Tomorrow cannot come soon enough.

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A thousand things went through my mind trying to sleep last night.

Tomorrow is my appointment with the Hepatologist. A few things made me do a lot of thinking last night when I should have been sleeping.

The first are questions I need to ask the doctor.

The second is what are we going to do about what is going on.

I know there is a big list of tests that Hepatologists can do to see what all is going on. My big thing is not waiting forever for the test to get set up as I have with other tests.

One thing that I read online is that both Liver and Kidney damager can happen from having Covid-19 which I did back in January. I never had blood work done during that time so they would not have found it back then.

So I got a lot on my mind but mostly it is about getting answers because so much has happened.

Then on the 9th I see my GI doctor again so will be able to get an understanding as to what can be done from her end.

All in all, I just want answers.

 

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I hope you find out what’s going on and it’s nothing bad.

 

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You’ve said multiple times that you take a ton of Tylenol. Tylenol or alcoholism both cause elevated ALT levels and are the most common causes, not fatty liver disease. You say you’ve stopped taking Tylenol. Unless you’re an alcoholic, your ALT will return to normal then.

 

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How are you doing zsnow you've been quiet. Hope you are doing well

 

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You’ve said multiple times that you take a ton of Tylenol. Tylenol or alcoholism both cause elevated ALT levels and are the most common causes, not fatty liver disease. You say you’ve stopped taking Tylenol. Unless you’re an alcoholic, your ALT will return to normal then.

Tylenol was All I could/can take for pain.. But at most I took two/four a day and really only on days were I was bound up due to the pain it causes.

But, that is what my PCP was worried about is that when I get bound up that the Tylenol was staying in my system due to something else.

So, I hope to get some answers. But, no I was not taking a ton.

Any amount of pain pills are a lot to me. I didn't take anything when I got my wisdom teeth pulled. I have a high pain tolerance but this gut pain is like nothing else.

Right now I am useing icyhot rub and essential oils.

 

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Tylenol is hard on the liver I know. I took a lot of it for pain and I swear after awhile it did nothing. The body adapts. I try not to take anything for pain anymore. I have rotator cuff surgery coming up and hope to get some celebrate to take for a few days to keep the swelling down. I know ice is the best. I use ice whenever I can. The cold deadens the nerve endings.

 

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Also, I have not had a drop of alcohol in over ten years and when I did drink a decade ago it was less than once a month. My PCP and the ultrasound technician feel like it may be a blockage so that is why I am seeing a liver doctor tomorrow.

 

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@may941 I was hospitalized for months with COVID. When I first had it, I brought it up on the forum in response to that idiot pilot who said COVID is no big deal, not different to a cold. That was the night before I was admitted. I got sick clear back in the beginning of November. I still cough more often than I don’t cough and I’m still on five EXPENSIVE medications that are just to treat COVID. I didn’t have pre-existing conditions except for being somewhat overweight. I was surprised that only one person on the forum cared at all, the kind @thudson. I’m very grateful to him to him for having remembered i was sick and reaching out to me.

 

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Even taking a few Tylenol for days on end can cause an elevated ALT. I speak from experience.

 

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Even taking a few Tylenol for days on end can cause an elevated ALT. I speak from experience.

Except that I only took them two/four at most every other day since the last time I saw my GI doctor back in November. They wanted to see where my pain level was once PT started happing every week. Before that, I was told by GI and my other doctors to take a lot more than that (2 at breakfast, 2 mid-day, and only if need 2 before bed or 1am).

During all that time before November I have had a few comprehensive metabolic panel tests done and not once did I test above 50 on my ALT.

The only thing that changed is that I got Covid in January which is also when I started feeling like crap. Once I was cleared to go back to PT nothing about my pain went away and my energy level never came back.

So I am seeing a Liver doctor because GI does not know from my ultrasound if there is any blockage so I have to see a specialist tomorrow to see.

 

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bummer-prayers are with you always-I am having my rotator cuff surgery in a week from tomorrow. Got a busy week getting things together before it happens. I am going though Medicare because the feds are giving me a real hard time.NO lawyer will take it because there is no money in it for them, I was a part time employee-everything boils down to money. I am thinking of getting a hold of my secondary insurance to see if they can help me. They must have lawyers. I have a lot of stuff documented. I would love to go after them. I really don't like this guy at all. He has no compassion and just doesn't care about me or my health or anything in fact. Take care and good luck tomorrow-if it is blocked at least you know what is happening and can get it fixed.

 

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So I am seeing a Liver doctor because GI does not know from my ultrasound if there is any blockage so I have to see a specialist tomorrow to see.

I don't recall everything I've written, so please forgive me if this is repetitive.

