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Hi Dr, Wanted To Follow Up, Not Sure If You
Question: Hi Dr,
Wanted to follow up,
Not sure if you remember me, but I had spoke to you about my elevated bilirubin and ca 19.9 being 71.
Dr did not want to do a Eus as it is too invasive so we did a pancreatic protocol ct scan which is normal along with a us which is normal and a follow up ca 19.9 level and now negative at 35 thank god. I am to have a mrcp soon. My bilirubin unconjucated seems to still be muldly elevated apparently I have confirmed gilberts syndrome like you stated after genetic testing.
Would any further workup be warranted once Mrcp comes back negative? Thank you Dr
Wanted to follow up,
Not sure if you remember me, but I had spoke to you about my elevated bilirubin and ca 19.9 being 71.
Dr did not want to do a Eus as it is too invasive so we did a pancreatic protocol ct scan which is normal along with a us which is normal and a follow up ca 19.9 level and now negative at 35 thank god. I am to have a mrcp soon. My bilirubin unconjucated seems to still be muldly elevated apparently I have confirmed gilberts syndrome like you stated after genetic testing.
Would any further workup be warranted once Mrcp comes back negative? Thank you Dr
Hi Dr,
Wanted to follow up,
Not sure if you remember me, but I had spoke to you about my elevated bilirubin and ca 19.9 being 71.
Dr did not want to do a Eus as it is too invasive so we did a pancreatic protocol ct scan which is normal along with a us which is normal and a follow up ca 19.9 level and now negative at 35 thank god. I am to have a mrcp soon. My bilirubin unconjucated seems to still be muldly elevated apparently I have confirmed gilberts syndrome like you stated after genetic testing.
Would any further workup be warranted once Mrcp comes back negative? Thank you Dr
Wanted to follow up,
Not sure if you remember me, but I had spoke to you about my elevated bilirubin and ca 19.9 being 71.
Dr did not want to do a Eus as it is too invasive so we did a pancreatic protocol ct scan which is normal along with a us which is normal and a follow up ca 19.9 level and now negative at 35 thank god. I am to have a mrcp soon. My bilirubin unconjucated seems to still be muldly elevated apparently I have confirmed gilberts syndrome like you stated after genetic testing.
Would any further workup be warranted once Mrcp comes back negative? Thank you Dr
Brief Answer:
Please go through the detailed answer dear.
Detailed Answer:
Hello dear and thanks for the follow-up,
Yes of course I remember your case thoroughly. Your genetic testing showed genes susceptible to Gilbert's and your CA 19-9 was high at that time.
Let's start with your query...
The first thing is if MRCP is also normal stop any further investigation (No need for EUS after that).
Why?
See EUS had a higher diagnostic accuracy than MRCP (64% vs 34%) in the etiologic diagnosis of Idiopathic (Cause unknown) acute pancreatitis and is preferred for establishing a possible biliary disease and Chronic Pancreatitis(which you don't have as CT pancreas was normal)diagnosis, whereas MRCP is very superior to EUS in diagnosing a possible benign or malignant or anatomic pathology in liver, bile duct, gall bladder, Pancreas, etc(Hepato-biliary) system.
Secondly, your CA19-9 has returned to normal limits with CT pancreas being normal; So pancreatic pathology is now out of question.
If MRCP turns out to be normal then just stop seeing doctors. You have nothing to worry. XXXXXXX won't affect you in any way so forget about it.
As advised earlier please do Basic breathing exercises, Yoga, and intermediate Yoga NIDRA daily.
Thank you and hope you stay fit and fine always.
Regards
Please go through the detailed answer dear.
Detailed Answer:
Hello dear and thanks for the follow-up,
Yes of course I remember your case thoroughly. Your genetic testing showed genes susceptible to Gilbert's and your CA 19-9 was high at that time.
Let's start with your query...
The first thing is if MRCP is also normal stop any further investigation (No need for EUS after that).
Why?
See EUS had a higher diagnostic accuracy than MRCP (64% vs 34%) in the etiologic diagnosis of Idiopathic (Cause unknown) acute pancreatitis and is preferred for establishing a possible biliary disease and Chronic Pancreatitis(which you don't have as CT pancreas was normal)diagnosis, whereas MRCP is very superior to EUS in diagnosing a possible benign or malignant or anatomic pathology in liver, bile duct, gall bladder, Pancreas, etc(Hepato-biliary) system.
Secondly, your CA19-9 has returned to normal limits with CT pancreas being normal; So pancreatic pathology is now out of question.
If MRCP turns out to be normal then just stop seeing doctors. You have nothing to worry. XXXXXXX won't affect you in any way so forget about it.
As advised earlier please do Basic breathing exercises, Yoga, and intermediate Yoga NIDRA daily.
Thank you and hope you stay fit and fine always.
Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Brief Answer:
Please go through the detailed answer dear.
Detailed Answer:
Hello dear and thanks for the follow-up,
Yes of course I remember your case thoroughly. Your genetic testing showed genes susceptible to Gilbert's and your CA 19-9 was high at that time.
Let's start with your query...
The first thing is if MRCP is also normal stop any further investigation (No need for EUS after that).
Why?
See EUS had a higher diagnostic accuracy than MRCP (64% vs 34%) in the etiologic diagnosis of Idiopathic (Cause unknown) acute pancreatitis and is preferred for establishing a possible biliary disease and Chronic Pancreatitis(which you don't have as CT pancreas was normal)diagnosis, whereas MRCP is very superior to EUS in diagnosing a possible benign or malignant or anatomic pathology in liver, bile duct, gall bladder, Pancreas, etc(Hepato-biliary) system.
