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GREENSBORO — Making it back home after a three-week life-or-death fight in a hospital seemed like a good thing.

Until everyone had gone, and 28-year-old liver transplant recipient Luke Neal, surrounded only by his thoughts, panicked.

“I was having an anxiety attack, and it was really hard,” admits the young teacher, whose body is rejecting a liver he received two years ago when his own failed. Doctors are trying to ward off end-stage liver failure.

“I felt paranoid,” he says, “like a lot of things were going wrong.”

Relatives who were at his bedside during the three-week stay at UNC Hospitals had to go back to his native Richmond, Va., where jobs awaited them. Many of his friends and co-workers have young families or other responsibilities.

Doctors let him go home because medical treatments were able to stabilize his liver, taking it from the worst level of rejection to midrange. His disease-fighting white cells remained low, but that also meant there aren’t enough of them to mount a more debilitating attack on the liver.

“It’s healing,” says Neal — sounding equal parts hopeful and wary, as the eyes staring back at him in the mirror remain a shade of yellow.

So the journey back to Room 109 at Aycock Middle School could be long.

“My heart says 'yes, you can do it,’ but my body’s telling me 'not yet,’ ” says Neal. 

Having low immunity prevents him from being around a lot of other people, especially children.

Doctors detected rising enzyme levels during an appointment Friday in Chapel Hill. They now plan a liver biopsy for Monday.

“They told me to bring an overnight bag,” Neal says, his voice trailing off.

They told him it’s just in case.

The journey back to health has often been frustrating for Neal, who is grateful at the life the liver — donated by the family of someone who ended up on life support — has thus far given him.

The language arts teacher feels like he’s making a difference with his kids, including an all-boys class this year. He calls it the Cool Dude Academy. At the beginning of the school year he was recognized for his kids having the most growth in reading scores at the school on state-mandated tests.

But on Thursday, he broke down crying while standing in line at the pharmacy.

Even with insurance, the prescriptions are expensive, especially for a young teacher.

“One or two co-pays isn’t that difficult, but when you have 15 and 20, it can be depressing,” says Neal, who admits he has a hard time asking people for help. The gauze he needs is $10 a pack.

Often exhausted, he even finds organizing the 40 pills he takes daily disorienting at times. His aunt gave him a pill organizer that divides the medicine into four daily trays.

“At times, I get overwhelmed and I want to scream, 'I need somebody!’ ” Neal says. “But I keep fighting.”

He missed dinner the other night because he was too drugged by his prescriptions to attempt to drive.

His principal is holding his job, but he warily keeps track of his remaining sick days.

In the meantime, he finds solace in the cards and letters he receives.

And, in walking the length of his backyard to a townhouse-style chicken coop where he keeps his exotic chicken collection.

His bantam birds, which are miniature, also fly.

The walk tires him out, but it gets him away from his bed, where he spends just about all his time asleep or working on lessons for his kids.

“This is healing me, too,” he says, as he explains that this weekend he’ll watch co-workers and friends expand the coop to give the birds more room to roam.

But as he speaks, a sudden quickening heartbeat — for no apparent reason — returns him to those thoughts.

Those thoughts, he says, that both terrify him and remind him to appreciate, even with his health and money problems, every second he has left.

Contact Nancy McLaughlin at 373-7049 or nancy.mclaughlin@news-record.com