It’s the re-test!

Talk about a feeling of trepidation. I definitely wasn’t casually waiting for the ELF re-test to arrive in my inbox. Worse than re-sitting my driving test. It wasn’t my fault that the car stalled when an ambulance came up behind me with its siren screeching – on a single-track road.

“5 – 7 days” turnaround ‘The Doctors Laboratory’ promised optimistically on their website. Shouldn’t there be an apostrophe there?

It’s been almost five weeks without wine and I sent off the blood specimen after four. I’ve already rechecked my total cholesterol and triglycerides and they’re down by 15%. Neither were abnormally high before but every little helps. I don’t know what I’d do without online blood tests.

I’d also booked myself in for an abdominal ultrasound with a friendly, local place in Kings Hill, Kent that does the scan for just £65. They normally scan pregnant women and offer photos in glorious 3-D. Somehow, I don’t think my liver and I will be receiving the glam treatment.

Overkill? Peace of mind, I’d say.

I’ve done some online searching to find out what to expect from the ELF re-test. I checked with Siemens first as they originated the test:

“ELF markers can help diagnose patients with mild-to-moderate liver fibrosis (usually asymptomatic), allowing clinicians to intervene before significant damage occurs.”

Professor William Rosenberg, MD
Centre for Hepatology
University College London

That’s one half of my old medical school (UCMSM), so the endorsement is promising.

The UK’s NICE (National Institute for Health and Care Excellence) says the following:

  • Consider using the ELF test in people who have been diagnosed with NAFLD (Non-Alcoholic Fatty Liver Disease) to test for advanced liver fibrosis
  • Offer retesting for advanced liver fibrosis for people with an ELF score less than 10.51 every 3 years to adults and every 2 years to children and young people
  • Consider using the ELF test for retesting people with advanced liver fibrosis

So re-testing is recommended. But over what time-scale? I’m inpatient when it comes to my health, as my husband Henry will attest.

There was nothing online about when to re-test. Perhaps four weeks was pushing it. After all, fibrosis takes years to develop.

Fibroscan gives a similar result to the ELF test, so I checked for that, too. There was definitely more evidence for using it to monitor progress with abstinence.

One of the evidential snippets was courtesy of that bastion of independent thinking, the UK’s Daily Mail. They scanned five heavy drinkers before and after a dry January. No one scored more than 7 at any point (2 – 7 is normal), three went down marginally and two actually went up. So, a rather pointless exercise, but it made good press.

The ELF re-test result arrived well ahead of the the lab’s projection, so I wasn’t expecting it.

Here’s the scale again:

I wasn’t anticipating the result, either. Still ‘moderate fibrosis’. Frankly, a bummer after four weeks of abstinence. But, looking on the bright side, the score hadn’t gone up. ‘Moderate’ is fine, really. I’m a moderate person – apart from in my former drinking behaviour.

This is where I started wondering whether it could be a mistake. One doctor I spoke to said the ELF test had too many false positives – meaning it was suggesting a degree of fibrosis that wasn’t actually present. Or could it be that moderate fibrosis takes longer to reverse than mild fibrosis?

It was fortunate that the ultrasound had been arranged for the same day. I went expecting the worse. BBC Radio 3 was playing minor key, melancholy Rachmaninoff in the waiting room.

So, that’s my liver. Nestling under my rib cage, just doing its thing and blissfully free of ethanol for a month. It’s not exactly like seeing a baby in the womb, live and kicking, but at least it’s alive.

And normal, according to the report:

Confused? I am. Time for a chat with a specialist. Maybe online blood tests aren’t the best thing since low-GI, gluten-free sliced bread.

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