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May 19, 2020 09:36AM
May 19, 2020 09:51AM
Hello my longtime BC friends-wallycat, SpecialK, peregrinelady-we've been through some things together, right? And many thanks to other posters, too! Every post but one was reassuring and I knew I'd find that here! :)
I had my telemed appt yesterday. It was very short (almost felt rushed) but okay. MO opened by saying that all my labs were fine, EXCEPT my AST/ALT. Right. He then jumped right into "I want you to have an ultrasound of your liver, and"...blah blah. I stopped listening for about a second because he didn't ask or even give me a chance to share diet, OTC drugs, supplements, anything.
So I had to jump back in and tell him this happened once six years ago, and we retested in two weeks after I cleaned up my alcohol intake, and they dropped to normal. Then he said, not unpleasantly, "okay, if that is what you want to do, we can retest in a month and and see if they drop first." I explained that I had been drinking more than usual, because of pandemic anxiety-and probably too close to the lab draw. I had to share with him that I had been taking more advil than normal and a few tramadol because of lumbar pain due to some different yoga poses I'd been learning (he said advil shouldn't make a diff but I wonder). Finally he slowed a bit and said exercise can cause #s to rise, etc.
I did tell him I didn't want to unnecessarily go into a medical facility just yet, for obvious reasons. I live right next to the Navajo Nation and they have, per capita, the highest rate of Covid and deaths in the country. It's just terrible there, effing tragic, and our med center treats most of the cases.
Finally I had to gently push him to tell me why he would want an US. He said I might have fatty liver, and he wanted to rule it out. I did a bunch of research on NAFLD, and it turns out it wouldn't be impossible for me to be develop it but most of the time it happens with obesity, diabetes, and eating a high fat high sugar diet. I'm not any of those. The protocol for reversing it or keeping it from getting worse is diet, losing weight, no alcohol, and exercise. And I'm doing all of that except alcohol (my BMI is already 20).
Interestingly I began to look at those of us on AIs and fatty liver, and a lot of research points to the fact that ER+ early stage BCers on AIs, not just Tamoxifen, are more at risk for developing this disease, and we have a lower survival rate if we do. Yikes.
The positive take away was that he didn't mention the c word at any time in the conversation.
Altogether the conversation felt very odd. He was rattling off words and if I had just said "okay" to the US, I think he would have told me his scheduling team would contact me and he would have ended the call right then and there. Proof again that we have to continue to be proactive in our health care.
Right now I feel about 80% confident it was alcohol that elevated my values just beyond ULN. I'll post when I retest. I feel like an ongoing lab experiment.
And if on the off-chance it is FLD, then I have to weigh if I want to continue on an AI and risk permanent liver damage, or stop the AI and risk recurrence. Either way feels like a crapshoot. Well, we know how to live with those odds, right?
Claire in AZ
PS I take lipotropic complex that has milk thistle in it rx'd by my naturopath, and just added 800 mcg of folic acid to my daily supplements. It is supposed to support liver function, too.
9/29/11 ILC, 2 c. stage II grade 1, ER/PR+ HER2-, 6/11 nodes, lumpectomy, DDAC x 4, Taxol x 12, 33 rads, Tamoxifen/arimidex/aromasin, BMX/immed recon 7/3/13 "In the midst of winter, I found in me an invincible summer.” Albert Camus