Livers, man. I tell ya.
In 2006, I went in to the Vanderbilt emergency room with a full scale gall bladder meltdown. Ultrasound confirmed there was a stone in the duct, and thirteen more lined up right behind it if that one were perchance to shift.
A bunch of preop bloodwork was done, including a liver panel which showed everything AOK.
They removed the gall bladder laparoscopically, pulling everything out through tiny holes rather than slicing open my whole abdomen. Which I appreciated, until the staple holding shut the bile duct from the liver to the (now absent) gall bladder popped open a couple of days later and I was back in the ER with bile spilling into my abdomen.
Tsk. Shoddy work.
They ran the same blood work, and found that the nearly absent liver enzymes (which leak out into the bloodstream when liver cells are stressed) had doubled or tripled in just a couple days. In a panic, they tested for hepatitis, twice. No hepatitis. The ran ultrasound on the liver. No abnormality. Nothing could explain the high level of liver enzymes.
Finally they fixed the leaky duct (it only took them three days to get around to it), and sent me home.
I went in a few months later, still not feeling quite right, and my liver enzymes were still crazy high. More tests. An MRI. Still no obvious reason. Liver looked fine. So, rather than start in on some REALLY invasive, and probably equally inconclusive, tests, we decided to wait a little longer.
A few months later I was feeling more myself again, and lo, my liver enzymes were completely normal.
I don’t know if it was the pain medication, the anti-nausea medication, the anesthesia, or the intense pain itself.
Then it happened again after another procedure. I forget which incident it was.
And then, earlier this year, a few months after the hideously painful miscarriage, I had elevated liver enzymes again. My primary physician got excited and wanted to send me in for hepatitis testing and a liver ultrasound, and I said no, no. That’s not it. Give it a few months it’ll be back to normal.
But I didn’t have a few months, because that’s when we found the tumor. Rather than a few months to recover, I went in for a biopsy (pain meds, anesthesia). A mere week after that, I went in for my chemo port placement (more anesthesia). Just before they put me under, I asked them to run the liver panel again, just in case.
I met later that same day to discuss my chemo with the oncologist, but then we looked at the liver enzymes from that morning’s sample, and wow they were high. Like really high. He put off the chemo, consulted with a hepatologist, drew a LOT of blood, and scheduled an ultrasound.
Long story short, they can’t find anything wrong with my liver, and chemo is starting tomorrow.
I also have an appointment with the hepatologist this week, too. Because, after 9 weeks of chemo, they plan on doing a MAJOR surgery to replace the shoulder. It would be nice to know before then what’s making the liver so very angry. Also, chemo is not good for livers.
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