10 day difference in labs before and after pain medication

[shadowme2]

I went by ambulance to the ER for severe muscle spasms on left side of my back. They drew blood before giving me any medication. While waiting for results I was given an i.v. of morphine and some sort of muscle relaxer. All labs came back in normal range so I was released with instructions to take Naproxen 500mg and Methocarbamol 750mg until script ran out. I only took Naproxen for 3 days (too fatigued already thank you) and the other one for 7 days. I went to my Primary for follow up urine sample, so asked her to run another hepatic panel. 5/14 hospital labs were Ast 24, Alt 27, Alk phos 147. Super! Labs 10 days later on 5/22 after pain meds Ast 48, Alt 61, Alk Phos 193. Not happy since my numbers have steadily been coming down for the last year taking Urso. Any thoughts? On another note Bili Direct raised from .0 to .1 both before and after so that's not good.

[shadowme2]

I guess I can't do math anymore either lol. It was an 8 day difference, not 10.

[ninjagirlwebb]

As with any blood work there can be sporadic fluctuations. The thing to look for are trends over longer periods of time. If you have an increasing slope of data points, think your doctor would note that.

Even people without pbc can have elevated numbers every now & then. It is only if it is consistently upward trending that will raise red flags for further investigation.

[7443jec]

I wish I understood all the abbreviations and numbers!!! My consultant sent me the results of 9 different blood tests but I don’t know what they mean. Apparently the AMA number gave the diagnosis of PBC. Ive got to wait until Oct for a fibroscan. Best wishes to you. X

[mrspeffer in reply to 7443jec]

Go on the internet and look them up. All the information you need it at your fingertips. You will find out what the abbreviations mean, what the function of the test is and the ranges tested for.

[EileenUSA in reply to 7443jec]

pbcers.org/about-pbc/tests/

Hope this helps!

[7443jec in reply to EileenUSA]

Many thanks, that looks very helpful. I will need to concentrate on it. X

[Candy12 in reply to 7443jec]

This is a good link to see what the tests are and what there for. It won’t give you the ranges, due to each lab having there own lower and upper range. The range for your particular lab, will be on the print out given to you by your doctor. Hope it helps a little.

labtestsonline.org.uk/

[7443jec in reply to Candy12]

Many thanks to you too, I will be making notes.x

[butterflyEi]

As ninjagirlwebb has said blood test results are best looked at over a longer term, I guess really the main thing is how are you feeling now?

[shadowme2 in reply to butterflyEi]

I feel pretty good now, thank you! Turns out I had a dislocated rib that was poking a muscle in my back causing spasms. For those of us who have given birth the pain was that bad. Coming in waves just like contractions. Yikes. Well, it's spring in Michigan so I've been pulling a lot of weeds, planting gardens, mowing, ect…..wish I new the exact movement that caused that so I don't do it again. Going to therapy and it's helping. It's troubling though because when you're in that much pain it would be insane to turn down any pain medication but you also don't want to hurt your liver. Oh well onward and upward. Lot's more work to do.

[mrspeffer]

Good Morning....Hope this find you without pain and feeling much better. I have unfortunately experience severe muscle spasm, and there is really no way around them but to take the drugs. That being said, our little livers will suffer from them. The good news is that if you flush your system out, this will help get your numbers back in range. Maybe a lemon water drink or a daily detox tea will help this along. Anytime we use pharmaceutical and non pharmaceutical medications, there is a chance the enzymes will react. Give it some time, you will be back to your "normal" levels in no time. Be well

[shadowme2 in reply to mrspeffer]

Thank you, that is my hope! Drinking lot's of Kefir and eating clean. Well mostly hah!

[danaLL]

I would asked to take labs again in two weeks and see if they go back down. That should be enough time. And you know going forward hi Pam And I’m not kind to your liver, but your numbers are so low that I wouldn’t worry even after a spike. Thank you for posting, I always try to figure out how different things impact my body with blood test as well. It’s helpful to see what happens with others

[shadowme2 in reply to danaLL]

I guess I'm more concerned about the Bilirubin Direct rising more than I worry about the enzymes and alk phos….

[danaLL in reply to shadowme2]

I do you see your doctor knows Best but mine has shot way up and is north of 1.0 and I am still a six on the melds score, Which is the lowest possible rate I know asking my doctor about that score has helped take a lot of stress off. Which is the lowest possible rate I knowIt’s my understanding that bilirubin number moves the slowest.

[shadowme2 in reply to danaLL]

So you mean .1 not 1.?

Wishing the best for you

[danaLL in reply to shadowme2]

Unfortunately 1. My total is at 2

[shadowme2 in reply to danaLL]

In reading gwillis posts it looks like it's possible to improve that number?? I sure hope so, it's something to aspire to anyways….I guess I'll find out soon enough as I've again improved my diet and am getting plenty of exercise. But wait, I just noticed you said your total is 2. That is not extremely high...prob a dumb question but are you sure your doc is checking bilirubin direct?

[danaLL in reply to shadowme2]

The total is 2. They check indirect, direct and total

[gwillistexas in reply to shadowme2]

I’m told direct bilirubin is the most important of bilirubin levels. My dr watches that & ALP.

[shadowme2 in reply to gwillistexas]

Yes the bili total I believe is how it runs through out the body, while direct is how it is specifically in the liver. As far as I know the range is 0.00 to 0.3. We don't want it to reach .3

Mine just raised to 0.1

Like all of us it's a bit tiring to always have this at the back of our minds but things could be worse. Hard to remember some days life before diagnosis. That free wheelin' spirit I used to have. Not complaining, just a thought.

[gwillistexas in reply to shadowme2]

My last hepatic showed direct 0.00 which surprised me. The one before that was 0.3.

[shadowme2 in reply to gwillistexas]

Wow, I don't get it but we'll certainly go with the 0.00! That is a question I have...if you can improve that count or once it's high is it permanent. Either that .3 test was wrong or there is hope for improvement. Promising news, thank you.

[gwillistexas in reply to shadowme2]

I looked back at my labs. When I was first diagnosed my direct was 0.4. Once I was on Ocaliva it came down. I’ve had a reading of 0.1, 0.2 & 0.3 in the past. Looks like it can fluctuate a little.

[shadowme2 in reply to gwillistexas]

A little? That's amazing! So glad to hear.

[gwillistexas in reply to shadowme2]

I’m scheduled to see hepatologist July 12th. It will be time for labs so we’ll see😊

[ninjagirlwebb]

My hepatologist told me not to dwell on any one specific test result. The important thing is to focus on the trends over time. If you chart the data and see an upward trend, then it may be a cause of concern. On the US patient portals, you can trend and create graphs of your data by just clicking a button. So that is useful.