Good News/Bad News

[ellyssian]

Results from the blood tests are back:

Cholesterol - doing great! Yay! (although keep up the meds at the current rate)

Liver Enzymes - not so hot; going in a little while to pick up scripts for more bloodwork and an ultrasound. Yay.

So I look up liver enzymes and possible indications and see a whole host of things unpleasant, with the final item indicating a cancer like my dad had, and an item in the middle list relating to the bile ducts going screwy, which is, essentially, what caused him to go. Not the kind of thing I need to see so soon.

On the positive side, there are, as I mentioned, a whole slew of things on that list other than those two scare-the-hell-out-of-me items that could skew the test results, and they range from the relatively benign("obeisity", which, technically, and by the popular measurements of the day, I am) to the nearly-as-bad medical ailments.

On the negative side, it's not as if my arm got ripped off and left as a bloody stump, so that's one more thing that Deb won't think I've actually got or need treatment for (in addition to asthma, high blood pressure, or high cholesterol.)

On the fair-to-middlin' side, all bets are off for what goes on tonight. I may or may not decide to go do the poetry thang, and I may or may not get to the aforementioned Sekrit Mission (which can't be mentioned here, to keep certain potential readers from reading of it!)

Comments

[celticess.livejournal.com]

I have the high enzymes. Now there are several common reasons why it happens:

1) Hepatitus of some sort(A/B/C) so commonly hep panel is run
2) Alcoholism (which would be evident doing history, etc)
3) Medication induced (things like regular use of tylenol can often cause this)
4) Born with unusual enzyme levels
5) Autoimmune disease (yes some arthritis type diseases will attack the liver)
6) Cancer (if they ever do this test have it done at least 2x as it notoriously gives false negatives and doctors tend to not mention that fact)

I am very low risk for hep. High risk for hep are people that are swingers, promiscious, or drug users. Since I didn't have a risky lifestyle I was seen as low risk but on occasion people can contract this from contaminated things handled by someone else with hep. To my knowledge when my enzymes were found high I had nobody I knew with hep. When I moved where I live now yes someone has hep but they are I think reasonably aware how to handle their disease so are unlikely to spread it.(they got theirs from contaminated blood back in the '80s)

I don't really drink. When I did drink I got maybe drunk 1-2x a year. I drank maybe 2-4 drinks every 4-6 months. Now if I drink at all it's maybe once a year one drink to two drinks and I really watch it as it will now make me ill due to the enzyme level. My maternal grandpa was an alcoholic so was one of my moms brothers. My mom is 1/2 irish american and she's not an alcoholic but I think carries the gene for it. I think this is why some people can be born with abnormal liver function.(ie I think it runs in families of alcoholics even if you don't drink)

Medication induced is the type I think I have. While I've followed the label instructions and percautions the fact is I was on several medications for around 20 yrs.(naproxen, tylenol, etc) Arthritis drugs can be quite hard on the liver.

The doctor however thinks I was possibly just born with unusually high enzymes. I don't know why he persists in the hep tests. But almost every time I have blood work done they run them all the same and as usual they come back negative.

There is also a chance in my case that it's some form of arthritis attacking my liver. I've got quite a few arthropathies but some of them are hard to pin down. Lupus can attack major organs for example but it can take 10 years or more to turn both tests(which is required for a dx) for lupus positive. I had turned one positive then years later that test result came back normal when I got retested.(they can go positive and negative off and on for years before locking into one)

Cancer is something I'm high risk for. But not liver cancer except as a secondary. I'm more high risk for benign hereditary breast cancer and malignant colon cancer.(the cancer grows in a polyp near the junction of the small and large intestine in nearly all the cases in my family making it very hard to find on a scope or scan. I did have a benign polyp removed when my son was 4 so with that and having 3 in my dads family die of the same illness, having gerd and IBS I'm very high risk so on the early screening program). Despite my risk factors no doctor has felt the need to run the test on me. I have been suffering from some pain in my liver off and on so later at some point I might request the test or a UT. A UT(ultrasound) likely would only show cysts not necisarily much beyond that so have limited usability depending on what they think they might find.

Anyways I'd not worry to heavily. It is more common to have the other things go wrong than have liver cancer.