Secondly, your CA19-9 has returned to normal limits with CT pancreas being normal; So pancreatic pathology is now out of question.
If MRCP turns out to be normal then just stop seeing doctors. You have nothing to worry. XXXXXXX won't affect you in any way so forget about it.
As advised earlier please do Basic breathing exercises, Yoga, and intermediate Yoga NIDRA daily.
Thank you and hope you stay fit and fine always.
Regards
Please go through the detailed answer dear.
Detailed Answer:
Hello dear and thanks for the follow-up,
Yes of course I remember your case thoroughly. Your genetic testing showed genes susceptible to Gilbert's and your CA 19-9 was high at that time.
Let's start with your query...
The first thing is if MRCP is also normal stop any further investigation (No need for EUS after that).
Why?
See EUS had a higher diagnostic accuracy than MRCP (64% vs 34%) in the etiologic diagnosis of Idiopathic (Cause unknown) acute pancreatitis and is preferred for establishing a possible biliary disease and Chronic Pancreatitis(which you don't have as CT pancreas was normal)diagnosis, whereas MRCP is very superior to EUS in diagnosing a possible benign or malignant or anatomic pathology in liver, bile duct, gall bladder, Pancreas, etc(Hepato-biliary) system.
Secondly, your CA19-9 has returned to normal limits with CT pancreas being normal; So pancreatic pathology is now out of question.
If MRCP turns out to be normal then just stop seeing doctors. You have nothing to worry. XXXXXXX won't affect you in any way so forget about it.
As advised earlier please do Basic breathing exercises, Yoga, and intermediate Yoga NIDRA daily.
Thank you and hope you stay fit and fine always.
Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you so much Dr for your detailed and prompt response.
Thank you so much Dr for your detailed and prompt response.
Brief Answer:
Welcome!
Detailed Answer:
Than you very much and would like to end up this conversation on a very old saying,
"Each day of life is special, Keep living every moment of it and take care of yourself".
Hope you remain fit and fine always.
Follow up after MRCP report to see if a MRI pancreas is required or not.
Thank you and may Lord bless you.
Welcome!
Detailed Answer:
Than you very much and would like to end up this conversation on a very old saying,
"Each day of life is special, Keep living every moment of it and take care of yourself".
Hope you remain fit and fine always.
Follow up after MRCP report to see if a MRI pancreas is required or not.
Thank you and may Lord bless you.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Brief Answer:
Welcome!
Detailed Answer:
Than you very much and would like to end up this conversation on a very old saying,
"Each day of life is special, Keep living every moment of it and take care of yourself".
Hope you remain fit and fine always.
Follow up after MRCP report to see if a MRI pancreas is required or not.
Thank you and may Lord bless you.
Welcome!
Detailed Answer:
Than you very much and would like to end up this conversation on a very old saying,
"Each day of life is special, Keep living every moment of it and take care of yourself".
Hope you remain fit and fine always.
Follow up after MRCP report to see if a MRI pancreas is required or not.
Thank you and may Lord bless you.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you Dr. May lord bless you too always.
Dr,
I was under the impression the Mrcp is a mri also. What would be reason for mri after mrcp god forbid?
Thank you
Dr,
I was under the impression the Mrcp is a mri also. What would be reason for mri after mrcp god forbid?
Thank you
Thank you Dr. May lord bless you too always.
Dr,
I was under the impression the Mrcp is a mri also. What would be reason for mri after mrcp god forbid?
Thank you
Dr,
I was under the impression the Mrcp is a mri also. What would be reason for mri after mrcp god forbid?
Thank you
Brief Answer:
Follow up.
Detailed Answer:
Hi again,
Most of the hospitals use an MRI machine of power 1.5 teslas.
Some use 3 Tesla while very few uses 5 Tesla machines.
Tesla means the amount of magnetic force applied to split the water content of an organ.
So what I mean to say is that if anything appears fishy in MRCP done very likely on 1.5 Tesla machines then a repeat MRI could be done on a 5 Tesla /3 Tesla for complete mental satisfaction.
That was what I mean by that.
And yes do ask your doctor that what is the Tesla MRI machine he is using for MRCP (minimum 3 Tesla is suggested), however many hospitals use 1.5 Tesla machines due to cost.
Hope I am clear now.
Follow up with reports and do remember to ask your Radiologist/Gastro about the Tesla machine they are using.
The higher the Tesla better would be the resolution.
Regards!
Follow up.
Detailed Answer:
Hi again,
Most of the hospitals use an MRI machine of power 1.5 teslas.
Some use 3 Tesla while very few uses 5 Tesla machines.
Tesla means the amount of magnetic force applied to split the water content of an organ.
So what I mean to say is that if anything appears fishy in MRCP done very likely on 1.5 Tesla machines then a repeat MRI could be done on a 5 Tesla /3 Tesla for complete mental satisfaction.
That was what I mean by that.
And yes do ask your doctor that what is the Tesla MRI machine he is using for MRCP (minimum 3 Tesla is suggested), however many hospitals use 1.5 Tesla machines due to cost.
Hope I am clear now.
Follow up with reports and do remember to ask your Radiologist/Gastro about the Tesla machine they are using.
The higher the Tesla better would be the resolution.
Regards!
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Brief Answer:
Follow up.
