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Old 11-07-2012, 12:00 PM   #46
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Re: Going to see a GI specialist.

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Originally Posted by abouttwodays View Post
I know! He just sat there shaking his head like, "wow."

The CT scan confirmed that there were no tumors, cysts, fat, lesions, any of those sorts of things on my liver.

My husband had lost his job a few months back so we were initially put on Medicaid. He just started a new job that doesn't offer insurance so they put us on the "medically needy" program with Medicaid. This means if I rack up a bill of $850 in a month, Medicaid will kick in and start paying. However, my doctor and my GI specialist do not accept the Medically Needy program so everything I have to pay is out of pocket until I get insurance. We were not initially aware of it not being accepted even though my doctor accepted Medicaid in general.

I'm looking into insurance options that we can afford. I have no idea how to shop for insurance, I've always been covered either under my parents or under my husband's work. My mom works for an insurance company though and she is going to help me figure out what type of plan would be best for me, even if I don't go with the company she has (Anthem BCBS.)

My understanding though is that with Medically Needy, if I did need an MRI and the one bill alone was over $850, Medicaid would cover it.
I am glad you got to see your regular doc and he is referring you to the GI doc, hopefully you will get some answers now! I see the GI doc tomorrow afternoon too and hope I get some answers.

I think the Medicaid program you are talking about is called a Spenddown where we live. The way it works here is you have rack up the amount of the spenddown before Medicaid will pick in and pay the rest of your bills. I have Medicare and the Spenddown but I never use the Spenddown because I have never had enough to amount to the amount required in order for it to kick in and pay. Medicare covers 80% of my bill so I am responsible for the other 20%. But here you used to could submit your bills the day you saw the doc and they would count it towards the amount but they stopped that, now you have to submit a receipt showing you have paid the amount before they will kick in and pay. At any rate I know how insurance issues are.

Hope you get some answers and myself as well!

 
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Old 11-07-2012, 12:18 PM   #47
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Re: Going to see a GI specialist.

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Originally Posted by gjet68 View Post
I am glad you got to see your regular doc and he is referring you to the GI doc, hopefully you will get some answers now! I see the GI doc tomorrow afternoon too and hope I get some answers.

I think the Medicaid program you are talking about is called a Spenddown where we live. The way it works here is you have rack up the amount of the spenddown before Medicaid will pick in and pay the rest of your bills. I have Medicare and the Spenddown but I never use the Spenddown because I have never had enough to amount to the amount required in order for it to kick in and pay. Medicare covers 80% of my bill so I am responsible for the other 20%. But here you used to could submit your bills the day you saw the doc and they would count it towards the amount but they stopped that, now you have to submit a receipt showing you have paid the amount before they will kick in and pay. At any rate I know how insurance issues are.

Hope you get some answers and myself as well!
Yeah! That sounds like what we have. We have to save all of our receipts and if the total for the month between my husband and I comes to $850, then Medicaid kicks in. I think...haha. So I really wouldn't have to worry about something big like an MRI because Medicaid is supposed to cover it. I am indeed praying my medical bills don't total $850 a month but at the rate I'm going right now, they very well might. The month just started and by Friday I will be at $250, assuming no lab work is done at my GI appointment. The doctor's office didn't charge me for today though as they had told me over the phone my doctor would be there last night and he wasn't and I had to deal with the moron.

Thank you and yes, I hope you get your answers as well! After I saw that doctor last night I felt just like you, wondering if it really is just all in my head yet I have a sense of knowing there is something that is just not right in my body. I have been trying to fight off a migraine with no success all because of how stressed I was yesterday.

 
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Old 11-08-2012, 07:31 AM   #48
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Re: Elevated liver enzymes, pain under right rib cage, coarse texture on ultrasound

Hi I am having a pain below my right rib cage, its been a week no other symptoms apart from pain and occasional belching..it doesnt pain when i press directly on it.. the pain is intermittent.. what could this be? pls i need an input..going to have a full abdominal ultrasound tomorrow..

