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27 July 2018 @ 09:44 am
Liver Disease Diagnosis  
I've modified my diet as much as possible to reduce inflammation, can't tolerate the level of Vit E suggested below but can tolerate 200 IU with food. I still have pain in the vicinity of my liver nearly every day, sometimes severe, and the area of my spleen sometimes has pain and is always tender. (When I went in to Urgent Care last summer with bladder infection symptoms the doc noticed tenderness in both areas. I should note that it had been years since I received a thorough abdominal exam like that. How many things could be caught earlier if doctors weren't afraid to touch fat patients or didn't convince themselves our fat is in the way so it's useless? We still feel pain and tenderness when examined and that tells you something!)

The referral to nutrition mentioned below is useless to me since Medicare (and therefore my secondary insurance) doesn't pay for individual consult. I may pay for one myself at some point, but basically I'm treating this as a stricter version of a heart healthy diet crossed with a modified diabetic diet with the hope of reducing inflammation generally. For my sanity I am not making weight loss a goal though some modest weight loss has resulted.

Gastroenterologist regarding trans-jugular liver biopsy results:

"As discussed on the phone, you have NASH (non-alcoholic steatohepatitis) which is inflammation of your liver from fat cells. There was a little bit of scarring (fibrosis, stage II) but good news is that there is not cirrhosis (complete scarring). Of course, we are trying to prevent cirrhosis so that would entail weight loss in a slow and steady manner. I have referred you to nutrition.
Also, vitamin E supplementation at 800 international units per day may decrease the inflammation and hopefully decrease fibrosis but that needs more studies to prove the latter."

Most recent liver panel:

Total Protein 6.8 g/dL 6.4 - 8.2 g/dL
Albumin 3.2 g/dL 3.2 - 4.7 g/dL
Total Bilirubin 0.4 mg/dL <1.1 mg/dL
Direct Bilirubin 0.1 mg/dL 0.0 - 0.30 mg/dL
Alkaline Phosphatase 131 U/L 26 - 137 U/L
AST 15 U/L 0 - 37 U/L
ALT 18 U/L 0 - 60 U/L

Last C-reactive protein test was 2015

C-Reactive Protein 40.2 mg/L

Recent cardiac cath showed no new blockages so that's great news! Even if nuclear scan showed a lowered ejection fraction.
W. Lotuswlotusopenid on July 27th, 2018 04:51 pm (UTC)
Basically one need to be a slender, financially comfortable, white, cisgender male to be taken seriously by far too many people in the medical profession. Exactly the type of person who is probably statistically less likely to need medical care. I'm glad this doctor did a thorough abdominal exam to identify the issue.
Tapatitapati on August 10th, 2018 06:48 pm (UTC)

Lord grant me both the confidence and the health care of a mediocre but financially privileged white man.
W. Lotuswlotusopenid on August 15th, 2018 12:39 pm (UTC)