Please could a GP answer a question? (Non-asthma)

Hi,

I feel a bit cheeky asking this here, as it's nothing to do with asthma, but I was hoping a GP could help me.

My dad went to the doc's several weeks ago with non-stop, all-over itching. Antihistamines had no effect (& no sign of fleas!!!) so his GP did blood tests for liver function & mentioned he may need a liver biopsy. My dad was told the first results were what would be expected for an alcoholic (despite this the doctor was happy for him to continue with his nightly glass of red wine), he's had 2 more blood tests, back for another next week & had to take in samples (I didn't ask for more detail!).

I was just wondering if it's normal procedure for it to take this long before referral? He's had no diagnosis or treatment (other than demazipan(sp?) & he's not sleeping well even with those). He's starting to get very tired & lacking in energy (probably not suprising, but does make me & my mum worry more!). Me & my mum want him to push for more answers (when asked about results from blood tests he just said he's sure the doctor would've mentioned if there was anything bad) & for a referral, but he's quite happy to just wait & see what the GP says. Although I'm very glad he's not getting stressed about it to me it doesn't seem right that it's taking so long with no progress. Also, my mum has a very low opinion of his GP!

I guess my question is should I bully him into demanding that more is done, or is the GP doing the right thing & do I just need to learn patience?

Huge thanks in advance to anyone who's able to give me answer.

Sharon

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Hi Sharon,

It's very difficult to know for certain without knowing more details, but a lot of investigation can and is done in primary care (GP-land) these days before involvement from the hospitals. Liver function tests can be quite tricky, because sometimes a few of the readings can come back slightly raised for no particular reason, then settle with time and watching/waiting.

There are a myriad of diseases that can alter the LFT readings, and I guess some of the samples your dad would have taken in would be to try to rule out those causes.

It can be very frustrating as a relative to watch this kind of thing unfold - especially if your relative isn't too inquisitive or can't tell you much about what was said in the GP's room. I've been on this end of it too - you get dribs and drabs of information which don't add up or don't tell you what you want to know and it gets very frustrating (particularly if you're medical like I am and some of the stuff that comes back to you doesn't make medical sense!).

I would see if your Dad will let you go with him to his next appointment, so that you can discuss the possible plans with the GP; if not, you could encourage your Dad to ask more questions. If neither of these is an option you may just have to sit on your hands for a while!!

Hope this helps,

CathBear

(A Fully-Qualified GP in all but the paperwork)

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It may be as simple as he may have developed an allergy / intolerance. Has he tried all types of antihistamines. I tried all over the counter ones over a year and only Telfast (prescrioption only) stopped my constant itching. Perhaps he is has developed an intolerance to sulphites in wine?

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Cathbear has briefly touched on this but just wanted to say one thing having recently done a gastroenterology placement, with liver disease as my consultant's speciality. It is quite common for liver function test (LFTs) to be derranged. My consultant had clinics full of people who proved to have nothing wrong but did undergo full examination and investigations. Like cathbear said often settle with time.

Please do not take this as there is nothing wrong with your father but at the same time there may not be. Hope that makes sense.

Consultants are always very keen for GPs to refer having done bloods and some other investigations first as it gives them a clearer picture.

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Thank you so much for your replies. It means such a lot just knowing that he appears to be getting the correct treatment.

I rang my mum to let her know what you'd told me & she was just about to call me to tell me he'd got an appointment through this morning for an ultrasound scan on Monday (he didn't even know the GP had requested this, so a bit of a suprise! Mind you, he does have ME, which plays havoc with his memory, so not reading anything into that!). Fingers crossed that this'll lead to a diagnosis before too long.

I will ask him to talk to the GP about his plans going forward, he may not be bothered but I think that would help put me & mum's minds at rest a bit.

Also, thank you for pointing out that there are many things that could be causing this & some will just sort themselves. I know it's a bad, bad, bad idea to google these things, but I couldn't stop myself & of course that just resulted in a choice of worst case scenarios!

Cathy, my gut feeling would be against it being an allergy. Not only with the LFT results, but also I've never heard mention of an allergies on my dad's side of the family - the allergies, presenting of bizarre symtoms & weird reactions to drugs are all on mum's side!

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Just a quick update, with great news - the ultrasound revealed sludge in dad's gallbladder, which is apparently the cause of his problems & he's going to have it out (goodness knows when, GP didn't seem to have got the principles of choose & book - grrrr!).

Thanks again for putting my mind at rest a bit before, it did really help.

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Hi Sharon - thanks for letting us know. Really pleased nothing too horrible going on! Glad we could be of help. All the best for your Dad when he has his op.

CathBear