Need advise..

[Cazza_BDA]

After coming out of hospital, being diagnosed with S4 liver cirrhosis, and unknown to me, an old back fracture. Having always had back problems, which I managed with normal drugs. I was happy to be able to get back to work on a phased level, which was great, and be able to talk to people again. Although trying to do my work, my back did suffer, not straight away but a day or so later. I did not tell anyone as the pain went, and I just got on.

Anyway, I collapsed suddenly at home, straight onto my back on the left hand side onto a hard floor. Having initially bruising and not being able to move or walk straight had xrays, no fractures found and examined by doctors for the norm and ECG. Again nothing remarkable noted. Now, weeks later, with the bruising gone, and not hurting anywhere when touched, but I do have pain inside my body on my left hand side which sometimes spreads to my front by the breastbone . Making it hurt when I breath. Dr said it might be muscular, and has just upped my medics from tramadol to morphine (low dosage, not wanting to cause damage to other organs). But it is not really working and I am getting really depressed and anxious, with the not sleeping, itching, the worse it has ever been, and also being paranoid about the not knowing what is wrong with me. I cannot get it out of my head it has something to do with the liver.

I only want to get back to work to be as normal as I can be, but know at the moment I am just not fit enough. Not doing much exercise as I am just so tired and exhausted all the time. I don't even trust myself to drive.

I am just not too sure where to go from here, and am just really beating myself up about all of this, and worried about work.

I have asked my Dr's Sec for a ultrasound on the left hand side, waiting for a decision on this. I am frightened something is wrong on my inside organs, which I do not know about, but is this the way I should be approaching this.

Can anyone give me any advise please..

[AyrshireK]

I think an ultrasound would be wise.

When did you have your last ultrasound or any other scan?

With a diagnosis of cirrhosis it is routine to be scanned every 6 months to check the liver for any changes plus to check on other abdominal organs, portal veinous flow and for any presence of ascites etc.

One of the organs checked would be your spleen which is on the left hand side of your body (liver being on the right). The spleen can become enlarged with cirrhosis and you may have blood clotting issues and low platelets as a result. A check of your spleen would be wise - some people with an enlarged spleen are advised not to do contact sports because of the potential risk of damaging it.

If your spleen is enlarged and you've had a serious knock then you should definitely get this checked out.

When also did you have your last bloods done? If the itching you describe is due to elevated bilirubin levels then there are medications, creams and such like that can be prescribed to try and alleviate the itching.

Definitely get these various things checked out because they are evidently affecting your quality of life.

Katie

[Cazza_BDA in reply to AyrshireK]

Thank-you Katie, I have had ultrasound, it was on my right hand side when I was in hospital about 6 mths ago which confirmed the cirrhosis. Once home, had a fibroscan also confirming the stage I was at, and a MRI which revealed nodules and benign legions, Dr wanted to keep an eye on this, so a couple of weeks ago I did had another MRI for the liver and abdomen with contrast. I am waiting for results, but was told it will takes about 6 weeks.

Do you think that my recent MRI would cover spleen as well? I am waiting until this Mon to get an appointment with Dr's. I have had bloods regularly, they cover liver, thyroid and kidneys, but not specifically the spleen, and will ask for another ultrasound and extra bloods. I am frightened if they refuse, once again anxiety creeping in.

I find it hard when the appointment is a Dr's telephone conversation, to ask about other things ie. Itching, as I feel pressurised that they just want to get you off the phone.

It does take a bit off your mind, when someone like you Katie, actually listens to what you are trying to get across, which I find it very difficult to do so. Thx

[Scrags64 in reply to Cazza_BDA]

Not much more I can offer. Katie's advice is great. Just to say though, don't let your Dr pressurize you when you are on the phone. Most of them are doing far less work than they were before. If you have a problem discuss it, and if they try the old 'well that's not what you phoned about' ask them how they can tell it isn't all related if they don't do all the tests. Good luck. X

[MisterX in reply to Scrags64]

"Most of them are doing far less work than they were before. "

This is completely untrue.

It's certainly important to say what you need to say without feeling time pressure. It may also be a good idea to write all the issues down beforehand so you don't forget to mention them.

[Scrags64 in reply to MisterX]

Well at my surgery it is most certainly true. They only have one receptionist on at a time, 1 doctor in and 1 nurse.

[MisterX in reply to Scrags64]

That's not evidence that "most of them are doing far less work than they were before".

At best it's evidence that your surgery only has 1 receptionist, doctor and nurse on at a time.

It's a wild exaggeration and grossly offensive to people who've not only worked relentlessly throughout the pandemic but had to do so under massive pressure and at great personal risk.

[chrisw740 in reply to Scrags64]

The thing is we've seen annual leave cancelled and deferred. Some of our e.u colleagues have had to return home. Also hospital staff get sick too. Many Dr's have spent less time in their usual specialities and helped out in other departments. Cardiologists, Oncologists etc ended up working to support ICU staff and now there's a massive back log.

G.P surgeries were/are commonly at the heart of the vaccination programme and all this goes on with really stretched resources whilst still trying to minimise risk. The number of staff shortages is extremely challenging for everyone.

Saying Dr's are doing far less work is dispiriting.

[Kristian]

Hi Cazza,

Your MRI will have picked up your spleen and other abdominal organs, so it should pick up if there are any issues. You may just have to wait the results.

If your fall and this persistent pain is after the MRI there may be a case for another ultrasound, so no harm in asking and to be honest it sounds like your doc is trying to help as much as they can.

Scrags does make a valid point about jotting things down that you may want to say over the phone with your doc. I always find with normal clinics, but even more so with phone appointments I'd forget to mention something that I wasn't sure was significant or not, but most times I did I got a good explanation back or further action resulted. So jotting down stuff, even if your not sure if its significant or not is a good thing to do.

I do agree too that phone appointments can seem a bit rushed at times. Thats not generally intentional, its just that you don't normally get that bit of thinking time you normally get when you have a face to face consultation. It is therefore easy to get flustered. I know it still is for me anyway. Its that immediacy that comes with, "ring ring...hello its Doctor x, what can I do for you today...". You don't have the usually pleasantries to help settle you in, lol, so having written down what you want to cover or raise will be helpful. Tell them you have them written down too. It helps them know that you are going through your list and it helps them know to give you a bit of time to go through everything too.

Hope thats helpful. I appreciate its probably still not going to be easy, but hopefully that'll help your next consultation.

[Cazza_BDA]

Thank-you all , I have wrote down everything for my phone call. I did not know about the MRI picking up anything on the spleen so will relax about that for now.