Detailed Answer:
Hi again,
Most of the hospitals use an MRI machine of power 1.5 teslas.
Some use 3 Tesla while very few uses 5 Tesla machines.
Tesla means the amount of magnetic force applied to split the water content of an organ.
So what I mean to say is that if anything appears fishy in MRCP done very likely on 1.5 Tesla machines then a repeat MRI could be done on a 5 Tesla /3 Tesla for complete mental satisfaction.
That was what I mean by that.
And yes do ask your doctor that what is the Tesla MRI machine he is using for MRCP (minimum 3 Tesla is suggested), however many hospitals use 1.5 Tesla machines due to cost.
Hope I am clear now.
Follow up with reports and do remember to ask your Radiologist/Gastro about the Tesla machine they are using.
The higher the Tesla better would be the resolution.
Regards!
Follow up.
Detailed Answer:
Hi again,
Most of the hospitals use an MRI machine of power 1.5 teslas.
Some use 3 Tesla while very few uses 5 Tesla machines.
Tesla means the amount of magnetic force applied to split the water content of an organ.
So what I mean to say is that if anything appears fishy in MRCP done very likely on 1.5 Tesla machines then a repeat MRI could be done on a 5 Tesla /3 Tesla for complete mental satisfaction.
That was what I mean by that.
And yes do ask your doctor that what is the Tesla MRI machine he is using for MRCP (minimum 3 Tesla is suggested), however many hospitals use 1.5 Tesla machines due to cost.
Hope I am clear now.
Follow up with reports and do remember to ask your Radiologist/Gastro about the Tesla machine they are using.
The higher the Tesla better would be the resolution.
Regards!
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Understood. Thank you so much for your responses. God bless. Will follow up with you soon. Will ask gi and radiologist the machine tesla they use.
Taks care Dr
Taks care Dr
Understood. Thank you so much for your responses. God bless. Will follow up with you soon. Will ask gi and radiologist the machine tesla they use.
Taks care Dr
Taks care Dr
Brief Answer:
Follow up.
Detailed Answer:
Hi again,
Yes being a doctor it's my duty to make you aware of those small things because even in CT machines there is a 16,64,126 slice CT machine In simple words a 16 Slice CT Scan machine is capable of acquiring 16 images per rotation while a 126 slice machine would capture 126 images from different angles in the same rotation.
Therefore chances of missing a particular pathology (if initial) is much higher for a lower sliced machine.
I would suggest you read the slice mentioned in the CT report or the films or else can attach their picture with a good resolution.
Thank you and my best wishes
Follow up.
Detailed Answer:
Hi again,
Yes being a doctor it's my duty to make you aware of those small things because even in CT machines there is a 16,64,126 slice CT machine In simple words a 16 Slice CT Scan machine is capable of acquiring 16 images per rotation while a 126 slice machine would capture 126 images from different angles in the same rotation.
Therefore chances of missing a particular pathology (if initial) is much higher for a lower sliced machine.
I would suggest you read the slice mentioned in the CT report or the films or else can attach their picture with a good resolution.
Thank you and my best wishes
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Brief Answer:
Follow up.
Detailed Answer:
Hi again,
Yes being a doctor it's my duty to make you aware of those small things because even in CT machines there is a 16,64,126 slice CT machine In simple words a 16 Slice CT Scan machine is capable of acquiring 16 images per rotation while a 126 slice machine would capture 126 images from different angles in the same rotation.
Therefore chances of missing a particular pathology (if initial) is much higher for a lower sliced machine.
I would suggest you read the slice mentioned in the CT report or the films or else can attach their picture with a good resolution.
Thank you and my best wishes
Follow up.
Detailed Answer:
Hi again,
Yes being a doctor it's my duty to make you aware of those small things because even in CT machines there is a 16,64,126 slice CT machine In simple words a 16 Slice CT Scan machine is capable of acquiring 16 images per rotation while a 126 slice machine would capture 126 images from different angles in the same rotation.
Therefore chances of missing a particular pathology (if initial) is much higher for a lower sliced machine.
I would suggest you read the slice mentioned in the CT report or the films or else can attach their picture with a good resolution.
Thank you and my best wishes
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Will attach dr. Thank you
Will attach dr. Thank you
Does not say in report that I can see dr.
Does not say in report that I can see dr.
Tbere are too many images to take photo of as they are on my patient portal and unable to download the image. Send you the report
Tbere are too many images to take photo of as they are on my patient portal and unable to download the image. Send you the report
Brief Answer:
Follow up.
Detailed Answer:
Hi again,
CT is ok.
Slices not mentioned(Could ask your Radiologist on next visit).
However checking on website of that centre MRI available is 1.5 Tesla.
So you could ask your doctor if a 3tesla MRI is available nearby.
Are you doing breathing exercises and yoga nindra(try it seriously it would help you a lot).
Thanks!
Follow up.
Detailed Answer:
Hi again,
CT is ok.
Slices not mentioned(Could ask your Radiologist on next visit).
However checking on website of that centre MRI available is 1.5 Tesla.
So you could ask your doctor if a 3tesla MRI is available nearby.
Are you doing breathing exercises and yoga nindra(try it seriously it would help you a lot).
Thanks!
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
Follow up.
Detailed Answer:
Hi again,
CT is ok.
Slices not mentioned(Could ask your Radiologist on next visit).
However checking on website of that centre MRI available is 1.5 Tesla.
So you could ask your doctor if a 3tesla MRI is available nearby.
