UW's Sharp plays through the pain
Huskies' gymnast postpones liver transplant for senior season
SEATTLE -- For gymnasts, enduring injuries is as much of part of their sport as tights, glitter, makeup and dance music. Endless torque from propelling oneself full-speed off vaults, bars, beams and floors doesn't do the body and its joints many favors.
Yet Washington senior Kylie Sharp has endured so much more than any other hardened gymnast, and you can see it in her eyes. They are strikingly brown and when the whites of those eyes are clear and bright, so is Sharp.
But for the last couple of weeks they've turned yellow. Again.
Sharp should have been readying to leave with her GymDawgs to compete on the beam and in the floor exercise this past weekend at the Metroplex Challenge meet in Fort Worth, Texas. Instead, she had jaundice. Her energy was zapped.
Sharp was up before dawn -- and on an operating table at Swedish Hospital's First Hill campus in Seattle. She had an endoscopy procedure Wednesday morning, the seventh medical procedure she has had in her career, during which doctors sent a tube down her throat and into her abdomen to balloon-open clogged ducts and allow bile to exit more freely from her dysfunctional liver.
"Basically, what the doctor has told me is two years down the road it's going to be a liver transplant," Sharp said.
"It will keep her out for one or two weeks," Huskies head coach Joanne Bowers said of the endoscopy. "We wanted her to do this now in the hopes she will feel better for the rest of the season and be able to help us toward the end of the season when we need her most."
Finishing a season she began would be a first for Sharp at Washington.
Sharp reached the Junior OIympic national championships in 2006, '07 and '08 while competing for Olympus Gymnastics in Sandy, Utah. She signed with Washington in November of her senior year of high school. A few weeks later, teachers and classmates began noticing Sharp's eyes turning yellow.
"The whole year I had been super-fatigued and things hadn't been going very well. And then a lot of people had noticed the jaundice in my eyes," she said.
Primary sclerosing cholangitis (PSC):
Three months later, in February 2009, Sharp had her first liver biopsy. She was told she had autoimmune hepatitis in her liver, a disease in which the body's own immune system attacks the liver and causes it to become inflamed. The disease is chronic, and inside Sharp's liver it has led to cirrhosis, or scarring. Doctors in Utah prescribed high doses of the steriod prednisone. But Sharp was still feeling like she'd been run over by a pommel horse every day, and her jaundice remained.
The long-term use of any steroid can cause serious side effects, such as diabetes, osteoporosis, high blood pressure, glaucoma, weight gain and decreased resistance to infection. The hepatitis alone can cause liver failure. Yet Sharp has more than that.
Upon her arrival at Washington in the late summer of 2009, Dr. John O'Kane, UW's associate professor of orthopaedics and sports medicine and the Huskies' head team physician, referred Sharp to the hepatology department at the renowned UW Medical Center. A second biopsy there discovered an overlapping disease -- primary sclerosing cholangitis. Her liver was twice as dysfunctional as initially thought.
PSC is another chronic disease that slowly damages the ducts that transport the digestive liquid bile. The ducts are inside and outside the liver. Bile travels through them from the liver to the gall bladder and the small intestine, where it helps digest fats and fatty vitamins.
"I called doctors all over the country, and no one had ever heard of a gymnast in college - no one had heard of any athlete - that had autoimmune hepatitis with this overlap," O'Kane said
Prednisone weakens soft tissue, and this past fall Sharp partially tore the patella tendon in her right knee. O'Kane injected Sharp's own blood into the tendon to try to accelerate healing and get her a full senior season. She started it by competing in Washington's first two meets.
But then recently her bile ducts became blocked. PSC zapped her characteristic zest and yellowed those brown eyes.
Weeks after Wednesday's endoscopy, Sharp intends to be back on the beam and the floor exercise in time to help the GymDawgs attempt to break through consecutive seasons of falling just short of the NCAA championships. The goal is to reach the national championships for the first time as a team since 1998.
"The thing that is most amazing to me about this whole thing is, you know, it's really hard to be a student-athlete. And this sport might be the toughest one. Just the whole experience," O'Kane said.
"This sport was really designed with a child in mind, and we have adult women who manage to continue to do this at a high level. You are fighting all sorts of things. You are fighting just the process of maturation. You are fighting bones and muscles and tendons that really don't want to land at 10 feet over and over and over again. But yet, impressively, there are a number of really tough, strong, determined women who are able to do this sport -- with healthy livers. That's the thing. With normal livers.
"Somehow she's been able to do all this with a significant liver disease. She's going to have a liver transplant at some point. And she will get through it, because if she can get through this and be a student-athlete and have a 3.0 grade-point average. ... The desire to do this and the strength to do this despite all the different ways that has made this hard is tremendously impressive," O'Kane added, turning to Sharp. "This is obviously something that you really, really wanted.
