Lots of Meds and Alkaline Phosphatase.

Hello~

I am a 35 year old female who has had her gall bladder removed around three years ago for pain reasons--- There were no stones or swelling etc.  I have also had a COMPLETE hysterectomy and an appendectomy.

I take quite a few psychiatric medications and a replacement hormone b/c of the hysterectomy.  EVERY SINGLE TIME I have a liver panel, my alkaline phosphatase is somewhat elevated and I still have pain in that area.  Right after my hysterectomy-- a year ago-- my alkaline phosphatase went through the roof and my liver was enlarged.  It is always a little enlarged.  My last liver numbers were:

AST-49
ALT-55
ALK-163

When I had this taken I was on a lot of Tegretol........   Now, I am on Elmiron, Cenestin 1.24, Atarax, Klonopin and Seroquel.  It still hurts in that area.... but I have fibromyalgia and myofascial pain.

My psychiatrist always looks at my liver numbers and said that this was about what it always was and not to worry.... but I am going nuts.  I do have a form of health anxiety.

Do you think this liver thing is okay?  I mean all my other numbers are fine.......and I am on a ton of meds...... This has been going on for a long time.........

If you were me, what would you do?  I would not have a liver biopsy--- people die from those-- or so I hear.  Thank you.

a patient no one listens to anymore,

Misti

[Kevin Pho, MD]

Further evaluation of the liver can be considered.  

Imaging with an ultrasound or CT scan would be a reasonable approach.  This can evaluate for things like fatty liver or a mass.  The liver enzymes are not high enough to consider a biopsy yet.

Another option would be a stone in the biliary tree - which can be evaluated with an MRCP - or Sphincter of Oddi dysfunction.  The latter disease may present with abdominal pain after a cholecystectomy.  It can be evaluated with Sphincter of Oddi manometry.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[hketsun]

If you have symptoms such as Jaundice and fever consider Recurrent Pyogenic Cholangitis. If not I think you may be worrying too much.

[Plath]

Hi~

I am not running a fever, and I am not jaundiced.... but the day after I posted, I was having such severe pain in my liver area, I was admitted to the hospital and stayed two days.  They gave me morphine, but that didn't even cut the pain.

They did an ultrasound and compared it to the ultrasound that I had last year of my liver.  Last year, my liver was normal size and everything--- this time, things have changed.  The sound waves were not bouncing back like they were last year..........and it was slightly enlarged........ but they cannot figure WHY I am in SO MUCH PAIN.............

The gave me a script of Morphine....... but I took 1/2 a pill --- 15mg--- tonight and I FLIPPED OUT!!!!!!!!!!!!!!    It messed me up......... I don't know why it didn't at the hospital, but it did at home.......  but it did...... I am scared to take it anymore.  I have Toradol... but it doesn't help much.........

I saw my family doctor today....... I have a follow up in like 8 days........  I don't know what is going on......... I just know I have never had pain like this in my life.

I am NOT touching those morphine pills again........

I don't know..........

[mabel8499]

Hi~
Do not crush, chew, or break an extended-release tablet. Swallow the pill whole. It will release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.
If you don't want to take the pill any more, do not stop using morphine suddenly, or you could have unpleasant withdrawal symptoms. Talk to your family doctor about how to avoid withdrawal symptoms when stopping the medication.

I am the administrator of the BBS which provides discussion to patients with liver diseases, Mabel. Our BBS is newly-opened. You can get much useful information and let others share your experiences there. Welcome to visit http://liver-health.info/. Thank you.