Around 3 days ago noticed that the colour of my pee was markedly above the normal pale yellow.
I initially thought that I was dehydrated, (the week before went up north with the family and did not drink much water, just coffee and only occasionally water. I have had no alcohol since the back end of 2015).
I also thought that I had contracted a slight dose of food poisoning initially, normal stools one day and the next a bit runny but then back to normal the following day.
Despite taking on plenty of water the colour remained dark yellow - I still thought that it was dehydration because I had a dry mouth and throat despite drinking adequate water, perhaps I was missing essential minerals.
Yesterday evening I thought that I had a tinge of yellow in the eyes and body, more striking this morning.
I went to Bangkok Khon Kaen hospital today to find out what was going on.
It seems to be a revisitation of the back end of 2015, only this time its to do with the liver - not the lung cancer and AAA episodes.
I saw a Dr. Apichat Sangchan (asst. Prof.)
He recommended I have a kidney and Liver function test, I also suggested to have a CBC. After that an ultra sound of the abdomen.
The results: Kidney all ok
Liver - not ok.
I had an annual Kidney, liver and PSA check done about 6 weeks ago where all appeared to be normal.
This time there was an 8 test for the liver
Total Protein 7.9 g/dl (6.6-8.7)
Albumin 4.4 g/dl (3.5-5.2)
Globulin 3.5 g/dl
Total Bilirubin 7.1 H mg/dl (0.0-1.2)
Direct Bilirubin 6.3 H mg/dl (0.0-0.3)
SGOT (AST) 265 H U/L (0-40)
SGPT (AST) 423 H U/L (0-41)
ALP (alkaline Phosphatase) 401 H U/L (40-130)
In November all that was tested was SGOT which was 17 U/L (0-41) and SGOT which was 20 U/L (0-40).
Was not able to query with the Dr. as I only noticed it when I got home. But that's water under the bridge now.
Maybe worth noting that the LFT should consist of the 8 tests above.
I have to revisit tomorrow as the Dr. recommended to have MRI with contrast + MRCP. Unable to have them today as I had something to eat between the tests and the results today.
ULTRASOUND UPPER ABDOMEN FINDINGS - The study reveals mark inhomogenous increase echogenicity of liver with increase periductal echo; parenchymatous changed of liver or infiltrating tumor could not be excluded. No detectable liver mass is found.
- Dilation of IHD in both lobes liver and dilatation of CBD (about 0.92cm in diameter) which could not demonstrate cause of obstruction due to much of bowel gas artifact.
- The thin-wall gallbladder is markly distended (about 11cm in length); hydrop gallbladder is suggested. No detectable gallstone is noted.
- The rest is about the Kidneys what all was ok.
- Dilatation of IHD in both lobes liver and dilatation of CBD which could not demonstrate cause of obstruction due to much of bowel gas artifact.
- Mark inhomogenous increase echogenicity of liver with increase periductal echo; parenchymatous
changed of liver or infiltrating tumor could not be excluded. Please correlate tumor marker and MRI + MRCP could be helpful.
- Hydrop gallbladder is suggested.
- Suspected renal stone at lower pole of right kidney (about 0.6cm) without hydronephrosis.
- Simple renal cortical cyst at lower pole of left kidney, about 2.85x3.06 cm.
The Dr. suggested that the obstruction is not a stone as there is no pain so the only other thing will be a tumor.
I asked what remedy is there is it is indeed a tumor - he said surgery.
As far as I understand the obstruction is in the bile duct inside of the liver and not outside. Is it possible that surgery could be done?
Having read a bit about it, it seems to be a rare and aggressive type of cancer (if that is what I have).
As the ALP indicates the obstruction, if its a tumor can it grow that fast (6 weeks)? Even though ALP was not tested in November, the SGOT was which I understand is the inflammation marker so I would expect them to go hand in hand i.e. SGOT normal in November I would expect that ALP would have been normal then. Now SGOT elevated and also ALP.
Also - would a PET scan be definitive more so than the MRI + MRCP, although I will be having these tomorrow anyway.
I would feel more comfortable if I were to be operated on in the Bangkok Bangkok hospital as I was in 2016 - more facilities, equipment including PET scanner and wide ranging physicians.
Sheryl - Could you comment on my post and any suggestions re doctors/professors in the Bkk Bkk hospital.
I am insured with Cigna Global - That's one ray of sunshine!!