Had ultrasound earlier today - not good news ....

General health and lifestyle
1

I saw my GP on Monday (3 days ago) and he tried to reassure me that I do not have cirrhosis.

However, I have continued to feel very unwell - as well as being very worried about the visible physical symptoms that developed on 30 August (now mostly gone).

So, I arranged a private upper abdominal ultrasound (including the liver) today.

I told the radiographer about the binge-drinking, elevated liver enzymes and that I have been feeling ill.

It is not good news.

Everything (gall bladder, pancreas, kidneys, spleen, aorta) is fine - except for the liver. The radiographer told me that it was bright and slightly enlarged.

Her report was brief, but reads as follows: "The liver appears of raised echogenicity. It is bright and fatty in appearance. No free fluid".

I knew I wasn't well and my instincts are seldom wrong. It's a pity they were not in this case.

I am devastated and kicking myself.

:-(

2

Sorry to hear your news Gav. My only thought right now would be to try and flush out your system with lots of water and juices, and of course stay off the booze. Try more exercising as well as this speeds up the system healing process.

Best of luck there buddy, hang in there.

3

Thanks, Tim.  I can stay off the alcohol and drink plenty of water and juices, but exercise is difficult because I just don't feel well: tired, weak, dizzy and lacking appetite.

I'd hoped-agaonst-hope that the ultrasound would be clear and reassure me, but I'm sure it's just confirmed my worst fears.

I am scared and I don't know what to do.

4

You missed off an important piece of information to this post, Gav - what happens next?  Do you already have an appointment to take these results back to your GP?

I don't know anything about liver diseases so I did a quick google search.  Cirrohosis is scarring of the liver due to continuous, LONG-TERM liver damage.  Note the words 'long-term'.

Your doctor appears to be correct in that you do not have cirrhosis!  A bright and slightly enlarged liver is clearly NOT cirrhosis.

Yoru ultrasound show shows your liver is SLIGHTLY enlarged.  Again, a quick google search shows that this can be caused by an infection, some medications, toxins, certain types of hepatitis, and auto-immune disease, metabolic syndrome, genetic disorders that cause substances to build up, abnormal growths, a problem with the blood flow, hepatic vein thrombosis.

Any of these causes (I would expect) would make you feel generally unwell.

It says how you get treatment for this depends on what the underlying cause is, so in my mind, that is your next step. 

I've read back on your previous posts before I've replied and I am not going to try engage you in a conversation based on whether your fairly recent drinking caused this, becase firstly, we don't know the answer to that, and secondly other people have already discussed this at length with you and no matter what, you are still convinced the drinking has damaged you.  Nothing I can say is going to change that.

All I will say is that instead of kicking yourself at the SMALL possibility that the drinking has played a part, and thinking you have given yourself irreversible damage (cirrhosis) when you clearly haven't, tell us what you are doing next.

 

5

Hi Gav

Don't be scared. Fatty liver is a reversible condition and you are doing the right thing staying off the booze. It may take some time for you to start feeling better but if it has been down to alcohol then abstinence will help you recover more quickly.

You will need follow up with your GP to rule out other liver problems. There is a set of bloods called 'a liver screen' and this covers some other diseases that may need to be ruled out e.g. Haemochromatosis or hepatitis etc.

Obesity and diabetes can also cause fatty liver so you need to take a healthy diet - but the liver is an amazing organ for healing. It's only once it is damaged beyond repair (I.e cirrhosis) that the lifestyle changes won't have much impact. Although even then, many people who give up the booze survive many years on only a small amount of functioning liver.

Take your scan results to your GP for a chat, I'm sure s/he will say the same thing. Ask for the liver screen and hopefully your LFTs will start improving and you'll start feeling better. Trust your instincts - you knew something was wrong and you did something about it! So well done you smile

6

Hi Joanna, thanks for taking the time to reply and in such detail.

The earliest appointment I could get with my regular GP was next Friday (eight days from now).  However, I'll give the surgery a ring tomorrow and see if I can get one of the receptionists to ask the GP to give me a call.

The radiographer who did the ultrasound asked me if I wanted her to send a copy of her report to my GP and I agreed to this.

My drinking over the past year and a bit, but especially over the past 5-6 months has been shocking - I would estimate at least 80 units a week, on average, and probablly double that when I indulged in short, serious binges, such as on 31 July/1 August and 27-28 August.

