Greenlight 2 months after

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My physician took a metabolic panel and my transamines in liver are elevated specifically ALT and AST , and 2 months before surgery they were very normal and actually very low. ALT and AST elevations can show Hepatitis of some form or malignancy. Before the procedure was done, the physician did not do a biopsy or PSA, because I was an Emergency Room admittance due to high BUN and potassium levels. So they catherized me immediately and a gusher of urine about 10,000 ml came out. What does anyone have to say about elevated ALT and AST.

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  • Posted

    Hello Mark, 

    I'm a bit confused. Are you saying they did a GL on you right after you were admitted to the ER due to high BUN and potassium levels? And the drained out more than 2.5 gallons of urine? Was this a scheduled GL or some sort of on the spot decision because of your retention. Again, not sure I understand what is going on. BTW what were your ALT and AST values?

    -- Jim 

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    • Posted

      Let me see if I understand this now...Comments in parens are my unprofessional evaluation.

      Is this what is going on?

      1. Your physician sent you to the emergency room based on high BUN and potassium. (He was concerned your kidneys were dysfunctional)

      2. In the ER they drained over 2.5 gallons of urine out of your bladder (probably the reason for your kidney problems and you probably had hydronephrosis (water in the kidney)

      3. In the ER they put a catheter in you for six weeks. (To drain and decompress your bladder so as both to protect your kidneys and rehab your bladder in preparation for GL surgery)

      4. Your ALT before Gl was 20 and your ALT before GL was "very low". Now your ALT is 76 and your ALT is 44.

      -------------------

      To start with, sounds like your ALT and AST were the least of your problems. They still are in normal or near normal range. In general, they would be many multiples of normal for hepatitis. That said, mildly elevated liver enzymes concern you, then ask your doctor for a hepatitis panel, including A,B and C. Can't hurt and given your age it's appropriate.

      So have your kidney function tests BUN and Potassium returned to normal? What about creatinine? How did the Green Light surgery go? 

      -- Jim

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    • Posted

      What happened to me was very strange. Let me explain.  For 2 years now, I had been retaining 300-500 ml of urine in my bladder and at the same time was complaining of pain in the prostate.  So when I visited the Urologist he always been an ultrasound in the office , where he say urinary retention, and along the way did 2 biopsies which came back ok. So he suggested that I do Greenlight immediately, but I did not want to do it, but continually went to him for ultrasound of bladder where they put the cold jelly on your bladder and check bladder retention, he did PSA was came back between 4-6 for several years.  I was urinating always but he claims I was retention, Urinary retention. He attempted to do a Urodynamics study on me , but when they tried it they never could get a cathether  in so they did not attempt or mention it any more. Continuously I was always mentioning pain under prostate area upon arising. He gave me antibiotics but it never really helped. So one day I went to another physician( a Urologist) and when he did the Ultrasound he said I was retaining 900 ml of urine and that he asked my permission to put me in twilight and do a cystoscopy. I did not permit him, but continually went to my old urologist.  So one thing I forgot to mention is that I do a very vigorous weightlifting routine, I mean even for a 30 year old it would be considered vigorous, I am 65. I would push the sled with weights on it , pull rope with weights for 1 hour at a time, hit the heavy bag than lift weights, continually. Than one day I was doing my common routine, and when I was a bit tired and I had 30 pound weights in each hand and was doing the farmers walk I fell in the gym, I tripped and severely bruised my knee, and it was terrible inflammed and so for 2 weeks I could not walk and was sleeping constantly but was not taking medicine for it. Maybe occasionally ibuprofen. Than about 2 weeks as my leg was getting better(broken baker's cyst) I stopped having bowel movements it was going on for 2 weeks and I was scared. So when I went to my family doctor he said it is constipation take Milk of Magnesia. So I said don't you think you should do a blood test he said no, take Milk of Magnesia. So I did that, and had bowel movements but severe diarrhea, very severe. So I said maybe the colon is blocked. So I was ready to go to a gastroenterologist and made an appointment and I asked for an emergency appt but he said it is not an emergency wait for an appt, so I said take a blood test at least so when I go into your office you will at least know what is going on. He said son, your symptoms sound nothing severe wait for appt.  So I go back to my family doctor and I say please give me a blood test. He relents, he orders a blood test in the morning, so I am walking around in a shopping mall at holiday time after the blood test about 3 hours later and I am noticing I am having a difficult time breathing, I am tired and it is even difficult to walk around, my cell phone rings, it is my family physician, he says , Mark immediately come in to ER, your kidneys are shutting down . So I get into my car and go to ER, and they try to catherize me but they could not get in, finallly they call my urologist and he sends one of his team to come to ER and catherize me and he is having problems getting through but finally he gets through and like a gusher, my urine starts coming out. They put me in the hospital because my kidneys were shutting down and within 3 days my family doctor says Mark 10,000 ml of urine and fluid came out of you. So I lost 10 pounds and my urologist says normal blood levels are coming back, go home with a catheter and we will schedule you for Greenlight in 6 weeks. So I had a bag and the urine was coming out great, I felt good and they scheduled me for Greenlight, they did not do a biopsy nor another PSA, I had the Greenlight and recovered after 6 weeks, than began tough treadmill routines and a bit of weights, and my family doctor ordered a metabolic panel and he said Mark everything is good but your liver enzymes are elevated. They had done liver enzymes for years and the  values were low, but except this time they were out of normal range. I was worried that maybe , just maybe after looking at all the things that abnormal ALT and AST indicate I could have one of them and I am nervous . My family doctor says let us wait 2 months and do it again, and I am thinking 2 months is a long time, can't we figure out what is wrong now by doing more extensive tests like CAT, MRI or ultrasound of liver, kidney and he does not suggest that , So I do not know if I should ask another physician what to do. Thanks

