AN UNPRECEDENTED, DOUBLE DISEASE
For gymnasts, enduring injuries are 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 don't do the body and its joints many favors.
Yet Sharp has endured so much more than any other inherently hardened gymnast.
Wednesday's was the seventh medical procedure she has had in the dozen or so years she's been in gymnastics. That's if you count the three biopsies she's had on her liver. And, oh, yes, she counts those.
Just like she counts the doses of the corticosteroid prednisone she's been taking every day for the last four years. It's at 10 milligrams now, after a startling high of 20 and a UW low of 2½ per day.
"I have two different liver diseases," Sharp said with a matter-of-fact tone Tuesday while sitting on a white padded chair against a wall of the Huskies' gymnastics workroom at Alaska Airlines Arena.
The 22-year-old Sharp has autoimmune hepatitis. The American Liver Foundation defines it as 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.
Autoimmune hepatitis can be managed through prednisone, as Sharp's has, but it cannot be cured. 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.
She has what Dr. John O'Kane, UW associate professor of orthopaedics and sports medicine and the Huskies' head team physician, describes as an "overlapping" condition, primary sclerosing cholangitis.
"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.
PSC, according to the American Liver Foundation, 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.
The cause of PSC is unknown. Just her luck, Sharp bucked the odds on this disease; about 70 percent of PSC patients are men.
Prednisone often weakens soft tissue, and this 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 deserves. 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," said O'Kane, who travels regularly with the Huskies' football team.
"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 what, 3.0 grade point average ..."
Dr. O'Kane then turned to Sharp, who was sitting to his right inside the gymnastics room.
He thought of the meeting he led four years ago upon Sharp's arrival at Washington as a scared freshman. He thought of the three liver biopsies she's endured while at UW. All the prednisone, up to 150 milligrams a week. The bile salts she's taken that's caused unbearable itching all over her body - "that was terrible," she says. "A terrible time in my life."
The shakes she often gets in her arms and legs. The debilitating fatigue. The related knee injury this fall.
"The desire to do this and the strength to do this despite all the different ways that has made this hard for you is tremendously impressive," O'Kane said to Sharp.
"This is obviously something that you really, really wanted."
Then the doctor turned to me as I tried to comprehend what Sharp has endured to be a Husky these last four years.
"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," O'Kane said.
He then turned 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."
"THIS IS GOING TO BE A PROBLEM. AND THIS IS WHAT WE ARE GOING TO DO"
The 5-foot-4 dynamo is the youngest of three children of Toynet and Jon Sharp. She, her now-26-year-old brother Dustin and 24-year-old sister Chelsie grew up in Herriman, Utah, a suburb between Salt Lake City and Provo. It has a population of about 22,000, according to the 2010 U.S. Census.
Sharp reached the Junior OIympic national championships in 2006, '07, and '08 while competing for Olympus Gymnastics in Sandy, Utah, from age eight through an operation in her junior year of high school. That was to remove a bone chip in her foot.
"Then the incision got infected," she said. "Ever since then I feel like everything has gone downhill."
She was considering Denver University - until she visited Washington for the first time.
"I loved it here," she says now. "Just one of those things, you know. Come here and fall in love."
She signed with UW 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. It was my high-school anatomy teacher who noticed it, which was really awkward; I'm not going to lie."
Three months later, in February, 2009, she had her first liver biopsy. Sharp was told she had the autoimmune hepatitis in her liver. Doctors in Utah prescribed high doses of prednisone. But Sharp was still feeling like she'd been run over by a pommel horse every day, and her jaundice remained.
Upon her arrival at Washington in the late summer of 2009, O'Kane referred Sharp to the hepatology department at the renowned UW Medical Center. A second biopsy there discovered the overlapping, PSC disease. Her liver was twice as dysfunctional as initially thought.
"That's when we started to talking about, `OK, this is going to be a problem. And this is what we are going to do,'" O'Kane said.
The doctor led a meeting with Bowers, UW senior athletic administrator Stephanie Rempe and the Sharps that determined whether her gymnastics dream would live on at UW.
"I do remember getting here my freshman year and I don't know how many people were in that meeting," Sharp said. "It was all these doctors and coaches and staff ..."
"It was actually just me, Stephanie and your parents and you," Dr. O'Kane said, smiling.
"I don't know," Sharp said, giggling. "I was a freshman. I was scared."
O'Kane told the Sharps he'd learned no medical colleague in America 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?" Dr. 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' 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, that we would continue to pay for her schooling even though she could not do gymnastics," Coach Bowers recalls.
Kylie's father turned to his youngest child and asked, "Is that what you want to do?"
Her reply was basically, you can stick that idea in your balance beam.
"I was like, `Heck, no, I'm not doing that!'" Kylie said.
"I'd been doing gymnastics since I was eight - 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 says.
Sharp then got hurt in preseason practice, on the beam. Of course she did.
"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 of soft-tissue pain. "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."
Though she hasn't been able to practice or compete as much as she would have liked, though they are days she can't even get through the team's demanding warm-up exercises before practice, Sharp is in UW's floor lineup. And Bowers says enthusiastically 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. Pretty cool ...."
O'Kane thinks so, too.
"I just don't think that actually stopping has ever been on the table for you," the doctor told her Tuesday.
She credits her Huskies' leaders for facilitating her relentless drive.
"Every day, I'm just so thankful. If I had gone somewhere else I don't think that I would still be in gymnastics," she said. "The people here have worked with me so well and helped me get through this.
"Every day Jo has been like, `I'll work with you. We will get through this. I will put you on the back side (of rotations), or whatever. I will help you get through this.'"
NOT AN END. A BEGINNING.
Sharp is on track to graduate in June with a degree in anthropology. That will make her the first in her family with a college degree.
"My dad says I am the smartest one in the family," Kylie says, giggling. "Obviously not just college gymnastics was a dream for me, but just going to college."
Her parents still live in Herriman, in the house where she grew up. Her father has retired as a sheriff and works as a police officer for Salt Lake City's regional transit system. Her mom manages the finances of a bowling alley her family owns. Toynet Sharp wanted to be at Kylie's bedside following Wednesday's liver procedure at Swedish but couldn't get time off work.
The dream ending to this dream college gymnastics career would be Sharp 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, she knows she is now almost overdue for that liver transplant. The survivability rate from it, according to the American Liver Foundation, 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 says. "I have all these dreams to travel -- everywhere. To New Zealand. I want to backpack through Europe, too. I am going to actually try to study abroad in the summer and graduate a month late, to Tahiti, to swim with sharks."
She laughs at that.
"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, she is considering applying to UW's Intercollegiate Athletic Leadership program with an eye on becoming a college sports administrator or coach.
A coach. Sounds like a perfect fit for me. After all she has endured, Sharp has one or three life lessons to share with young student-athletes, wouldn't you agree?
"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 says.
"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."
Forget judges' scorecards. Forget how many events Sharp has or has not been able to complete as a Husky.
Kylie giggled one last time, deservedly happy over what she has accomplished at UW.
"I wouldn't want to have had a different college experience," she said, those eyes sparkling through the jaundice.
"The last four years have been amazing."
About Gregg Bell Gregg Bell is an award-winning sports writer who joined the University of Washington's staff in September 2010 as the Director of Writing. Previously, Bell served as the senior national sports writer in Seattle for The Associated Press. The native of Steubenville, Ohio, is a 1993 graduate of the U.S. Military Academy at West Point, N.Y. He received a master's degree in journalism from the University of California, Berkeley in 2000.
Gregg Bell Unleashed can be found on GoHuskies.com each Wednesday.
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