Not a Good Check-up

I had an appointment with my PCP this morning.  She is monitoring several things with my labs that have been off. 

I've had elevated liver enzymes(ALT).  I started taking the Milk Thistle and they have come down but not where they need to be.  She took me off cholesterol meds because it was better and hoping that the liver enzymes would come down more.  They did but they are still elevated at 69.  So Friday morning I am having a liver ultrasound to make sure something else is not going on.

Total Cholesterol was up to 202, LDL 124 and Non-HDL 136 - all high.  My triglycerides, VLDL and HDL were all good.  She put me on 5 mg. of Crestor at night - this is a very low dose and it does not go through the liver.  I really wanted to stay off the cholesterol meds...

BUN is 30 which is high - normal is 6 - 24
BUN/Creatinine Ration is 42 - high - normal is 9-23

My White Blood count has dropped to 3.7 - normal is 4.0 - 10.5

All the other labs that she did are within normal ranges.  She does not do the comprehensive labs.

I have no idea what is going on.  I take my vitamins every day.  I take 2 multivitamins, dry D3, B Complex, Calcium, Iron, Milk Thistle and B12.

Any thoughts, suggestions - ideas???

Linda

**Update** I spoke with the nurse in my surgeon's office and she said to go ahead with the ultra sound and do as the PCP suggested and follow up in 4 weeks with more labs and see where they are then.

Hi Linda!  Sorry to hear that your labs are off, but I really don't know enough to give any advice.  I hope you get everything on track and I will be keeping you in my thoughts and prayers....and I will even swing a lizard or two!

Beverly

Thanks Beverly,
I was thinking about calling Ginger and tell her what was going on and see if she has any ideas or suggestions....
Linda

You know it probably wouldn't hurt.  It may be something they are familiar with and have seen before and they may have an easy solution for you!  That is what they are there for, right?  Good luck to you.

Beverly 

Linda, my ALT is still elevated too (about 75) but Dr Elariny said it's not the AST, which is the one to really worry about. Keep after the milk thistle and don't worry.

Sounds like your high cholesterol is hereditary like my DH's. His is controlled with a low carb diet and meds right now, the good news is the meds are actually working.
 
I second the idea of sending a copy to your surgeon's office. They probably see labs like yours a lot...I think there are some things that are just kind of normal for malabsorptive WLS patients.

--gina

Thanks Gina, 
It made me feel better to hear what your surgeon had to say.

Both parents have high cholesterol, I was sure hoping to not have that to take that medicine anymore.

I called my surgeon's nurse and am waiting to hear from her.  I guess I'll do the ultrasound Friday morning just to make sure.

I've been using the Voltrex cream for my arthritis and one of the side effects is bleeding ulcers - it is an NSAID.  My surgeon ok'd it(since it was a cream and I shouldn't have to use very much of it) as long as I take prevacid(generic) everyday while I use it.  I'm wondering if this could be causing some of the problems.  I'm going to stop using it on my hand and see what the labs look like in 4 weeks.

Linda

I haven't heard of NSAIDS affecting liver enzymes but I have heard that constant use of Tylenol will. You don't think you have an ulcer, do you?  I don't think a small amount of topical cream will hurt either unless you're really sensitive to NSAIDS.

--gina

I don't think I have an ulcer.  I have no pain and am not passing blood.  I hardly ever take Tylenol anymore.

I used to take Aleve almost daily before WLS.  The sheet on the Voltrex just said to tell your doctor if you have liver problems(along with a lot of other things)!!

Linda
I just wanted to say keep your chin up, hopefully there isn't anything to worry about with your liver. Also I think your blood work should be monitored by your surgeon not your PCP.  Like Gina mentioned---I don't have faith when it comes to my PCP and WLS- it's the same reason why there are specialist for other things (ortho, derm, etc).  My PCP was dead sure I had reflux-he was super wrong--I had 3 stomachs and a horrible potentially dangerous internal hernia.  One visit to my Dr and he knew things were not right internally...Just saying---I would get those labs over to your WL Dr ASAP.  Keep us updated!

I see my surgeon in August and he will do the really comprehensive labs, but my PCP keeps check on my cholesterol, A1C and other things like that.

I put a call into the surgeon's nurse just to check with her. 

I had a fatty liver prior to surgery.  The white blood count actually bothers me more than the liver enzymes.  She wants to do labs again in about 4 weeks to make sure it is up some, but didn't really suggest anything to do to bring it up.

Thanks and I will update when I find out something.  I'm glad they found out what your problem was and got you fixed up!!

Linda