ALT keeps going up, now 432, can't get to see GP

[rosysparkle]

Hi everyone,

I have Crohn's disease and for years I've been on azathioprine to keep that under control. My ALT has been high for a few years, around 70 - 100 and the docs have always said that as long as that it stays under 150, that's OK. About six weeks ago I had a routine blood test and my ALT was over 200, so I was told to stop the azathioprine altogether, and get another blood test which I had last week. The nurse rang me this morning to say my ALT has gone up to 432. But the only advice she had was to wait two weeks and have yet another blood test.

I can't get in to see my GP for four weeks unless it's an emergency. I'm tired all the time, have very little appetite and I have some mild right upper quadrant pain. Some days my urine is dark and my poo is a bit yellow, but some days they are both normal.

I'm worried that my liver is being damaged and it's getting worse, but I can't get to see my GP. Should other tests be getting done as well as all these blood tests?

[Hidden]

I would ask for ANA, and ASMA blood work. How is your ast and alp some call it alk

[Dewan52]

This is undesirable that patient like you still have to wait for GP consultation with alt 432.This is alarmingly high.Plus yellow urine, right upper quadrant tenderness. You better visit emergency room and tell them that you are having acute upper quadrant tenderness which is unbearable.They are bound to do the needful that you require.

[Sherrych]

You have all the same symptoms I was having with my liver disease(AIH) I’m very surprised they aren’t addressing this now. Alt in the 400 mark is not good. I would call this an emergency.

[GrittyReads]

I cannot be absolutely certain, but I think your GP practice is in breach of guidelines if you cannot get to see a GP with such a blood reading.

Have you checked if the practice has an emergency service? For example, my practice runs a system, whereby you turn up or phone (turning up is better) at opening time and can usually be allocated a slot to see one of the GPs either then, or later in the day - although it may not be your chosen/usual GP. That's what my practice does. They always leave some free appts with each GP scheduled for that day, in addition to the other slots that have been booked in advance. I think they also have a GP who takes all-comers, although in my practice even these 'emergency' slots have often gone. When that happens, they get a GP, or a nurse, to phone for a phone consultation, which may result in you then being seen - or told to go to: chemist/A&E/hospital, if they think it is or is not an emergency. Obviously this can all still be less than ideal, but I've never heard of someone being turned away with no advice of what to do. Maybe we are lucky because all our reception staff are lovely, long-suffering and really clued up.

Check again, and if they don't have some sort of a back up system, I would go to A&E, as I'm sure this should not be left to be ignored for 4 weeks.

[rosysparkle]

Thank you all. I will check whether I can get an emergency appointment for tomorrow if I turn up at opening time. My Crohn's nurse has just rung to tell me to get another blood test next week - I told her about my symptoms and she said she would contact my GP urgently.

I always feel so powerless in the face of doctors and receptionists and I need to try to be more assertive!