Aa
Biopsy ? / jmjm & others
i'm scheduled to have a bx in sept. i just found out that my doctor who is going to do it does not use unltasound guided bx. can someone explain what the difference is? is it more dangerous to have it not US guided? please explain the pros & cons. i was told by the docs nurse that if i wanted a "guided" bx then i would have to have a radiologist do the procedure. i'm a nervous wreck as it is about getting a bx and then to hear this about he does the bx "blind". i have been putting bx off until i found out that the FibroSCAN has me between a F1 & F2 and FibroSURE 10 months ago had me at F0! now i want the bx for the real answer. thanks for the help
On a related bx point:
I asked the hepatologist who is running my Prove 1 study for his recommendation on a follow-up bx to determine if my histology was improving after a decent period of SVR. His two-part response was:
- He counsels against bx other than after a confirmed HCV diagnosis and before starting treatment.
- If I really wanted to know, then his advice was to wait at least one year, and preferably two years.
His message was that regression in fibrosis has been observed, but the time rate of change is slow. I guess the compelling point here is "it took 20+ years to get to Stage 3, so don't expect to be back at Stage 1 or better in a year or so".
Anyone have more data on this issue??
I asked the hepatologist who is running my Prove 1 study for his recommendation on a follow-up bx to determine if my histology was improving after a decent period of SVR. His two-part response was:
- He counsels against bx other than after a confirmed HCV diagnosis and before starting treatment.
- If I really wanted to know, then his advice was to wait at least one year, and preferably two years.
His message was that regression in fibrosis has been observed, but the time rate of change is slow. I guess the compelling point here is "it took 20+ years to get to Stage 3, so don't expect to be back at Stage 1 or better in a year or so".
Anyone have more data on this issue??
Copy: is it possible to progress one or two stages in less then a year if labs are normal for the most part?
--------------------------
I would go with Dr. A's opinion, which I believe is that given your stats and testing, that is not the case. Is it *possible* -- I guess anything is possible, but more likely that one or both of the tests were off a little -- and probably the Fibrosure. You didn't answer my question as to whether Dr. A. thought you should treat now or not?
MO: As far as blood drawing or injections I feel a nurse does it much better. every doctor
-----------------
The best injections I ever got were from a doctor but can't remember one every taking blood one way or another. There's a reason I go to Quest for blood draws -- as opposed to a NP -- and that's because in general they do a much better job for the simple reason that they draw blood all day long. I'm certainly not against guided biopsy's, but I say go with the most experienced person and let them do what they are comfortable with.
FL: When it comes to the bx, both he and I know to go to guy with the expereince - the radiologist, in my area.
-------------------------------------
I think that is my point also. Go with the experience. Radiologist in your case.
--------------------------
I would go with Dr. A's opinion, which I believe is that given your stats and testing, that is not the case. Is it *possible* -- I guess anything is possible, but more likely that one or both of the tests were off a little -- and probably the Fibrosure. You didn't answer my question as to whether Dr. A. thought you should treat now or not?
MO: As far as blood drawing or injections I feel a nurse does it much better. every doctor
-----------------
The best injections I ever got were from a doctor but can't remember one every taking blood one way or another. There's a reason I go to Quest for blood draws -- as opposed to a NP -- and that's because in general they do a much better job for the simple reason that they draw blood all day long. I'm certainly not against guided biopsy's, but I say go with the most experienced person and let them do what they are comfortable with.
FL: When it comes to the bx, both he and I know to go to guy with the expereince - the radiologist, in my area.
-------------------------------------
I think that is my point also. Go with the experience. Radiologist in your case.
Radiologists are MD's..
-----------------------------------------------
Well that shows how little I know. I thought they were just under the wire of being a doctor. Thanks for the info.
-----------------------------------------------
Well that shows how little I know. I thought they were just under the wire of being a doctor. Thanks for the info.
Radiologists are MD's.. My tx doc (a GI) is a master with the scopes. He can do a light show with his scopes that would be the envy of the Hayden Planetarium and catch a fly with the tweezer attachement like a Jedi. When it comes to the bx, both he and I know to go to guy with the expereince - the radiologist, in my area.
