Problems with liver

I am due to see gastroenterologist shortly I saw  her earlier in the year for an unrelated problem even then my alkaline phosphate was above normal range but not worrying  so  since then it has crept up and up  and I was wondering whether it could be sjorgens related or the fact im off steroids

No Margaret I wasn't offered anything but hoping if liver problems are sjorgens related the gastro consultant will start me on something. Iv had lupus and sjorgens for many year and haven't had any organ involvement but having said that I have always been on steroids. I live in Kent UK and my rheumatologist is totally useless I saw him in September and he told me that my alkaline phosphate was high but gave me no advice or suggestion as to why or even whether it could be a result of sjorgens. Told me to see him in a years time and gave me no blood test sheets because I have been stable. how the hell will he know how im doing in a years time without looking at my blood grrrr,  

Thanks for that Margaret, I was hoping to go to Cyprus for a year but probably out if the question now sadly. I went May June July and loved it so much and the nice weather made me feel so much better I decided to come back and put my house up for rent but plans are on hold for now

hi Christine, can you go ahead with your plans? Would you have somewhere to stay if you came back temporarily to see a specialist? That way you can carry on with your plans. I doubt that there will be an emergency situation here. I understand your concern and obviously I can't say that for sure. I am not a specialist. But can only imagine that your rheum is at least informed enough to know you are not in an emergency situation with the liver situation. One would hope he/she would at least know that. We get pretty poor treatment sometimes don't we. So annoying x

Christine,

If I were in your shoes I'd investigate the healthcare situation in Cyprus. I worked in the NHS for more than 10 years and have now lived in another European country for more than 40 years, and I can assure you that healthcare is better in most EU countries than it is in the UK - including those we perhaps think of as being less developed. (Sweden is one exception that I know of - they operate an identical system to the UK, which is totally free at point of service but with identical drawbacks.)

If you get your Cyprus trip in before 2019 you might well be eligible for treatment under the Cyprus system - well, at least in the Greek jurisdiction. Not so sure about the Turkish half. You'd need to look into the forms you'd have to take with you to ensure your NHS contributions would be taken into account. It's true that most EU countries require the patient to pay a small part of the costs of treatment - even for fully-paid up nationals of the country - but most of them offer much more choice than the UK.

I'm not kidding - it really might be worth looking into. But hurry up - the Br exit clock is ticking!

I will see what the gastro specialist says when I see her hopefully it isn't anything too serious and she puts me on steroids or another med to stabilize it and bring down the enzymes if that's the case I will still go and get it checked out in Cyprus from time to time  but obviously if it my liver has anything too nasty I wont be able to do that. Im not even sure it is anything to do with autoimmune yet it was just a coincidence on my part that the enzymes rose as I tapered off the steroids. I was only on 5mg a week in the first place which was a maintenance dose.

That's what I was hoping to hear Lily I am retired so should be able to go to the hospital in Paphos and pay a small charge to see a doctor who will then give me my repeat prescriptions.  I was planning to take a copy of my blood tests with me to show them, I was hoping that they would give me regular blood checks. I was due to go for three months in May but a month before I went I was diagnosed with diverticulitis so I missed three weeks because of all the tests I needed. where do you live Lily 

Hi Christine,

I live in Belgium, and I'm certainly no expert on Cyprus. I've never even been there on holiday. My only visit was a two-hour refuelling stop at the old RAF base at Dhekelia on a troop transport flight returning from Hong Kong to RAF Brize Norton in 1973!

However, I have a pretty good overall understanding of how the various EU health systems work. Here in Belgium, as in most EU countries outside of Scandinavia, we operate on a kind of public-private combination. This means that even if someone isn't eligible for treatment under our health service, they don't have to see a fully private doctor and pay exorbitant fees. They pay the going rate (fixed by the government) for their treatment, but without getting anything back from the State medical insurance, as a Belgian resident would. Here, a consultation with a rheumatologist would cost around €70 and a blood test probably €40-100 (depending on what was ordered). Both residents and foreigners would pay the same amount, but residents would get a partial reimbursement from the government.

Ditto for prescriptions. There's no such thing as the scandalous UK private prescription here. A prescription is a prescription. Everyone pays the government-set rate for medications, but foreigners don't get the reimbursement.

However, foreigners who have private health insurance can usually claim back some of their costs for treatment, and you can claim from the NHS under some circumstances, using the EHIC card.

As I say, this is only a general overview, and I know there are some exceptions. Perhaps you could spend a month or so in Cyprus first and check out the situation before committing? I'm sure a bit of nice weather would make you feel better!

Incidentally, I suppose you know that one of the side-effects of long-term corticosteroid use is fatty liver? I take your point that it was only noticed after you stopped the steroids, and you were only on a low dose anyway, but I suspect there could still be a connection. I wouldn't worry too much in any case. Fatty liver in itself isn't considered very serious, unless it's advancing or causing other problems.

Thanks Lily that info helps. gp thinks there is more going on with my liver than the fatty side of it as the alkaline phosphate is rising all the time but will find out when I see the gastro consultant, well I hopefully will anyway. fatty liver stinks especially as I don't drink im 5ft 2in weigh 8st 7lbs and go to do two aqua classes a week using water weights and I also do a body sculp class which involves lifting weights. Im 67 this year x

Oh dear, it's just not fair is it? I'm 73, the same height as you but weigh 9st 8lb and drink a bit more than I should - though no bingeing - and my doctor says my liver is in better nick than his! I do, however, exercise regularly like you, as well as making sure I avoid junk food and eat plenty of vegetables and oily fish.

Sometimes we just get dealt a rotten genetic hand, don't we? I seem to have done reasonably well on the health front so far, in spite of the appalling history of cancer in my father's family, but have aged very badly from the point of view of appearance, as my mother did. I don't stoop and still walk very briskly, but I have saggy skin and my face is a complete mess. I have a friend who's five years younger than me, and when we meet new people they always assume I'm her mother!

Its good that you have had good health Ive not been so lucky I was a sickly child with juvenile RA, then endometriosis and hysterectomy, lupus, diverticular  disease and now problems with my liver but so far im here to tell the tale.

I was a sickly child too. The survivor of twins, I weighed only about 4lb at birth (in the middle of an air raid in the East End of London) and nearly died of pneumonia and bronchitis every winter till I was 8. It probably didn't help that I lived in all that smog, in a single, damp room with two chain-smoking parents.

I was lucky in that we finally got rehoused away from it all in the spring of 1952. I think this was probably just in time. If we hadn't, I suspect I'd have been among the 30,000 deaths caused by the (in)famous smog of the winter of 52-53. Once I got into clean air and proper housing, there was no stopping me!

I'm amazed that my lungs have got away with it so far, given the damage they must have suffered during my first 8 years. I can still remember crying when I left the house to go to school on winter mornings because the acidic fog felt like a knife in my chest at every breath. Yet I had no chest problems at all from the age of 8 till two years ago, when Sjogren's started affecting my lungs. The resilience of the human body truly is amazing!

As you say, you're still here to tell the tale too. Long may that last! We most be tough old birds to have survived all that childhood illness.