Are you doing breathing exercises and yoga nindra(try it seriously it would help you a lot).
Thanks!
Follow up.
Detailed Answer:
Hi again,
CT is ok.
Slices not mentioned(Could ask your Radiologist on next visit).
However checking on website of that centre MRI available is 1.5 Tesla.
So you could ask your doctor if a 3tesla MRI is available nearby.
Are you doing breathing exercises and yoga nindra(try it seriously it would help you a lot).
Thanks!
Above answer was peer-reviewed by :
Dr. Nagamani Ng
I haVs started some yoga dr and it sesms to be helping. Are slices the same as series? They have pictures of 13 different series. I will upload. Will also look for a 3 tesla. Thank you
I haVs started some yoga dr and it sesms to be helping. Are slices the same as series? They have pictures of 13 different series. I will upload. Will also look for a 3 tesla. Thank you
Brief Answer:
Follow up.
Detailed Answer:
Hi again,
Have gone through the images and resolution is good.
One question in my mind is that why CA19-9 was done...I mean as a part of routine investigation or you are having any other chronic condition/disease or any medication(prescription) which you are having.
I mean was there any symptoms regarding pancreatic or Hepato-biliary problem.
Sorry for asking details but a complete history is required to make advises better.
As of now go for MRCP;If it's ok shut down the case.
Thank you and have a good day ahead.
Follow up.
Detailed Answer:
Hi again,
Have gone through the images and resolution is good.
One question in my mind is that why CA19-9 was done...I mean as a part of routine investigation or you are having any other chronic condition/disease or any medication(prescription) which you are having.
I mean was there any symptoms regarding pancreatic or Hepato-biliary problem.
Sorry for asking details but a complete history is required to make advises better.
As of now go for MRCP;If it's ok shut down the case.
Thank you and have a good day ahead.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
Follow up.
Detailed Answer:
Hi again,
Have gone through the images and resolution is good.
One question in my mind is that why CA19-9 was done...I mean as a part of routine investigation or you are having any other chronic condition/disease or any medication(prescription) which you are having.
I mean was there any symptoms regarding pancreatic or Hepato-biliary problem.
Sorry for asking details but a complete history is required to make advises better.
As of now go for MRCP;If it's ok shut down the case.
Thank you and have a good day ahead.
Follow up.
Detailed Answer:
Hi again,
Have gone through the images and resolution is good.
One question in my mind is that why CA19-9 was done...I mean as a part of routine investigation or you are having any other chronic condition/disease or any medication(prescription) which you are having.
I mean was there any symptoms regarding pancreatic or Hepato-biliary problem.
Sorry for asking details but a complete history is required to make advises better.
As of now go for MRCP;If it's ok shut down the case.
Thank you and have a good day ahead.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Hi dr,
I have a hx of gerd along side chronic nausea and esophagitis, premature ovarian failure, fibromyalgia, alopecia areata and svt.
I am only on prilosec 40 mg daily
I went to md for the chronic nausea and discovered i had poi and no cycle for 4 mts, she recommended hrt. She had sent me for a coag panel and factor 8 came back elevated at 212. She than sent me to a hematologist. The hematologist made me fill.out a questionnaire and was concerned about 6lbs of wt loss within a yr due to chronic nausea.sometimes had a light brown yellow stool, some pain in my back with severe gerd and elevated bilirubin and ran a bunch of tests and it came back my coag normal, but ca 19 was 71. She than mentioned doing a pt scan but insurance would not pay so ssnt me to a gi dr. And fast forward to all i have told you.
Slices for scan are at 32 they have stated as i called them. I have also found a place i can do mrcp at 3t.
That is hx dr.
I have a hx of gerd along side chronic nausea and esophagitis, premature ovarian failure, fibromyalgia, alopecia areata and svt.
I am only on prilosec 40 mg daily
I went to md for the chronic nausea and discovered i had poi and no cycle for 4 mts, she recommended hrt. She had sent me for a coag panel and factor 8 came back elevated at 212. She than sent me to a hematologist. The hematologist made me fill.out a questionnaire and was concerned about 6lbs of wt loss within a yr due to chronic nausea.sometimes had a light brown yellow stool, some pain in my back with severe gerd and elevated bilirubin and ran a bunch of tests and it came back my coag normal, but ca 19 was 71. She than mentioned doing a pt scan but insurance would not pay so ssnt me to a gi dr. And fast forward to all i have told you.
Slices for scan are at 32 they have stated as i called them. I have also found a place i can do mrcp at 3t.
That is hx dr.
Hi dr,
I have a hx of gerd along side chronic nausea and esophagitis, premature ovarian failure, fibromyalgia, alopecia areata and svt.
I am only on prilosec 40 mg daily
I went to md for the chronic nausea and discovered i had poi and no cycle for 4 mts, she recommended hrt. She had sent me for a coag panel and factor 8 came back elevated at 212. She than sent me to a hematologist. The hematologist made me fill.out a questionnaire and was concerned about 6lbs of wt loss within a yr due to chronic nausea.sometimes had a light brown yellow stool, some pain in my back with severe gerd and elevated bilirubin and ran a bunch of tests and it came back my coag normal, but ca 19 was 71. She than mentioned doing a pt scan but insurance would not pay so ssnt me to a gi dr. And fast forward to all i have told you.
Slices for scan are at 32 they have stated as i called them. I have also found a place i can do mrcp at 3t.
That is hx dr.