The visible symptoms that appeared suddenly on 30 August were just scary: extensive bruising, darkening of skin on backs of my hands and the genitals, spots under the skin, painful rash on chest, red palms, some hair loss and more general thinning of hair.  Except for the hair-thinning, those symptoms have generally improved or have gone. 

The best way I can describe how I'm feeling now is that it's like having the flu, but without the cough and runny-nose.

I don't have any doubt that the drinking has harmed the liver and is why I'm feeling ill.  I've also lost over a stone in weight in the past month.

Hopefully I'll manage to speak with the GP tomorrow.

Gavin.

7

That's much more positive, Gav :-)

Going forward is what you need to concentrate on.... not ifs and buts and whethers or maybes....

I was drinking 65-70 units a week regularly for many, many years and for a woman this is high.  I had liver tests done recently for another matter and they showed that my liver is now actually healthier than it was 10 years ago.  As BikerBlue mentioned above, the liver is quite a remarkable organ with amazing ability to heal in the early stages.

My point is that you are going to feel pretty foolish at wasting all your time and energy worrying (and probably making yourself feel even worse as a result) if further tests show that you are simply suffering from a minor infection which has caused the slighly enlarged liver and all your other symptoms!

And just IF your drinking caused, or even slightly contributed to an underlying liver issue, then what can you possibly do about it now?  Absolutely nothing is the answer!  Beating yourself up over the possibility is not good for your mental or general health.

Have you considered that if there is an underlying issue not connected at all to drinking, then if your drinking has brought this to your attention sooner rather than later by creating additional symptoms, that is actually a good thing?

It's a waste of your time and your energy that you should be putting into positive lifestyle changes.

Only you can make these changes and I'd really, really LOVE to see you focus on making those and reporting to us what you are doing.  Even if that is something as simple and straightforward as buying a bag of carrots as a first step to eating healthy!  It doesn't matter what it is, as long as it is positive.

How about making a commitment to post to us on one small, positive change you make every day until you get your appointment?

Now there's a challenge.... :-)

8

Thanks, BikerBlue.

The first and second time I ever seriously binges on alcohol was twice in October last year.  On both occasions, I felt really rough for a few days afterwards, but nothing beyond that.  I then drank only moderately from November to March this year.

Then, I started drinking more heavily again generally, with occasional short but very heavy binges.  So, it's really been 5-6 months of heavy drinking.

My first indication that something was wrong came in June/July - I started to regularly sweat profusely and had intolerance to heat.  My skin also often felt clammy.  I then drank to block-out these symptoms.

But the scary symptoms came-on suddenly on 30 August, 24-48 hours after my last serious binge: extensive bruising, darkening of skin on backs of my hands and the genitals, spots under the skin, painful rash on chest, red palms, some hair loss and more general thinning of hair.

Since then, I was sure that I had damaged my liver and feared that I had developed cirrhosis.  A doctor in the local hospital (I was in hospital from 29 August to 1 September) and my own GP have assured me that I do not have cirrhosis, but they've just been going on liver function tests.  Of course, I think that my enzymes are not raised by that much because my liver is badly damage, so not releasing that many enzymes into the blood-stream.

I am scared stiff.

9

I should add, Gav, that until your appointment I am more than happy to chat on the phone to you.  PM me and I will send you my phone number.

This is ONE condition to this though - I want to help change your negative thinking to positive thinking.  As mentioned to you before in your threads, you are seriously stuck in a negative thought process over this.

When chatting to you, I only want to hear positive things you are doing, positive thoughts you are thinking.  I do not want to hear about your symptoms or how bad you feel.

I am always happy to give up my own time to help people, that isn't an issue, but to do so I have to feel that I am really helping them make some kind of change for the better.  In my opinion (as someone who counsels and helps a lot of people), providing you with a soundboard until your appointment can be beneficial to you, but it will be neither useful to you or a good use of my time if I engage in helping perpertuate your negative thinking cycle.

So, if you would like my number (I am in the UK) PM me :-)

 

10

Hello again, Joanna.

I've been drinking beetroot juice, carrot juice and apple juice, as well as water, regularly since the middle of last week.

