The Oxycodone is for breakthrough pain. Most times I only use it twice a day, once or twice a week and sometimes not at all. I just started it yesterday. So My Fentanyl patch keeps me free from most pain.

Pea, did you google fentanyl?

Also, I found this while reading about fatty liver disease.

Drug interactions

Methotrexate, a medication used in the treatment of cancer, psoriasis, and rheumatoid arthritis, inhibits the enzyme dihydrofolate reductase and therefore limits the availability of methyl groups donated from folate derivatives. Rats given methotrexate have shown evidence of diminished nutritional status of choline, including fatty liver, which can be reversed by choline supplementation (2). Thus, individuals taking methotrexate may have an increased choline requirement.

Maybe choline would help.

Violeta,
On the second page, I stated what he took me off of, MTX was one of them.

Yes, I do realize that, I just thought you might like to try to undo any possible damage that it may have caused. That type of damage doesn't usually clear up by itself.

Did you google fentanyl?

Yes, I read my whole Fentanyl paperwork and looked it up on-line. It said if you already have liver disease this could cause problems but I don't have liver disease.

Oh, good.

I think it's time for a specialist. Did this most recent lab go up 3 times of the previous or 3 times of the original? Look at all the drugs and supplements you take. And it could be a combination of all of them....MTX and the others could be too much for your liver. A long steady rise over time could mean it IS your liver, if the drugs don't prove to be the cause. Did they do GGT, LDH? Here is a link for liver panel tests. Hope the docs figure it out soon.

hi Pea,

blood work and ultrasound can be easily done to evaluate (biopsy may ultimately be needed however). sounds like you've already had viral hepatitis ruled out.

1. drugs and alcohol. anti-tnfs, tylenol, mtx, prednisone, alcohol, etc. time away from these will be telling. ultimately, if transaminases (AST and ALT) rising and ultrasound and possibly biopsy would be indicated.

2. HHC (hereditary hemochromatosis). genes for this are common in people of european descent (10% of that population). its a problem with absorbing too much iron and - over many years - depositing it in organs. liver and pancreas are usually first in line. evaluate, initially, with iron studies (TIBC, transferrin saturiation, and ferrtin or gene studies) which, if provocative would be followed up with biopsy[/b].

women who carry the genes for HHC often do not manifest the disease because women lose iron out of their bodies monthly from menarche to menopause - thus they dont deposit it their organs.

3. NASH (non-alcoholic steatohepatitis). more common in females and diabetic individuals. evaluation with ultrasound or MRI can be helpful, the structural changes in the liver are visible and telling.

4. AIH (autoimmune hepatitis). several variations, and can initially be evaluated with blood work (antibody testing and serum protient electrophoresis). again, liver biopsy is ultimately confirmatory.

5. wilson's disease. too much copper, deposits in organs. seems unlikely but can easily be screened for with blood testing or more likely 24 hour urine collection for copper excretion. if provocative --> biopsy.[/b]

6. the list goes on a bit, but the most common etiologies are listed above.

testing may be further influenced by pattern of LFT abnormalities. if a "cholestatic" appearance emerges then special kinds of imaging of the biliary system (tiny bile ducts in your liver lead to gallbladder, and separately to the common bile duct which winds up emptying into your duodenum) may be needed. a biopsy may yet be needed here as well if the tiny bile ducts within the liver appear to be involved rather than the biliary system outside of the liver).

Carotenoids / Article from France (autotranslated)

http://www.lepoint.fr/chroniqueurs-du-po...-1493319_57.php

Have fruits and vegetables in the skin!
The Point.fr - Posted on 06/08/2012 at 10:30
What we eat can be read on our face ...

Fruits and vegetables protect the skin against various attacks and improve its appearance -

We know: packed with antioxidants, mainly carotenoids, fruits and vegetables protect the skin against various attacks. Less is known about their effect on the appearance thereof. Two Scottish researchers have studied the issue. Their work is detailed by Dr. Thierry Gibault, nutritionist and endocrinologist in Paris in EquatioNutrition , the magazine Aprifel (Agency for Research and Information on fresh fruits and vegetables) intended for health professionals.

Carotenoids are powerful free radical scavengers, which protect various tissues of our body against oxidative stress. The enemies of our body (like the sun's UV, ozone or tobacco) in effect create damage in the DNA of our chromosomes, proteins and cellular lipids. They participate in many degenerative processes increased by advancing age, but also involved in cardiovascular disease, diabetes and various cancers.

Staining

The first of the studies cited by EquatioNutrition involved measuring, three times in six weeks, the skin color (in seven different points) of 35 young volunteers. Their daily consumption of fruits and vegetables was estimated using a questionnaire. The results show that simply increasing the amount of fruits and vegetables eaten for a month and a half for the skin changes color. More precise measurements indicate that these variations are associated with carotenoids, and not to melatonin (pigment responsible for tanning).

The second study was designed to measure the level of food needed for the skin color is perceived as healthier or more attractive by an observer. Pictures of faces were shown to students. For each, two types of skin color were presented, one corresponding to a low consumption of fruits and vegetables, the other to strong absorption of these products. Each participant had to choose the face that seemed the most young, healthy and attractive. It shows that the color variations involved in decision - however small - of fruits and vegetables are favorably valued ... Consume without moderation so!

Wowzer, the hit's keep coming. I am now scheduled for a MRCT on Thurs. morning. My AST and ALT numbers are still climbing after being off of MTX and Remicade for over 5 weeks.

AST-74 New range reference's now: AST (10-45)
ALT-141: Ranges: 10-65

They want to look at the liver duct and the pancreatic duct. The last time they looked at the pancreas duct and it was slightly dilated but Dr. said it was fine.

I fell ever so slightly apart as I am so sick and tired of tests and being poked and prodded every week. Let's say I had a meltdown and my husband called my primary/psychiatrist/pain specialist in one before he came home to set all of this up for me. They have no problems jumping through hoops for him but not for me. He isn't mean, but firm, I'm not mean but firm. What gives?

You all told me before what it could be or what it could mean. For me it mean's I have to cancel yet once again a couple of vacations I had planned. I don't know why they just didn't skip to where they just barely open ya' up and take a look see. They already have a full ultra-sound of my abdomen taken a month ago. I am having a very bad ugly pity party. Sorry guys but this is where I come to have them. Wish I could offer up some good green tea.