Had my long-awaited liver consult today at the University of Kentucky. I took my roommate (who is also my medical surrogate) with me because I had a lot of trepidation and I knew he would ask any questions I forgot to). He said I was his emotional support animal. :) Met the nurse practitioner, who took a detailed history and was rather impressed by my ability as a medical historian regarding my personal health history, my medical terminology understanding, my (theoretical) knowledge of nutrition (I have a lot of that, it's the putting it into practice I have trouble with), and my willingness to work on my health.
I don't have definitive answers yet [they took a lot of specific bloodwork designed to give a better idea of my liver function, as opposed to just the enzymes--shout out to Miss Benita in the lab at UK Kentucky Clinic, who literally took my blood with the barest sensation of a needle stick] I need to have an MRI to get a better sense of the damage, as at this point it could be fatty liver disease, fibrosis, or Nonalcoholic steatohepatitis [NASH]. the latter is eventually what killed my mother, although she went through all the stages first. I was a little reluctant to do an MRI because I do hate closed-in spaces and they didn't really want to sedate me, and open MRIs are not as good and often have to repeated anyway on a regular scanner, but she agreed to give me something to take the edge off and we'd go from there. Since I hadn't eaten or drunk anything, there was another test they could have run today, but the MRI would be better, she said. She is also sending me to a consult with an obesity doctor at UK who works with patients by helping keep them accountable for changes they're making in their lives. She didn't think going to a dietician would really help, as I know what I'm supposed to do, but coming up with a plan and sticking to it by having to report to someone would be beneficial. She did not give me the 'lose 30% of your body weight' talk. She said it would help if I lost 10%, which for me is a little over 30 lbs, although even getting down the 25 I've gained over the last year would help. I eat very healthy at home, rarely get take away or go out to eat, so my main nemesis is empty sweets from the vending machine, so that's an angle to work on.
They also got me set up on the patient portal so I could message her and get lab results, some of which have already come in. I see her in three months, after the MRI and obesity consult are completed. I feel better about where I am now. We had a very detailed discussion (down to taking small amounts of acetaminophen vs. the large amount of ibuprofen I've been taking for my musculoskeletal pain (she'd prefer the former to protect my kidneys even though acetaminophen isn't usually considered the best for the liver. We have a plan in place. It's a start.