I generally love walking, but just don't have the energy.  I felt as if I was going to pass out several times when driving to and and from my ultrasound appointment today.  I really feel rotten.

I don't think there's any infection - on Monday, my GP said all of my blood tests - I had more than liver function tests done - were normal except for the AST and GGT parts of the liver function test.

I really don't have any doubt that the past 5-6 months of drinking have brought me to where I am, and now I have to deal with that on top of the pre-existing depression, anxiety and insomnia - it's not a nice place to be at.

Gavin.

11

Like myself, you need to string some sober days together regularly.

There's a book that introduces a technique that gives you a shot of willpower against drinking daily. It's to do with setting your life up so drinking becomes more painful than not drinking.

I found it on Amazon 9 days ago, and I'm 8 days sober.

It's called 'How to stop or control your drinking habit in 30 minutes' by John Bleck and it's currently free. It's a very short read and I'd recommend it to anyone who worries they will falter.

I think it will give you a giant shove toward helping your liver rebuild itself.

Good luck.

John.

12

Ya know what? You are not alone, many of us on this forum have gone thru much the same as you and we WILL persist in our endeavours to find solutions !!!

I retired in early 2009 and quickly found myself over indulging in the booze 'cause I found myself bored while in the winter months. One day after another for several months and I was hooked.

You haven't mentioned anything about your past or your age, so I'm guessing you are probably retired or just unable to work because of your condition.

Physical activities for me during the winter are non-existent other than shoveling snow confused pls try and keep busy. I became a couch potato and drank.

And yes, I have gone thru the tired, weak, dizzy and lacking appetite. etc. days as well...it WILL pass. as for your other physical comments, your GP can address them and releive your worrys. Could just be age related.

If you feel you must drink, then try Naltrexone or Nalmefene (Paul says it is gentler on the liver). I'm hoping he will reply to you, as he is a Clinician nurse, addictions specialist. A good source of information on this subject.

Also there are many other good people on this forum for support...I was just as scared as you when I found this site in early March - feel much better about myself and more confidence TO BOOT !

Joanna has given you an excellent offer - take her up on it if you haven't done so already.

13

Hi Gav

I'm so sorry you feel scared, it must be horrible for you. You really need to see your GP, I know you're struggling to get an appointment but some GPs will ring you if you phone up and ask for a call back.

Approx 1 in 10 heavy drinkers get cirrhosis and that is usually after 10 or more years of heavy or dependent drinking. You're right to think that the LFTs do not always correlate to the level of liver damage (although in early liver damage are good markers) but a few things you say suggest that you have fatty liver rather than cirrhosis and this condition is reversible if you stop drinking. 1. Many of your symptoms have improved 2. Your ultrasound scan result 3. Improving LFTs

Of course, nobody on this site can tell you anything for sure, you need your GP to examine you, look at your scan results and bloods, and if necessary s/he will refer you to a specialist. If not necessary you can still be checked up by your GP. Try not to worry.

You may have had an episode of acute alcohol hepatitis that put you in hospital. That can happen to anyone, even a tee-totaller who goes on a sudden alcohol binge if they drink enough!

I know you say your hair loss is continuing but this could be stress-related and hair loss can take months to reverse/improve. Anyone who is suddenly acutely ill for any reason can lose their hair.

It is unclear why some drinkers end up getting cirrhosis and others don't. Research suggests that other factors come into play including genetics or another liver disease. That's why I said be sure to get the liver screen bloods done. For example, if someone has hepatitis C, that is curable these days. But if they don't know and don't get treated, about 30% will get liver cirrhosis. And if they drink heavily as well, the risk is even greater.

I hope I'm reassuring you here and not making things worse! You really are doing the right thing by stopping drinking. Don't forget, giving up alcohol itself can reveal underlying anxiety (which I think you mentioned you had) and this is going to cause you to worry more. Worry and stress only makes things worse.

Fatty liver is reversible - keep reminding yourself of those words smile

Be kind to yourself, take one day at a time and hopefully you'll feel better soon smile

14

Hi Tim.  Thanks for that.

I'm 46.  I took voluntary redundancy from my job of 24 years three years ago.  I had little choice.  I felt good when I left and did other things for a year and was happpy doing so.  Then I had a health scare in summer 2013 that traumatised me and other negative life events hit me and I've been suffering from depression, anxiety and insomnia ever since - and been unable to work.

