Medical test results in

Discussion in 'The Watercooler' started by dreamer, Mar 24, 2008.

  1. dreamer

    dreamer New Member

    GP says I do have hepatitis and diabetes. Actually his office accused me of overindulging in alcohol- apparently not reading the history I just updated for them this past week saying I do not indulge.
    They then did not believe me. I am seeking a new doctor.
    BUT, the diabetes and hep could be from the Lupus/rheumatic illness.....or could be from the medications for it (methotrexate, prednisone, Humira and large doses of Ibuprofen)
    I am so discouraged.

    The good news is my lungs are fine! YAY!
  2. Tiapet

    Tiapet Old Hand

    I'm sorry the office treated you like that. I have been there done that myself, although I don't have hepatitis I do have a fatty liver. First they tried the alcohol thing on me (I don't indulge but rarely if at all - now never) and then they tried to blame fatty foods (of course because they see an over weight person). It is all the medications I have been on. Changing your doctor will help and certainly make your feel better when they are better able to listen and HELP you, which is what is suppose to be their job to begin with! (hugs)
  3. Hound dog

    Hound dog Nana's are Beautiful


    I'm glad your lungs checked out fine.

    I can't stand it when docs or their staff just assume something. I know that while in most cases it might be true, there are exceptions to every rule. Docs need to keep that in mind to stay sharp.

    Sorry to hear about the hepatitis and the diabetes. I hope the new doctor has a better attitude. If he doesn't, keep looking.

  4. gcvmom

    gcvmom Here we go again!

    Could you perhaps switch your care to a GI who would be better able to understand the impact your medications are having on those organs? And maybe they could coordinate things better with your rheumetologist? Just a thought.

    I'm familiar with some of those medications since they're used for people with Crohn's disease like my son.
  5. Marguerite

    Marguerite Active Member

    I know this might sound crazy, but I DON'T switch doctors for something like this - instead, I re-educate them. Because with a fatty liver plus diabetes, they're going to accuse you of drinking too much and eating too much. My doctors began from that point until I managed to convince them otherwise. I know my gastroenterologist doesn't believe me when I tell him I don't eat fatty food or drink at all.

    Every doctor I've had treating this, has initially blamed my liver problems on diet and alcohol, until I do the whole 'cooperative patient' thing and convince them otherwise. THEN they pull out all stops trying to find the answers.

    It's like a husband whose wife is found murdered - the detectives don't look past him for the murder, until they do the investigations and realise it wasn't him. THEN they go looking for the real killer.

    To move on too readily is to eventually collect a list of doctors you will never go back to, and thereby limit your future options.

    If instead you do your best to demonstrate and prove your 'innocence', you will have a collection of doctors who believe you and who will fight for you. You will also have better continuity of care.

    However, if your doctor is a total ratbag who refuses to ever consider that he may be wrong, then of course you should move on.

    Good luck with this one. I'm fighting this at the moment, I've developed my own paté de foie gras and I'm on the edge of diabetes. Currently dieting drastically and taking expensive diet pills. Not happy, but I have no choice.

  6. Marguerite

    Marguerite Active Member

    Sorry, something I just remembered - get the doctor to look at your ratio of ALT to AST. If your liver is poisoned (ie by alcohol or other toxins) then the ratio is different, to a liver which is auto-immune-damaged. I'm not sure if this still holds true if your bilirubin is high, though.

    There is a condition called non-alcoholic steato-hepatitis (NASH). The steato-hepatitis refers to fatty infiltration of the liver. You can get this infiltration as primary (such as a fatty diet, with fat being deposited in the liver) or secondary, with scar tissue forming and fat being deposited in the scar tissue because the body isn't using that bit for anything useful.

    If the doctor's OFFICE made some remark about alcohol use and it WASN'T in jest, you should be able to make a formal complaint. That is unacceptable (even if it's true). Complain to the GP, make a fuss and ask the doctor what you have to do to conviince him that this is not due to alcohol intake. It's not just your reputation; what is more important, is you want the doctor to have a good understanding of the cause and not get sidetracked by a misunderstanding.

