Re: Dawn, NASH, biopsy the gold standard

[Guest guest]

Oh my gosh I feel better already just having someone to talk to.

Here are the results of my ultrasound. I'll leave out all

the " normal " finding and just put the abnormal findings:

FINDINGS:

Liver is markedly echogenic with heterogeneous echo texture and

marked decrease in through transmission. Common duct is mildly

enlarged with diameter 0.7 cm. No evident duct stone.

IMPRESSION:

Appearance of the liver is consistent with fatty infiltration, but

not typical for fatty infiltration. The heterogeneous appearance

suggests other possibilities including early cirrhosis. Mild

enlargement of common bile duct is of uncertain significance.

I know I don't even have a true diagnosis yet, but always before my

ultrasounds pretty much said " appearance is consistent with fatty

liver " and that's about it. This result is pretty drastically

different and coincides with the timing of new pain/symptoms. I

have pretty severe constant pain now from the bottom of my

breastbone radiating to under my left ribcage. I don't know what

that means, but I never had it before. Could have something to do

with the enlarged common bile duct, but my gallbladder was normal on

the ultrasound and there didn't appear to be any stones?? Hmmm...

I'm trying very hard not to jump to the end before I even have a

true diagnosis. You are right that I don't have any symptoms of

decompensation - unless it's significant that along with the new

pain is what feels like stomach distention or bloating. My

discomfort factor has gone way up in the last 3 months. My fear is

totally based on where this " could go " and my gut feeling (that has

always been there) that something is wrong inside.

Thank you so much for keeping me in your thoughts and prayers.

On a lighter note Bobby, I'm intrigued by your screen name. Are you

native american? I'm only asking because I am of Ojibwa decent. In

any event, I like your screenname robwalkingeagle. :-)

>

> Dawn, I do not blame you one bit for being the least bit anxious

over this turn of events. I want to say that I am doubtful of anyone

trying to claim " early cirrhosis " unless they see nodular

appearance of your liver, and are pretty sure there is scarring, and

you have no signs of decompensation. That could be interpreted as

early cirrhosis, I suppose, but I'm only speculating. Signs of

decompensation are leg swelling, abdominal swelling, mental

confusion.There is only one sure way to diagnose cirrhosis other

than seeing the liver directly like my surgeon did, and even then,

he took a biopsy. A biopsy is it. That is the gold standard. For

some reason, doctors are hesitant to have a liver biopsy done. It is

an invasive procedure which is not without risks. So, ask, no if

you need to , demand a NEEDLE biopsy. Your hepatologist will not

like a wedge biopsy, which can give a false positive for heavy

scarring, because it contains part of the very fibrous

> liver capsule. It needs a good pathologist to read, whereas a

needle biopsy does not have this concern. I hope you get a good

hepatologist on your case, and they can offer you some answers to

your questions. I have a little voice in my head that want me to

tell you to calm down, you need not write the ending, before the

story unfolds, but I tend to be very melodramatic myself, and then

lately it has not been unfounded. My wife is also very sick with a

condition called chiari malformation. So am going to ignore that

little voice, because I don't want to you to have one more person

tell you that you are worrying for nothing, or being hysterical, or

what ever, You have every right to be upset. I would be to. If you

need to vent, or want more specific questions answered, or what

ever, I am on yahoo instant messenger. My user ID is

robwalkingeagle@...

> My blackberry is no 24/7. I have met so many good friends in this

group. Now I dont feel so alone. And one more thing, I will add you

to the top of me and Sharon's prayers for tonight. Love, Bobby

>

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