Scared & Confused

Hello Cstar1079.

I was diagnosed with PBC Dec 2010 when I was by that time 46. (I started itching early 2010 which led to PBC diagnosis.) My only symptons I knew about in 2010 were itching and at the time fatigue. Some on this site do say that they are forgetful but I can't say if down to PBC though possible. Over 5 years on from diagnosis I hve the itch which has altered, it is now mainly confined to later night, fatigue vanished some point during 2011.

I wasn't diagnosed via biopsy, I had abnormal liver function test (LFTs) and it was found I had antibodies (known as AMAs) that along with the 2 symptons at the time gave diagnosis. I am in the UK and if you can be diagnosed by how I was there is no reason to have a biopsy. I know if I was requested to have a biopsy now I'd not agree due to the fact currently it cannot alter any treatment for the PBC (there is just the urso and any other symptons we can develop can be then dealt with). A biopsy takes only a very tiny sample and may not be an accurate picture of the liver as being a large organ, one part can be damaged, another not. It is said to be able to stage PBC but I don't go in for these so-called stages. I just go along with how I am.

Urso is apparently taken for life once you are PBC diagnosed. I have read of some discrepancies on this site with diagnosed PBC patients who have normal LFTs and no symptons (known as asymptomatic) who aren't given urso at the time. Usually though if you have abnormal (or elevated) LFTs then you are given urso. Even if the LFTs return to normal at a later date we still have to take the urso.

Normally though a biopsy cannot give an accurate picture of the whole liver it is said to be able to diagnose PBC due to cell changes that are throughout the liver in PBC. I think the damage to our liver comes from the affected bile ducts. We have many bile ducts throughout the liver hence the variable condition I think.

I think it is usual for a doctor to check certain vitamin levels once diagnosed with PBC. My hospital doctor did back then (he said my Vitamin D was 'a bit low, but not bad'. Looking at the figure I then got, it was only the line. I've never had supplements as yet). Some are undertaken judging by certain variations in the full blood count, I think Vitamin B is one of them.

I think we all go through the ups and down in the early days of diagnosis and wonder what might lie ahead. To me the best we can do is to try to keep as healthy as possible, make those lifestyle changes if need be. Try to steer clear of any unnecessary medications too.

I came to a decision long since now that I had PBC (I used to be under the illusion that if the itching ceased I didn't have PBC) and that nothing will change it. I haven't got normal LFTs but they're said to not be dramatically high either and they seem to be quite constant at each blood check since dropping considerably following starting urso.

I try to get on with every day, enjoy life as best as I can and any symptons I may develop I'll deal with them then and not dwell on them meanwhile. I think if I did wonder I'd not enjoy life now. These things may never happen so would be useless worrying. Once you clock up a year and then another you start to think differently about PBC.

Hi cstar, as others reply on here they will all say, don't panic X they will also say speak to the pbc foundation, they are brilliant, friendly and very helpful.

They can answer all your questions, just if you phone them have any results handy.

I am new to this since last year and still waiting on some results to be clear.

There are people on here that have had pbc for 20 years or more so your in good company.

I'm frustrated with my GP and specialist as they don't seem to relay info to eachother and seem to think it's ok to leave you hanging around for months without results. I have the itch, the positive AMA, tiredness, real aches In the body, and the foggy memory.

But luckily it sounds as tho you have good Drs and specialists around.

Try not to worry as it uses up energy and it's pointless if there's nothing you can change xx

Rest when you can, enjoy your children, get on with the life you can live, it might be in small doses but when you have the energy use it wisely lol and when your tired rest.

Remember speak to the foundation.

All the best.

Hello Cstar1079,

I shall message you directly.

Best wishes

PBC Foundation

Hi Cstar1079, my heart goes out to you. Peridot and Twinkle have said it all, please follow their advice. I would add that I've been taken off the Urso as well - ?NHS money saving exercise - the progress of my PBC is slow as it is with most people, although the fatigue has a very negative effect on my life - I used to bounce with energy! The Foundation will offer you support and lots of information. It is scary, I can understand that as I've been very alone in my struggle. All I can say is, learn all you can about the condition as it affects you and then use your GP and Practise Nurse to help you understand anything that doesn't make sense, e.g. jargon - that's what they get paid for! The more you communicate your concerns, the more likely it is you will get answers. Lots of Love. xxx

Hi, I was diagnosed at 35, although I had symptoms for 5 years before that, so I don't think they can say you are too young.

Your gastro is correct, when they do a biopsy they are taking a tiny sample of a very large organ. This is the main downside to biopsy. However the fact that it was clear means you can be reassured that its unlikely to be at an advanced stage.

It is the case that more people are caught early with this condition now, and I was told by a research hepatologist that if its caught before the bile duct it damaged it can be prevented from the domino effect of damage to surrounding cells which continues throughout the liver.

So I think you are best off continuing on urso. See if your bloods improve. There will be other tests developed to look at your liver, like a new multi scan being trialled currently, which may provide better info in the future. There is also an Enhanced Liver Function test (ELF), which has been designed to assess the liver for fibrosis/ cirrhosis, instead of biopsy. Maybe you could ask for that to put your mind at ease. Not all Hosp can do the test, but you can send blood to a centre that do.

Try not to worry. Get on with things as best you can, get meds for itch if that becomes a problem, and I'm sure you will find you feel much better. Many people on this site have no problems with pbc and have had it many years. In most cases even if it does advance it happens very slowly so don't panic

Trust information from pbc foundation.and British liver trust, don't pay to much attention to other stuff on internet, it is often outdated.

Wishing you well

Take care

E

hi Cstar

I've been on urso 16 years now, had symptoms for 4 years before that. In early years could only work part time, symptoms now not half as bad as they was, back working full time, learnt to pace myself. Now 51. One saying always helped "more likely to die with PBC than because if it." I also found some foods set off the tiredness and itching.