kim3101

This message board is really my last hope so I pray to God someone responds to this post.
I have had chronic pain for about 10 years now. Mainly in both knees, left hip and lower back from arthritis, scoliosis, a slipped disk, and chronic bursitis. I've had 9 major knee surgeries in 10 years and have done everything known to mankind to manage my pain. I've been at the same pain clinic for about 3 1/2 years now. For the last two years I have been on 20 mgs of methadone TID and have tried multiple other drugs for breakthru (not really breakthru as the meth alone is not enough to get my pain reduced by 40% so I take the alloted BT's as prescribe on a daily bases - docs are aware buy will not increase my LA med). As of a few days ago I now take 4mgs of dilaudid QID in addition to the methadone. It seems to be the best combination thus far as my pain recently has been some what controlled (about a 4/5). So, in a nutshell, that's my history. Now for my lastest crisis.
About a month ago I was admitted to the hospital for an intense migraine which ultimately led me to dehydration (thus the admit). During routine blood work they discovered by ALT and AST (live enzymes) were highly elavated. My ATL was in the 700's (should be between 5 and 40). At the time, I was taking Norco, 10/325, QID. This was replaced with Dilaudid via PCP while in the hospital. My enzymes started to come down. An utltrasound was done and I was told the test showed fatty liver characteristics. Since the enzymes were coming down, it was left at this and I was discharged.
About 1 week after discharge, my ALT was down at 110. Two weeks later, last week, my ALT climbed to 125. Not a huge jump and nothing compared to the 700's I was at. My PCP called and said she knows how much pain I am in but because of the high enzymes, she wanted me to reduce my pain meds by 1/2 (I actually spoke to her rude nurse). She must have been convinced it was the pain meds causing the liver problems. Especailly since stopping the Norco and enzymes came down. I explained to the rude nurse, this was not possible as my pain was barely managed at the current dosage. Not to mention decreasing methadone by 1/2 could cause serious complications. She, the rude nurse, told me she would tell my doctor I "refused" her medical advise and hung up.
Since then, I have read just about everything and anything I can find about liver damage and opiods. With the exception of pain meds that contain tylenol, I can not find any supporting documentation that says opiods can cause liver damage.
I'm hoping someone on this board has been through a similiar experience and can offer some advise.
My next step of course, is to make another appointment with my PCP or perhaps even put a call into the pain clinic to get their advise. In the meantime, I am a wreck. If in fact my pain medicine is causing liver damage, then I have to make a choice to go back to a life of excruciating pain 24X7 or liver failure. What a choice. That's like asking someone to pick which child of theirs they would save if both were dying.
Oh! And one last tid-bit. I had my gall bladder removed about a year ago. At that time, my liver enzymes were also high however, dismissed because of the hot gall bladder. Not sure it matters but thought I'd throw that in.
If anyone has ever had elevated liver enzymes, I'd love to hear from you.