Bilirubin in urine...previous elevated liver enzymes.
I recently had a routine urinalysis as part of my pap test. I can view my lab results online before the doctor ever contacts me. The results of the urinalysis came back positive for bilirubin. There was also a 2nd result, which said something like "Bilirubin 1+ confirmed by Icotest." From what I've read, bilirubin is never supposed to show up in your urine and if it does, it signifies something going on with the liver. I did have Hep B & C tests a little over a year ago and both of those came up negative. I've only been with my husband the whole time since then, so I doubt that is the cause. What bothers me though, is that when the final results of the pap test were posted, the urinalysis results were deleted and there is nothing about the urinalysis listed in the final results. I think what concerns me the most is that a little over a year ago, during bloodwork for something completely unrelated, they found that my liver enzymes were slightly elevated. My GP said it was no big deal.
That said, I told the doctor when I was there for the testing that I have felt AWFUL for the last few months. I constantly feel that achy feeling you get when you're sick, yet I have no other symptoms. I'm tired all the time, yet I have a hard time falling & staying asleep. I walk around in a total fog half the time. I don't know if any of that is related, but it's been getting worse over time & my GP doesn't seem concerned. I've also gained about 25 lbs in the last year, mostly in my abdomen and constantly feel bloated. I've had IBS like symptoms, but never really pushed the issue because I figured of all things that COULD be wrong, that's minor in my opinion. I'm also always very itchy, even when my skin isn't dry. I was diagnosed years ago with Fibromyalgia and Rheumatoid Arthritis and also have Psoriasis, so I feel like one big walking autoimmune disorder.
I don't know if any of this is related, and there are a whole list of other symptoms that I don't feel like getting into right now. I'm just not the type to complain to the doctor for every last little thing that bothers me. But now with the bilirubin in my urine, I'm a little concerned. Any insight would be greatly appreciated.
Re: Bilirubin in urine...previous elevated liver enzymes.
now is that time to simply 'push' your GP into doing for his patient, you. if he wont, find someone who actualy cares about their patients. for him to simply blow off high liver labs really IS inexcusable without bothering to follow up on this for you. do you remember just what was out of range then you are very right in that there is never supposed to be bili in our urnine. you DO most definitely need some in depth liver labs done along with getting just a basic abdominal ultrasound too. these two things are what REALLY gives you the best overall picture of now any organ is really doing. the one thing you need to remember is with ANY actual labwork done, in order for it to actually even go out of the normal ranges, certain functions would have to be impaired to a higher degree or actual real ongoing damage to an organ that eventually impacts real fuction just has to be there before ANY labs actually change.
i would just make an appt with your primary at this point to actually discuss the odd findings that showed up in your UA(was there any trace protien found there in that UA as well or just the bili?) and to set up an ultrasound(this IS very much needed for you right now too)and a full workup done on your liver with all the right labs done. it wouldn't hurt to also check out your kidneys too only becasue some really insane types of kidney or liver disease can include both organs(one particular kidney disease called PKD,which i have is like this and a very common genetic disease). they just need some checking too. if he refers you just for a full abdominal US, this will actually look at ALL of the abdominal organs down to actual blood flow thru things like the portal vein within the liver. if this particular vessel gets blocked or impaired it can create ALOT of different problems and or symptoms too.
do you notice ANY yellowing of your skin or espescially within the whites of your eyes? it is actually much easier to really see the eye whites/jaundice if you simply take a mirror and go outside in the day light? for some reason, in home lighting does not always allow you to really see this, but bright inadvertant daylight really shows it well. even standing by a bright window can show this better than right under like a light in your kitchen can. it just does for some reason, espescially at the early stages.
but DO follow up and discuss everything with your current GP. if he is not willing to go thru this with you or simply even do his job for you, seek out another primary care doc asap. you just deserve better care and not have important stuff not followed up on. this most definitely needs following up with more in depth testing just to find out what is causing this to even begin with. an ultrasound in your case really would help tons with looking at the most crucial areas of possible involvement.
i myself am currently living with both a kidney an liver disease and my youngest son needed a transplant at age 12 from a 'suprise" liver failure he was going into and we did not even know he was actually sick, at all. so i do have some experience in this area. just do what you NEED to in order to get these very badly needed needs met. if you have to change docs, well, you just do it. this is your health and well being that your GP is simply supposed to care about when he took you on as a patient. he can be fired at any time if he fails to do the job for you, ya know? you just deserve a caring hands on primary who gives a rats butt about you and what is best for you too.
i do hope this is nothing major for you. please do keep me posted as to what you find out,K? just push if you have to or go another route. luckily you DO have options here in most cases. Marcia
Re: Bilirubin in urine...previous elevated liver enzymes.
Thank you so much for your kind words, Marcia. Sometimes I just need to be pushed to push the doctor, ya know? I take care of my husband and kids first...then myself. But this actually concerned me. I also have kidney problems, though not severe, in the form of chronic kidney infections and stones. I don't think there was any protein in my urine this time. I'm pretty sure the bili was the only thing abnormal.
