Questions I should ask my doctor on first visit after diagnosis.

[Boomer642]

I have recently been diagnosed with severe fibrosis (F3). I am obese (5’7”-246lbs) and have begun a weight loss diet and am hoping to gain more information in better treating my condition. I believe that I have a narrow window of opportunity to halt and hopefully reverse my condition before it progresses any further.

I have not yet had a follow up visit with my doctor since the Fibroscan. I would like to be prepared for my visit, but this is all new to me. What are some things that I should be aware of and what questions should I be asking my doctor at that first visit? My doctor is not a specialist.

[nash1996]

Have you thought about a biopsy? My Fibroscan originally showed F3 but then I went on to have a biopsy and it lowered that to F2. A biopsy isn't fun but it helped to get more clarity for me. Fibroscans can overestimate scarring when there is active inflammation in the liver, my repeat fibroscan after I'd got my liver enzymes down was F2 and my Dr felt this was much more accurate and in line with the biopsy. If your Dr isn't a specialist you may need a referral to a hepatologist.

[MINTVCX in reply to nash1996]

I would say if only NASH is suspected there is no need to have a risky (invasive procedure of course not so dangerous but still) liver biopsy. If F1, F2 or even F3 the same treatment (healthy life style). But of course it it always doctor's call. And yours if you are ok with some risk of complication.

[nash1996 in reply to MINTVCX]

My hepatologist recommended a biopsy despite suspecting NASH. Different specialists probably deal with things in different ways I guess.

I'd definitely recommend Boomer642 asks to see a hepatologist/gastroenterologist as I get the impression they're only seeing a general doctor.

[MINTVCX in reply to nash1996]

I fully agree. Every case is different and I have described general procedure.

[Boomer642 in reply to nash1996]

Thank you. At present I have made no decisions other than to lose weight and greatly limit my intake of certain ingredients (i.e. salt, sugar, flour, etc.). That much I know. Right now, I feel that I don’t have enough knowledge to be asking the right questions. I don’t want to find myself in a situation where I ask: “I wish I had known that before I decided X, Y and Z”. Your suggestion of a biopsy will certainly be on my list of questions with my doctor.

[Rodmail]

The talk below of biopsy and consultations seem to me . . . evasive. You already know everything you need to know. 5'7" - 246 lbs.

You don't need to dig in for anything else. Get the weight down. FAR DOWN. Then worry about granularity in measurements. You already have all the data that matters. 5'7" and 246.

Diet is 80% of weight loss. Exercise is 20%. Schedule workouts, but make the meal after each workout the one you develop habits around. Meaning, that meal is tuna sandwich (with brown bread). Or chicken sandwich. And That Is It. Do that over and over and over. It becomes the habit and it defines low calorie intake that might otherwise offset what you lost in the workout.

[Boomer642 in reply to Rodmail]

Thank you. I've already begun relearning how and what to eat. I started by removing everything I knew was bad from my refrigerator and cupboards

[Optimistic-koala]

hi Boomer642, I want to share this resource as there has been a lot of misinformation around the link between body weight and NASH/NAFLD. New studies are coming out quite consistently finding the harms of intentional weight loss, and in fact are finding little to no evidence of it helping someone’s liver function in the long term. It is something that might improve for the first 6 months to a year, but as there is no way for humans to reliably keep weight off for more than 2-5 years (less than 5% do) it can be quite harmful for your body size to fluctuate.

Here is a link to a resource I found very helpful as someone in a larger body as well.

I wish you all the best in your journey!!

haeshealthsheets.com/fatty-...

[Boomer642 in reply to Optimistic-koala]

Thank you. I will take a look at this. I have heard that fluctuating body weight is not good. Unfortunately, it's an issue that I've had for many years. I'm hoping to change that. I have to.

[Boomer642]

Thanks. I'll took a look.