I have a hx of gerd along side chronic nausea and esophagitis, premature ovarian failure, fibromyalgia, alopecia areata and svt.
I am only on prilosec 40 mg daily
I went to md for the chronic nausea and discovered i had poi and no cycle for 4 mts, she recommended hrt. She had sent me for a coag panel and factor 8 came back elevated at 212. She than sent me to a hematologist. The hematologist made me fill.out a questionnaire and was concerned about 6lbs of wt loss within a yr due to chronic nausea.sometimes had a light brown yellow stool, some pain in my back with severe gerd and elevated bilirubin and ran a bunch of tests and it came back my coag normal, but ca 19 was 71. She than mentioned doing a pt scan but insurance would not pay so ssnt me to a gi dr. And fast forward to all i have told you.
Slices for scan are at 32 they have stated as i called them. I have also found a place i can do mrcp at 3t.
That is hx dr.
I am not sure why she had tested it possibly due to my symptoms and lab work assuming that qpuld be investigative reasons. I am mot sure.
I am not sure why she had tested it possibly due to my symptoms and lab work assuming that qpuld be investigative reasons. I am mot sure.
This was my initial query to you Dr a three months ago. As forwarded
I want to give you full story. I have been my whole life with gerd, i had recently went to hospital as it was very severe. Upoer gi showed chronic esophagitis and negative biopsy. Also labs at that time showed total bilirubin of 2.2 as I also want to mention intermittent nausea and inability to eat so lost maybe 6 lbs within a yr. Still have intermittent nausea and most recently had labs for coag for poi. ct with contrast showing mild fatty infiltrate of liver at 13 cm at this time in May everything else was normal. Hematologist Dr may have tested
Possibly because my labs from hospital were total bilirubin 2.2, albumin 4.9, and nausea combined with inability to eat loss of 6lbs in a yr, but as mentioned ct scan normal aside from what i mentioned. Now ca 19.9 71 now what does this mean? I would like to mention i have 3 auto immune disease and have a hx of high monocytes can be up to 15 sometimes since i am a kid. I also have a hx of my bilirubin total waxing and waning sometimes going up to.1.5 and 1.7 on all bloodwork from.being a child. I am worried. Should i be concernes about ca 19.9? Thank you
I want to give you full story. I have been my whole life with gerd, i had recently went to hospital as it was very severe. Upoer gi showed chronic esophagitis and negative biopsy. Also labs at that time showed total bilirubin of 2.2 as I also want to mention intermittent nausea and inability to eat so lost maybe 6 lbs within a yr. Still have intermittent nausea and most recently had labs for coag for poi. ct with contrast showing mild fatty infiltrate of liver at 13 cm at this time in May everything else was normal. Hematologist Dr may have tested
Possibly because my labs from hospital were total bilirubin 2.2, albumin 4.9, and nausea combined with inability to eat loss of 6lbs in a yr, but as mentioned ct scan normal aside from what i mentioned. Now ca 19.9 71 now what does this mean? I would like to mention i have 3 auto immune disease and have a hx of high monocytes can be up to 15 sometimes since i am a kid. I also have a hx of my bilirubin total waxing and waning sometimes going up to.1.5 and 1.7 on all bloodwork from.being a child. I am worried. Should i be concernes about ca 19.9? Thank you
This was my initial query to you Dr a three months ago. As forwarded
I want to give you full story. I have been my whole life with gerd, i had recently went to hospital as it was very severe. Upoer gi showed chronic esophagitis and negative biopsy. Also labs at that time showed total bilirubin of 2.2 as I also want to mention intermittent nausea and inability to eat so lost maybe 6 lbs within a yr. Still have intermittent nausea and most recently had labs for coag for poi. ct with contrast showing mild fatty infiltrate of liver at 13 cm at this time in May everything else was normal. Hematologist Dr may have tested
Possibly because my labs from hospital were total bilirubin 2.2, albumin 4.9, and nausea combined with inability to eat loss of 6lbs in a yr, but as mentioned ct scan normal aside from what i mentioned. Now ca 19.9 71 now what does this mean? I would like to mention i have 3 auto immune disease and have a hx of high monocytes can be up to 15 sometimes since i am a kid. I also have a hx of my bilirubin total waxing and waning sometimes going up to.1.5 and 1.7 on all bloodwork from.being a child. I am worried. Should i be concernes about ca 19.9? Thank you
I want to give you full story. I have been my whole life with gerd, i had recently went to hospital as it was very severe. Upoer gi showed chronic esophagitis and negative biopsy. Also labs at that time showed total bilirubin of 2.2 as I also want to mention intermittent nausea and inability to eat so lost maybe 6 lbs within a yr. Still have intermittent nausea and most recently had labs for coag for poi. ct with contrast showing mild fatty infiltrate of liver at 13 cm at this time in May everything else was normal. Hematologist Dr may have tested
Possibly because my labs from hospital were total bilirubin 2.2, albumin 4.9, and nausea combined with inability to eat loss of 6lbs in a yr, but as mentioned ct scan normal aside from what i mentioned. Now ca 19.9 71 now what does this mean? I would like to mention i have 3 auto immune disease and have a hx of high monocytes can be up to 15 sometimes since i am a kid. I also have a hx of my bilirubin total waxing and waning sometimes going up to.1.5 and 1.7 on all bloodwork from.being a child. I am worried. Should i be concernes about ca 19.9? Thank you
Brief Answer:
Every thing is linked to other.
