Friday, January 7, 2011

First Liver Clinic Appointment

Nervous. Just plain nervous. It is so hard to convey all the proper information to a new doctor, help him/her to believe that I know what I am talking about and understand that I always tell the truth. I was being seen at the liver clinic because of a referral from Acute Care due to pain under my right ribs.

The Acute Care doctor thought I had a gall bladder problem (though I never had gall bladder pain),  swollen fatty liver because I am overweight, felt that I have eaten too much fried food (Ha! Haven't eaten fried food in many years!) and the pain was from my liver. Boy, was she wrong on all counts!

I was very skeptical of her diagnosis. I thought something else was wrong. After my visit to Acute Care, I had contacted Dr. K. because they discovered during an x-ray that a lung infection that she had been treating was not yet completely gone. I was going to need another run of antibiotics. She prescribed 500mgs of Levaquin for 14 days. Within two day of taking it, my pain was gone and has never returned. I thought that maybe the liver might have been infected and the antibiotic dealt with it.

I arrived an hour early with a list of my medications, hospitalizations and diseases and family medical history. I also brought a timeline of the recent lung infection and its correlation to the liver pain.

A smart and beautiful resident in her final year did the interview and exam. She listened as I shared the timeline. She believed that I did not have the pain from my liver but the pain was actually from pneumonia in my lower right lobe. That made sense to me because of the cessation of pain after two days on the Levaquin.

After the resident’s initial interview, she returned with the doctor. He was fantastic. He said that they don’t see a lot of people like me (HA! Wonder what that meant?!) and that he believed that the fatty liver was caused by the long-term prednisone use. This is important as I plan ahead to be qualified for the lung transplantation process. 

He also explained to me that they have recently discovered Fatty Liver and the complications that can follow. It is a benign disease but it may trigger inflammation which can cause fibrosis of the liver. Hello! I have fibrosis of the lungs! I understand fibrosis.

Inflammation of the liver can be brought on by the Big 4: diabetes, high blood pressure, high cholesterol and obesity. All four. I have one. They are just beginning to understand this whole process and he said that Fatty Liver will be the primary reason for liver transplants within the decade.

He does not believe I have inflammation because of the blood tests I had during my visit to Acute Care but he wants to keep an eye on it. He wants to look at my fasting cholesterol levels and a pre-diabetes test then we will meet again in six months. 

All good news. I walked away from the appointment with relief and the feeling like I am in really good hands. I  phoned Michael right away to share the good news. We celebrated last night with my first dinner out being on the new diet. Michael had a killer Lobster Roll and I had a small half crab salad. He also had a cocktail!  I had the olive!

I must pause here to comment about the waiting room. It wasn’t pretty. There were many people there who were clearly dealing with current or past alcohol abuse. I actually talked with the doctor about it and he said that he is often the first person to talk bluntly about the damage alcohol abuse has done to their bodies. He tries to get them into programs to help them stop but he also realizes that alcoholism is a disease that is not easy to “fix.”

All in all, it was quite an education.

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