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Posted 11/18/2013 8:22 PM (GMT 0)
Hello all. Unfortunately my first post is not a pleasant one, but I suppose few are.

My history and layman's guess at symptoms lead me to believe I probably cirrhosis of my liver. I'm trying to get treatment but I have a few obstacles and need some advice about doctors. A history:

I'm an alcoholic male, just turned 26 a few weeks ago. I started drinking at 18, infrequently but heavily at parties in my last months of high school. In college I drank the way many unhealthy students do, having weekend binges. I was known for having a high alcohol tolerance. By my senior (fifth) year I drank heavily most nights of the week. I didn't graduate because I was more focused on drinking and doing nothing. I've been mostly employed since then, drink every day. Usual cycle is get up and go work for 8 hours, pick up cheap vodka on the way home, drink 500-750ml, fall asleep, wake up and repeat.

3 years ago on Thanksgiving (still was in school) I was hospitalized with some form of gastrointestinal issue that caused lower abdominal pain. They never figured out what it was. After admission, however, my unconjugated bilirubins spiked and I got mild jaundice. They took a bunch of blood tests etc. and ultimately said they didn't know what caused it, but that I might have Gilbert's syndrome. Oh, and that I have fatty liver and need to stop drinking. They poked my liver, I said ow, and they said "See? Stop."

Didn't stop drinking. I always said I'll stop later. From time to time I'd a few twinges of pain that I assumed to be from my liver. Over the past several months it's turned more into slight aches. Today in a bright bathroom at work I discovered my eyes are slightly yellow. Read up on more signs, I might confirm for semi-easy bruising, reddish palms, and I have nosebleeds more than one would expect. When I got home I chugged a beer and threw away the rest of my alcohol. I don't think it'll be hard for me to stay off for the next few days, but I'm terrified about the next few weeks

So now my current task is to get to a doctor and wait for them to confirm I have cirrhosis.

Anyway, thank you for being patient while I spilled my guts.

My first hindrance is that as of October 31st I'm no longer a dependent and no longer have health insurance. Funny how the timing works out. I'm eligible for COBRA continuation, and am also trying to find other rates. I expect my life could start getting very expensive very soon. The COBRA will last 36 months if I opt for it, at $270/month. Would I be screwed after those 36 months are over and nobody wants me? Do I take it because I have it? I know nothing about insurance.

As far as doctors, where do I start? I had a primary care doctor 2 years ago, but I've lost records and can't remember his name, though I suspect he might have left the office he was at and started a new one. Do I even want to schedule an appointment with him if I am able to? Should I cut straight to the chase and go to an ER? I reaaaaally don't want to do that without insurance.

I have other questions but I figure I've typed enough paragraphs to get a start. One final thing, my sincerest sympathies to those who have acquired liver disease through no fault of their own. Here I am asking for help when I went ahead and did everything short of munching on Tylenol to ensure that I ruined my liver. I feel like a pretty big jerk.
Posted 11/18/2013 8:40 PM (GMT 0)
Unit, welcome to the forum. It is very dangerous to self-diagnose. It takes YEARS of heavy drinking to develop cirrhosis, unless there are other factors involved...such as overuse of ibuprofen or acetaminophen (Tylenol.) So you dodged that bullet.

You MUST abstain from drinking. You sound as though you have developed a real drinking problem. You may not be able to stay sober on your own. Get to AA as soon as you can. Don't go to one meeting and decide it's not for you. Go to as many meetings as you can in a week and do that for at least 6 mos. (and hopefully for many years to come to insure you are free from that demon. You will learn how to cope w/o alcohol and to discover your underlying issues. If you don't like the first meetings you go to or don't feel comfortable, find another group or one at a different time. There are many younger people going to AA these days...many court-ordered, but they usually end up staying.

Consider this a wake-up call. You are still drinking every day? You are continuing to damage your liver...and that job won't last much longer.

As to insurance, talk to your parents about that. You might also try to get Medicaid. Don't listen to the negative stuff about Obamacare, or the health plans there. Medicaid is being expanded to cover people like yourself who cannot pay for regular insurance. You should look into this NOW as it may take awhile to get approved and enrolled. And they won't accept you will you have other insurance.

Meanwhile, if you can do the Cobra, I would do so.

Start fresh with a new primary care doctor. Also, get a referral from him/her to a gastroenterologist (GI doc.)

Calm down. Stress is just going to make you want to drink. I have been a sober alcoholic for 27 yrs., thanks to AA. And I never take my sobriety for granted or allow myself one drink of anything. I would've been dead long ago had I not stopped drinking.

Do keep us updated. If you have any other questions, feel free to ask.

