Biopsy- Geno 2

Hi All,

Just got off the phone with my Hepatologist.  When I originally saw him, he discouraged me from having a biopsy but now I want one.  He's very resistant!  Keeps bringing up a 1% chance of complications (bleeding) and telling me I need to decide now what I'll do when I get the results back (treat or not treat).  He wants me to start Tx now even though he describes my viral load as "low" (its 123,000) but my ALTs and ASTs are pretty high (111/64).  He finally relented and said he'd set it up but, OMG it was difficult.

Any and all opinions welcome.  Thanks so much.
Verdugo

[FlGuy]

A biopsy is not without some risk.  Some docs, with geno2 and geno3 patients, don't recommend a bx and just suggest treating regardless of biopsy biopsy. In some ways, the doc makes sense.  What would be different in your position if it came back as stage1, stage2, stage3, stage4?  Would your decision be different depending on the results?  Would you not treat if 1, but decide to treat if 3?  This is the crux of the 'watch and wait' perspective or the 'get it over and kill it dead' perspective. There's alway colloidial silver, blood letting, camel's milk, electric skull cap, blood radiation, hyper bariatric, coffee enemas and the ole reliable - down on your knees prayer.  Good luck in your decision!

[Verdugo]

Yeah, I would wait to Tx if the biopsy came back Stage 1.  I've had the disease for almost 40 years.  Why do you think that's a bad idea?  A new drug could come out with less Sx, right?

V.

[FlGuy]

I don't think that either waiting or treating is a bad idea.  It depends on the person's circumstances.  And, there are a lot of factors in play like family situation, work, insurance, other health issues.  There is a lot to weigh for the decision to be right for you. If the stars were all aligned and you were inclined to treat no matter what, then the biopsy result might not be relative.  Based on what you say, it is a determining factor.

[meki]

Just a suggestion.

Perhaps a ultrasound would be a good first step.

I was of the tackle it now - get it over with - no matter what phase... Because YES... They can come out with better drugs --- but do you really want to wait 10 years to see if there are side effects?  I didn't - I didn't want to see if the HepC would be fine for a couple more years, and then voraciously kill me... I didn't want to give it that chance.

I also had NO CLUE how bad the SX would be. I mean - I thought... woohoo no problem - little flu feeling. Ahem... boy was that a rude slap in the face.

Anyhow - even knowing what I know now... and knowing 3a/2a/2b genotypes are easily treated with good results... While I would dread the repeat side effects, I would do it all over again.

IF - However, I was a 1a non-responder, I'd have to think about it seriously hard.

SERIOUSLY hard.

Anyhow - again - check on the ultrasound. Most people don't have bad reactions or a lot of pain on the biopsy... Unfortunately I sucked at it. Painful, burning feeling - with almost exactly the same info as the ultrasound.

So - good luck - either way.

[ladybug52]

When I originally found this site, I knew I was a geno 2, just not how damaged my liver was. Luckily my dr recommended a bx so I knew more of what I was dealing with. When I found out I was  at stage one, I knew I had plenty of time to wait, or could go for it and then stop, if I couldn't handle tx sides.
It gave me more options. A friend who is also a geno 2, has cirrohsis, so she's really committed to tx, and has actually lenghtned her tx.
I think the more info the better, thanks for the new medical term: trepanantion! I may try it on my youngest if he doesn't leave for college soon.
Bug

[Verdugo]

Thanks for that, FiGuy.  

Hey, you forgot trepanation in your earlier list.

Cheers,
V.

[cruelworld]

i think meki has great advice. as far as now or later, regardless of the stage
i stand with the consevative crowd. dont wait to start, you cant predict the future events in your life that may impair treatment.

[moondog52]

The key to what type of biopsy is your platelet count (it's in you CBS results).
130k/ml is low normal. My hospital cutoff point from a "regular" biopsy is 70k.
My plats were at 69k, so I had to do a transjugular biopsy method. You can easliy look this up, but basically a small catheter is run down the juglar, thru the right side of the heart (where the valaves *aren't*) and down to the liver. Then they feed a special needle (you don't want to know what they call it!) and grab a couple of samples.

This way any bleeding stays *in* the blood system, so it's supposed to be much safer. They give you plenty of meds, takes about 30mins actual time (4 hours of waiting!) and then have someone drive you home .... take a snooze and you're fine the next day.

BTW, if you don't already know, platettes are what make your blood clot.