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Dr. SH
Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8789
Experience:  Doctor of Medicine
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Is My Liver Failing? I have Chronic Fatigue Syndrome and

Resolved Question:

Is My Liver Failing?

I have Chronic Fatigue Syndrome and am a heavy drinker (I am working on this with my psychologist). Originally our plan was to leave the drinking alone, and to tackle the underlying causes of the CFS, with the hope that afterwards I would be able to reduce my alcohol consumption more easily (“tackle the cause, and the symptom might go away on it’s own; there is little point in focussing on tackling the symptom without addressing the underlying cause” – aka, the drinking being the symptom of other underlying psychological issues being gradually dealt with).


– Facial Swelling –

Over the last couple of months I have been on a diet and lost about 20 lbs. However, I was sad to see I was not loosing much from my face. In the last couple of weeks I became aware that really my face was swollen. Today my face is very puffy and rather uncomfortable – reminiscent of when I had mumps. My face also feels very flushed, although it does not look so.

On a related note, while I have gone down over 4 dress sizes, I am struggling to loose weight from my abdomen and hips.


– Digestive Symptoms –

I have had small spotting of blood from my rectum on 3 occasions in the last 2-3 months (I was always going to go to a Doctor about it if it happened “one more time”). My stools are usually very dark and often small and hard. I attributed this to the fact I am (and always have been) prone to dehydration as I am terrible at drinking sufficient water during the day, the alcohol consumption (which I knew would be increasing my dehydration levels), and the fact I cut out lots of carbohydrates for my diet (eating more lean protein and salad). I have fairly frequently suffered from ‘explosive diarrhoea’ over the last 6 months (perhaps up to 4 times a month), but I attributed this to the IBS associated with CFS.

I suffer from occasional stabbing gut pain which is extremely severe, but usually lasts no more than 5-10 seconds, and only happens 1-2 times in a row, with weeks to months of no pain in between.

Over the last 3 months I have also noticed I have a more sensitive gag reflex – I can no longer clean my teeth properly as I retch when I try to get to my back teeth.


– Cognitive Symptoms –
(Inc. muscle pain / weakness)

I have problems with cognitive dysfunction (including generalised confusion, disorientation, and memory loss), but these are also symptoms of the CFS. Similarly I suffer from weakness, fatigue, have trouble sleeping, and also suffer from muscle cramps and muscle pain (particularly in my upper back/shoulders and calf muscles recently), which are also all CFS symptoms.

I have slight tremors/feeling of shakey-ness sometimes, but I have always attributed this to the frequency I ingest large amounts of caffeine in order to combat the CFS symptoms (for when going to work etc.)


– Skin Symptoms –

I have very itchy skin, which has gotten worse over the last 3-5 months. As I am prone to eczema, this was put down to the stress caused by some of things we were doing in therapy, and the changes I was making in my daily life and thinking patterns, as well as generalised stress and anxiety stemming from occasional panic attacks that I might not recover from the CFS and other related anxieties. The itchy skin is resistant to any soothing creams or topical treatments. The worst effected area are my underarms (which are scratched raw from night-scratching), although I also get very itchy feet. Other patches move and change around my body.


– Repertory & Cardiovascular Symptoms –

I often have a faster heartbeat and can be breathless, but I attributed this to my long term de-conditioning relating to the CFS (I was practically bedridden for over 18 months), and being an asthmatic and a smoker (7 a day). Now my mobility is increasing I am doing more, but was not surprised by these symptoms as a result.


– Additional –

I drink about 8 shots of vodka a night, mixed with coke. I have drank almost every day for over 3 years (although for some periods half that amount). I am concerned I am now an alcoholic, but didn’t feel like I could tackle additional therapy alongside the work I am already doing. I have spoken to my GP about my concerns, but the only suggestion was to follow that option.

I think in the last month or so I have grown more sensitive to alcohol, but I attributed this to being on a diet. This Friday and today however I feel really unwell generally – not hungover as such, but just sort of horrible and unclean, like I might be coming down with the flu, but not quite.

As noted, while I have had many of the symptoms I know to be associated with liver problems, it was only today, after googling about the facial swelling, that I realised that I might have unintentionally ‘explained away’ red-flag symptoms...

(More text prepared – please initiate conversation and I will paste)
Submitted: 4 years ago.
Category: Medical
Expert:  Shantal-Mod replied 4 years ago.