Detailed Answer:
Hi,
Biliary cirrhosis means that bike ducts would die off slowly and slowly over period of months and if CT abdomen is normal it's excluded.
Now catch in your case is undermanaged GERD. Untreated/Undertreated GERD would irritate the muscles of stomach and esophagus resulting in spasm which presents as nausea.
You are taking only prizolec 40 mg once daily(which is a very baseline dose and I don't think would be helping you).
Let's forget about all high fi stuff like Autoimmune ...Cirrhosis ...etc etc...And let's take your problems one by one.
Firstly you should try controlling the symptoms of your GERD(you are receiving half treatment for GERD only).
GERD as the name suggest consists of two parts-
Gastro esophageal-acid production which is controlled by ppi's like Pantoprazole 40-80 mg twice daily initially.
2)Reflux disease-Now Prizolec is not going to control reflux. For preventing reflux Domperidon 30 mg tablet is taken once daily.
Along with it initially tablets like Zofran 4mg should be taken twice for few days to provide relief from nausea.
Diet has to be light preferably veg.
No alcohol smoking and fast food.
See body is a closed system and one part is linked to other.For e.g if you are having Acidity and nausea it's but natural that you won't take proper food.So in long runs you would loose weight.
The fats present in food are required to produce hormones which in terms effect your ovary etc.
So my advice is instead of moving from one investigation to other...Start from begining...Treat your stomach first.Once gut is fine your appetite would be fine..Hope you can understand that it's a multifactorial problem and treat first thing first before getting enticed by hi-fi terms used by doctors.
It's a difficult thing to explain but hope you could get that almost every thing is linked to other thing.
Please feel free to ask any query.
I would be more then happy to treat you.
May God bless you.
Regards!
Every thing is linked to other.
Detailed Answer:
Hi,
Biliary cirrhosis means that bike ducts would die off slowly and slowly over period of months and if CT abdomen is normal it's excluded.
Now catch in your case is undermanaged GERD. Untreated/Undertreated GERD would irritate the muscles of stomach and esophagus resulting in spasm which presents as nausea.
You are taking only prizolec 40 mg once daily(which is a very baseline dose and I don't think would be helping you).
Let's forget about all high fi stuff like Autoimmune ...Cirrhosis ...etc etc...And let's take your problems one by one.
Firstly you should try controlling the symptoms of your GERD(you are receiving half treatment for GERD only).
GERD as the name suggest consists of two parts-
Gastro esophageal-acid production which is controlled by ppi's like Pantoprazole 40-80 mg twice daily initially.
2)Reflux disease-Now Prizolec is not going to control reflux. For preventing reflux Domperidon 30 mg tablet is taken once daily.
Along with it initially tablets like Zofran 4mg should be taken twice for few days to provide relief from nausea.
Diet has to be light preferably veg.
No alcohol smoking and fast food.
See body is a closed system and one part is linked to other.For e.g if you are having Acidity and nausea it's but natural that you won't take proper food.So in long runs you would loose weight.
The fats present in food are required to produce hormones which in terms effect your ovary etc.
So my advice is instead of moving from one investigation to other...Start from begining...Treat your stomach first.Once gut is fine your appetite would be fine..Hope you can understand that it's a multifactorial problem and treat first thing first before getting enticed by hi-fi terms used by doctors.
It's a difficult thing to explain but hope you could get that almost every thing is linked to other thing.
Please feel free to ask any query.
I would be more then happy to treat you.
May God bless you.
Regards!
Above answer was peer-reviewed by :
Dr. Kampana
Brief Answer:
Every thing is linked to other.
Detailed Answer:
Hi,
Biliary cirrhosis means that bike ducts would die off slowly and slowly over period of months and if CT abdomen is normal it's excluded.
Now catch in your case is undermanaged GERD. Untreated/Undertreated GERD would irritate the muscles of stomach and esophagus resulting in spasm which presents as nausea.
You are taking only prizolec 40 mg once daily(which is a very baseline dose and I don't think would be helping you).
Let's forget about all high fi stuff like Autoimmune ...Cirrhosis ...etc etc...And let's take your problems one by one.
Firstly you should try controlling the symptoms of your GERD(you are receiving half treatment for GERD only).
GERD as the name suggest consists of two parts-
Gastro esophageal-acid production which is controlled by ppi's like Pantoprazole 40-80 mg twice daily initially.
2)Reflux disease-Now Prizolec is not going to control reflux. For preventing reflux Domperidon 30 mg tablet is taken once daily.
Along with it initially tablets like Zofran 4mg should be taken twice for few days to provide relief from nausea.
Diet has to be light preferably veg.
No alcohol smoking and fast food.
See body is a closed system and one part is linked to other.For e.g if you are having Acidity and nausea it's but natural that you won't take proper food.So in long runs you would loose weight.
The fats present in food are required to produce hormones which in terms effect your ovary etc.
So my advice is instead of moving from one investigation to other...Start from begining...Treat your stomach first.Once gut is fine your appetite would be fine..Hope you can understand that it's a multifactorial problem and treat first thing first before getting enticed by hi-fi terms used by doctors.
It's a difficult thing to explain but hope you could get that almost every thing is linked to other thing.
Please feel free to ask any query.
I would be more then happy to treat you.
May God bless you.
Regards!
Every thing is linked to other.
Detailed Answer:
Hi,
Biliary cirrhosis means that bike ducts would die off slowly and slowly over period of months and if CT abdomen is normal it's excluded.
