appropriate, sustainable activity rather than constantly chasing new performance records.
I continue to recognize the importance of individualized medical advice.
Staying Active During My Trip to Bosnia
Travel changed my normal routine.
In the United States, I have access to my usual cycling equipment, gym facilities, and familiar daily schedule.
While staying in Bosnia, I spent more time walking and used stationary cycling when available.
At times, my overall activity decreased compared with my normal routine.
I also noticed changes in abdominal bloating and digestive comfort during periods when I was less active.
Walking sometimes helped me feel better.
However, I cannot conclude that changes in exercise alone caused those digestive changes.
Diet, meal timing, medications, and underlying gastrointestinal conditions may all have contributed.
The experience reminded me that consistency matters, even when circumstances change.
Understanding What My Results Really Mean
My trip provided useful medical information, but it did not produce a simple answer to every question.
Some findings were encouraging.
My albumin was preserved, my hemoglobin was within the laboratory reference range, and several additional liver investigations were negative or within range.
My pancreatic elastase result was normal, making significant pancreatic enzyme insufficiency less likely.
Other findings required continued attention.
My platelet count was severely reduced, my white blood cell count was low, and my liver enzymes remained elevated.
My digestive investigations also identified a mildly elevated inflammatory marker.
I do not interpret these findings as proof that my liver has healed or that my complications have disappeared.
Cirrhosis is a serious condition that requires long-term medical supervision, even when symptoms improve.
What I Learned From My Visit to Banja Luka
Returning to Bosnia gave me the opportunity to focus on my health in a different environment.
It also reinforced several lessons that I continue to carry forward.
First, objective medical testing matters. Feeling well is important, but laboratory results and imaging provide information that symptoms alone cannot reveal.
Second, chronic liver disease requires continued surveillance. A history of esophageal varices, portal hypertension, and portal vein thrombosis cannot be ignored simply because bleeding has not recurred.
Third, exercise should be sustainable. My personal preference is to remain active through consistent, manageable workouts rather than extreme physical challenges.
Fourth, digestive problems deserve attention. Symptoms that have existed for years should not automatically be dismissed as normal.
Fifth, normal results are valuable too. My pancreatic elastase result did not provide a diagnosis, but it helped make one possible explanation for my digestive symptoms less likely.
Finally, understanding my medical records gives me a greater sense of control. I cannot control every aspect of chronic disease, but I can remain informed, follow appropriate treatment, and make decisions with my healthcare team.
My Journey Continues
As I reflect on my time in Bosnia, I am grateful for the opportunity to undergo additional testing and gain a clearer picture of my health.
My journey with cirrhosis has included difficult experiences, hospitalizations, bleeding complications, and uncertainty.
But it has also changed my priorities.
Today, I value consistency, prevention, medical knowledge, and the ability to enjoy everyday life.
I continue to cycle, walk, spend time outdoors, and pay attention to how my body responds.
I know that feeling strong does not mean I am free from medical risk.
My objective is not to prove that I can push harder than everyone else.
It is to preserve my health, maintain my independence, and continue doing the activities I enjoy for as long as possible.
My liver disease is part of my life, but it does not define everything about how I choose to live.
The journey continues.
RS
Personal Health Journey | October 2026
Medical disclaimer: This article describes my personal experience with liver disease, diagnostic testing, and exercise. It is not medical advice. Laboratory results must be interpreted by qualified healthcare professionals in the context of each patient’s medical history. Individuals with cirrhosis, portal hypertension, varices, or cardiovascular disease should obtain individualized guidance before changing medications or exercise routines.
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