So I Go To The Emergency Room...

[sistahdee]

Last night because I wasn't feeling well (from acute Hep B) and the doctor ran some tests (ALT & AST) and did an ultrasound.  The ultrasound comes back ok for liver and other organs, the blood tests obviously show elevated levels somewhere in the 500's and 800's respectively (don't have my results in front of me), then low and behold, the doctor comes in and says "It's chronic, I'm referring you to a specialist who can begin giving you treatments."  WTF! Here we go again with the dumb doctors here in L.A. who have not done their homework nor have they done complete HBV testing, but they automatically determine what's wrong with you from a very vague test.  So of course I debated him telling the man that I just tested positive last month and in order for him to declare me chronic (and start me on drugs I probably don't need), i would need to be monitored over a six month period and further testing would be needed.  His response was "Well I'll just print you something off the internet from Mayoclinic.com and you can read it."  Ha Ha!, he sounds just like my Primary Care Physician when she told me to read about HBV on WebMD.com!  They must've gone to the same medical school.  The most ignorant people I have ever seen are so-called "doctors", maybe I should stick to the internet for my information because it's obvious the professionals have no clue.  I remember when my poor mother lay suffering in pain in the hospital back in 2007 from a kidney infection and stones which had got so bad that she needed IV antibiotics, how we "waited" on the "specialist" to come in and examine her (which was days away).  Well, that never happened because the infection was so bad that it killed her on the morning that the "specialist" was supposed to arrive.  I had been taking her to her to the doctor for months before the hospitalization for the complaints of "frequent urination, back pain, urine odor, etc." but the doctor never "found" anything and dismissed her complaints as related to "old age" or her being a "hypochondriac".  I couldn't believe that her condition could have been caught in time and treated but was neglected instead, leading to her death.  I really have no faith in these doctors anymore, they're only out for the money and couldn't care less about the patients, just a bunch of ignorant morons.

[sistahdee]

Sometimes the reputation of particular hospitals and doctors are shared but mostly health care is something private.  This is Los Angeles you know...too many "V.I.P's"

[Sharp7]

That's the best part about having widely differing opinions: if they disagree with me, I go with one whose opinion is the same as mine ;-). Of course, I am always willing to be corrected or educated by them, if they are so inclined.

Actually, I don't usually make it an us-and-them thing. They have jobs to do, and many of them do it very well. And I? It's *my* life (or death or whatever), and I'm going to take full responsibility for how I deal with it when I can. And at times when the medicine is beyond my control (quick action required, too many variables, or for surgery), I still try to do the best I can to pick the right kind of doctor.

I intend to sound preachy (though I might have given that impression)... I was just writing about how I look at things.

But... I notice... you seem to have gone through a lot of health-related hardships!

I was wondering about how social interactions work there... does the reputation of a hospital or doctor spread by word-of-mouth there? or do people treat their health issues as strictly private affairs and are reluctant to discuss health, doctors and hospitals?

This last thing may not have anything to do with you or me... just something I felt like asking now.

[sistahdee]

No they're not the same doctors but my mom died in the same hospital where I had a botched up c-section, lost my ovary, caught an infection and had seizures during the operation.  I will never go there again, and the other hospitals aren't that great either so I guess I'll just pray that God will heal me because the docs are terrible!  You ask five docs what's wrong with you and you get ten different answers, lol.

[sistahdee]

Hey Stefano, I don't think it is fulminant Hep B or they would've kept me in the hospital (the E.R. doctor consulted with the Gastro specialist over the phone about my test results), and the ultrasound showed no damage to liver and AST/ALT was maybe 500/800 range.  I went because I was just feeling under the weather with stomach issues and no appetite and also for the hospital to do more tests since my appointment with the specialist is a few weeks from now.  I was a little dehydrated and they gave me some IV fluids for that and sent me on my way.  These docs just don't know what they're talking about for the most part, it's not the first time I've been given wrong info from doctors.  As a matter of fact, when I gave birth to my last child 18 years ago, the doctor removed one of my ovaries without my knowledge or consent, which I found out about years later during an exam!  I was under anesthesia when I gave birth (c-section) so I did not know what was going on, and the docs excuse was I had a tumor the size of a grapefruit, but the truth is he made a mistake when opening me up and accidentally severed my ovary which was unrepairable.  I could not sue him for various reasons so he got away with it.  I've had doctors "guess" what was wrong with me with no test results because they just lacked education or something, I don't know.  So I don't always take them at their word when they tell me something, I've seen them in action far too many times making mistakes.

[stef2011]

by the way another good point of our healthcare system, if you are not satisfied by doctors you can sue them and if any single detail to save a life or cure a disease has not been followed the doctors are charged of murder or damages.
so in our country they are scared to death lately becuase they always end up on national television and sometimes they are ruined even before getting to court, so even if ingorant doctors exsist you have the tools to fight them
on the contrary we have problems with surgery, we now have less doctors in that field because they are afraid...

[Sharp7]

Sad to see that somehow, you keep getting stuck with awful doctors! Are you getting treated at the same hospital that treated your mother so badly?

I understand coming across bad doctors once in a while, but this frequently?

Anyway, whenever I go see my doctor, I always take my big file with me, that has not just my medical records, but all kinds of relevant documents about the drugs I am taking, the procedures I wish to be done, or the drugs that I want to discuss (research findings, etc.).

The current doctor says I should stop reading so much :-). Of course, I do not like that attitude in doctors, and I would have changed doctors, except that she treats me well. Anyway, the reason I bring it up: bringing such a file is one way to never be told "read WebMD" or some such crap.

[stef2011]

i m so sorry synthoms are so bad.there is only one reason as i posted earlier to start treatments immediately and that's if during acute hbv you get very bad liver function tests that you might risk life.
this is not called acute hepatitis B in medical terms but fulminant hepatitis or liver failure, can you check if the doctor wanted you to start treatment for that reason just to be 100% sure?

fulminant hepatitis is rare and only on percentages like 1%, salvage therapy is made by entecavir or tenofovir ot the combo and cortison.the immune system overreacts and damages liver too much so they lower immune system by cortison and stop virus replication by entecavir at the same time.this is a rescue therapy to save from death because in normal acute hbv these drugs might interfere with immune system and make hbv cronic

alt and ast are relatively important, although i am cronic i have had an acute hbv many times while immune system tried to clear hbv, the longest was when 19yo and seroconverted hbe negative.my alt was 1500 and kept from 1000 to 1500 for about 3-4 months, a total of 6 months with alt higer than 500.
so don t worry about alt, you have to check sieroproteins, ggt, alp, bilirubin, PT, and don t know these in english colinesterasi, ldh.

usually you end up with no damage from these acute flares are followed by hbvdna und and normal alt/ast.hbsag can be cleared even after 1 year, the rule of 6months is wrong, you just check if hbsag declines or increases to know