Now catch in your case is undermanaged GERD. Untreated/Undertreated GERD would irritate the muscles of stomach and esophagus resulting in spasm which presents as nausea.
You are taking only prizolec 40 mg once daily(which is a very baseline dose and I don't think would be helping you).
Let's forget about all high fi stuff like Autoimmune ...Cirrhosis ...etc etc...And let's take your problems one by one.
Firstly you should try controlling the symptoms of your GERD(you are receiving half treatment for GERD only).
GERD as the name suggest consists of two parts-
Gastro esophageal-acid production which is controlled by ppi's like Pantoprazole 40-80 mg twice daily initially.
2)Reflux disease-Now Prizolec is not going to control reflux. For preventing reflux Domperidon 30 mg tablet is taken once daily.
Along with it initially tablets like Zofran 4mg should be taken twice for few days to provide relief from nausea.
Diet has to be light preferably veg.
No alcohol smoking and fast food.
See body is a closed system and one part is linked to other.For e.g if you are having Acidity and nausea it's but natural that you won't take proper food.So in long runs you would loose weight.
The fats present in food are required to produce hormones which in terms effect your ovary etc.
So my advice is instead of moving from one investigation to other...Start from begining...Treat your stomach first.Once gut is fine your appetite would be fine..Hope you can understand that it's a multifactorial problem and treat first thing first before getting enticed by hi-fi terms used by doctors.
It's a difficult thing to explain but hope you could get that almost every thing is linked to other thing.
Please feel free to ask any query.
I would be more then happy to treat you.
May God bless you.
Regards!
Above answer was peer-reviewed by :
Dr. Kampana
Thank you so much dr. I dontthink dompeiridon is avaiin the US. Is there anything else I would be able to take? Also would gerd cause yellow stool sometimes? I often get bouts of constipation with diarrhea? And I should still do mrcp correct? Can you tell me what may have elevated ca 19 and now its back to normal,should i be concerned with cancer still at this point? Thank you so much for all you do
Thank you so much dr. I dontthink dompeiridon is avaiin the US. Is there anything else I would be able to take? Also would gerd cause yellow stool sometimes? I often get bouts of constipation with diarrhea? And I should still do mrcp correct? Can you tell me what may have elevated ca 19 and now its back to normal,should i be concerned with cancer still at this point? Thank you so much for all you do
Dr. One more question. My sugar is ok and not diabetic but why when i am nauseous ans force myself to eat something nausea goes away?
Dr. One more question. My sugar is ok and not diabetic but why when i am nauseous ans force myself to eat something nausea goes away?
Brief Answer:
Follow up.
Detailed Answer:
Hi there,
Metochlorpramide tablet...you can take slow release tablet once in morning.
No GERD won't cause yellow stools but all colors of stool from yellow to brown to green are normal(if they are off and on in nature).White and Black tar like stools are suggestive of problem.
See our guy contains large amount of good bacterial colonies which are essential for proper digestion of food.In most of the patients with GERD this Flora is disturbed and hence stools are not normal i.e some feel constipated other feel like having diarrhea while some may have both.
There are 4 types of personalities as per medical sciences and gut related issues are usually found in Type A and C personalities(Anxious,curious and a sort of perfectionist type).
All these issues are some how related to anxiety also.Anxiety stimulate sympathetic nervous system which disturb the complete digestive process and hence can be a cause of GERD and other problems.Thats why I am suggesting you to do Yoga NIDRA and Breathing pranayam in my every reply.
MRCP is suggested because firstly if you won't go through this your anxiety levels would remain high.So once test is done chapter of pancreatic pathology closed.
Why CA19-9 was elevated and then it returned to normal-No answer but calm down it's normal now.
Just go for MRCP and close the chapter of Hepato-biliary pathology.
For GERD and gut problems-
Tab Prizolec 40 mg twice can be increased to 80-40 or 80-80 initially depending on response.
Metoclopramide slow release once a day.
Probiotic like VSl#3 twice daily.
Eat light vegetarian home cooked food.
Minimum duration-15 days.
Follow up after that and please try to do Breathing exercises(pranayama-see on you tube) daily for 15 minutes.
Thank you.
Follow up.
Detailed Answer:
Hi there,
Metochlorpramide tablet...you can take slow release tablet once in morning.
No GERD won't cause yellow stools but all colors of stool from yellow to brown to green are normal(if they are off and on in nature).White and Black tar like stools are suggestive of problem.
See our guy contains large amount of good bacterial colonies which are essential for proper digestion of food.In most of the patients with GERD this Flora is disturbed and hence stools are not normal i.e some feel constipated other feel like having diarrhea while some may have both.
There are 4 types of personalities as per medical sciences and gut related issues are usually found in Type A and C personalities(Anxious,curious and a sort of perfectionist type).
All these issues are some how related to anxiety also.Anxiety stimulate sympathetic nervous system which disturb the complete digestive process and hence can be a cause of GERD and other problems.Thats why I am suggesting you to do Yoga NIDRA and Breathing pranayam in my every reply.
MRCP is suggested because firstly if you won't go through this your anxiety levels would remain high.So once test is done chapter of pancreatic pathology closed.
Why CA19-9 was elevated and then it returned to normal-No answer but calm down it's normal now.
Just go for MRCP and close the chapter of Hepato-biliary pathology.
For GERD and gut problems-
Tab Prizolec 40 mg twice can be increased to 80-40 or 80-80 initially depending on response.
Metoclopramide slow release once a day.