Hugs,
Connie
Posted 11/18/2013 8:57 PM (GMT 0)
You could pay the $270 a month Cobra from the money saved by not drinking. Go see a hepatologist and get an examination to see what condition your liver is in. AA sounds like a third step (no pun intended) in getting back to normal. I doubt your liver is shot, but if you don't quit boozing, it will be eventually.
Posted 11/18/2013 10:24 PM (GMT 0)
I want to second Connie's advice, check into whether you qualify for Medicaid. As to Cobra, are you sure about the 36 months? I was on Cobra after I was let go by my employer and the maximum time was 18 months. (2007) I used it until for 6 months until my husband could add me to his work coverage during open enrollment. So while you are checking about Medicaid, keep up the Cobra. If you end up not qualifying for Medicaid, check out your state's health insurance exchange or the federal one if your state has deferred to them. ( healthcare.gov). There are bronze, silver, gold, and platinum plans with different deductibles, co-pays and co-insurance requirements. You will probably be eligible for a subsidy from the Feds to pay your monthly premium. I would purchase the best coverage ( platinum is the best and bronze the least) you can afford w/ a deductible, co-pays, and co insurance and out if pocket amounts you can handle financially. My step son who is 26 and healthy purchased a silver plan in the Bronx NY, and with his subsidy, his cost is $80 per month! No I am not an insurance salesman but have been researching this as I was transplanted in August and eventually want to return to work. When I do, I will lose my Medicare and since I am not sure I will find employment w/ benefits, I have been studying this matter!

Good luck to you in your sobriety!

Susie
Posted 11/19/2013 12:08 AM (GMT 0)
Quit beating up on yourself. Stay sober. Come here and go to AA. Oh, and get thine rear to a doctor and get checked out. Yes, you will be able to afford health insurance with what you save from buying alcohol.
Now git on with you to the doctor!!

Sandia

Post Edited By Moderator (hep93) : 11/18/2013 8:59:17 PM (GMT-7)

Posted 11/19/2013 9:57 AM (GMT 0)
Unit,

Congratulations on admitting you have a problem and looking to do something about it. It's hard to admit one's failures or weaknesses so you took a big step by coming and asking for help.

1. Don't worry about the insurance right now, go see a hepatologist, if you need a referral go back and find out where your primary care guy went. They are required to give you your records. If not, find a new one ASAP. Besides, if you stop drinking, you may not need a great plan for many years to come.

2. Stop drinking, you're just a baby and no matter what the cause of your liver problem (assuming that it is) , you will certainly make your life so much worse. If you get weak, come here and ask me how liver disease progresses and I promise you, it will make you throw out the bottle.

3. Try to finish your education with the extra time that you have on your hands. Go nights if you can't afford to quit work. It will keep you out of trouble, and it will benefit you greatly, it may even keep you alive :)

4. Get some counseling if you can, like Connie said, AA is a wonderful place to start.

5. Maybe you could ask your family for help, I'm sure they would jump at the chance to support you.

6. Come back here often and give us updates, we care about you and we don't judge folks here in this forum. Many of us started with the same issues you are having right now.

When you're in your 20's you think you can't HAVE a good time without alcohol, but it's that mindset that takes away your options, because eventually it will kill you. You got an early start on alcoholism but you also got an early start on seeking help, kudos for that. I choose not to drink, but only because I feel better the next day if I do not. But I found I have just as much fun without it, and you can too.

One of my brothers is an alcoholic and from experience, I can tell you that you may need medication to stop drinking safely so you should go to a doctor STAT. In the ER they tell him to be honest about how much alcohol because it can cause severe problems that require medical intervention.

So good luck to you son, we'll be waiting to hear back from you :)

Hugs,
Mae

Post Edited (Mae be here) : 11/19/2013 3:10:35 AM (GMT-7)

Posted 11/22/2013 8:57 AM (GMT 0)
Hello all, and thank you very much for your help. It helped me calm down quite a bit and try to stay objective. Sorry for leaving you all hanging and not thanking you for your replies sooner, though I have been reading them from my phone and they are very much appreciated.

I thought I'd give an update. For the couple of days after my post I was out of town visiting my parents. Didn't drink. Talked with some insurance people and had more or less decided on a new insurance plan that was a bit cheaper than the COBRA continuation. Got a hold of my primary care doc but was waiting until today to schedule an appointment, since my work schedule comes out every Friday.

Yesterday morning (Thursday) I came back home for work (started at 3:30am). Noticed my eyes were slightly more yellow and I had a low fever, but didn't know how I could pay for urgent care since I'm in-between insurance. For two very stressful hours after work I made a bunch of calls, made a long drive through awful traffic to get my insurance card (had left it at home thinking it was useless) and struggled with my phone data (we had a huge storm on sunday that knocked out some communications infrastructure) but eventually I found out that I can still use my old coverage for now, though it means I have to go with COBRA. Oh well.

