Shauna

[Guest guest]

As you know, lab tests are a snapshot of the situation at the time the

sample is taken. As you're probably also aware, your body attempts to

keep things similar but not the same; in other words homeokinesis

applies to living organisms not homeostasis. Combining these two ideas

your albumin value varies every day, perhaps every hour. It's more

likely that your serum albumin level gradually declines as liver

function worsens. But it's possible that you were tested when it was at

it's nadir during a drop from previous. It also could be that it is on

it's way down and you've caught it as it's progressing lower. The fact

that you're other results are holding stable could be a good sign, but

then again, perhaps not. The only way to tell is to follow the trend.

Without examination determining if your abdomen is larger due to either

ascites worsening or an enlarging spleen or both is impossible. So I

can't agree with your doctor's impression, although he may have guess

correctly, especially if he was viewing your abdomen while you were

lying exposed (your abdomen) on the examination table. Sometimes you

can actually " see " an enlarged spleen if the person is slim and the

spleen very prominent. Your platelet count is fairly low. I would

imagine it's because of sequestration in your enlarged spleen. That's

the most common cause in those of us who experience enlarged spleens.

With your current mentioned lab values I would suggest that your liver

is starting to be unable to compensate for the damage done over the

past number of years. I would expect a gradual, but more significant

than in the past deterioration of both lab results and in particular

symptoms and signs, unfortunately. Now is the time to have more

frequent lab testing and to be especially good to yourself.

Aubrey, M.D.

Liver disease '81, Psoriatic Arthritis '89, UC '90, PSC '92, Liver tx

10/5/98