PART 1: Is knowing really better? GI appointment, and all things considering.

I've decided to start here, rather than the usual pouring-forth on All Things Ephemeral (alter ego).  Doesn't matter why--just something I decided to do.  Maybe it's just the one tiny thing that makes me feel as if I have some control over things.  Probably deluding myself, to tell you the truth.

This is just part 1 of 2 with regards to yesterday, as there are two distinct components here that I REALLY need to talk about.  I figure I'd do you guys a service and break the topic up so the read isn't as overwhelming, and so it will also be easier to keep up with in case you don't want to read it all at once.

So, I finally saw the GI/liver specialist yesterday.  The visit went very well in all ways.  I've NEVER seen a doctor who genuinely showed compassion for his patients!  I was blown away..almost in tears.  Seriously, this is a rarity.  He's young, and he earned his IM degree at Johns Hopkins, then went on to California for DO school.  He holds several scholarships/honors awards and is published.

He introduced himself when he walked in, and asked 'how are you today," but not in a casual "hey how are ya?!" way, but in a genuine.. wanting-to-know-how-you-actually-feel way.  I was a little caught off guard. So he concluded his introduction with telling me his background (briefly and without wasting time), and then added... "So my new patients ask why I'm here [in AL]."  He explained that after earning his degrees he wanted to come back to AL and be near his family (Birmingham), which is about an hour and a half away from Montgomery.  How selfless!  I mean, this guy could have his pick of places to work, including Johns Hopkins, but he chose home, his family.  GREAT fortune for our area to have this guy!

I handed him my last lab report, which is FAR larger than most college research papers, and he began going through them asking me about my symptoms, etc.  He left NO stone unturned.  As he looked at my liver enzymes (ALT, AST, etc, etc.) he remarked on how significantly elevated they are, focusing immediately on my Aldolase.  He looked at all the other labs and remarked on many things, actually putting it all together in a way that no other doctor I've showed these labs to even came close to doing.  Impressed yet again... I continued to listen.

He stated, with nearly 100% absolute certainty, that one of the things I'm dealing with is myositis (sometimes called polymyositis).  But he kept going...  and here's basically where I'm at with all of this:

Doctor suspects...

Autoimmune hepatitis.
Myositis/polymyositis.
Duodenal ulcer.

My ferritin is low (he said significantly low), and added that the usual effect liver issues, etc. has on ferritin levels is that it goes UP, not down.  The fact that my ferritin is depleted makes him suspect bleeding (ulcer).  That coupled with symptoms is pointing to that.

My autoimmune markers for autoimmune hepatitis were negative, but my Dr. just shrugged and said that a good deal of people who have AI hepatitis have false-negative labs.  He then mentioned I will likely need a liver biopsy.

Myositis--he ordered another lab that wasn't previously done, one specifically for myositis.

Procedures/tests scheduled and yet to be scheduled:

EGD (endoscopy).
Colonoscopy (procedural, even though I had one last year).
The top two tests/procedures will be done in 4 weeks.

Liver Biopsy - to be scheduled.

These are suspicions, really, until proven either by conclusive test results OR process of elimination.  Either way, my Dr. is awesome, and he doesn't give up easily.

In the meantime he is addressing the vitamin D deficiency, which he professed his shock that I wasn't already being treated for that (seen two other Dr's who knew about this but didn't address it).  I take one dose of Rx vitamin D once a week for 16 weeks, at which he tells me my Vitamin D should be replenished.  I've also been given an additional medication for stomach issues (ulcer?).

The backdrop to the above is a big complication--that of relationship, happiness..or lack thereof, and a simple matter of needing peace, serenity, and place where I can heal...

THAT is another talk show. And THAT is part 2....