Ultrasound of Liver

Had my liver looked at today!  Ultrasound lasted about half an hour.  Here are the results:

Narrative

Ultrasound abdomen, complete

History: 59-year-old male with elevated liver function tests. Previous cholecystectomy.

Comparison: None.

Findings:

Liver: Diffusely increased echogenicity compatible with fibrofatty change. Liver is of normal size measuring 16.9 cm longitudinal dimension.

Gallbladder: Surgically removed

Bile ducts: No dilatation. Common bile duct measures 2.2 mm.

Pancreas: Not well seen

Spleen: Upper limits of normal for size. 13 cm longitudinal dimension. No focal abnormality seen.

Kidneys: Limited views show no hydronephrosis. There is a 1.5 cm cyst in the right kidney and a 1.2 cm cyst in the left kidney.

IVC: Intrahepatic portion normal

Aorta: Visualized portions normal.

Dictating Workstation: HMINWKS10

Impression

Ultrasound findings compatible with fibrofatty change within the liver. No focal abnormality.

Status post cholecystectomy.

Small bilateral renal cysts.

Borderline splenomegaly.

The new reporting system by MY LG Health is great and fast!  The test was this morning and I had the results tonight!  Bad news is the patient sees the results & I do not understand the results!  My research!
Meet with the doctor next Tuesday!

Starting on Fatty Liver Disease! and Kidney Cysts!

Great Three Mile Cardio Workout

Trying to stick to my cardio with a "brisk" walk for 3 miles!  Here are my splits:

Mile 1 - 16:50

Mile 2 - 16:42

Mile 3 - 16:44

Total 3 mile Walk - 50:16

Found an article on - How Fast is Brisk Walking

Rule of Thumb

The Centers for Disease Control and Prevention (CDC) says that brisk walking is at a pace of three miles per hour or more (but not racewalking) or roughly 20 minutes per mile. That equates to about five kilometers per hour or 12 minutes per kilometer.

It looks like I'm under the "20 minute" per mile pace!!

The article goes on to state:

However, fitter people still will not be in a moderately intense exercise zone at that pace. A pace of 15 minutes per mile, or four miles per hour, is more likely to put fitter people into a moderately intense exercise zone.

That will be my goal! 15 minutes per mile!!!

From My Heart to My Liver!

As I mentioned in early posts, the Liver has been a bad boy!  Here are some of the blood test results from the past few years!

The problem area is the AST & ALT readings!  Notice the fluctuations from 2007 to 2013!

What is causing the Liver issues?  Here I found some ideas - What Do Elevated Levels Mean?

AST (SGOT) and ALT (SGPT) are sensitive indicators of liver damage or injury from different types of diseases. But it must be emphasized that higher-than-normal levels of these liver enzymes should not be automatically equated with liver disease. They may mean liver problems or they may not. For example, elevations of these enzymes can occur with muscle damage. The interpretation of elevated AST and ALT levels depends upon the entire clinical evaluation of an individual, and so it is best done by physicians experienced in evaluating liver disease and muscle disease.

Moreover, the precise levels of these enzymes do not correlate well with the extent of liver damage or the prognosis (outlook). Thus, the exact levels of AST (SGOT) and ALT (SGPT) cannot be used to determine the degree of liver disease or predict the future. For example, individuals with acute viral hepatitis A may develop very high AST and ALT levels (sometimes in the thousands of units/liter range). But most people with acute viral hepatitis A recover fully without residual liver disease. Conversely, people with chronic hepatitis C infection typically have only a little elevation in their AST and ALT levels while having substantial liver injury and even  advanced scarring of the liver (cirrhosis).

Next game plan is:

April 2 - Ultrasound of liver and April 9 meet with the "Liver" doctor!!!

Another Brisk Walk!

Had another great walk today on the Lancaster Junction Trail!  Fives miles at a brisk pace!  Thought I would do some research on what is considered a brisk pace!

What is a Brisk Walking Pace?

Couple of points from the article:

1 - SPEED _ Brisk walk is about 3 mph.  That is about 10 minutes for 1/2 mile.  The trail is marked every 1/2 mile & today I averaged about 8:40 per mile.  So, I was brisk!

2 - BREATH - Need to catch breath?  Nope!  Was breathing fine!

3 - HEART RATE - Did not wear my heart rate monitor, but I usually will be in the 95-105 range.

Check out the graph below:

What is your age & what is your Target Heart Rate?

I'm 60 and I am hitting between 95 - 105 on average.  My goal will be to get closer to my upper range of 120-128!!

Cardio Workout Goes Well

Did my 5 mile cardio this morning and things went well.  I wore my heart monitor and had no obvious PVC's!  Mix in brisk walk & little jog during the 5 mile trek!  Here are some details:

Total time of workout - 72 minutes
Heart Rate Start - 76
Heart Rate High - 113
Heart Rate After 5 minute warm down 79

Did my workout on one of my favorite trails - Lancaster Junction Trails

One Week to Go on Experiment of Meds

Next week I have another blood test to see what the results will be after two months without my statin - Atorvastatin!  I have been on Lipitor, and the generic Atorvastatin for over ten years, and my liver results on my latest blood test were high:


Hepatic Function Panel       Your Value  Reference Range  Units       Flag
Protein Total Serum               6.9               5.6-7.9                 g/dL         None
Albumin                                 4.5               3.5-4.9                 g/L           None
Bilirubin Total >21 Days       0.9               0.2-1.2                 mg/L        None
Bilirubin Direct                      0.2               0.0-0.2                 mg/L        None
Alkaline Phosphatase            67                 34-104                 U/L          None
AST (SGOT)                        67                 13-40                   U/L          High
AST (SGPT)                         122               7-52                     U/L          High
Gamma GT                           49                 9-64                     U/L          None

Notice the AST (SGOT) & AST SGPT) results are on the high side!  So the past two months no Astorvastatin!

As I have mentioned earlier, one thing I have noticed is my legs feel great!  During exercise & normal daily routine, the legs feel great!!

Entering Second Month Off of Atorvastatin

The experiment continues!  This will be my second month off of Atorvastatin (generic Lipitor).  I will be anxious to see what my cholesterol levels will be at the end of the month!

Again, the reason my cardiologist took me off was my last blood test - Liver readings not good!  Apparently, taking statins & Liver issues are common!

Check out the article on Web MD - Cholesterol Management 101

In the article it was stated:

“Outside of measuring liver biochemistries for the purpose of periodically updating a patient’s medical history, we can find no scientific or medical basis for monitoring aminotransferase levels during long-term statin therapy as a measure to enhance patient safety. We acknowledge that the Panel’s recommendations are at odds with current prescribing information for marketed statins; however, we are optimistic that the regulatory agencies and pharmaceutical industry will update their recommendations to be consistent with evidence-based data cited in this article.”

Well, they think it is not an issue!  Especially if statins help with heart disease!  Futhermore:

Well what does this mean? In a nutshell it means that for too long many people have been denied life saving statins. There is solid evidence that they markedly decrease cardiovascular morbidity and mortality. I was actually stunned when I looked at the package inserts for all the statins that are sold. The recommendations for liver testing were all different, yet the class of drugs’ effect on the liver is the same.

Another article states:

Two liver enzymes in particular (alanine aminotransferase or ALT, and aspartate aminotransferase or AST) may be mildly elevated, but it is safe to continue treatment unless they rise by three times the upper limit of normal.

I will continue to research and ask questions!  Here were my results in question:

More to come!