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Question about fatty liver/NASH
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Question about fatty liver/NASH

First a little history.  I am a 33 year old woman.  I have had severe depression for over 15 years and during that time I have overdosed on ibuprofen twice.  I have also had horrible migraines and have taken more than double the normal dose of tylenol for them.  In 2007 I had gall stones and had to have my gall bladder removed.  Apparently it was very infected and the surgeon had a hard time removing it, resulting in a lot of bleeding.  At that time, the doctor did not mention that my liver was fatty, which I assumed they would be able to tell while they were that close to it.  Ever since my gall bladder was removed, I am still having pain on my right side, under my rib... exactly where it hurt from my gall bladder.  They did liver function tests and blood work and said everything looked fine and that it could take 6 months to a year before the pain stopped.  It never stopped.

About a year ago I started having more pain, not only on my right side, but also the right side of my abdomen under my right breast.  I also started having a lot of other problems and was diagnosed with a hiatal hernia.  I started gaining more weight, and ultimately ended up dropping out of college because of the pain and fatigue.  Here are some of the more severe symptoms:

*extreme fatigue - I literally feel drained at all times and can barely get enough energy to do normal things like take a shower, get dressed, etc.  Forget about cleaning, that just completely wipes me out.

*itchiness - I itch all over, especially my arms, back and scalp.  

*dermatographia - mostly on my hands, sometimes on my feet and forearms.  This is very severe, if I have any pressure on the palms of my hands or fingers, they swell, develop huge welts and burn and itch very badly.  When this happens I can't even touch anything because of the pain, it makes it impossible to do even basic things.  This happens every day, throughout the day.

*joint pain - my hands, elbows, hips and knees mostly.  I was tested for RF and it came back negative, I am seeing a rheumatologist now and waiting for more lab results to come back.  My hands are the worst at the moment, it's hard to hold or open anything and even just using the computer is becoming increasingly difficult.

*swelling - my legs, ankles and feet are swollen at all times and now my hands are swollen off and on.

Some other symptoms are alternating chills/hot flashes, nausea, dizziness, excessive sweating, loss of appetite (although I am still gaining weight)


About a month ago I was diagnosed with type 2 diabetes and put on amaryl.  The doctor also said that my liver enzymes were elevated, but she didn't give me exact numbers.  She sent me for an abdominal ultrasound which showed that my liver was fatty and she sent me to a gastroenterologist for that and the hernia.  On the referral she wrote "possible nash".  I had the consultation with the GI doctor and he is sending me for a upper GI endoscopy but when I asked about my liver he basically just dismissed it as a fatty liver and said that nash is the same thing.  From what I've read, nash is a more severe form of fatty liver and means that there is liver damage and scarring.  I asked about having a biopsy to rule out nash, and he said it wasn't necessary.  I also asked him if it was normal to have pain with fatty liver, and he said it probably wasn't pain from my liver, but just muscle pain...  which I completely disagree with since I have had this pain since 2007 and it's getting worse.

So my question is, should I push for a biopsy or just wait and see?  The pain I have is just a constant dull, achy pain, but there have been a couple of times in the past 6 months where the pain got so severe that I couldn't move or even breath.  It was so bad that I would have gone to the ER if I was able to get up and drive there.  The severe pain lasted for about 15-20 minutes then slowly went back to the dull, achy pain.  I know there's not much they can do for NASH, but I would rather know for sure if I have liver damage than to just sit around and worry about it.  
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