Confused and Anxious Beyond: Questions about fatty liver and cirrhosis

Thank you - I am trying to be as hopeful as I can...I am a Child Pugh of 6 score and like I said my bloodwork is better than most healthy people apparently. I also only have a liver stiffness of 9.0 kPa and my meld score in July was 13 but my GP has not tested my creatine or INR (or AST) again since July but if I use my July numbers on those and my current sodium and bilirubin I would be an 11 so my guess is I am likely much lower than that but wont know until I get my Creatine and INR tested again - hoping she does that soon. I think she is wanting to leave it until the hepatologist sees me for some reason. My platelets are bouncing a little but I am at 137 which is low but not too bad.
I read the ascites may open the discussion on transplant but - knock wood - mine seems to be under control with no alcohol and diurtics but I understand that still puts me into the decompensated category.
Time will tell - my GP says my liver is fully functioning and now it will heal since September and my liver stiffness did go from an 11.8 in July to the 9.0 kPa on Nov 1st, some of that would be due to me quitting alcohol but I think some maybe is improvement...hoping.

Did your liver function take a long time to come back? Did they ask you about transplant due to having had ascites? Was the ascites not reacting to treatment? I wish you all the best as this is the scariest path I have been on and I am so upset with myself.
Take care and wishing you all the best!

No ascites to speak of. I had a tumor so HCC, liver cancer. They watched it until it hit 2cm then ablated it. My liver function has been pretty good since I cleared the hep c virus and the AFP tumor marker went down after the ablation. Yes, it is all pretty scary, but I am at Mayo Jacksonville and very confident in the care there. Keeping my hopes up that I will not get another tumor. Please don’t be upset with yourself. Just do your best each day. You have made a decision to be as healthy as possible. You are on the right path. Happy New Year to you and yours.

Hi. I currently have NASH F2/3. My liver enzymes are good, within normal except ggt. My doctor and transplant coordinator are little different in approach. If I get to f3 I will have liver biopsy bc I am always told scans may not be able to catch everything all the time. I have been told an MRE is more accurate than fibroscan but not always covered by insurance. BTW, I am 33 years post liver transplant. Lots of experiences over my journey. Hope this offers info to ask ur doctor. If this still bothers u, you should consider second opinion. We must trust our hepatologist. If not, pls change. Hope this helped

You should never drink alcohol again, do not take ibuprofen at all, only take up to 2000 mg of Tylenol per day. Stay away from recreational drugs. It sounds like you are very close to having a liver transplant due to cirrhosis. you gotta take care of yourself buddy you only have one liver and liver. Transplants are not fun.

Thanks Beracha!! I am sorry to hear that you have NASH after a transplant and I wish you so much success in this journey!!! I appreciate your response!
I did have the MRE as I am in Canada so my 9.0 kPa and 1.73 m/s is pretty accurate...do you mind me asking what yours is? Also did you have a "nodular contour" show up on any imaging you have had done? My descriptions have said nodular contour which I know can be a sign of cirrhosis but if I am correct I understand you can have a nodular contour with Fibrosis 2 or 3 as well? Then there is the ascites but I still wonder if perhaps my liver being so enlarged (17.4 cm in July) that might have put pressure on the portal vein as I do not have portal hypertension according to my GP. I have read that ascites can come on in stage 3 fibrosis for some people and think possibly because I went from fatty liver to possible cirrhosis in 20 months maybe things ramped up internally for me...or maybe I sadly do have cirrhosis but I sure am hoping not.
Like I said I drank more than I should in the last two to three years but did not have a problem before that. COVID hit and my Father passed away and I was depressed and full of anxiety and unfortunately turned to alcohol for relief which I so much regret...I am very athletic and eat well and I am so angry with myself for doing this to my body and I have to stop letting it consume me. I cannot wait to see a Hepatologist but am still on the wait list - either way I am completely alcohol free for 6 months as of today in fact - I am working out and eating clean and trying my best to heal my liver and pray it can still be repaired!! I still do not know how you can have cirrhosis that quickly or have it with a liver stiffness of 9.0 kPa and then the 1.73 m/s which is equal to a 7.5 kPa???

Thanks Dik - I am actually fortunate enough to not be near needing a transplant which I am so very grateful - and my apologies I should not have put my original post on the Transplant section but I did not notice - I only saw a question from someone else about liver disease - sorry!
My condition is stable and believed to be stopped for progress and the ascites has cleared and is being controlled currently by diuretics. My liver stiffness is 9.0 kPA and my bloodwork is all good - my ultrasounds say fairly homogenous and has cirrhotic morphology but my last two did not say nodular contour - just fairly homogenous and mild irregularity and the on radiologist stated his impression was hepatic steatosis but my GP is saying no he is not correct and it is cirrhosis. Cannot wait to see the hepatologist and what the next Elastology results and ultrasound will be in April - crossing my fingers and saying so many prayers!! In the meantime I am doing my best as that is all I can do. Thanks!!

Good luck 👍🏻

Thank you very much...just curious what made you think I was very close to a transplant...asking since you have been through that and so I am curious what other than ascites made you think that? Here are some more details since you have been through all this maybe you have advice or thoughts? I am apparently stopped for progress and knock wood - my ascites seems under control with the diuretics anyway. My bloodwork all went back into range pretty much within 2 1/2 weeks of abstaining from alcohol and I fortunately have had all along no other symptoms at all. I look healthier and feel great - appetite and skin and nails are all good..it is hard to believe I have this going on if the ascites did not happen. I have no idea what to think at this point - clearly I have liver disease but what level I am still not sure although my GP says early cirrhosis...my Fibroscan shows what would be fibrosis 2...My ultrasounds twice have said fairly homogeneous with normal echogenicity and portal veins: Normal hepatopetal flow within the portal vein with a PSV of 25 cm/s and TAPV of 23 cm/s. Normal directional flow within the hepatic veins and splenic vein...
The last elastology was 9.0 kPa and the radiologist put:
Liver: Hyperechoic liver fairly homogeneous, although there is mild contour irregularity at the subcapsular areas of the liver which could be in keeping with underlying chronic hepatopathy such as early cirrhotic/fibrotic change. Measures 15.3 cm in sagittal dimension. Normal echogenicity.
Median Elasticity: 9.0 kPa
IQR/Median: 13%
Median Speed: 1.73 m/s
IMPRESSION
Hyperechoic liver in keeping with steatosis, although there is minimal irregularity of the liver contours today and as seen on the previous study dated October 30, 2023. Allowing for this, underlying early cirrhotic change would not be excluded

@chinup23 - seeing a transplant specialist doesn’t necessarily mean you need a transplant. First of all they are generally the best in the field and can help you get an accurate diagnosis. Second, if your condition could lead to a transplant you will have completed a lot of the work and will be positioned to be listed if/when you’re eligible. Side benefit - you will have already established care with the transplant team.

@chinup23 Thanks - I am hoping I am nowhere near that...My CP is a 6 and my Dr tells me we have stopped progress so now I am just waiting to see the specialist (Hepatologist)....