Probiotic like VSl#3 twice daily.
Eat light vegetarian home cooked food.
Minimum duration-15 days.
Follow up after that and please try to do Breathing exercises(pranayama-see on you tube) daily for 15 minutes.
Thank you.
Above answer was peer-reviewed by :
Dr. Raju A.T
Brief Answer:
Follow up.
Detailed Answer:
Hi there,
Metochlorpramide tablet...you can take slow release tablet once in morning.
No GERD won't cause yellow stools but all colors of stool from yellow to brown to green are normal(if they are off and on in nature).White and Black tar like stools are suggestive of problem.
See our guy contains large amount of good bacterial colonies which are essential for proper digestion of food.In most of the patients with GERD this Flora is disturbed and hence stools are not normal i.e some feel constipated other feel like having diarrhea while some may have both.
There are 4 types of personalities as per medical sciences and gut related issues are usually found in Type A and C personalities(Anxious,curious and a sort of perfectionist type).
All these issues are some how related to anxiety also.Anxiety stimulate sympathetic nervous system which disturb the complete digestive process and hence can be a cause of GERD and other problems.Thats why I am suggesting you to do Yoga NIDRA and Breathing pranayam in my every reply.
MRCP is suggested because firstly if you won't go through this your anxiety levels would remain high.So once test is done chapter of pancreatic pathology closed.
Why CA19-9 was elevated and then it returned to normal-No answer but calm down it's normal now.
Just go for MRCP and close the chapter of Hepato-biliary pathology.
For GERD and gut problems-
Tab Prizolec 40 mg twice can be increased to 80-40 or 80-80 initially depending on response.
Metoclopramide slow release once a day.
Probiotic like VSl#3 twice daily.
Eat light vegetarian home cooked food.
Minimum duration-15 days.
Follow up after that and please try to do Breathing exercises(pranayama-see on you tube) daily for 15 minutes.
Thank you.
Follow up.
Detailed Answer:
Hi there,
Metochlorpramide tablet...you can take slow release tablet once in morning.
No GERD won't cause yellow stools but all colors of stool from yellow to brown to green are normal(if they are off and on in nature).White and Black tar like stools are suggestive of problem.
See our guy contains large amount of good bacterial colonies which are essential for proper digestion of food.In most of the patients with GERD this Flora is disturbed and hence stools are not normal i.e some feel constipated other feel like having diarrhea while some may have both.
There are 4 types of personalities as per medical sciences and gut related issues are usually found in Type A and C personalities(Anxious,curious and a sort of perfectionist type).
All these issues are some how related to anxiety also.Anxiety stimulate sympathetic nervous system which disturb the complete digestive process and hence can be a cause of GERD and other problems.Thats why I am suggesting you to do Yoga NIDRA and Breathing pranayam in my every reply.
MRCP is suggested because firstly if you won't go through this your anxiety levels would remain high.So once test is done chapter of pancreatic pathology closed.
Why CA19-9 was elevated and then it returned to normal-No answer but calm down it's normal now.
Just go for MRCP and close the chapter of Hepato-biliary pathology.
For GERD and gut problems-
Tab Prizolec 40 mg twice can be increased to 80-40 or 80-80 initially depending on response.
Metoclopramide slow release once a day.
Probiotic like VSl#3 twice daily.
Eat light vegetarian home cooked food.
Minimum duration-15 days.
Follow up after that and please try to do Breathing exercises(pranayama-see on you tube) daily for 15 minutes.
Thank you.
Above answer was peer-reviewed by :
Dr. Raju A.T
Will do all you suggested dr. Thank you much and god bless you. Will follow up with mrcp results.
Will do all you suggested dr. Thank you much and god bless you. Will follow up with mrcp results.
Brief Answer:
Follow up.
Detailed Answer:
Hi again,
Don't worry MRCP would be normal.
But follow the medications I suggested and tell me if there is 20-30% betterment in a weak.
Regards!
Follow up.
Detailed Answer:
Hi again,
Don't worry MRCP would be normal.
But follow the medications I suggested and tell me if there is 20-30% betterment in a weak.
Regards!
Above answer was peer-reviewed by :
Dr. Raju A.T
Brief Answer:
Follow up.
Detailed Answer:
Hi again,
Don't worry MRCP would be normal.
But follow the medications I suggested and tell me if there is 20-30% betterment in a weak.
Regards!
Follow up.
Detailed Answer:
Hi again,
Don't worry MRCP would be normal.
But follow the medications I suggested and tell me if there is 20-30% betterment in a weak.
Regards!
Above answer was peer-reviewed by :
Dr. Raju A.T
Dr
I thank you so very much for all your knowledge and helping put my mind at ease. Will talk to.you soon.
I thank you so very much for all your knowledge and helping put my mind at ease. Will talk to.you soon.
Dr
I thank you so very much for all your knowledge and helping put my mind at ease. Will talk to.you soon.
I thank you so very much for all your knowledge and helping put my mind at ease. Will talk to.you soon.
Brief Answer:
Thanks.
Detailed Answer:
Hi,
Definitely you would feel better.
Thanks
Thanks.
Detailed Answer:
Hi,
Definitely you would feel better.
Thanks
Above answer was peer-reviewed by :
Dr. Kampana
Brief Answer:
Thanks.
Detailed Answer:
Hi,
Definitely you would feel better.
Thanks
Thanks.
Detailed Answer:
Hi,
Definitely you would feel better.
Thanks
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Kampana
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