Acute Hep C, hasn't started treatments yet due to co-existing cellulitis

[PatPM]

My sister and I are both worried about her daughter's health.  While working in New Orleans on a clean-up crew, she developed a really bad infection, which had to be treated in the hospital there.  It was basically cellulitis due to an anerobic bacterium.  She has been taking Flagyl for a week now, the hospital did a good job of cleaning up the area (removed 500+ cc of infection) and that seems to be stabilized.  While she was in the hospital, she had several other blood tests done, and to make a long story short, she has a very acute case of Hepatitis C.  We don't know the viral count yet - should have that ready on Tuesday after the holiday.  Of course, my niece is horribly sick, on pain meds for the cellulitis, and has no appetite, is lethargic, disoriented etc.  We are very worried that we are letting precious time slip by that could be used to salvage her liver.  She has moved back in with her mother but she has no insurance, no income, etc.  Her mom is on SSDI also, so you know money is tight.  I plan to get the paperwork started next week for the various PAPs available for Interferon, etc.  She won't see the GI doctor until Thursday, so really, no PAP can even get approved any sooner than that at the earliest.  My bottom line question is whether we should get her to the ER and let them decide what to do in the short term, or wait for the GI doc's appointment.

Just would like some advice / guidance.
Pat in Alabama

[jmjm530]

Just caught your post. I thought NY might be interested, not so much about the trial, as that this person talks about a doctor that NY might want to see. Usually by the time I see one of her posts, she's gone. So if you catch her before me, great.

-- Jim

[jmjm530]

If it was a food thing, it wasn't the cheeseburgers that gave me the ibs, but if anything it was introducing too much fiber into my diet too fast coming off of treatment. That and/or an intestinal but I had around the same time combined again with treatment withdrawal. But, yes, that cheeseburger was good and after over a year of deprivation I felt like a little boy eating one for the first time. It's like that with a lot of things now that treatment is over. Yeah, you deserved those words and more, as this place can be tough going at times, especially when you're on the treatment drugs. Hope you can enjoy your own Cheeseburger soon!

-- Jim

[jmjm530]

Kalio says: Hep c is a slow moving disease, when she is better from this current infection she can deal with seeking out treatment for the hep c if that is what she is going to do.
----------------------------
Not sure, but I think the current thinking is that the earlier you hit Hep C in the acute stage, the better. Older thinking I believe was to wait and see if you cleared it on your own. That's why I think she should make it a priority to see a hepatologist ASAP to help guide the decision. Pat -- make sure if and when you call the hepatologist you clearly state your daughter has ACUTE hepatitis C, and make sure that info is given directly to the doctor. I would assume that this would get you in the door sooner.

-- Jim

[jmjm530]

Certainly her infections should be dealt with right away but I do believe in multi-tasking :) and I don't think it would hurt for her daughter to at least get into see a liver specialist ASAP and then make a treat/no-treat/ or wait a while and treat decision when appropriate. Here's a link to some current thought on the subject and at first glance the odds of Pat's daughter successfully clearing the virus appear to be quite excellent. But, as you read through some of them, you can see that it's not exactly clear cut and therfore expert guidance at this stage could make a big difference later on.
http://www.hivandhepatitis.com/hep_c/hepc_news_acute.html

[jmjm530]

Just to add a little, the process as I understand it works a little differently in the acute stage as opposed to in the chronic stage where the majority of us found out we had the disease.

Most of us in the chronic stages go through a long period of waiting for multiple tests, biopsies, etc, with the start date of the actual treatment not being so important since we've had it so long. I could be completely wrong, but once the diagnois is confirmed, I wouldn't be surprised if they give her  the first shot almost immediately, if the treat decision is made. BTW I went through the acute stage myself 37 years ago but unfortunatly, nothing to treat it with back then.

[jmjm530]

I agree with Beagle, when in doubt bring her to the ER to at least look at the infection.

Regarding the acute hep c, I suggest you see a liver specialist (hepatologist) as opposed to a gastroenterologist. Hepatologists are usually found at your larger, teaching hospitals. I only say this because they are more cutting edge in treatment being usually more current on the literature. Lately, there's been some shift in thinking of how, when and if to treat acute Hep C as opposed to waiting to see if the immune system will clear it by itself as it does in around 20-30% of all cases. A hepatologist might be better to guide you in this decision. All the best luck. The fact that they picked up your daughter's hep c in the acute phase is actually excellent news because at that stage the chances are she will get rid of completely one way or another. Many of us here didn't realize we had hep c until 20-30 years after infection, and therefore ended up both harder to treat and with liver damage. Your daughter should be just fine in the right hands. All the best.

-- Jim

[Mister beagle bailey]

Another thing to explore is those states were declared a state of emergency, so they got sick cleaning up, then the gov. should pay for their care.  See someone in the hospital about that and let them know they have no ins.

BEAGLE

[jmjm530]

If anyone sees New York girl before me, perhaps you can refer her to "preciousones" post of 5/26 (post c18) in thread entitled "Largest U.S. Hepatitis C trial Provides Insight". It's about the doctor she's tryng to get an appointment with.

-- Jim

[Mister beagle bailey]

I just wrote it down so I don't forget.  If she get's her home PC up and running, she'll be on, her kids fried it.
Will check it out , where is it being held?

BEAGLE

[cuteus]

I have one question. How do they know is acute hep c? Given the post above, there are no details as to whether this person had a negative hep c test previously to the positive one. I was told that it was hard to determine how long we have been infected with the virus. So, for all we know, she could have been recently diagnosed with a chronic hep c infection?  The fact that the poster is worried about salvaging her liver makes me wonder if we are in fact talking about hep c.

[Mister beagle bailey]

I wouldn't wait for an appointment with the GI dr with an infection like that.  I would take her in she has what your daughter has from working in all that bacteria in New Orleans.  There are ways to get them free drugs from the drug companies.

But I think you need help now first to get the infection under control.  I just put a call out for help for you.

BEAGLE