    If you have a fatty liver due to excessive alcohol intake, that is one thing. But if it is something else and nothing is done about it, then treating the patient as an alcoholic is not going to fix the underlying cause. Tell the doctor. See what he says, before you decide to move on. You could even ask to be referred to someone who is prepared to listen to you and look for more possibilities.

    I hope you can get some help.

  7. SearchingForRainbows

    SearchingForRainbows Active Member

    I'm glad your lungs are fine. Sorry to hear about the diabetes and hepatitis.

    Thinking of you... WFEN
  8. dreamer

    dreamer New Member

    I am changeing GPS not just becuz of this. When I was at the appointment last week, the doctor was incredibly rude, and difficult. He was that way the last time I was in his office, too. He has been my GP of record for almost 20 years. 2 years ago my old rheumy, in the same clinic, same practice group- had Sensory Integration Disorder (SID) since they had not found a rheumy to replace him, my GP there would run my routine labs in interim. I called the GP while still seeking a new rheumy, becuz the clinic never did get a new rheumy, and I was set with an appointment for a new one much farther away- but was due for my labs. when I went in that time, GP charged me as a new patient, becuz I had not been there in over a year. He steadfastly refused to run my routine labs, said he is not a rhuemy and he woudld not do it, no matter what rheumy said.
    Whne I was in his office the other day, he came in and was sarcastic from moment he entered the room. Asked me why I was there, I told him becuz it had been awhile and I did not know what things we should monitor at my age. Still being sarcastic he said he wanted to put me on statins. I said wwell, should we first do labs to CHECK my cholestrol, he said well why bother? He did not think I was commited to doing anything, anyway. He said well, I do not think you are commited. I said I do not know what you base that on. So he said your blood pressure, it is 130 over 90, and you do not take medications for that. I said well, I did not know it was a problem.
    I had gone to see GP at my new rheumys insistance that I needed to check in and just have a general check up. GP did not seem interested in much of anything.
    I asked GP for dietary guidance for better overall health and he mostly ignored me. He said look, I do not hand out pills for the sake of handing out pills. I said I am not looking for pills. He said no and if I want to give you pills, I am not sure you will take them. I said well, it would be good to determine if i NEED pills before I simply take them. Then he decided to do some labs- he sounded angry that rheumy had not checked my blood sugar. Well, at my last rheumy appointment, my rheumy again asked me when I last saw my GP and he urged me to go in to see GP----I told GP rheumy urged me to see him. THat seemed to make GP even more sarcastic and difficult.

    It triggered my PTSD and anxiety to a point I cried all the way home from GP just as the last time, 2 years ago. Felt to me like 2 years ago he thought I did not come in often enough, in spite of me saying at that time, I had not had any concerns and he had not recommended a time span for next appointment....and now when he seemed to imply I should not be there becuz I did not have a specific enough big enough concern. So at GP appointment, he did NOT recommend a next appointment time span. I got my labs drawn, my XRay done and left.
    He had told me I would get copies of my labs within 2 weeks and not to call. Their new policy is to simply mail copies to patients. (I thought that weird becuz previously you had to fight to get a copy of labs or even values) Yet Fri morning docs office DID call. Not on my cell # I provided, but my house phone. I got the voicemail just afternoon and called back. Got the infernal voicemail at docs, left mesage with all info, and my cell #. An hour later someone called me back to tell meshe could not find my chart. She said she would call when she found it. I called again 2 hours or something later again.....actually GOT a human, who said they would call me back within an hour. They didn;t so I called back again. ANswering service answered and said the office had sent phones to service already so they could clear out patients faster so as to go home, but if they told me they would call, they still would. They didn;t. I called Sat morning, but they were not in for holiday. I waited till noon Monday, and they still did not call, so I called. Left another message with voicemail. They finally called me just before end of day Monday.

    The nurse who called me was droning on and on berateing me for my drinking with my diabetes and hepatitis etc.
    She did not set up a next appointment, no follow up suggestions, nothing.