"It's not like she is a really, really good football player and you put all this work in, in hopes of being a top draft pick with a signing bonus and all that."
He looked back to Sharp and said, "Why did you do this again? Why did you want this so bad?"
She didn't miss a beat.
"I love it," she said. "I so wanted it."
Upon diagnosing Sharp, O'Kane led a meeting with Bowers, administrators and the Sharps that determined whether Kylie's gymnastics dream would live on at UW.
O'Kane told the Sharps that he didn't know any medical colleague in America who knew of a case of an athlete competing with two, long-term liver diseases that would require a transplant.
"The first question was, after accepting there was going to be a transplant down the road, is doing college gymnastics in any way going to accelerate this process and make her sicker?" O'Kane said. "The general consensus was that it probably wouldn't change the procession of the disease. The problem was that some of the medications that she had to take would probably interfere with gymnastics training."
Prednisone not only makes tendons susceptible to more injury in a sport already full of pain, it affects bone strength. It changes body weight, a huge consideration for a gymnast trying to soar against her own mass. The drug Sharp takes also inhibits the body's ability to fight infections; skin infections are common with gymnastics, with many shared mats and apparatuses.
And UW was concerned about allowing Sharp to compete and then potentially becoming liable for a liver transplant.
"Kylie was told by us that she could go on a medical hardship because of the severity of the disease, medicine, training, etcetera, and that we would continue to pay for her schooling even though she could not do gymnastics," Bowers said.
Sharp's father turned to his youngest child and asked, "Is that what you want to do?"
"I was like, 'Heck, no, I'm not doing that!' " Kylie said. "I'd been doing gymnastics since I was 8 -- I actually started a lot later. But it was something that I never wanted to quit. Even with everything that happened in high school, with all the injuries, it was something I wanted to do."
The Huskies agreed to let her compete for them, "with the stipulation that we would all work together in limiting her numbers and the pounding she would take each day," Bowers said.
Sharp then got hurt in preseason practice, on the beam.
"Within about four weeks of making the decision that she was going to try to do this, she immediately got the injury that we were worried about," O'Kane said. "Immediately.
"No one that I was able to reach had any experience in this with an athlete. So the big question wasn't the disease itself, but what amount of prednisone would be safe to take chronically and be safe to compete. Because the higher the dose of prednisone the more you have to worry about the side effects. There is no evidence to base the answer to that question."
Sharp hasn't been able to practice or compete as much as she would have liked because there are days she can't even get through the team's demanding warmup exercises before practice. Yet she is still in UW's floor lineup and Bowers said that she "can really help us on beam."
"It has changed every year, trying to figure out a way to get through it," Sharp says. "I look back now, four years, and see that I have made it."
Sharp is on track to graduate in June with a degree in anthropology. The dream ending to her college gymnastics career would be helping Washington and its five seniors to that elusive national finals appearance. UW came within one final, flawed routine last spring of ending that 15-year absence from the NCAA championships.
"Our class, we've gone through it the last two years of being right there," Sharp said. "I mean, being a tenth of a point off. I would probably just cry. I don't even know what I would do. I would be so excited. I'm going to be so excited. That's how I will put it."
Beyond her sport, Sharp knows she is now almost overdue for that liver transplant. The survivability rate from it is more than 80 percent.
"We've talked about that," O'Kane said. "The fact that's out there is the difference between having a fatal disease and ... I mean it's not a small deal to need a liver transplant. But it is something that when the time comes she will do. And when that time comes, it will not be as hard as what she is going through now."
Yet Sharp wants to live life -- and live it fully -- with her old, flawed liver before she gets a new one.
"I have my whole dream list. It goes on forever," she said. "I have all these dreams to travel -- everywhere. To New Zealand. To Tahiti, to swim with sharks. I want to backpack through Europe, too. I am going to actually try to study abroad in the summer and graduate a month late. I also want to skydive. And I have this obsession with whales. I want to do that in the spring, as well."
After all that, Sharp is considering applying to UW's Intercollegiate Athletic Leadership program with an eye on becoming a college sports administrator or coach.
"Obviously I am a big dreamer. But I don't think you should just dream your dreams. Go out and fight for them. Make them happen!" she said.
"There have been so many people out there saying, 'I don't know. I don't know if you can do it. I don't know if you should do it.' I just kind of said, 'No. I want to do it. I can do it. This is what I have always wanted to do. And I have figured out a way.
"I mean, there have been days when I had to dig down deep to make it through the day, but it has been always been worth it in the end."