For about a year, I didn't drink any more alcohol than I had been doing for about 25 years, but last August I started to drink more, including the two binges in October that I mentioned.  Then I reverted to moderate drinking for a few months, and then the heavy drinking started again in March this year, and so on.  Boredom has been part of the reason for drinking, but mostly it's been to block-out depression, dark thoughts and to alleviate symptoms of alcohol withdrawals.

I've tried counselling and CBT without success.

I'm going to ring the doctor's surgery a bit later and see if I can get past the receptionists to speak to the GP.

Gavin. 

15

Thanks, Tim.

Gavin.

16

I got in touch with my GP this morning and passed-on the brief report from the radiographer, saying that my liver was bright on the ultrasound, slightly enlarged and fatty in appearance.

He said that that was in line with our discussion on Monday, my liver function tests, and that it was nothing to worry about.

I am to go back to get the various blood tests repeated next week and go back and see him once the results are back from the labs.

I guess I should find this reassuring, but I can't get the elevated liver enzymes, those horrible, visible symptoms that suddenly appeared on 30 August, and just feeling like I have a constant flu (without the cough and runny-nose) out of my head.

I'm going to go for a good walk soon and see how I get on.

17

This condition can be reveresed by eliminating or reducing alcohol intake...and eating more fruits and veggies...and less fatty foods.

Take vitamin C, folic acid and zinc.....google fatty liver and learn about it...you CAN be ok...but you will have to work for it sad.

Sorry you are suffering.

18

Well, I had a long consultation with my regular GP today, and he talked me through the results of the liver function tests, complete blood count and clotting tests that I had on Tuesday of this week.  I couldn't get a copy of everything - there was too much - but here are some important ones:

Serum Albumin:  48 g/l  (normal range: 35-50);

Serum total Bilirubin:  7 umol/l  (0-21);

Serum gamma GT:  70 U/L  (0-61 - it had been as high as 121 in August);

AST serum level:  23 U/L  (0-40 - had been as high as 96 in August);

Alk Phos:  84 U/L  (30-130);

Platelets:  390  (150-450);

Prothrombin Time:  9.3  (9.0-12.0).

Unfortunately, there is no AST value.  The doctor said that is not done routinely, and I have never had it checked for either by the doctor's surgery or hospital.

Everything else in the various blood tests was in normal ranges.

The docor said that the AST quickly coming back down to normal and the GGT returning to near normal (he said it takes longer to do so after a spell of heavy drinking) and the other normal, healthy test results show that I definitely do not have cirrhosis or any form of permanent liver damage or advanced liver disease, and that the fatty liver will resolve itself with continued avoidance of heavy drinking.

I'm sure he thought I was crazy, saying things like I was worried that an already damaged liver would not show raised enzymes because it was not functioning and would not be producing them, but he said that, if that was the case, there would be many other abnormalities in the tests, whereas everything else was normal, and I would also be displaying very severe symptoms, other than just tiredness.

I asked him about my minor hair loss and more general thinning and poor condition of hair.  He said it was not liver related, but may be hormonal.  He raised the idea of checking my thyroid function (my mother and sister both have thyroid issues), but then we started talking about something else and forgot about that.  I think a thyroid problem might explain some of the symptoms I've been displaying - tiredness, weight loss, hair problems, excessive sweating - and, if there is a problem with it, it's easily fixed.  I'm not worried about that, but, if it is not functioning properly and is put-right, I might feel physically better.  So, I'll see how I feel for a few days and think about going back to get it checked.

So, as far as the liver is concerned, I guess I am still worried because it showed-up fatty on the ultrasound, I'm kicking-myself about the excessive drinking, and stil don't feel physically great, but guess I should feel somewhat reassured and just try to continue to live more healthily than I have been doing for most of the past year.

 

19

Juicing.turn it around. The liver has a potent ability to regeneratea and heal itself. Research it. Turn it around. You can.

20

Gavin, good to hear your news...now stop worring and just let your liver heal itself as I and others have already mentioned.

Also please re-read my post from last week.

I am trying to walk more every day and find I can go longer distances. Cutting out the booze is hard to do, but I've cut way back until the withdrawl systoms creep up. Then just a few and stop. Please stay strong.

How about you?

Take care, Tim