Primary Care Physician?

[emarie96]

I tried to get my PCP to order a fibrosure or Liverfast test for me, but the nurse called back this morning and said that she declined it because it was not developed by western medicine and she said she is unsure of accuracy. The nurse also stated that a liver function test alone is enough to assess the damage to the liver. To which I told her that I'm not sure that I believe that as I have heard that you can have damage/fibrosis and have normal tests. I asked her to test my ferritin and INR/PT as a precaution because it has not been tested since 2018. She stated that as long as my LFT (AST/ALT) keeps trending downwards then she will not be referring me. Any advice? Thanks

[nash2 Partner]

Well, you have a winner there. Just as background Fibrotest and LIVERFASt were both developed in France using much of the same research that produced the FibroScan system. I view that as "Western" medicine. They are all Medicare approved if that means anything. Just my view of course, but that doctor is dangerous to your health. So many of us have arrived at a cirrhosis diagnosis without elevated ALT that I view that dogma as bordering on malpractice. It is certainly true that elevated ALT is a big red flag but docs who go strictly by that are not well informed. In case it matters, here is a paper from a liver specialist about it

aasldpubs.onlinelibrary.wil...

I suppose it depends on your state and insurance situation but you should be able to seek a second opinion if you believe your care isn't meeting your needs.

Wayne

[nash2 Partner in reply to nash2]

Hi Erica

Just to be clear, I don't want you to be more afraid because of these comments. You are taking better care of yourself and all of my earlier comments apply. If the nurse who contacted you explained the docs view correctly that doctor is poorly informed and you should consider alternatives if you can. There was some confusion last year but I think you can arrange to order LIVERFASt direct, depending on where you live, for a cash price of $199. If that might be of interest I can double check that for you.

Wayne

[emarie96 in reply to nash2]

Wayne,That would be absolutely great. My doctor absolutely will not budge with her opinion in things. It means the world to me that you address my level of fear as that has been hard to control. I would love the reassurance of a blood test if possible. I live in Ohio.

[nash2 Partner in reply to emarie96]

I'll get back to you about what you can do in Ohio.

[emarie96 in reply to nash2]

I appreciate that more than you know!

[AllHis in reply to emarie96]

Where in Ohio? How close to Springboro, OH? I can send information on a clinical trial in Springboro for NASH…I gave up on trying to see a hepatologist. I registered for a liver study. You can now say “social media” referred. You do not need a doctor referral. I had a Free FibroScan and got paid!

[emarie96 in reply to AllHis]

I am close to Columbus so that area would be a few hours from me. I'd like to try to get a blood test first if possible but thank you so so much

[AllHis in reply to emarie96]

I’m in Cincinnati. It’s near Dayton and an hour’s drive for me. So far things have been good, and very beneficial for me. I’m very grateful. My plan is to get diagnosed, begin the study drug & present a hepatologist with my findings. The blood test that Wayne talks about seems like a good first step. Hugs!

[99problem in reply to AllHis]

I can totally vouch for this approach . I did something similar to obtain my fibroscan . Some doctors can be very dismissive

[LeiL]

I skipped the doctor referral and insurance hassle. Easier to pay the $199.00

[emarie96 in reply to LeiL]

If you don't mind me asking, how did you go about getting the test done/ordered?

[LeiL in reply to emarie96]

Actually got everything from the link supplied by NASH2. Filled out the info, Customer Service called and we discussed self-pay or insurance. Blood is drawn at Quest Labs. The only hiccup was Quest required a hard copy of the order. I had to return home, contact the company, and hen return to Quest. This tool an additional 3 hours.

[emarie96 in reply to LeiL]

Does the paper that you fill out to get the test done have physician contact information on it? I guess I was under the impression that a physician was required to order it.

[LeiL in reply to emarie96]

They have a licensed physician sign the order. You will know the name and contact info of the doctor who issues the order.

[kensimmons]

What I don't understand here is three things -

Why don't you get the INR test yourself to calm your nerves? It costs less than a night out at the movies -

findlabtest.com/lab-test/bl...

mdsave.com/procedures/proth....

mdsave.com/ohio

questdirect.questdiagnostic...

Regarding the fibro - I don't understand why does the doctor just not order it? What does she care? If I am a doctor, why the heck wouldn't I say "I don't know about this thing, I think ast/alt is good enough, but, okay, whatever, if it calms you down, go have a test...". I mean, why not?

Third, why can't you get a hepatologist in Columbus? I mean, there is a liver transplant center right there that takes new patients all the time.

Surely you can find a pcp doctor who will say, okay, I'll refer you, go see these guys at the transplant center - they're the experts -

wexnermedical.osu.edu/trans....