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My husband, liver problems?

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SGirl432
New Member
Joined : Nov 2015
Posts : 5
Posted 11/19/2015 3:50 PM (GMT -8)
Hello everyone! My name is Sarah and I am new here.

My husband has been ill for a while and doctors aren't quite sure what it is. He has a HIDA scan in a few weeks to look at his gallbladder. Another theory is possible liver problems. His CBC is relatively normal with the only abnormalities being slightly elevated Lym A, and slightly low MPV. What gets me is his Metabolic Panel is absolutely normal!

For example his liver enzymes are:

20 Lipase (8-78 range)
18 AST (10-58)
29 ALT (5-50)

It blows my mind that it could be liver related with good liver panels. The only other thing that is "off" is trace ketones in urine and 2.0 urobilinogen which is 0-1.0 normal range.

I feel sorry for him. He was such a strong, hardworking man, now he is very skinny and no muscle tone left. I just wish we could get a diagnosis! Have you guys ever heard of someone with a bad liver with such good labs?


Thanks
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woofer5
Regular Member
Joined : Jul 2015
Posts : 87
Posted 11/19/2015 8:44 PM (GMT -8)
Hi Sarah, sorry to hear of your husband's illness and no diagnosis makes it tough.
The short answer is yes, you can have liver disease without elevated enzymes and despite an essentially normal cbc and cmp. ALT and AST are really coarse markers and indicative of liver inflammation...pretty much a sign post to do more tests and find some answers. The lipase, while it can point to liver problems is more indicative of something going on with your pancreas or pancreatic duct. I've never heard of a lym A...I think this is referring to lymphocytes...a small elevation here is likely just something like a viral infection...maybe a cold. Trace ketones in the urine is pretty unremarkable, particularly without weight gain or diabetes. And a slightly low mpv...who knows...could be normal for him. If it were a more substantial decline than you could look to why his bone marrow is not producing platelets quickly enough and in sufficient numbers. But again, that's not him.

How long has he been ill and what are his symptoms? how much weight loss? and is he just starting to get worked up for this? If he's booked for a HIDA scan then they must have done an abdominal series (3 x-rays...2 abd and 1 chest) and probably an abdominal ultrasound. Was the ultrasound negative? Any CT scans? Do you know any other results?
It sounds like they're just starting to work up a differential diagnosis.

Anyway, this forum has very helpful and knowledgable folks and they have tons of first hand experience. It's a great place to ask questions, explore problems and sometimes just "talk" or vent.
I hope you and your husband get some answers soon.
Best of luck.

____________________________________

2013 / Diagnosed and successfully treated for hep c geno 1b with Telaprevir, Interferon and Ribavirin...treatment duration 24 weeks.
Retired CRNA (aka nurse anesthetist)...approx 35 years experience in the ER and anesthesia.
Exposure was likely a bloody needle stick from a known hep b patient in 1977. Hep B never progressed to the chronic phase...my own, healthy immune system crushed it.
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SGirl432
New Member
Joined : Nov 2015
Posts : 5
Posted 11/19/2015 9:45 PM (GMT -8)
He's very fatigued. No jaundice of any kind. He complains of abdominal pain and shoulder pain. He acts differently than he used to for sure. He had a CT scan of the abdomen done 7 months ago with no contrast and it wasn't positive for anything. He had an abdominal ultrasound 9 months ago. It was also normal. He began filling a little sick in January and has progressively gotten worse.

His skin is also very dry and flaky, especially after a shower. He tells me his legs cramp sometimes and I could imagine so with how little he is. There are other things, sometimes it is hard to keep track of.

Could the HIDA show any cirrohosis? I don't think he has anymore scans besides that scheduled. They go off the last abdominal ultrasound / CT and don't think it's necessary. I wish they would do another scan or ultrasound just to see if there are any differences!
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themiz
Veteran Member
Joined : Feb 2013
Posts : 1891
Posted 11/20/2015 4:52 AM (GMT -8)
Welcome to the Hep forum, SGirl. We are a support group of people with liver disease, and those who love them. I am so sorry your husband is having health problems.

