8/24/22: Hepatology Appointment

I dare say today's phone appointment was a pleasant conversation!

The doctor carefully reviewed the up-and-down trend of my LFT results over the past year. He said my current results are "completely normal" and indicate normal liver function!

I asked if that means I no longer have fatty liver disease? He said yes, given my BMI and LFTs, I can say I do not have fatty liver disease. 

I know by now that doctors never order tests to confirm normal results, but I figured I'd ask anyway if I should get another FibroScan. He said sometimes, imaging results are "consistent" with fatty liver, but when a biopsy is performed, there's no fat. The FibroScan also looks for scarring, and the important thing is that my prior FibroScan showed little to no scarring. Since everything now points to normal liver function, there's no need for a FibroScan. 

I was impressed that the doctor spent a surprising amount of time reviewing my hormone therapy regimen, even asking about my ovary removal and side effects. I told him that my side effects on anastrozole (mostly just joint stiffness in my fingers, since other symptoms like hot flashes and vaginal dryness can be attributed to menopause) are worse than when on Tamoxifen, but better than when I was on exemestane, and I consider them manageable. He emphasized the importance of finding the right balance between treatment and side effects; he didn't say it outright (presumably because these medications are squarely in my oncologist's domain) but it's clear to me that since Tamoxifen was the probable culprit leading to my liver problems, I'm unlikely to have a recurrence of fatty liver as long as I can withstand the side effects of other medications and stay off Tamoxifen. 

I had one final question about whether or not to worry about my ferritin number still being a little elevated. Because my ferritin was very high (538) around the same time my LFTs were high, and it has since decreased to only being a little high (202), the doctor said it's likely related to the fatty liver, and he's "not concerned".

I'll have one final follow-up in 6 months just to make sure everything is still normal.