Hi, @michellesauer. I had a liver disease, PSC (Primary Sclerosing Cholangitis), also a disease of the bile ducts. My PCP referred me to a gastroenterologist (GI) at the very beginning when he saw my abnormal labs. PSC is a progressive disease and also was prescribed URSO. My GI took charge of my liver care because he had the knowledge and experience that my PCP not studied. I had labs drawn every 3 months and routine check-ups with him for 8+ years before my symptoms developed. When I began to experience mild tiredness/fatigue, he told me that fatigue is a common symptom of any liver disease. However eventually my my fatigue became worse, my liver function labs increased; and other liver symptoms developed (jaundice, fluid rentention, itching). At that point I was referred for a transplant - which had always been on the radar due to my particular disease.

Every one's liver disease will demonstrate similar - and - different symptoms. Some patients with PBC do advance to transplant. The only way for you to know what is going on with your liver is going to be to connect with a liver specialist. I want to urge you to contact the medical center that you mentioned talk to someone in the liver or gastroenterology dept for a referral or an appointment. You deserve to know what is happening and whether there is need for further investigation or treatment.

Does this sound like something you can do?

@michellesauer , I am a good days drive to Mayo Clinic in MN and figured out I could find out more new, concrete information from a trip there than I could accomplish otherwise. It is a shift in your mindset, more of a long term approach. Knowing you are confident to figure out how your liver is doing, it may be worth considering how they can help. You could ask your primary care to refer you or you can contact them yourself. Either way, they are on the leading edge of research and care. A lot to consider.

Here is some information to get you started on your search. I don’t see anywhere in Denver listed. Maybe there is an academic medical center there that is not on this list.
- best hospital rankings: https://health.usnews.com/best-hospitals/rankings/gastroenterology-and-gi-surgery
- for a Mayo appointment: https://mayocl.in/1mtmR63

When do you see your primary care doctor next? A thought…your first liver doctor sounds like they understand what is happening with you and would have your records. Would it be worth a call to them to see how they could help you find care?