HELP, ANYONE, DR GREENBAUM!!!!

I had my DS with Dr. Greenbaum  in 2010 and have never had any issues. A few months ago I started having severe pain in my upper right quadrant. I do not have an appendix or a gall bladder. I was told I did not have pancreatitis. My liver levels seem awfully off the charts but I have no idea what this means. They did a CT scan and said it was normal and he has now scheduled me for an US in two months. The pain is awful, I have had nausea and vomiting. He is keeping me on hydrocodone but in truth I am a bit upset because he will not explain anything to me.

My weight stays maintained at 135 and I took this surgery seriously but if any of you could help me understand some of these result because I don't feel like I should be in this kind of pain. Thanks everyone.

COMMENTS: FASTING
Test Name In Range Out Of Range Reference Range Lab HEPATIC FUNCTION PANEL

IG PROTEIN, TOTAL 6.3 6.1-8.1 g/dL 

ALBUMIN 3.9 3.6-5.1 g/dL

 GLOBULIN 2.4 1.9-3.7 g/dL (calc) 

ALBUMIN/GLOBULIN RATIO 1.6 1.0-2.5 (calc)

BILIRUBIN, TOTAL 1.2 0.2-1.2 mg/dL 

BILIRUBIN, DIRECT 0.6 H < OR = 0.2 mg/dL

BILIRUBIN, INDIRECT 0.6 0.2-1.2 mg/dL (calc)

 ALKALINE PHOSPHATASE 217 H 33-130 U/L  AST 1230 H 10-35 U/L    Results verified by repeat analysis on dilution.

 ALT 391 H 6-29 U/L

 AMYLASE 11 L 21-101 U/L IG CBC (INCLUDES DIFF/PLT)

IG WHITE BLOOD CELL COUNT 4.4 3.8-10.8 Thousand/uL

RED BLOOD CELL COUNT 3.81 3.80-5.10 Million/uL 

HEMOGLOBIN 12.4 11.7-15.5 g/dL 

HEMATOCRIT 37.8 35.0-45.0 % 

MCV 99.4 80.0-100.0 fL 

MCH 32.5 27.0-33.0 pg 

MCHC 32.7 32.0-36.0 g/dL 

RDW 16.3 H 11.0-15.0 % 

PLATELET COUNT 172 140-400 Thousand/uL 

ABSOLUTE NEUTROPHILS 3300 1500-7800 cells/uL 

ABSOLUTE LYMPHOCYTES 779 L 850-3900 cells/uL 

ABSOLUTE MONOCYTES 189 L 200-950 cells/uL

ABSOLUTE EOSINOPHILS 114 15-500 cells/uL

ABSOLUTE BASOPHILS 18 0-200 cells/uL 

NEUTROPHILS 75.0 % 

LYMPHOCYTES 17.7 % 

MONOCYTES 4.3 % 

EOSINOPHILS 2.6 % 

BASOPHILS 0.4 %

URINALYSIS REFLEX IG COLOR DARK YELLOW YELLOW   APPEARANCE CLEAR CLEAR  

SPECIFIC GRAVITY 1.013 1.001-1.035  

PH 8.0 5.0-8.0  

GLUCOSE NEGATIVE NEGATIVE  

BILIRUBIN NEGATIVE NEGATIVE  

KETONES NEGATIVE NEGATIVE  

OCCULT BLOOD NEGATIVE NEGATIVE  

PROTEIN NEGATIVE NEGATIVE  

NITRITE POSITIVE NEGATIVE  

LEUKOCYTE ESTERASE NEGATIVE NEGATIVE  

WBC NONE SEEN < OR = 5 /HPF 

RBC NONE SEEN < OR = 3 /HPF 

SQUAMOUS EPITHELIAL CELLS NONE SEEN < OR = 5 /HPF 

BACTERIA MANY NONE SEEN /HPF 

HYALINE CAST NONE SEEN NONE SEEN /LPF

I'm no expert, but I have to ask how long you've been taking the hydrocodone? That will affect your liver results in a negative way if you've been taking a lot?

Off and on for years but tons of acetaminophen due to arthritis and several knee surgeries.

I am sorry you are going through this, and that it has upset you. If you are unable to get an explanation from Dr. Greenbaum, I would suggest discussing the abnormal lab results with your pcp. Of course Dr. G is the expert on the DS and your pcp isn't, but internists should have experience dealing with abnormal liver tests. I would also ask specifcally whether or not you should continue to take acetominophen at this point, since we know that it can affect liver function. ask if any of your other medications, whether prescription or OTC, could also be having a negative affect on your liver.

and see if you can get the ultrasound moved up. 2 months seems like a long time for you to wait when you are in pain and have abnormal labs.

Larra

I would stop any liver toxic substance unless specifily ordered by a provider THAT HAS SEEN THE significantly elevate liver enzymes(labs). You liver has taken a hit from something! I would stop the tylenol and please please NO alcohol... Please have this addressed before two months. Good Luck! Hope you feel better soon!