 
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Old 11-08-2012, 12:28 PM   #49
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Re: Going to see a GI specialist.

I am heading out to see my Gastro doc will update when I get home. Hope you get some answers too!

 
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Old 11-08-2012, 12:50 PM   #50
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Re: Elevated liver enzymes, pain under right rib cage, coarse texture on ultrasound

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Originally Posted by Scorpio3172 View Post
Hi I am having a pain below my right rib cage, its been a week no other symptoms apart from pain and occasional belching..it doesnt pain when i press directly on it.. the pain is intermittent.. what could this be? pls i need an input..going to have a full abdominal ultrasound tomorrow..
Have you had any blood work done? Let us know how the ultrasound comes back!

 
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Old 11-08-2012, 01:17 PM   #51
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Pain in my back, never hungry...should I tell my GI doc?

So yesterday while I was at the doc he asked me if I was feeling pain in my back below the shoulder blade kind of. I let him know that for about 3 weeks now I have felt what almost feels like a pinched nerve but have just assumed I've been sleeping funky. He just sort of nodded and wrote stuff down.

Anyway, today my back is driving me nuts! I have been doing a lot of laundry and such, trying to clean the house up because I have hardly been home all week and my back is killing me. But it only hurts in my right ribcage area, figure just below the shoulder blade, a few inches to the right from the spine and extending all the way over to my side. Putting my hand horizontally on my back right under my shoulder blade would cover the area that hurts. It doesn't hurt to touch it like a sore muscle would, yet the pain is comparable to a sore muscle. Resting does not help. Do you think this is related to the liver pain or could it be just a sore muscle?

Also, for a few weeks now I have noticed that I am rarely hungry. It also takes about 1/3-1/2 of the amount of food I used to eat to make me full now. I've always been a generally hungry person capable of eating a lot of food (not that I SHOULD eat a lot of food, but my stomach can hold a lot....I think I owe it to my days of binging). Now it takes a yogurt to fill me up. I read last night if your spleen is enlarged it could be pressing on your stomach thus making you get fuller, faster and feeling less hungry. I don't know how enlarged my spleen really is but does this sound like a possibility of why I am feeling this way? Because up until last night when I read about that it totally confused me and if I try to eat my typical amount of food I feel sickly full.

One more thing...where do you feel pain from your spleen? My doctor seemed surprised that I didn't feel pain from my spleen being enlarged. He had been pressing on my belly under my left side of my ribcage and it didn't hurt. However, last night I woke up to some pain in the left side of my back, about halfway down from my shoulder. It was a deep, throbbing pain and I couldn't stand to lay on my back. I turned onto my right side which alleviated the back pain but within a minute I started to feel sore behind my ribcage on my left side. It went away after about 10 minutes. Could that have been spleen pain? Or is your spleen not in that area? According to pictures online, that would be where my spleen is but I don't know if you can feel it in your back.

And I lied, I have one more question. Can your liver have spasms? Earlier today I felt these crazy spasms where I typically feel the pain from my liver. I put my fingers under my right ribcage and pressed upward (think trying to get my fingers behind my ribcage) and I could feel that area twitching like crazy. Don't know if it was a muscle or what but it was weird.


Should I let my GI doc know any of this? Or does any or all of it seem unrelated? I mean, I know it's best to give more information than less, but I don't want to flood him with a bunch of stuff that is likely to be entirely unrelated.


And good luck gjet68!! Update when you get back!

