Thanks for the info. I was going to look into this, but since I haven't had a bx, I guess I am not eligible. You saved me some time and work.
if i might add, the fibroscan mentioned earlier is only being used on subjects who had a liver biopsy within 6 months, & have not treated for hcv, this is what I was told in an email by them. it is not readily available for all that ask for one.
I am interested in this info, as well. Since my GI doesn't think a bx is necessary, since I am already txing and the risk etc, I am REALLY wanting to get more of an idea of my stage/grade etc. Obviously Brian Fog was making me think that I had a CT, when actually all I had was an Ultrasound. I was interested in the billirubin and also platelet counts that could indicate cirrhosis.
Do you think at this point in tx, 16/48 that it is SOC to ask for a CT or other scan to find out if I am cirrhotic? It is MY worry and not really necessary for my continued tx, unless I relapse or have some problem. What do you think?
Thanks Mike, this is also my understanding. I flagged Kalio and MyOwn on this so they won't miss your comments in your post above.
My Own...
Sounds like you're getting up to speed on things and if you haven't found them, here are some other good sites for research and discussion on Hep C:
http://janis7hepc.com/
http://www.hepatitisneighborhood.com/default.aspx
http://www.projectsinknowledge.com/
http://www.thebody.com/treat/hepatit_c.html
http://www.hcvadvocate.org/
From: http://www.mayoclinic.org/cirrhosis/diagnosis.html
Diagnosis of Cirrhosis at Mayo Clinic
The first step to properly diagnose a patient's liver-related problem is to gather an in-depth medical history and conduct a physical examination. Because early stage cirrhosis often lacks symptoms, physicians typically discover the disease during checkups for other conditions.
If cirrhosis is suspected, a Mayo Clinic physician will conduct blood tests that measure certain enzymes. Additionally, blood work will determine if there is excess bilirubin in the blood. Bilirubin is a substance related to normal breakdown of red blood cells. It is normally broken down by the liver and excreted in urine. High levels left in the blood may signify a damaged liver.
Imaging studies may include ultrasonography, a computed tomography (CT) scan and magnetic resonance imaging (MRI). Each study provides different views of the liver and can provide additional clues about liver function.
The last and most conclusive way to diagnose cirrhosis is a liver biopsy. A physician removes a tiny sample of liver tissue and examines it under a microscope. The procedure can be conducted using a needle biopsy technique that typically requires only local anesthesia.
My experience is that biopsy is the best test. We've discussed the drawbacks to biopsy before - sampling size, heterogeneity, subjectivity etc. But, if you have esophageal bleeding, red palms, HCV and a hard liver on palpatation there isn't much need for any test. CT scans are usedful but generally not conclusive about the bottom line issue. You may recall that I got my liver because the CT scan showed a lesion. I asked if it was cancer and was told that it was in an area that they couldn't biopsy so they didn't really know. It wasn't cancer as it turned out but they really had no idea what the lesion was. This was 2000 and perhaps the CT scans are better but I believe that they are clues only about gross architecture. You gotta stick that needle in to truly know - at least for now, that is. Mike
I change the font on the list to 14 pt. in case the doc has me out of my clothes
Why not take a bottle of bubbly too... or at least a long stemmed rose.... ;-)
My doc uses CT scan to check for it. He is not big on biopsies if you have decided to treat. He figures it is a unnecessary risk ad ot as great at diagosing liver condition as we are led to believe, he always says to me "depends on the sample" you an get a good spot and miss things and vica versa. Every doc is different. Those who choose to wait he does wat a biopsy. He did do a US prior to check for any tumors fatty liver etc. which came out "perfect" his words..he didnt want to do a biopsy while I am on IFN at ALL and said CT scan is good at revealing cirrhosis, even better according to him than a biopsy where it can be missed. They have a big whiz bang new machine here that you probably have up there too. I think it is tomography? not sure. Takes all kinds of views of things. Plus they also looked at gall bladder, kidneys and all that junk too and all looked good, so that was good news! Also they can see the portal tract, bilary business and even blood flow rates I believe which are all relevant and they are all normal.
If you can get them to do a CT scan, it was painless and easy as pie to do but really since you are aready txing, it probably wouldnt change a thing you are doing.
I will email later on after 3 when I get back, I actually have an outdoor activity/visit today and I feel up to it for ONCE!
How accurate is the ultrasound to tell if you have cirrhosis? I thought the only way to tell was with a bx.
