Posted 8/29/2008 1:08 AM (GMT -6)
The severe fatigue you describe can also be due to liver problems from your medicine. I would be sure to get copies of your liver function tests from your doc or lab and make sure they are not abnormal. You will also be able to see your blood counts and all. the doc may not be totally honest about them being absolutely normal because he may expect some rise. The sore throat you describe can be from acid reflux, which is also a sign of liver problems. I would definitely get my labs and see for yourself. Then, if they are elevated, you can speak to your doc in a more educated way and confront him about them if need be. You can get really sick from liver stuff. Also, there are several autoimmune liver conditions that are quite serious that mimic lupus symptoms in that they are not totally confined to to the liver but cause other problems. Rheumatologists do not always screen for these unless you specifically ask. Normal liver function tests or even very low liver function tests can be signs that your liver is developing cirrhosis and not working well enough to produce the liver enzymes they measure in the liver function tests, so liver function tests are not the be all and end all. If you experience pain in the upper right quadrant of your abdomen, pressure under the rib cage, pain in the shoulder, or itching and jaudice (looking for yellowing of the whites of your eyes or under the tongue) can help you sort of see if there is anything striking. Giving the meds you are taking, I would get copies of the labs. You might be anemic or something as well. I get copies of all my labs. Docs seem to look past the labs during checkups unless I confront them. Now they know I will and address stuff. It's fine, I know they are swamped, so if I have my questions ready, it helps them in case they missed something in going over my labs in the hall outside the door before my appt.
I hope you feel better and can get your labs. If the liver tests are abnormal or very low or if you have any feeling that you might be having liver problems, I would request to see a hepatologist (a liver doc), who can do an ultrasound and get a picture of your liver just to be sure. bilirubin and albumin are only markers of End-Stage liver disease (terminal) and by the time those go abnormal, you are looking at some serious measures. So if they focus on those, ask to see your regular liver function tests like ALT, SGOT and the rest.
--Sometimes I think the surest sign that intelligent life exists elsewhere in the universe is that none of it has tried to contact us. Bill Watterson (1958-) cartoonist "Calvin and Hobbes"
Ills--Sjogrens-Lupus-like AI Disease, Hashis, Vitiligo, spinal stenosis/fusion with plate, salivary/lymphectomies, Diabetes, NAFLD, COPD, RLS, neuropathy, trigonitis, hystero, diffuse brain atrophy, GI nightmare
Meds--Plaquenil, Evoxac, Metformin, Synthroid, HCTZ, Estradiol patch, Prosed, Detrol, Klonopin, Ultram, Vicodin, Restasis, Albuterol, steroid injections and pred prn