 
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Old 11-08-2012, 11:12 PM   #52
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Two Tests down, one diagnoses, one more test to go

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Originally Posted by abouttwodays View Post
And good luck gjet68!! Update when you get back!
Sorry it took me so long to update but I have been busy this evening since I got home. I saw the Gastroenterologist this afternoon. He was really very thorough and I felt that he seemed to know exactly what he was talking about. I have the results of my HIDA scan in my hand, he gave me a copy. I wont post the whole thing as some of it is insignificant just going to share the main parts of it here: The last part of the findings read: "There is some persistent retention of activity within the upper left quadrant of the abdomen that may represent billary reflux into the stomach". Now, the Impression reads like this:
1. Normal visualization of the liver, gallbladder, common bile duct and small bowel.
2.Normal gallbladder ejection fraction equal to 89%
3.Possible billary reflux into the stomach.

End of Report

Ok, with all that being said the doc said that the test indicates I have some billary reflux which is different than Acid Reflux in that it isnt stomach acid but bile that is refluxing. This sets one at risk for Esophageal Cancer. He said rather than throw medication at me right now he wants to do a Esophagastroduodenoscopy (EGD) which simply means he is going to run a light or a scope down my throat to check things out in there. I will be sedated for the procedure, I would not attempt it otherwise. I am scheduled for that Monday.

He stated that my Gallbladder appears fine. So he thinks the pain I am experiencing is from an Ulcer in my Small Intestine. So this test will tell him whether I have such an ulcer. If the ulcer is bleeding that could explain my anemia.

He said that as far as the Polyps on the Gallbladder go, the thinking is to just watch them and take a wait and see approach. He said they can and do sometimes turn into Cancer. He wants to repeat the sonogram in a year to see if they have grown any, if they have he will then remove the GB if they grow above 6 m.m. I was not too comfy with that part of the decision and may push to have him repeat the test in 6 months rather than wait a year for my own peace of mind.

On to the elevated liver enzymes. Mine are very low compared to what they usually are and have been in the past. They are as close to normal as they can possibly be. So, with that being said he said in patients whose liver enzymes tend to rollercoaster such as mine do, often the liver function tests will not be a good indicator as to the health of the liver. In other words what he was saying was that you could not put much stock in the results of those tests as they could be near normal and you would still have a diseased liver. He said he probably could not get me into my Hep doc any sooner than I could so the plan is to keep my appt with my Hep doc in January and odds are he will need to repeat the Liver Biopsy since it has been over 10 years since the last one. I am not looking forward to that. The last liver biopsy I had was very, very painful and I was in tears from it. I normally have a high pain threshold but that made me miserable.

So that is where I stand at present. Once I have the EGD on Monday, I will update again as soon as the results are in. I am hoping that they do not find anything too serious.

 
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Old 11-09-2012, 01:39 PM   #53
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Got back from GI doc!

Well, this dude is just as lost as anybody at this point from what information is currently available. He said there is definitely something going on that we need to find out. Something he brought to my attention was the fact that my platelet count was low (though not drastically low) and said that could be related to my spleen and the cause of the bruising on my legs.

Basically his main area of interest at this point is autoimmune hepatitis. He is looking into that and any metabolic issues at this point.

He is having me run bloodwork on the following...

- CBC (Hgb, Hct, RBC, WBC, Plt)
- PT with INR
- PTT, activated
- ANA w/Reflex Titer
- C-Reactive Protein CRP
- Ferritin
- Iron
- Sed Rate By Mod West
- Ceruloplasmin
- Alpha - 1 - antitrypsin

That's all straight off my prescription for the lab and I have no idea what a majority of it means haha.

So now we are checking into labs to itemize the cost of each test to see what is cheaper for me to get done and where. So I probably won't be updating about my condition until these labs come in. We will see if these give me any answers. He did say that there are more things we can test for, but he just doesn't want to overwhelm me and test for things that may not be necessary, causing me to go bankrupt before we even find out what is wrong lol. So we will see. More than anything he seemed to be leaning more towards an autoimmune issue though.

Last edited by abouttwodays; 11-09-2012 at 01:41 PM.

 
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Old 11-09-2012, 01:56 PM   #54
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Re: Got back from GI doc!