Yes, contracted it during a spinal epidural in 02/03 but unfortunately they thought it was a drug alllergy rather than acute hep that they think it was now, they can resemble each other.Unfortuately, contrating it later in life, esp geno 3 is a bad thing I have learned. It is what it is and I will go forward from here. I have read all that says it can reverse but the chances arent real good however I am a firm believer in anything is possible. You know me, I wont believe the new drugs will be here until they are and I dont figure I'd be one of the lucky ones to have a reversal at this stage but I am sure open to it occuring!
If goes where you are intimating, he better come up with the rose. You bring up a good point about the champagne - we haven't had a rousing discussion on alcohol and hcv in the last 5 minutes or so.
How'd little Goof (the child , that is) do on the trip?
You guys have probably see this but just to show I am ot a died in the wool pessimist, thought I'd share this.
It made me fee good about the og term tx as they seem to connect histological improvement of cirrhotics with longer term tx.
http://janis7hepc.com/cirrhosis7.htm#can%20cirrhotics
Babbled to you down at Return to Sender. Seems I was running around to much and lost my place. Peace to you
Awwww man. What a complete and total let down Kalio. I am truly sorry you got that diagnosis. A real shocker, isn't it.
I mean, the cirhossis is bad enough, but look at the company it puts you in. I won't single anyone out, but you're in a rarified club indeed. I know this is a tough one. It'll be OK though, seriously. BTW, I think I was watching the Paris Hilton home video running backwards when I got the call.
I gotta work on the salt thing. I never touch a salt shaker but it's in everything it seems. Hang in there, Kalio.
LOL Goof, well at least it's a bunch of joksters!
Yeah, scary stuff but what can you do. Got a friend who was working at my husbands' jobsite one week and the next in UCLA having tx for nonHodgkins lymphoma,, he's 52. It could be worse.
I have been lucky so far ad ever been sick.. Im too mean to croak. ;)
Hope you had a good time over the pond. Have you checked out some of the stem cell therapies for cirrhotics? I thik they are doing some of the work in Ediburgh. Also in UK. No Carolina too I believe..Its late but I will find the links and post tomorrow.
Now I REALLY think I will visit your facility for another opinion at some point.
Did I respond back/
can't find it...
you're a sweetie, and I'm confused...
Kalio what did I miss? Are you ok?
Beagle
That question is already on my list. A couple of minutes ago I change the font on the list to 14 pt. in case the doc has me out of my clothes and in case my glasses are out of reach.
I'm so sorry to hear this. As the liver is the only organ that regenerates it self, can the liver rid it self of the cirrhosis after your cured of the virus being it's in the early stage?
Beagle
Probably not. Once it is cirrhotic the cirrhotic part can't reverse itself. So far it is still functioning well, fortunately you can survive with only part of your liver functioning. Hopefully it will continue to function. Staying on IFN and watching it closely are all I can do. I do not need to be evaluated for further action unless or until it stops functioning and starts to fail.
I guess some gals will do anything to be a member of the "funny guys in the room" club!
Ahem...
<ul>
My information says 'early cirrhosis' can reverse. I was given a 50/50 shot of regaining 2 stages. At last visit Doc offered his opinion that my general health (which ain't so bad but energy is lower than I'd like and my brain ain't what it once was) will show improvement over a 5 year window. There are exceptional cases where cirrhosis has completely reversed - I think Cecil cites one on his site. So there is definitely room for optimism. Maybe FLguy will update us after his upcoming consult.
BTW, do I remember correctly that you contracted the virus relatively recently?
Goofy thanks that is great news for Kalio and others who have early stage cirrhosis.
Hope you are doing well
Beagle
I finally talked the doc into a CT scan, since all my blood levels didnt reveal anything out of whack he didnt think I needed a biopsy, but he did the scan to shut me up I think.. was going to tx anyway and the CT scan showed I have cirrhosis. Fortunately it is "early" and I am in the first category on the scale with a score of 5.
I guess some gals will do anything to be a member of the "funny guys in the room" club!
Can do sorry, I thought there was a Hep B forum on here. :)
Paris hang in there, 2 shots to go. I had some really bad weeks too. Don't know why some weeks are better or worse then others but they are. Just think in 2 weeks you'll be done and start to feel better and you will feel better. All you are going through is normal and I know you know that, just think some times we all need to hear it.
Beagle :)
We're all just full of music tonight.
JHoy, stay in touch.
this is a great group here.