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    • Posted

      Hi Mark,

      That's a very interesting story and glad things got sorted out -- sorta -- in time. 

      It's easy to be a Monday morning quarterback, but one thing strikes me, and it's that your doctors never should have let things gotten that far with your kidneys. Given your significant retention for years (300-500ml, maybe more) you should have had ultrasound studies of your kidneys and bladder as well as periodic bloodwork including kidney function tests. Maybe you did, but you didn't mention it. Had you, I think the kidney issues would have been picked up earlier.

      Don't know what to make of your elevated liver enzymes, but given all you've been through, and your strenuous physical routine, I'm not sure they mean that much. But if it were me, I'd see a hepatologist (liver specialist) and he will most probably run several diagnostic panels as well as an ultrasound or MRI of the liver. 

      So the Green Light was a success? Have your bph symptons gone away? Are you still having any retention issues or a better question is has your urologist tested you for retention lately with an office bladder scanner? If not, I would ask for a bladder scan because you want to make sure that your retention is now gone or at least within acceptable levels. You do not want to put your kidneys through that again. And maybe, until you have your health issues sorted out, lay off the weight sled a little. My back started hurting just reading about it smile Not to mention the stress that I imagine  kind of workout can put on some of your kidneys and liver if they aren't functioning 100%.

      -- Jim

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    • Posted

      Make sure you get a kidney ultrasound to make sure your kidneys are clear now. Sounds like you had hydronephrosis (water in the kidney) before the GL due to all that retention. You want to make sure it has been resolved completely especially since you're still retaining urine. You will also want periodic (maybe every 4 months) bladder scans to make sure your retention is not increasing, because once it gets over say 400ml, you may need to take more action. Seeing a hepatologist is good idea but doing these two things are equally, if not more important. 

      Jim

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    • Posted

      Hey Mark  After reading yours and Jim post.  I don't think you should have had the GL.  To me it seams like you had more problems with your kidneys and your bladder.  Then your prostate. Most of the time when a urologist can't find a problem they assume that it's the prostate and want to cut it out. And then you still have the problem.  I hope things get better for you and try to relax and not have any stress.  Also I know you want to work out but they to take it easy until you heal more   Ken 

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    • Posted

      Mark now you have to deal with the problem.  I would find another urologist that will deal with your kidneys and bladder and not rush you into surgery. Rest please and heal  Ken  Good luck
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    • Posted

      Mark,

      Given your signifcant retention, there is no doubt something needed to be done. Whether it was GL or something else may be up for debate but the important thing moving forward is that you keep monitoring your retention and kidney function. Whether that is with your current urologist, or another is up to you, just do not neglect seeing one.

      Jim

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    • Posted

      Hey Jim  Do you think his prostate had some from of prostatitis and was inflamed.  I don't remember reading that the doctor said it was enlarged.  Now he has to deal with what is his left with. That is what happens when men are rushed into surgery.  I had that retention once I was just bleeding Before he did surgery on me I had him sign a paper that my prostate was to stay in tac.  I did not know him of trust him.  Ken 

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    • Posted

      Hi Ken,

      It's unclear without all his medical records whether or not a surgery was necessary or not. There's a very good chance it was necessary, given they cathed over 2.5 liters out of him, not to mention the kidney issues.The important thing is moving forward. Sounds like he will get another opinion on things with a new urologist. 

      Jim

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    • Posted

      Yes that is true but I think he should have gotten a second opinion before he had the surgery.  As far as I read there was nothing that said that his prostate was inlarged.  The surgery did not fix his kidney or his bladder.  He's still holding urine.  But it's to late now he has to move on and see what another doctor will say  I would not trust the other one.  I feel sorry for men that doctors do that to.  The doctor should have told him to go and get another opinion to play it safe.  Take care  Ken  I still say that he did not need it.  His prostate was not the problem

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