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Biopsy: Is it as bad as I fear?
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Biopsy: Is it as bad as I fear?

How bad is this procedure actually? It am becoming increasingly fearful of it. I assume it is quite brutal or can be.
23 Comments Post a Comment
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163305_tn?1333672171
I was worried about it and it turned out to be easy breezy.
My doc had me raise my arm above my head, count to three and surprise ! it was over. Really it felt like a pin prick.
I've had three and they are nothing though I guess some people have had problems but not I.
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1815939_tn?1377995399
I had some medication with mine. They don't knock you out, because you have to hold your breath and follow instructions. However, they can give you something so you don't feel any pain and it makes you less nervous. Mine went smoothly and I felt no pain from the liver biopsy needle. I had no complications, no bleeding, and no real pain afterwards, just a dull aching for a day or so. My doctor used a CT scan to guide the needle and he went in below the sternum, which I think gives the patient less pain. (There are no ribs to go between.)

If you are at Duke, you will probably have experts doing your procedure.
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Avatar_f_tn
I was nervous about mine too. However, it is absolutely nothing to sweat over! They give you meds at the site of where they will do the biopsy, and give you something in an IV, and it's is over super fast. I would say maybe 5 minutes back there. Checking in and getting ready took way longer. I wouldn't worry about it. The anxiety before hand is way worse than the actual procedure! Keep your head up! :) It will be over before you know it!!!!
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Avatar_m_tn
It can be as quick as described if you have an experienced Dr you need to make shure they have experience the first one I had went like a breese not so good the second time not so good diffrent Dr due to Ins.
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5979406_tn?1378068301
Oh, I am very, very glad to have asked this question. I am also glad to be going to Duke.
From their site: "Duke’s team of physicians and nurses provides outstanding clinical care to patients with a variety of liver conditions. Many patients can take advantage of the latest breakthroughs before they become widely available through clinical trials  say many folks up there for liver things may be selected for trials."
Thanks, again, LC
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5979406_tn?1378068301
I forgot to ask what sort of drugs they gave you? I would think a lidocaine would be enough? Did you have any IV drug to make you spaced out or whatever? I really don't like that stuff.
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1815939_tn?1377995399
They definitely numb the skin and under the skin with Lidocaine.

You do not need to get the IV drugs. If you do not want IV drugs, just tell them you don't want them.

If I recall correctly, they gave me IV Versed and Fentanyl. I was wide awake but felt no pain and less anxious.
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Avatar_f_tn
  MIne was just fine. They gave me a tiny bit of liquid Ativan in an I.V.,  enough so I thought the Nurse and Liver Doc were my best buddies, and afterwards,the greatest nap :)  
   I cant believe I was so frightened, putting it off for years, only to find out it wasn't painful. I felt a jolt when they did it, but no pain. I asked them< "when will the procedure start?" and they said, "were finished, and held a piece of my tissue up, for me to see, it was floating in a lil test-tube. The Doc and Nurse seemed relieved my tissue was still red. I ended up being a "Stage 2" , when I had thought, from a Fibro-Sure test I had, (and I had platelets below the normal range) that I was cirrhotic (which is called "Stage 2") so I was very glad I got that biopsy. I really had a need to know what the tissue in my liver looked like.
  After the procedure, they will instruct you not to lift anything heavy, for a certain amount of time. Good luck, Lili~
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1652596_tn?1342015226
it was a piece of cake.  they gave me a valium for my anxiety and then they gave me an iv and i was out.  woke up 1/2 later and it was over.  good luck.  belle
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Avatar_f_tn
  Oops, I've got a typo up there in my post, I meant "that I was cirrhotic (which is called Stage 4".
   Also, the biopsy can be a Stage off, lower or higher. And they will also grade the inflammation of your liver, with grades 0~4, just like the stages. I had stage 3 inflammation~
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5979406_tn?1378068301
After reading your posts, it looks as if I am 'good to go' with some courage anyway. Thanks, Lili
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Avatar_f_tn
That's a good thing then~  my personal opinion concerning the biopsy is that the benefits over-power the small risk involved.  
   Knowing what stage you are in is extremely helpful, in terms of making a decision for when you need to Treat your liver disease, and more than ever, currently. Why do I say this? Because just recently, the Medical Field has discovered a whole bunch of different meds (competing companies, developing similar acting meds) termed "2nd generation Direct-Acting Anti-virals,"( or abreviated=DAA's) that directly attack the Hep C virus, where-as, prior to 2011 (when the 1st generation of DAA's were approved, for treating geno 1's, these being Incivek and Victrelis) the only meds available were Interferon and Ribavirin, dubbed SOC Treatment (stood for "standard of Care"). Interferon can cause damage, so the long term plan is to completely phase Interferon out of the new Treatments!
   If you end up having the fortune of getting a biopsy which is at stage 0, 1, or even 2,  then you would have the luxuray of waiting for the FDA to approve these superior meds, and Sofosbuvir is scheduled to approved in Dec.2013. Another med regime has been fast-tracked to be approved in 2014, made by a company called AbtVie, and you can read about this particular Treatment if you type "Aviator Study" into the search engine.
   The whole land-scape of Hep C Treatment is suddenly changing, and there is so much more promise now, for a cure, for everybody.  It is an exciting time, for people with Hep C, and full ofpromise...finally!
   Before now, if you look at other posts from several years ago, people were having to treat with Interferon, sometime for 72 weeks~
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1815939_tn?1377995399
"If you end up having the fortune of getting a biopsy which is at stage 0, 1, or even 2,  then you would have the luxuray of waiting for the FDA to approve these superior meds, and Sofosbuvir is scheduled to approved in Dec.2013."
-----------------------------------------

I don't think I would be telling people with Stage 2 fibrosis that they have the luxury of waiting for the new meds, especially at age 64.

