I'm 24 years old. Never drank alcohol. No history of viral Hepatitis. I don't take any medications. No drugs. No smoking. No diabetes. Weight 120 kg. Height 192 cm. Was diagnosed with NAFLD 1,5 years ago after an ultrasound . I was at my Gp's the other day. She said she saw fluid around the liver. Not sure if it was asceites. Blood work normal,but ALT is slightly elevated. INR/Bilirubin/Cholinesterase/ other liver enzymes are normal. She referred me to the university hospital thinking I have cirrhosis. Since I'm a medical student myself I know that NAFLD can't possibly developed this fast to cirrhosis specially that no other ultrasound signs of cirrhosis were present. I now can't book an early appointment at the university hospital or any other private clinic.
Since that visit I'm feeling down. And can't focus on any thing in my life. It feels awful.
Has anyone similar experiences? How should I deal with this mentally until I get a chance for a Fibroscan.?
Any help is appreciated. Have a good day!
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Modo1
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I’ve been very stressed and worried about my liver. I’ve had a multitude of ultrasounds, ct scans, and an MRI and they all say my liver is normal. Every now and then one will say fatty liver. My spleen is now enlarged and they are worried I might have severe liver damage as well. Currently waiting for them to call and schedule biopsy. I hope everything works out for you. I calm myself down by reminding myself that worrying isn’t going to change a single thing. Keep us updated!
I think fibroscan is a good idea in your case. Or better SWE. But keep it mind in early stage of fibrosis they are not so accurate.Meanwhile I will check some other rare disease that can lead to fibrosis. Just to rule them out. So Aih (ANA, AMA etc.), gamma globulin, Wilson disease (ceruplazmin, copper), iron, ferratin level (hemochromatosis) and HCV/HBV (I think as you wrote you do not have them but). Of course they can be some small indications only and other tests are needed to confirm them.
I had NALFD which they thought had progressed to cirrhosis. Are you overweight? Have the doctors said anything about improving your diet? I managed to reduce the damage significantly in 6 months luckily
Out of interest, did your doctor put you on a very strict supervised diet, or were you just told to reduce your weight?Its a real shock to be told you have NALFD, I was recently diagnosed, the most frustrating thing I found was that only the diet factor seemed to be taken into account, when to me, the actual cause is much more important, when for me, my diet is pretty good generally.
How did you manage to reduce the damage if you dont mind me asking?
I was told I needed a total diet overhaul, immediately to stop the progression. It was very scary and I thought I'd left it too late. I also worked out 3 of 4 times a week with daily walks. I ate nothing with sugar at all, and the majority of my meals were homemade from scratch. I stopped all fast food like mcdonalds etc. It was pretty miserable some days as I still got cravings but was worth it.
Hello Modo1, as you know being a medical student, you’ll know that most medical diagnoses are derived by ruling out what it’s not. So, you’ve already ruled out alcohol, medications, viral Hepatitis etc, So already your narrowing the field down as to what could be the problem.
As this diagnosis is still ongoing, I think to would be wrong to try and guess, and of course, this is best left to the professionals. I would just rule out any tattoos or possible Hep C.
When you mention the University Hospital, are you referring to certain tests and scans that your GP has ordered up, or has your GP referred you to a gastroenterologist? (Most local hospitals don’t have a hepatologist).
Sadly you are having to play a waiting game as many hospitals are trying to catch up on cancelled appointments. Being a medical student you may have already learnt about that saying that doctors and nurses make the worst patients.
I would use this waiting time as a learning opportunity. Why not have a look at the “Futurelearn” online courses. There is an excellent course entitled “Liver Disease: Looking after Your Liver”. They run these courses every few months and are a good start for those who would like to understand more about the liver: futurelearn.com/courses/liv...
These courses are free to do, but if you prefer not to wait, you can pay and sign up, and do these courses at any time.
By doing this you’ll be turning any negative thoughts into something positive, by trying to understand what might be going on.
Has your GP carried out an ELF (Enhanced Liver Fibrosis) blood test? This test is a lot more reliable than the basic liver function test and can highlight possible fatty liver, and liver fibrosis. You may at some point require a liver biopsy, to see what is going on.
Just try and hang on in there and try and turn your worries into positive thoughts and actions. Try and ask yourself, if you had now finished your studies and were now working as a nurse or doctor, what advice would you be offering your patient about their mental health concerns at this time?
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