My husband, themister, was diagnosed with cirrhosis and Hep C in 2005. Glad to say he has successfully cured the Hep C, but the damage was done to his liver before he even knew he had that nasty virus. He is now waiting for a liver transplant and has been very ill for several years.

Here is something for you on gallbladder symptoms. www.everydayhealth.com/gallbladder/symptoms/


My husband has had a HIDA scan prior to the removal of his gallbladder, and here is link for you about the HIDA scan testing. www.mayoclinic.org/tests-procedures/hida-scan/basics/definition/prc-20015028

The hardest part is often waiting for answers from the specialists, labs and tests. Again, welcome! Big Hugs
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SGirl432
New Member
Joined : Nov 2015
Posts : 5
Posted 11/20/2015 6:29 AM (GMT -8)
Thanks for the link. Many of those gallbladder symptoms sound similar, but his symptom list seems a lot larger. I am just so worried, because they won't do another CT scan or ultrasound even though it has been so long since he had one.

The only good thing is he quit drinking about a month ago. Granted, he never was a big drinker, but more of a social drinker. Is there any particular liver problem that is more prone to "normal labs" than others?


Thanks again for the help.
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woofer5
Regular Member
Joined : Jul 2015
Posts : 87
Posted 11/20/2015 10:27 AM (GMT -8)
Hi again, hopefully the HIDA scan will help to isolate what's going on. It does sound a lot like gallbladder/biliary disease...particularly with the radiation of pain to the right shoulder.
The link that themiz posted is well worth the read. Mayo articles are always good stuff, they offer great descriptions and explanations without having to interpret a scientific abstract.
Just a word about the HIDA scan...no it won't "show" cirrhosis directly...it's a flow study (bile ----> biliary tree) and will show obstructions (or partial).
The lead suspect for a HIDA scan is a stone(s). However, the results could help point to a secondary cause...say for eg., the scan showed a partial obstruction...which, in fact, could be the result of cirrhosis.

As themiz said...waiting is awful and the fact that this has been going on almost a year is worrisome. It's impossible to second guess this and his doc may be doing the best he/she can....this is best answered by you both. Has your husband seen any specialists...particularly a gastroenterologist? His symptoms could be the result of literally more than a hundred conditions/illnesses. A few suggestions:
A second look/opinion is never a bad choice.
Push to have repeat blood work done...it should include thyroid studies if not done previously...and not just a TSH...should also have a Free T3 and Free T4.
If the HIDA scan is negative/inconclusive, I'd push for another scan. A repeat US or CT scan...whatever is indicated.
Keep in mind...and this is no knock on physicians...no doc, no matter how good, will pay attention to you like you will.
Sometimes it's tough to walk the tightrope between being a patient advocate and being assertive and not be seen as the aggressive...PITA patient or spouse, but you have to try.
Keep in touch and let us know about the HIDA scan.

____________________________________________


2013 / Diagnosed and successfully treated for hep c geno 1b with Telaprevir, Interferon and Ribavirin...treatment duration 24 weeks.
Retired CRNA (aka nurse anesthetist)...approx 35 years experience in the ER and anesthesia.
Exposure was likely a bloody needle stick from a known hep b patient in 1977. Hep B never progressed to the chronic phase...my own, healthy immune system crushed it.
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themiz
Veteran Member
Joined : Feb 2013
Posts : 1891
Posted 11/20/2015 11:14 AM (GMT -8)
SGirl,

To maybe put your mind a bit at ease on the scan concern.

My husband is being monitored for liver cancer(HCC) while he is waiting on a transplant. And he also has a TIPS (shunt) that must be monitored. He has had scans ordered every 6 months. The doctor's will figure this out. I am glad your husband quit drinking alcohol while sorting this out. Big Hugs
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ppm guy
Veteran Member
Joined : Apr 2010
Posts : 1261
Posted 11/21/2015 6:26 PM (GMT -8)
sgirl432,
no i have never heard of anybody having liver disease with with clean blood work and extensive imaging, all being negative.
ast is also a extrahepatic manifestation, that is a muscle wasting marker.

do you have his albumin blood value. also a creatine kinase test could shed light on his muscle damage. worth reading!!!

check out LABTESTS ON LINE to see if that could help.

the elevated urobilinogen is the reason, the drs are checking liver function. what i dont understand is the hida scan.. that is needed when urobilinogen is low.

