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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 26383
Experience:  Over 20 yrs of Family Practice
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I have been having a lot of pain in my upper right area. I

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I have been having a lot of pain in my upper right area. I just had some blood work done and I dont understand why the dr is blowing me off. I have blood in my urine and protein. And my RBC is high at 4.91, HGB at 14.3, platelets low at167, all phos at 105, and AST at 58.
Hi--do you have the normal ranges for all those values for that particular lab? Have you had either an ultrasound or ct scan of the abdomen? Were you screened for hepatitis and do you have any specific medical conditions?
Customer: replied 3 years ago.

No, they didn't give the range for normal. They just have a H or a L. They did a CT scan and it came back normal. I had blood work done a yr ago and had a Hep B test done and it said positive. But no value was given. I have high blood pressure, but that's my only major medical issue. I dont drink, smoke or do drugs.

OK--but what about the ultrasound or scan and the hepatitis screen? And what's your kidney function like--what did your doctor say about the blood and protein in your urine?
Customer: replied 3 years ago.

They didn't do a ultrasound. Just the CT scan. Other then a small Bochdalek hernia, everything else was normal. They didn't test kidney function.

OK--and we can continue after this if you'd like. Your liver enzymes are only mildly elevated and it could be consistent with a fatty liver but you need a scan to look for that. It's treated with proper diet, weight loss if necessary, and control of cholesterol levels. While I would screen you for hepatitis, your enzymes aren't really high enough for me to suspect that the screen would be positive. Your platelets are a little low but not disturbingly so. The hemoglobin is somewhat high and I would have you see a hematologist to evaluate for polycythemia vera Blood and protein in the urine could be from an infection or a kidney stone or from kidney disease so you need an ultrasound of the kidney for that.
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Customer: replied 3 years ago.

I do have a history of kidney "gravel" and infections. I'm just so scared that I have something major going on and its being missed.

I understand--how long have you had the pain Charlette? And where is it located exactly?
Customer: replied 3 years ago.

This last time it started yesterday morning. The pain is right where my liver is. I had my gallbladder removed 8 yrs ago, so that's not it. And for the last yr, pretty much every morning I wake up and I'm so queezy I have to take zofran so I can eat some breakfast before I have to go to work.

And all your doctor has ever done to check this out is the recent blood work?
Customer: replied 3 years ago.

The blood work I just had done was at the hospital. My dr has moved and now I'm without a dr when I need one the most.

So this was an ER doctor you saw? Did he arrange for any kind of follow up?
Customer: replied 3 years ago.
He gave me the name of a dr. That was it.
So do you plan to see a family doctor or an internist about this?
Customer: replied 3 years ago.

I dont know what kind of dr I should see.

Well for now it can be either family practice or an internal medicine specialist. You need a ct of the abdomen to start out but from what you've told me you probably will need to see a gastroenterologist for upper and lower endoscopy to check for irritable bowel syndrome, celiac disorder, and possibly something call sphincter of Oddi spasm which is a cause of postcholecystectomy syndrome--gall bladder like pain without the gall bladder. I don't think fatty liver explains your pain and nausea

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