If they're looking for biliary blockage, there are two basic tests that they'll typically do. The first is an MRCP, which is simply a specialized MRI. They'll use an antenna coil over your abdomen, and they may inject a gadolinium contrast partway through the test depending on the specific things the doctor wants to see. I get this done once a year, and they do gadolinium for most of them. It has no effect on most people, but for whatever reason it makes me feel sick for about a day and a half. If your doctor wants contrast, it's worth asking what the benefit is, and whether there are any problems with gadolinium accumulating in the body because of your liver and kidney issues.

The second test is an ERCP, which is done with an endoscope that they put down your throat while you're sedated or anesthetized. They use a side-facing port to cannulate the sphincter of Oddi, then put a tube in and squirt in dye that they can see under X-rays. The whole procedure is done on an X-ray machine, and they use fluoroscopy to guide the scope. You'll be out for all of that, and you'll wake up with maybe a sore throat. Possible complications are pancreatitis from getting the dye in the pancreatic duct (which connects to the common bile duct), infection, and a very, very small chance of perforation. I've had at least a dozen of these, and I've only had one complication the whole time (a perforated bile duct on my second one, which required a few days in the hospital). During the test, they may use a brush to collect samples of the cells lining your bile duct to check for cancer, and they may put in one or more stents to hold the ducts open. Be aware that if they need to place stents, they're temporary, and you'll need an EGD (quick scope down the throat, far less involved than an ERCP) in a few weeks to a few months to remove them.

Sometimes they'll do a cholangioscopy instead of the ERCP, if they have the specialized scope required. This puts a scope into the bile duct that they can use to see the ducts directly. This gives them more control, and it's how they finally dilated the bad blockage that had me hospitalized over and over again in 2018. They'd tried to do it half a dozen times with ERCP, and they finally sent me to a different hospital to get the cholantioscopy, which was successful. Then they screwed up the billing and ended up trashing my credit, but that's a different story.

Some questions you might want to ask your hepatologist:
* Which tests are you going to do?
* What do you anticipate learning from these tests?
* What are the possible condition that could be causing my symptoms?
* What are the potential complications of the procedures?
* If you're using gadolinium contrast for an MRCP, is there a chance that my liver/kidney issues will cause it to accumulate in my body? If so, can you get the information you need without using contrast?

Good luck with your appointment!

 

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thanks for the education-appreciate it.

 

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There is very little to say to any here who are struggling with extremely difficult conditions except respect to you all and hope for some simple relief from pain and suffering.

 

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Itapilot,

Thanks for that info.

I have researched the ERCP test. (You said about it in a past post to me) but not the MRCP.

One thing that was talked about by my PT person was that they did not have me drink the stuff for the MRI but only did the bromine into my rectum. She wished that they had me drink the stuff so that It would tell them more information. So I guess I need to bring both tests up tomorrow then and see what the doctor feels.


Like I stated before. MY PCP hope that this was all due to a virus. But, during the retest of my ALT, it was up and not down. PCP felt that there was not the reason it would/should be as high as it was because nothing medication-wise changed, in fact at that point I was taking little to any pain meds because they wanted to see what was what without it.

Right now I am taking nothing for pain but essential oils and using an icy-hot roller so.

Thanks for the questions to ask my DR. tomorrow as well.

 

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The contrast for the MRCP is injected. They'll start an IV before the test, then in the middle of the test they'll tell you that they're going to inject the contrast. I usually feel a warm flush at that point, but nothing unpleasant.

The worst part of the MRCP is that it takes so long, and they give you instructions on when to breathe in and when to hold your breath. For me, at least, their instructions to breathe in are too soon before they tell me to hold it. I've had a couple of tests where the time I had to hold my breath seemed very long, but mostly it's just for a few seconds.

 

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The contrast for the MRCP is injected. They'll start an IV before the test, then in the middle of the test they'll tell you that they're going to inject the contrast. I usually feel a warm flush at that point, but nothing unpleasant.

The worst part of the MRCP is that it takes so long, and they give you instructions on when to breathe in and when to hold your breath. For me, at least, their instructions to breathe in are too soon before they tell me to hold it. I've had a couple of tests where the time I had to hold my breath seemed very long, but mostly it's just for a few seconds.

I have had a few CT scans so I know what that dye feels like.

Going to ask about both tests tomorrow and see what the doctor says.

 

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I wish you the best and that you find the answers you need to be well.

 

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Well this sucks. Getting more blood work tomorrow and got to set up for another test and I freaking chip one of my teeth eating dinner. So now I looked up where I can go in the morning because all I have is Medicaid so the list is small and yep my mouth is killing me and I can't take anything for it.

Hepatology appointment went well. He is doing another test and looked over all my scans and ultrasound and feels that my gallbladder may be the issue so testing that and some other things.

Dang I hate have to go to the dentist just hope they can get me I right away or I will be at the ER/ED so I can get pain medicine.

 

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Good Luck-be well-many blessings