So I went to an urgent care center at 3pm and they ran a full set of liver and pancreas tests but held off on imaging. The nurse commented that my blood pressure was high haha. Last night at about 9 they called and said that my liver levels were elevated and they want me to come in for an ultrasound and to see the gastro doc. Some hepatitis results still to come today.

Anyway, I woke up a bit ago to get ready for work and found that now my skin is starting to yellow and my eyes are worse. So I will be calling off and heading back to the urgent care when they open at 7am (3 hours from now). I haven't noticed any other symptoms other than an occasional twinge from what is presumably my liver.

Hopefully things don't get too much worse. Anybody have any thoughts on why my jaundice seems to be getting bad *after* I stopped drinking? Kind of a bummer :(
Posted 11/22/2013 1:20 PM (GMT 0)
Unit, In my case it took awhile for my jaundice and facial spider veins to go away. Not saying that our cases are even remotely close, I had been drinking for the better part of 20 years heavily. Could be a number of things that's got your liver out of whack and the alcohol just made it worse. We tend to scrutinize ourselves more when we find something wrong with our health. Hopefully you're just jumping the gun here. Maybe you're looking too hard for signs and are seeing what's been there all the time. I'm in no way suggesting that you don't have liver damage but you need to be diligent in finding out what the source is.

You're doing the right thing by going to get it checked out, and that's where I went wrong, You're far ahead of where I was by doing something about it. Seeing a doctor is your best defense of cutting this off before it gets out of hand. Should your next results come back and it doesn't look good, then set up a appointment with a Hepatologist. There are some great G.I doctors out there, but for the most part they are under-qualified for properly treating or diagnosing liver disease. I'm glad you came back and gave us an update on your situation. You're doing all the right things.

Ziff

Post Edited By Moderator (hep93) : 11/22/2013 1:52:30 PM (GMT-7)

Posted 11/22/2013 8:53 PM (GMT 0)
I agree with Ziff.

Hugs,
Connie
Posted 11/23/2013 2:00 AM (GMT 0)
Susie, just saw your post again: In my case as a "loss of dependent status" it's 36 months. From what I've read 18 months is for termination or loss of hours. I'm in fact looking into government subsidy, which it seems can be quite large. My only current problem is I seem to be 96% poverty income, and the requirement is 100-400%. So I'm looking into bagging groceries a few hours a week as supplemental income smilewinkgrin

Thanks Ziff, I've read through a number of your other posts in the forum and it sounds like you've had quite a ride. I appreciate your thoughts

Mae, I think I'm doing well on a number of those points! Hopeful for #3 (finishing my degree) especially, it's amazing how much more time there is in the day when I'm not trashed for half of it.

Update time:
I took a second bili test today, and it's up to 4.1 from yesterday's 3.0. Otherwise the rest of the tests are the most current info

ALBUMIN 5.8 GM/dL
ALKALINE PHOSPHATASE 101 Units/L
ALT (SGPT) 67 Units/L
AST 114 Units/L
BILIRUBIN, DIRECT 0.6 mg/dL
BILIRUBIN TOTAL 3.0 mg/dL
PROTEIN, TOTAL 8.9 GM/dL

Hep B Surf Ab QN >1000.00 mIU/mL

Ultrasound results
HISTORY: Jaundice. Elevated bilirubin. Fatty liver.
FINDINGS: Sonographic examination of the right upper abdomen was
performed. The liver shows an overall increase in echogenicity
compatible with fatty infiltration. The liver shows no focal
parenchymal areas of abnormality. No intrahepatic biliary dilatation
is seen. The CBD is not well-visualized but there is no evidence of
extrahepatic ductal dilatation. The gallbladder shows a 1.6 cm
gallstone within the fundus without evidence of wall thickening or
pericholecystic fluid. The right kidney and pancreas are
unremarkable. No free fluid is seen.
IMPRESSION:
1. Fatty liver without intra-or extrahepatic ductal dilatation.
2. Cholelithiasis without overt evidence of cholecystitis.

So a floating gallstone and fatty liver. I think I can call that better than my fears! Still, they want me back in in 2 days for another bilirubin total as well as a Hepatitis B check. They asked me if I have had a hep b vaccine in the past but I doubt it. The thought of that 16mm gallstone does make me cringe though. Like a time bomb, except instead of exploding it wants to find a nice duct to move into and then terrorize the neighborhood.

I feel like there are other things I'm forgetting to add, but I'm quite tired and am having trouble keeping my thoughts in order

BTW, is there anybody here who has a lot of PVCs and/or NSVT or VT?
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