Since he hasnt had any contrast lately, a ct or mri with contrast of the abdomin could make sure they didnt miss something.

im probably over stepping boundaries now,so remember to always run everything by your dr..
barry
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SGirl432
New Member
Joined : Nov 2015
Posts : 5
Posted 12/22/2015 3:49 PM (GMT -8)
Just an update. His HIDA scan came back normal. He saw the doctor today and while the gasteroenterologist doesn't believe it is related to the liver, he took blood samples to check for hepatitis, pancreas enzymes and also to check for celiac's disease. If it is hepatitis, how long can someone go with a decompensated liver? From the outside he seems to not have changed much, still very lucid yet still very fatigued. My biggest fear is they find something wrong too late. He has been going through this for a year.


Thanks

Post Edited (SGirl432) : 12/22/2015 6:40:48 PM (GMT-7)

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ppm guy
Veteran Member
Joined : Apr 2010
Posts : 1261
Posted 12/22/2015 5:40 PM (GMT -8)
agree with your GI. liver has been ruled out, now he/she can concentrate on nutritional disorders. i would ask dr if colonoscopy is in order. all men should have one by age 50.

best to you and your guy, and enjoy the holidays
barry
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SGirl432
New Member
Joined : Nov 2015
Posts : 5
Posted 12/26/2015 4:35 PM (GMT -8)
Hypothetically, if the Hepatitis test came back positive, how long can someone live with a decompensated liver? Thanks
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themiz
Veteran Member
Joined : Feb 2013
Posts : 1891
Posted 12/26/2015 5:35 PM (GMT -8)
Sarah,

No one knows the answer to your hypothetical, life expectancy question. My husband has lived with stage 4 cirrhosis at least 10 years, so far. He is very sick now, but he continues to plug along while waiting for a transplant.

Hep C is now a curable disease with a 12 week treatment. People can live with the Hep C virus attacking their liver for decades before it progresses to cirrhosis.

I know you are concerned about your husband's health. His gastro has run labs and done extensive imaging, and it looks like he ruled out liver disease. Your husband and you are very lucky to have this wonderful news :) Big Hugs
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A.Ziffle
Veteran Member
Joined : May 2011
Posts : 2092
Posted 12/26/2015 6:24 PM (GMT -8)
VIEW IMAGE.
"Myself being one, who likes to stay on the edge of" medicines. I cant take claim for this therapy. As the drunk next to me pondered on the matter one suuny evening Rambling mindlessly. It's been along time. Hell i was just gloomy and BAMMB!!!! Haapy as a Clam you'd say. (
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A.Ziffle
Veteran Member
Joined : May 2011
Posts : 2092
Posted 12/29/2015 1:22 AM (GMT -8)
I had just replaced my keypad with a (cheapy). The link was about the transition into yoga with mind you very nice work being done. They keyboard was giving me a fit and already been cranky anyhow. as you see it the message the post and the meaning was a total wash.

Ziff
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Blahblah
New Member
Joined : Dec 2020
Posts : 2
Posted 1/30/2021 5:41 AM (GMT -8)
What happened to the OP? Anyone can find her again? Someone has same exact symptoms can’t find answers either. Please help.
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Blahblah
New Member
Joined : Dec 2020
Posts : 2
Posted 1/30/2021 7:59 AM (GMT -8)
Anyone have these symptoms or heard similar? Please
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straydog
Forum Moderator
Joined : Feb 2003
Posts : 19434
Posted 1/31/2021 6:32 AM (GMT -8)
Blahblah, Sgirl has not posted in this forum in 5 years. This forum is very slow this is why you are not responses. I am sorry to hear about your friend.

Take care.
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JimmyM73
Regular Member
Joined : Jan 2021
Posts : 33
Posted 2/11/2021 6:45 PM (GMT -8)
I am a two year survivor of HEP C . Took 90 days of Epclusa had Hep since I was a teen 73 now
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