    I think if I have a problem like diabetes, I need a docs office I can reach. I need one who will talk with me. Not accuse and berate me, and not one who delivers crummy news in such a manner. I see my rheumy on a very regular basis, I see my gyne on a very regular basis. My gyne is in same clinic/practice as my GP. I have had no problems dealing with either of them or with the nurses and office people when I see either of them.
    Bummer is to find a new GP, I am going to have to now travel outside of my town for one. I really preferred to have a very local GP- but, I doubt I can manage to continue to deal with this doctor behaving so poorly.
  9. flutterbee

    flutterbee Guest

    I'm sorry you had such a bad experience. I'm trying to figure out why they would put you on blood pressure medications for 130/90. Unless it's because of the other stuff, cause that's really not high.

    With the way this doctor is behaving, I would not only find a new GP, I would want the tests redone. Second opinion. I'm not sure I would trust anything from this guy.

    And statins can cause other problems so while I absolutely would take them if you need them, I would absolutely not take them without checking to see if I need them. I think one of the things they check before putting you on statins is your liver, so you'll definitely want to talk about that with your new GP.

    Dreamer, there have been studies coming out over the last few years that show a significant increased risk of coronary artery disease among patients with RA. And of course, it's there with the lupus, too. Diabetes just adds to it. I would talk to your rheumy about whether you should have some cardiac testing, too.
  10. dreamer

    dreamer New Member

    Heather, I agree. Which is part of what I told GP at the start of that visit. Seems he was just bound and determined to decide whatever-----yes, I do have belly fat, to go with stick thin arms legs and bottom.....and he seems to have decided I just right off had all the "metabolic syndrome" stuff before we even began any discussion. I am not sure what the values were for fasting blood sugar, or triglycerides etc.....or any of my labs...but I am quite disturbed. I know the elevated c reactive related to RA is a problem, too.....

    Ah well, today I did go out to book store, got a few different books on better healthier eating/cooking.- altho by dinner I had not yet read enough to think of anything other than a plain baked 3 ounce peice of plain salmon and some steamed broccoli and steamed asparagus, drizzled in fresh lemon. The family balked, too bad. They all certainly can only benefit from eating that way, too. LOL. Maybe by tomorrow, I will come up with something else, LOL. I am TRYING to view it as a big adventure, now. BUT I am still quite hurt and angry and upset about how the darned GP and his office people handled things.
    And yeah, I am miffed at rheumy now, too for not checking blood sugar all this time. I think when I see him in 2 weeks, we are gonna rexamine the medications more, better. we have been trying to decrease pred, and I think I am wanting him to dump the mtx. Sadly even a small decrease in the pred brings back the rheumatic symptoms hard and fast. I already ditched the ibuprofen.and gonna discuss the Humira. There HAS to be some kind of balance here. Either way, better eating habits are a good idea.
  11. Marguerite

    Marguerite Active Member

    After all that - yep. Move on. And didn't you say that you don't drink? So what gives that nurse the right to berate you as if you do? Or was she basing it on what the doctor had perhaps written in your files?

    I can understand the rheumatologist not checking blood sugar - it's not really part of their brief. I'm currently seeing a gastroenterologist for the liver etc stuff. He was the one who ordered fasting blood sugar, PLUS fasting insulin (done at the same time) which in my case showed that although my blood sugars is normal, the insulin was raised which indicates my body is pumping it out in much greater quantities because my cells are sluggish to respond ie insulin resistance.
    My cholesterol and triglycerides are normal, I've been eating a low-fat, low carb diet for years, plus I don't drink. This sort of thing can still happen even if you do the right thing - your body can still let you down even if you don't abuse it. Medical staff should not make assumptions or berate you unless you really are ignoring their advice or treatment.

    This doctor sounds like a lazy, conceited ratbag. "Richard Cranium" comes to mind.

    Good luck with finding a new GP. A suggestion - ask a support network dealing with rheumatoid arthritis if they can recommend someone in your area who has a good reputation with others in your position. Or ask pharmacists in your area for names of doctors they would recommend.