In addition, for people with Genotype 3, which is what LiliChen has, the new Sofosbuvir and Ribavirin treatment has lower SVR rates than the current SOC treatment (Interferon and Ribavirin).

So it is best to use a bit of caution and check the study results before telling people that they should be waiting for newer "superior" meds.

http://www.hivandhepatitis.com/hepatitis-c/hepatitis-c-topics/hcv-treatment/4081-easl-2013-sofosbuvir-ribavirin-cures-most-genotype-2-hepatitis-c-but-genotype-3-response-is-lower
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Avatar_m_tn
One should always keep this in mind when suggesting people can wait. It's not just stage 4 we need to be concerned about. And this comes from one of the "new" drugs we here about.

"Patient response rates to hepatitis C therapy can be variable, depending on factors such as viral genotype and subtype, and liver fibrosis. Patients with genotype 1a, IL28B genotype TT and METAVIR scores of F3 and F4 can be particularly challenging to cure," said Maria Beumont, M.D., medical leader for simeprevir, Janssen. "Janssen is committed to advancing hepatitis C therapy for even the most difficult-to-cure patients."
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Avatar_m_tn
Should add the above comment is for ALL genotypes not just geno 1's
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Avatar_f_tn
   True, Pooh~  I believe the SVR rate for geno 3's with Sofosbuvir is much lower. I am wondering this;  If someone who was a geno 3 did participate in a Study, of one of the new DAA's,  and didn't achieve SVR, couldn't they then go on, to use their Medical Insurance, to Treat with the SOC?
   Also, I did choose to treat, as a Stage 2, because my platelets suddenly dropped below normal, and stayed that way for a half year, while liver enzymes increased from twice as high as norm, to ten times as high.
   I also developed new joint pain, from the Interferon, but  alot of that has cleared up. Of course, if Interferon can be avoided, patients and Doctors would all prefer that course.
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Avatar_m_tn
I always find it strange that it seems that the people here that are NOT cirrhotic seems to think it's fine for those to wait and maybe become cirrhotic, bet you a dozen donuts you wouldn't  change places with us that are. Trust me it's no fun at all, besides that the constant worry we have.
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Avatar_f_tn
  Lilichen mentioned in another post that she is going to Duke, and they also conduct Studies there. I think she is in good shape to Treat, which ever way she decides to do it. But there is no use in jumping ahead, until her Biopsy has been done. For all we know, Can-do, she could be a stage 0. If that was the case, or a stage 1,  then I would think doing a Interferon Free Study would be good.
   It would be rare to go from a stage 1 to a stage 4, in two months wouldn't you agree?  It is the stage 2 that is the tough decision. Like I said, I treated at stage 2, with Interferon,  and would support someone who also wanted to do that. But before I did that, I made two attempts to get into two different Clinical Trials, and each time, I was discluded because my enzymes were too high. I was watching my labs, and when my platelets stayed low, and I got a cirrhotic FibroSure test, I certainly RAN into Triple Treatment.  
  
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Avatar_m_tn
When you say waiting at stage 2 is no problem then I see you have not read what I posted as once one becomes stage 3 or 4 they become harder to treat and that comes from the experts so it's just not me making things up... Now I guess waiting at stage 2 is something you made up, big difference.......... In case you don't remember posting this here it is...."or even 2,  then you would have the luxuray of waiting"

I do agree that one can wait a few months to see if newer treatment hits the market, keep in mind though there are others that read here and for different reasons they might not be able to treat right away with these meds, like say your a genotype 1 and have treated prior.
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Avatar_f_tn
  Yes, then we can agree...Stage 2 is the tough one. A "watchful wait" should be conducted with a Hepatologist involved, checking the labs frequently, while waiting a couple of months, to see if a newmed will be approved, or if a chance at a Clinical Trial (Study) is at all available.
   But certainly, a decision should be made soon, with a Stage 2. I had grade 3 inflammation, and many symptoms besides the platelets at 120 and the elevated liver enzymes. I had itching below the skin in my upper arms, and once the platelets dropped, tons of bleeding all of the sudden, when I flossed, and also horribly painful muscle cramps. All those symptoms are gone, since I Treated, as well as the residual joint pain I had, from the Interferon.
   I am respectful of the burden it must be, on you and other members here, who have to deal with cirrhosis,and as you mentioned in your post above, the constant worry involved.  I think you are very brave, and I like your Can-Do attitude,  If I may inquire, did the cirrhosis sneak up on you, or were there any warning signs?
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Avatar_m_tn
I have had two liver biopsies. I was pretty nervous for both but, of course, everything went fine. Back at home same day with no problems and no pain.  
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5979406_tn?1378068301
I have read and reread all the answering posts to my original question and thank each and every one who responded. I and many others can and do learn and learn and hopefully, can in turn benefit and help others.
Well, as I type this is the 6th of the month and next Thursday 12 Sept. I go to Duke in the morning for my first appointment.
On a side note, since a week ago I have been drinking 3 litres daily of bottled water and juicing with a minimum of 6 different combined vegetables and fruits, varying the combo each time. Altogether I am taking in a lot of clean and non-problematic liquid (e.g., coffee would be considered problematic as we all know).
I am bringing this up because I definitely feel a difference, I feel far better since this regimen.
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1986676_tn?1329866071
For me I was nervous.
In the in it was over quickly.
I didn't have meds.
Don't worry.

Reva

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