take him to a regular family type doc for some deeper better hepatic type of bloodwork along with a good hands on pal;pation of his abdomen by an actual doc,not just an NP alone. he just needs much more than an NP right now. our son was showing some real subtle symptoms like occasional tummy aches along with occasional nose bleeds. he actually saw an NP too for his sports physical to play football and ONLY because he suddenly didn't 'feel" like playing at the last minute is the reason he is alive today at all. somehow this supposedly knowledgable NP completelty missed the fact that our sons liver was NOT neatly tucked up under his ribcage, but centered right in the middle of his upper abdomen and hard and very enlarged. i could not believe what took place less than two months after this "perfect" exam where she actually cleared him to play freaking football. he actually had had an enlarged liver along with a very enlarged spleen the whole time. we found out, when our son actually vomited up a ton of blood at school one day that he was actually down to only about 20% of his actual liver function left and was also in whats called portal hypertension too. meaning the P vein had been closed off by scar tissue so the blood could no longer flow thru it so it just backed up into his liver and spleen and into the vessels in his stomach,which had started to break and bleed in there.

the insane thing here is we did NOT even have a clue that he was even sick. that is just becasue the other organs kick in to help compensate for any failing organ. our son ALSO had to go on soy based formula as a infant since he would vomit up infamil like all the time. once we switched,everything got better for him and he could tolerate that just fine for some reason.

believe me,i am not trying to freak you out here or anything but his liver simply does need some further more in depth testing right now. this could be some level of actual congenital type of liver issue that usually show themselves around like ten to twelve years old. this may not be a huge issue in the end, BUT, you DO need to take him to an actual real family doc if nothing more, just to get that docs opinion once HE actually does that hands on physical with also palpating the abdomen, just to make certain everything is okay from the outside.

i just would NOT take any chances here til you have fully evaluted that liver,inside with at least an ultrasound along with that full hepatic panel run again. this is a big better safe than sorry type of situaion that you simply NEED to find that underlying cause of all the symptoms. there IS a reason for his high bili count that has to be found out. i would not give him ANY milk thistle til you have gotten that blood work redone since that could "mask' real counts on his lab work and you do not want to do anything that could possibly change that right now til you KNOW whats going on. but no matter wehat you have toi do here,he really NEEDS to be evaluated by a real knowledable and experienced DOC,not a mere NP,trust me on that one. this may all be for nothing in what i am telling you, nd i do hope that IS the case, but this does need to be thoroughly checked out before anything else gets done for him. i cannot express that enough right now. just have him seen by someone other than an NP who has an MD after their name. i do hope this is some kind of a fluke or temporary situation that will resolve itself,but DO please get that liver completely checked both inside and out just to be sure everything is okay. honestly,you just have no real clue as to what can be going on even inside your own body at times til it just happens to either show up on some type of scan, or sympyoms start to present themselves over time. please keep me posted, marcia