  12. dreamer

    dreamer New Member

    Ironically, I had to do yet another "history update" at this last appointment at GP and one of the first questions was about alcohol consumption. So it was right there. Family history also was right there, listing my brother with type 1 diabetes.

    My GP did say becuz the rheumy Rx'ed pred, HE should be who orders blood s ugar, routinely, - my rheumy DOES order liver enzymes routinely. I do tend to agree with GP about that. Even if the rheumy would then have GP, GI or internist deal with abnormal results.

    Sadly I travel quite far to have a rheumy. There is not one closer, when I was last in his office, there actually were a few others from my area there for that same reason. My part of the state has a hard time attracting and keeping specialists of any type becuz- according to newspaper and docs I have talked to or worked with, the malpractice etc is just ridiculous. Especially ridiculous. So, maybe I will begin crossing the border into the next state. Actually it is not far at all. I just never did do that before becuz my old insurance would not cover out of state, but, now my Medicare should.

    I think the nurse who talked to me was just being...a jerk. She made an incorrect assumption and ran with it. She assumed I drank and assumed I already knew I had diabetes and hepatitis.

    I have been studying everything very hard now yesterday and today.....between my nurseing textbooks and internet and several books from bookstore and emailing my brother, and things I remember from first husband (he was diabetic altho he died from it in 86)

    SO yes, I have read about insulin resistance, too, and metabolic, I am working on a list of more questions for a doctor. Meanwhile I am working on assembling meals that I can eat that are agreeable and favorable for the combination of information I DO have about my status (the various diagnosis'es). DRagged my bicycle back out as the snow is now melting.....sought out my doggies leash so we can walk more......

    So yeah, I have begun to deal with the issue at hand, the diagnosis.and yeah I know that nurse attitude does not change the test results......but- I am still hurt and angry. People do not have to be careless or rude. Not so pleasant news can be delivered in a better manner. and in a more timely manner.

    Whew, so much to learn! So much to work on! So many questions.
  13. Abbey

    Abbey Spork Queen

    I didn't read all the replies, but I have auto-immune hepatitus. I've been in remission for 8 years. (They said I wouldn't last a year without a transplant.) Oddly enough, that is when I took over the board from Momma Bear because I was bed ridden and bored.

    It took going to USC and seeing the head of the liver transplant doctor before they correctly diagnosed it. After rapidly going downhill within a month, he took one look at me and said he knew what was wrong. The sad thing is it like looking for a needle in a haystack to know what brings this on. Tylenol and Oriental supplements are on the top of the list, but I didn't do either of them. I still think it is when they found mold and asbestos at a school I taught at years ago. It fit the time of when the disease started.

    The drugs they have you on are GREAT. Humira was the one that saved my life. It was experimental at the time, but I didn't really have a whole lot to lose. I am supposed to be a lifer for Prednisone, but after high dosages for a couple of years I just couldn't take the side effects anymore. Fingers crossed that I don't have to go back on it ever again.

    Good luck, and I hope you have a really qualified doctor. The doctor at USC told me that auto-immune hep is one of the hardest things to diagnose and many doctors are not up to date on how to do that.

  14. dreamer

    dreamer New Member

    Abbey, I agree, the medications saved my life. Prior to my medication combo, I was basically a quadriplegic. And THAT did not sit well with my bipolar/hypomania.
    ANd yes, I am going to urge docs to check into my hepatitis, see if it is related to my illness, my medications, my diet or what. See what we can do abuot what here.
    Meanwhile I am immersed in tons of books, LOL- coming up with some creative meals. I am sure better eating habits will not hurt, LOL. and of course, now with nicer weather, getting outside for more exercise is much easier and more pleasant and fun.
    Nah, I have not taken any tylenol in ...20? years? and even then, very very rarely....and no suplemtns.....until this week, now I am doing OMega 3s.
    I am going to hold you as an inspiration to me, that it can get better. THank you for shareing. I love to hear good outcomes. :)
  15. Wiped Out

    Wiped Out Well-Known Member Staff Member