"There's a myth that anyone who has a liver problem has brought it on themselves" This quote is from a Crohn's disease patient living with a blocked portal vein hoping for a liver transplant (Independent 31st Oct 2010)

Tuesday, 9 November 2010

Hunt the hepatologist

At my 6 week check it was suggested that I be placed under the care of a hepatologist. Hepatology is the branch of medicine that incorporates the study of liver, gallbladder, biliary tree, and pancreas as well as management of their disorders and is a sub-speciality of gastroenterology. Dr Caravan-a-nan is a gastroenterologist. I don’t know if he has a sub-speciality.
Step1: Ask my contact on the Macmillan website. Yes she sees a consultant hepatologist at Addenbrookes hospital. She got names from a poster on the chat forum, took them to her GP and was referred from there!
Step 2: British Liver Trust www.britishlivertrust.org.uk. Their Medical Advisory Committee are senior hepatologists and members of the British Association for the Study of the Liver www.basl.org.uk
Step 2A: Get sidetracked by a description of ‘compensated cirrhosis’. “Compensated cirrhosis means that the liver is still able to cope with or compensate for the damage and carry out most (sometimes all) of its functions. Cirrhosis ranges from mild (at the beginning) to moderate and severe. Severe cirrhosis can then progress to decompensated cirrhosis. In general people with compensated cirrhosis have normal liver function for serum albumin, clotting factors and bilirubin. But without treatment compensated cirrhosis does progress inevitably to decompensated cirrhosis where the liver is not able to perform its normal functions.”
11am Time to follow the British Liver Trust advice and go for a snack: “snack between meals to top up on calories. Cirrhosis affects your ability to store glycogen, a carbohydrate that gives you short-term energy. This means that your body has to use its own muscle tissue to provide energy and this leads to muscle wasting and weakness."

Snack time evolves into feet up on sofa time watching old episode of House MD, followed by lunch.
2pm Step 3: Find a 2010 survey of UK hepatology provision by the Foundation for Liver Research. There are 27 non-transplant centres in the UK and 6 transplant. The report says that in Cheshire there is one non-transplant centre at Stepping Hill hospital but so far I’ve been unable to confirm they have a hepatologist there. There is one hepatologist listed at Manchester Royal Infirmary, Dr Martin Prince. There is a Department of Hepatology at Macclesfield but it seems the consultants there are gastroenterologists without a sub-speciality in hepatology. There were no hepatologists listed for North Manchester but there are hepatobiliary surgeons. Soon after my diagnosis a GP cousin sent me the name of a consultant at Basingstoke, one of the non-transplant centres. I've come across references to the hospital quite often. They specialise in the treatment of Pseudomyxoma Peritonei (PMP) a very rare cancer that usually begins in the appendix. How confusing is this!
Time for some exercise.
Walk: 0.5 mile
Wii fit: 30 mins aerobics then later 30 mins yoga. Total = 1 hr
Kitchen: 30 mins Nigel Slater's bubble and squeak cakes

10pm. Even after a hot bath I am now seriously stiff, so totter off to bed. Night night.

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