Dr A did put some weight on the F-sure test but did say it relied on one blood maker to much and sometimes can by off a stage.
-------------------------------------------------------------------------------------------------------------------------------------------
When I went to Dr.A, he told me that my "0" score from fibrosure test was more reliable than a bx. Told me I don't need a bx. Maybe if I was planning a bx and had the scan and the score of HIS scan came out different he would have given me the same answer as he gave you. Or possibly his opinion has changed since I saw him. A bx scares me because there is always risk, but a retired Hep doc told me that he did at least 1,000 or maybe he said 'THOUSANDS -with an 'S' can't remember, but anyhow he said he never once ran into a problem.
As far as not getting a guided bx,,,,,, no way Jose. I don't care what anyone says- thats nuts. I wouldn't let someone cut my hair with a blindfold on even though they cut 100's of people and thats just hair - so why that I would ever let someone take one snip out of my LIVER with a blind fold so to speak??. My question to the doctor would be " okay you don't want to use an Ultra sound,,,,what if you were a doctor in Europe and you took 3 samples - would you then use an Ultra sound or depend only on your nose like a rescue dog or whatever method you use on people (other than your MOMMA - she gets the guided I would GUESS)
Copy - do what YOU feel is best, really. Don't do something if you feel deep down that its not something you want to do. I just don't understand why a doctor wouldn't use an Ultra sound and if I was in your shoes and felt I had to get the ultra sound to feel comfortable, I would let the Radiologist do it. As far as blood drawing or injections I feel a nurse does it much better. every doctor that ever stuck me with a needle hurt me - yet 99% of the times a nurse used a needle - I never felt it.So just because a Radiologist isn't the doctor doesn't mean he is not as good at doing the procedure. He may have done more than the doctor -who knows?
Either way I wish you the best and I hope you feel confident and peace in whatever you decide.
-------------------------------------------------------------------------------------------------------------------------------------------
When I went to Dr.A, he told me that my "0" score from fibrosure test was more reliable than a bx. Told me I don't need a bx. Maybe if I was planning a bx and had the scan and the score of HIS scan came out different he would have given me the same answer as he gave you. Or possibly his opinion has changed since I saw him. A bx scares me because there is always risk, but a retired Hep doc told me that he did at least 1,000 or maybe he said 'THOUSANDS -with an 'S' can't remember, but anyhow he said he never once ran into a problem.
As far as not getting a guided bx,,,,,, no way Jose. I don't care what anyone says- thats nuts. I wouldn't let someone cut my hair with a blindfold on even though they cut 100's of people and thats just hair - so why that I would ever let someone take one snip out of my LIVER with a blind fold so to speak??. My question to the doctor would be " okay you don't want to use an Ultra sound,,,,what if you were a doctor in Europe and you took 3 samples - would you then use an Ultra sound or depend only on your nose like a rescue dog or whatever method you use on people (other than your MOMMA - she gets the guided I would GUESS)
Copy - do what YOU feel is best, really. Don't do something if you feel deep down that its not something you want to do. I just don't understand why a doctor wouldn't use an Ultra sound and if I was in your shoes and felt I had to get the ultra sound to feel comfortable, I would let the Radiologist do it. As far as blood drawing or injections I feel a nurse does it much better. every doctor that ever stuck me with a needle hurt me - yet 99% of the times a nurse used a needle - I never felt it.So just because a Radiologist isn't the doctor doesn't mean he is not as good at doing the procedure. He may have done more than the doctor -who knows?
Either way I wish you the best and I hope you feel confident and peace in whatever you decide.
Have an Answer?
You are reading content posted in the Hepatitis C Community
Learn about this treatable virus.
Getting tested for this viral infection.
3 key steps to getting on treatment.
4 steps to getting on therapy.
What you need to know about Hep C drugs.
How the drugs might affect you.
These tips may up your chances of a cure.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
