### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi, I recieved a call from my doctors nurse stating My Alkaline level were at 184 and my live ALT was at 67 and was just told to come back in a month for another blood test. I have struggled with trying to get my doctors to help me come to a diagnosis but I dont get one. What does this level of alkaline mean? One doctor in Chapel hill said I had Mycosi fungoides and I suffer from inflammation of the knees and my thyroid was removed several years ago due to non-malignant growths. I moved to Elgin, Illinois and was sent to Rush hospital and now been told I am a mystery. He doesnt feel I have mycosis fungoides...ayyy I just want to get better and cant seem to find the way to get the help I need. When I asked my doctor what can I do or what should I expect...he said...well or these test are wrong or your a tremondous liar. I cried driving home. the results say one thing but when I ask what is the next step he would say...see you in three months...I have had 2 major knee flareups since and sincerly dont know what to do..Can you help or guide me. I appreciate it. Thank you, Linda

### output:

Hi Linda, Thanks for asking. Based on your query, my opinion is as follows.1. Raised alkaline phosphatase levels indicate mild bile duct obstruction. ALT in elderly at 67 is bitten increased, but due to medications and liver damage can be near normal limits.2. You might be suffering from osteoarthritis. X-ray or arthroscopy is necessary to identify the amount of damage.3. As there are limited details present, I cannot comment further. Do repeat the test for alkaline phosphatase and ALT after a month, to check whether CT is necessary to identify further cause. Hope it helps. Any further queries, happy to help again.