I do understand the scared by results feeling. My enzymes are quite high. I'm not supposed to have even neociteran or even that rare once a year drink. The once a year drink does make me feel ill. If your enzymes are high you must follow liver disease percautions even if your otherwise healthy because if not you can get ill in reaction to whatever. So read labels on things when getting them to be safe.

[ellyssian.livejournal.com]

Yeah, I'm sure mine is (at least partially) medication induced, as I was always told that was a possible side effect. Or it could just be wonky results.

But it was just no fun to see those other items on that list of possibilities.

[celticess.livejournal.com]

I know particularly with our risk factors. But if your otherwise doing ok and no symptoms of other things I'd not worry too much. I think primary liver cancer is very rare and the most common way to get secondary is after operation on a primary.(how my dad got it)

If some of the meds had a warning and you've been on them awhile thats the most likely explaination. Though docs often will just say "we don't know for sure but it's not ___" Which I don't find comforting either because I wish they would just say "yes it's x" so you could be done with it. Also it's a bit irritating to not be able to take neociteran. Not that I ever took a lot of it but you know when your sick with a cold it's nice and warm and helps the ick.

[patrixa.livejournal.com]

Cancer, not blockage of ducts killed Dad. The blockages were caused by cancer-formed clots also present in brain and heart, causing failures there as well. But it was cancer which destroyed his liver yielding the jaundice which could not be "cleaned" as clots kept forming and forming. No amount of stents, nor even an artifical bile duct (which does exist and of which MGH is the major developer) would have helped. Were it not for the aggressive cancer, the ducts could have been taken care of.

Blood tests that show an existence of not cancer exactly, but a proclivity towards it, should be done. That's how Dr. Firn first had evidence of Dad's cancer. All the June kids were encouraged to have such testing done after uncle Richard's family died of it within 2 yrs.

Cholesterol drugs have a high incidence of causing liver problems. A cut in dosage seems reasonable, accompanied by a change in your diet, i.e., smaller cheese and meat portions, increasing protein via non-meat foods. e.g., beans and fish using less fat in prep and servings. You can cut down on those immediately.

I wonder why an ultra-sound test: what is dr. looking for? I don't know what he will be able to find from it. You MUST ask what and why...it is your body and you deserve to know exactly what is happening to it. I got answers about what and why for each test done to Dad. I made sure I understood what they said even if it took a few times to be clear.

I don't recall exactly what the Mt. Auburn technicians answere, but it was sort of like: ultra-sound on the leg (soft tissue?), CAT scans on abdomen and lungs, after which an MRI was done on the abdomen for greater clarity.

So I'm hoping that medication is the cause of your rising enzymes because that will be the simplest to cure...you can change your diet if meds must be lowered or changed. Do you take lipitor? Because MIT recommends zocor--both Dad and I were switched 4 or 5 yrs ago (2 different drs)

[ellyssian.livejournal.com]

Still taking lipitor, and he wants to keep me on it. I haven't talked to the doc, and won't until the results from these tests come back.

I had the blood done, but the ultrasound is by appointment, so is scheduled for early Monday morning. From what I read, you use a CAT scan when cancer is suspected, ultrasound just to poke around in general without being intrusive:

There are many reasons for performing an abdominal ultrasound including looking for a cause of pain, for stones in the gallbladder or kidney, or for a cause for enlargement of an abdominal organ.

As for my medications, kidney failure is a rare side effect of Quinaretic; Norvasc doesn't list kidney issues as a side effect, but does say you shouldn't take it if you've ever had kidney disease; and Lipitor has been known to cause rare cases of liver disease. So yeah, most likely cause right there, in one or all three.

[patrixa.livejournal.com]

MERDE! MERDE! (polite French for...)

re Lipitor? ask why and why are you not at least decreasing it while awaiting results. You are right on ultra-sound, I just couldn't remember clearly.

Always question why for any meds., specially if you have researched it. I know docs don't want you to do research, but the time for them to as demi-gods (the fashion for many years) is over; they are partners in your health care, ergo, must be able to explain and reassure without ego and include you in on decisions. Dr. Zhu was a wondeful example of this and able to discern how much (pretty near everything) info we needed to understand. most docs need prodding. Your doc, if the same who treated your for heart etc, seems to be right on, so I doubt he'll mind your queries...I hope. He does know about Dad, right? I'd like to know ASAP conclusions and decisions and will wait as patiently as possible.