This week we took Ashley to the pediatrician because she has a distended abdomen, complained of belly pain and was very pale. However, despite all of that she wanted to dance so she went to dance class on Monday night. Then Tuesday afternoon we were at the pediatrician. After an examination, a decision was made to have Ashley go in for blood work and an ultrasound. The thought was that her belly was distended due to ascites. Ascites is fluid accumulation in the abdominal cavity and is very common in patients with liver disease. Plus Ashley gained 3 pounds in less than a month with no growth in height. But before the ultrasound Ashley had labs. Her blood work came back and although her liver function appears to be normal, her CBC's are out of whack. Her platelet count is the lowest it has ever been, 80 thousand (normal is 150K to 450K). A low platelet count means she is at risk for spontaneous bleeds. Her white blood cell count is also low (at risk for infections), as is her lymphocytes and her monocyts as well as her Hemocrit. What does that is mean? I really have no idea, and I wish I did. However, I am predicting that she just a virus that is causing these wacky numbers.
After labs she was then sent for an ultrasound, which had to wait until the next day because she needed to be without food for 8 hours. On Wednesday morning we drove to Arnold Palmer Hospital and Ashley's abdomen was scanned. I love watching ultrasounds, trying to figure out what the technician sees. But with Ashley's I can pretty much see things before the technician does, after looking at various ultrasounds of Ashley's abdomen over the last 11 years, I pretty much know what I am seeing. We noticed that her liver seemed to be even more scarred (fibrosis/cirrhosis) then the scan done in 2007 but she has no ascites. We also noticed her liver cysts also appear to be slightly larger but not to significant. However, her spleen has certainly increased in size which would explain her low platelet count as well. When a person has liver disease the spleen will eat up platelets instead of allowing them to stream through the body as they are intended, this can cause a low platelet count and an enlarged spleen. An enlarged spleen means that Ashley has physical limitations. Ashley's ultrasound was pretty much the norm for her, but the fact that her liver seems to continue to scar means that her liver disease continues to progress.
The pediatrician feels that Ashley should see a hematologist about her abnormal blood counts. He has sent her latest test results to her liver doctor at Shands Hospital. My guess is that Dr. Andres will not agree to a Hematologist consult but he will say it is what it is, and it is a progressing liver disease.
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