Ignored Diagnosis Bad Doctor

[GAEPG]

I am a little annoyed with my EX-physician. A few years back my Liver enzymes were off at my Annual Physical. Earlier that year I had an ultrasound for unrelated issues...they sent the entire report to the doctor. So, after him telling me about my labs he was looking through my chart and said, "OH...you have fatty liver disease" I was like..."what?!?" He didn't explain it. He didn't tell me it was dangerous. He told me maybe try weight watchers and lose some weight and that was it! Never any other testing...not even Liver Function tests. So, I continued to live life per usual. After a Vacation where we did a bit more drinking than usually my stool turned clay colored. I googled it and low and behold that shows liver issues. I have a new physician who I am hoping can shed more light on what I am supposed to be doing. I thank you for this website. I made a list of the Liver helping foods and went out and bought them all. Alcohol has been shelved forever...why didn't he at least tell me not to drink? Sugar is a bit harder but making headway. I am waiting for my lab test results from the new doctor. I don't know if I should ask for a Liver Function test or if that is just a no brainer that the doc should be doing. I would love to get a Fibroscan to see where I am at. Should I ask the doctor about that also? I am worried about this all now that I see that it can lead to things like....ummm...death! WTH is the matter with the medical professionals these days?

[nash2 Partner]

Hi Gaepg, a few thoughts. It won't make you feel better but yours is a common story. Fatty liver has been considered to be mostly benign for decades. In a context where people had a better diet and didn't live as long it was mostly true that people died from something else and medicine had no useful advice anyway. Things have changed but many docs still view fatty liver as minor. OK, important point. Try to be a bit less anxious. You do need to find out what is really going on but the disease strikes slowly most people have an opportunity to be proactive. Try to get a diagnosis from a hepatologist, or at least as gastro doc with a liver subspecialty. Your PCP is likely to be of no help at all. Diet is a treatment. You have to stop eating things that are hard on the liver to give it a chance. Here is a link to information on diet that we recommend, but getting a physician relationship that works for you is key.

fattyliverfoundation.org/co...

Good luck Wayne

[GAEPG in reply to nash2]

Thanks so much!

[JamesDC]

There is an emerging new set of diagnostic tools (new blood tests/ algorithms, Fibroscan technology, etc) that will likely usher in a new age of enlightenment for physicians. Frankly, the tools they've had until recently haven't always been the most accurate/helpful/consistent. Likewise, it can be hard to pursue new diagnostics without companion therapeutic options. Good news is that new products are being developed as well. There is reason to think that clinical discussion of NAFLD will soon be much stronger with clear recommendations of how to reverse the liver fat composition and restore the liver to full/better health. We have reason to hope and reason to make the changes needed to improve our liver health.

[JamesDC in reply to JamesDC]

Note to those who seek to study:

- liver function tests are not always a good proxy to understanding the true status of the liver. They are an effective tool in "starting" the screening process. This leads to other tests to rule our certain serious issues/conditions. However, these liver enzyme scores are not an accurate means of determining the liver fat composition (steatosis).

- ultrasound is often used to "confirm" the diagnosis of fatty liver. Here again, there are often issues with consistency in testing and comparing charts from year to year may not be easy or particularly accurate for determining the exact level of liver fat or the progress/regress that occurs over time.

-MRI is much better, but very expensive and not readily available to most people.

- new tools such as Fibroscan are now becoming more common and will be much more accurate/ useful to determining changes in liver fat over time.