Sounds identical to my first dx from my hep doc. What gets me is mine has never been bad enough to require treatment according to all the docs I have seen. So it has just been a wait and see approach with retesting of labs every 3 months until we notice some changes for the worse. The treatment for AIH is Corticosteroids from what I understand and Immunio-suppressants to suppress the overactive immune system. I bruise easily too. I wish I had thought to ask for a copy of my Ultrasound as well but didn't. I wish you luck, I had a blood panel run but have not had the Autoimmune markers checked in a while, I may mention that to my doc after this EDG is over with. Good luck and keep us posted!

 
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Old 11-09-2012, 01:57 PM   #55
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Re: Got back from GI doc!

The low platelets and enlarged spleen, along with the coarse echotexture is pointing to cirrhosis of the liver. Since your not a drinker they are trying to figure out why. I suspect a liver biopsy is in the future. All those blood tests are labs to check for cirrhosis. Has he mentioned this at all?

 
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Old 11-09-2012, 02:03 PM   #56
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Re: Got back from GI doc!

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Originally Posted by Hypochondriacyy View Post
The low platelets and enlarged spleen, along with the coarse echotexture is pointing to cirrhosis of the liver. Since your not a drinker they are trying to figure out why. I suspect a liver biopsy is in the future. All those blood tests are labs to check for cirrhosis. Has he mentioned this at all?
Well, I think it was you who told me that an ultrasound is only as reliable as the person doing it and reading it. According to my CT scan, the texture of my liver was ok. The only thing they got from my CT was that my liver and spleen are enlarged.

Nobody has said a word about cirrhosis and I'm assuming it's because of how the CT scan came back.

 
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Old 11-09-2012, 02:07 PM   #57
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Re: Got back from GI doc!

Imaging method cannot tell if you have cirrhosis. I had liver biopsy looking for cirrhosis. It did not show on my several MRI, CT and liver ultrasound.
I hope you do not have it!!!!

Good luck

 
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Old 11-09-2012, 02:08 PM   #58
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Hypochondriacyy HB User
Re: Got back from GI doc!

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Originally Posted by abouttwodays View Post
Well, I think it was you who told me that an ultrasound is only as reliable as the person doing it and reading it. According to my CT scan, the texture of my liver was ok. The only thing they got from my CT was that my liver and spleen are enlarged.

Nobody has said a word about cirrhosis and I'm assuming it's because of how the CT scan came back.
Oh I didn't know you had the results of the CT scan. Yes THAT is more reliable then the ultrasound and probably would have shown any nodules. They may di an MRI next, that's also supposed to be good

 
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Old 11-09-2012, 02:08 PM   #59
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Re: Got back from GI doc!

I guess Imaging method cannot tell if you have cirrhosis. I had liver biopsy looking for cirrhosis. It did not show on my several MRI, CT and liver ultrasound.
I hope you do not have it!!!!

Good luck

 
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Old 11-09-2012, 02:09 PM   #60
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Re: Got back from GI doc!

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Originally Posted by gjet68 View Post
Sounds identical to my first dx from my hep doc. What gets me is mine has never been bad enough to require treatment according to all the docs I have seen. So it has just been a wait and see approach with retesting of labs every 3 months until we notice some changes for the worse. The treatment for AIH is Corticosteroids from what I understand and Immunio-suppressants to suppress the overactive immune system. I bruise easily too. I wish I had thought to ask for a copy of my Ultrasound as well but didn't. I wish you luck, I had a blood panel run but have not had the Autoimmune markers checked in a while, I may mention that to my doc after this EDG is over with. Good luck and keep us posted!
From what I've read about autoimmune hepatitis is that they try to keep from giving meds for as long as possible just due to the side affects of the medication. So I guess it's good that it's not progressing that fast! I'm assuming you already knew that though hah.

And hey, it seems like your gastro doc has got you on a path to getting you answers! Let us know how your tests come back!

 
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