Something I read recently kind of concerns me too. For the last few years, I've been getting more & more of these tiny little pin point dots all over my abdomen. They're bright red & literally the size of a pin point. I noticed a small cluster of them a few years ago, and they've just been increasing over the years, especially more recently. They never go away and they don't bother me. They're just increasing in numbers. I've asked various docs about them and nobody ever seemed concerned, so I wasn't either. One doctor said that they were petechiae, but those go away, don't they? I read that having those, along with other symptoms similar to mine can signify a liver problem.
I've also had problems for the last few months with this aching pain under my rib cage on the right side. It's not sharp...more like a throbbing crampy feeling. It's there most of the time & sometimes it's worse than others, almost making it hard to take a deep breath. I mentioned it to the doctor when she was feeling my abdomen & asked if I had IBS like symptoms. She said it was probably just indigestion, which is what I always passed it off as even though it didn't feel like indigestion.
I'm not a hypochondriac by any means, but the way I've felt for the last 6-8 months combined with all of these little things and what I've read when you put them all together really concerns me. I know my body & I know when something just doesn't feel right. I truly appreciate your advice and kind words. I'll be calling my GP tomorrow to make an appointment. I'll let you know what I find out.
Re: Bilirubin in urine...previous elevated liver enzymes.
sounds good, just push this doc to do the 'right things" for you if you have to. you DO have rights as a patient for "appropriate' care ya know? if he wont,go somewhere else.
with regards to those red dots? are they at all kind of 'raised up" off the skin a bit or just 'in/on' the skin like part of it kind of thing? do you have ANY of these anywhere besdies the trunk area like on your face anywhere? just knowing if these are indeed raised op off the skin AT ALL really would help to ID them better. there are what are called a "nevis" or a spider nevis too that have like tiny broken little cappillaries kind of surrounding the dots? these can be indicative of liver disease. these can also be called 'angiomas" too. these can actually be indicative of a couple of things or be a totally unrelated thing too. it all depends upon other possible factors here.
this one particular bright red 'dot' my son had appear on his upper cheek one day kind of right under his eye, we never really understood just what it actually was or why it could even be there at all. well, move ahead two years and seeing the GI doc at the childrens hospital who we had to see after my sons suprise liver failure culminated in whats called portal hypertension? he had actually vomited up alot of blood one day at school, right after he had also had what was supposed to be a 'full' sports physical by who had to be the most ignorant and stupid nurse practioner on the planet like less than a month before this even happened? but thats a whole other story. the thing here is, his 'new" GI doc from the U of MN who had come to childrens in st paul that day since the other doc we saw had run tests and found that there was absolutley no blood actually flowing thru his portal vein anymore and that he had some insane mutation of an actual kidney disease as well that supposedly was inherited from me or my hubby that we were told one of just HAD to have but we just did not know it either? that GI doc told me after, that she knew immediately without even looking at any of his actual test results that he did most definitely have a rather progressed form of actual liver disease that had closed off that P vein ONLY becasue she saw that bright red dot on his cheek. blew me away, let me tell ya.
but if the dots YOU have if only present on the trunk area are actually raised up and not into the skin itself and no noticable raise at all when you run a finger over them,this could mean that you may also have a somewhat weaker vessel structures too. since you DO have both kidney and livver issues going on, that NEED for that US is even more important just to really 'see' what could be in or on the kidneys and the liver too.
the type of kidney disease i have which my sister was also found to have after i told her she also needed an US to see if she had this inherited disease that we did NOT even have a freaking clue actually was even running in our family at all which is called polycystic kidney disease. the one thing that just comes along with even having this,among other things,is it makes us born with just naturally weaker vessel walls for some insane reason. i too have exactly what you described in various places on my front and sides on my trunk too. mine are all the raised up(very slightly) form of this stuff. these just can happen with weaker vessel walls. tiny cappillaries just break for whatever reason and create those tiny dots.
the bigger thing here right now for you would be to get in to see that doc and make him do the bloodwork on the liver AND kidneys and refer you for that badly needed US too. once you get just that stuff done at all it will really give you the best possible set of baseline info. any steps beyond that would kind of be dictated by what was or was not really found in there. the combo of bloodwork and the US really are the best types of tests to really 'look' at what needs to be evaluated at this point. given your ongoing symptoms here, i do think you have something going on in the kidneys and that liver too, just like i do. is there ANY family history that you are aware of that would indicate any kidney or liver problems? high blood pressure problems or even certain vascular problems or malformations like aneurysm? just things you need to look into here on the off chance this could be some type of a genetic or inherited type of thing. believe me,just the PKD that i have is a very very common type of kidney disease that even people with it do not have a clue til it has really progressed itself. some people will never have symptoms and some will have this progress to a larger degree too. its the mere fact that the functions will actually stay within all norms(mine still are despite major devistation going on with liver and kidneys right now) for a very long time so you just 'assume' everything is just fine. but looking at the actual organs with any type of scan really would most defintiely 'show' a very different type of picture going on in there. this is why BOTH blood work and the US are really what are needed to show the bigger piscture.
just get that appt and see what this doc decides to do for you. and always remember you do have other options as far as docs here too. good luck lynae, Marcia
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