Hello,

I've been working hard to find a Professional to assist you with your question, but sometimes finding the right Professional can take a little longer than expected.

I wonder whether you're ok with continuing to wait for an answer. If you are, please let me know and I will continue my search. If not, feel free to let me know and I will cancel this question for you.

Thank you,

Shantal

Customer: replied 4 years ago.
Yes, please keep searching. Thank you
Expert:  Shantal-Mod replied 4 years ago.

Hello,

Thank you for getting back to me. We will continue to look for a Professional to assist you.

Thank you for your patience,

Shantal

Expert:  Dr. SH replied 4 years ago.
Hi there,
Thank you for writing to us.
Have you had some blood workup like a basal metabolic profile or a comprehensive metabolic profile?
Please let me know.
Regards
Customer: replied 4 years ago.
After submitting this question I went to my GP who has ordered some, but the date isn't till the 8th Oct! He obviously isn't concerned that I could be in any immediate danger (and he might well be right), but I felt rather uncomfortable that he was making such an effort to explain that so many of my symptoms could be due to the CFS – For while I agree, and there may be anything sinister lurking, it is undeniable I have been drinking heavily, and I don't want my symptoms to be dismissed only to discover later than they were masking something more sinister...
Expert:  Dr. SH replied 4 years ago.
Thank you for the additional information.
I understand your concerns and I would have probably also been concerned if I were in your place.
I think that 8th of October is a reasonable time to have your tests done, I mean its not that far off and I assure you that till that time you should be okay.
I also think that with your symptoms in addition to the metabolic profile that you should also have a thyroid function test done if you have not had that done already.
You should try your level best to quit drinking and should join a formal program to help quit or at least limit your drinking habits because this, in the long run, can land you into a lot of trouble.
Let me know if you have any further questions or if you wish to add anything.
Kindest Regards
Customer: replied 4 years ago.

Update: I had my contraceptive implant removed yesterday (coincidence), and the nurse looked a little bewildered then said in a soft tone “so, are you a bleeder” I replied “no, never before” and she looked confused and thoughtful before sterry (sp?) strip on it, and a plaster, then bandaged my whole arm to help stop the bleed.


 


Should I be concerned by this in light of the other symptomology…?


 


 


Also, as information is comforting and informative, could you please explain to me in lay terms the usual progression for liver disease? For instance, if I do have problems, are they reversible? Other than quitting drinking, is there any other precautions I ought to be taking right now (nutritional supplements etc.?)


 


Many thanks for your continued support.

Expert:  Dr. SH replied 4 years ago.
Should I be concerned by this in light of the other symptomology…?
Nope, I would not be worried about this. However having said that the most important thing is to try your level best to quit drinking which is something that is ABSOLUTELY necessary for you in the long run. Presently however your symptoms are MOST LIKELY not related to liver disease as I see it.

Also, as information is comforting and informative, could you please explain to me in lay terms the usual progression for liver disease? For instance, if I do have problems, are they reversible? Other than quitting drinking, is there any other precautions I ought to be taking right now (nutritional supplements etc.?)
Liver disease in the early stages is reversible i.e. in cases of acute hepatitis it is reversible.
If liver disease is advanced, which is UNLIKELY in your case, it is then irreversible.
In advanced liver disease one can have fluid in the abdomen (ascites), swelling of the feet due to accumulation of fluid, bloody vomiting, black colored stool, episodes of unconsciousness or reduced consciousness to name some important complications.
Let me know if you have any further questions.
Do rate me for my services when you are done asking.
Kindest Regards
Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8789
Experience: Doctor of Medicine
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Customer: replied 4 years ago.

Thank you for your reassuring comments. While I am determined to get my drinking under control, I am struggling to deal with that and the CFS/psychology work at the same time; knowing I need to make changes and that I am at risk I at least have time to sort my life out – as oppose to being a ticking time bomb who’s life is already over.


 


Thank you for your help and support.


 


Do you have any information or advice as to what groups are available to help me with the drinking? I have heard about Drinkaware, but I’m not sure what they do, and wondered if you had any inside info as to what my best option might be?


 


 

Expert:  Dr. SH replied 4 years ago.
http://www.nhs.uk/Livewell/alcohol/Pages/Alcoholsupport.aspx

Above is a weblink where you may find some help.

Kindest Regards