Esophageal Verices Warning Again

My friends, I know I brought this up before, but I have a cautionary tale regarding what I'm going through and what you should be aware of. I had an examination for Esophageal Verices about a year and a half ago. The Gastro banded one. A year ago, he repeated the examination and found none.

So on I went with my life as I felt normal. My last ultrasound had a conclusion of "mildly Cirrhotic". This morning, I had another examination for Verices and sure enough, the Gastro found and banded three. He gave me a photo of the stomach where the verices were growing. What I mean by growing is that the blood vessel will start to form a balloon like visual abnormality in a section of the vein. If this balloon were to burst, especially while sleeping, internal bleeding can occur without you knowing it. This is very scary and could cause death.

So in essence, I questioned the doctor today and asked if one does not have Cirrhosis but has Hepatitis C, can one get Esophageal Verices. He said yes. So please be warned. I'm very fortunate that my Gastro who has been treating me for nine years is always on top of this. Is yours? I would strongly recommend asking him even if you do not have Cirrhosis.

The banding is done in a 20-30 minute procedure. The anesthetic used is Propofol. This drug is what supposedly caused Michael Jackson's death because he was given it steadily and not in a normal dosage for his sleep disorder. I had the opportunity to discuss this anesthetic (which looks like milk) and its propensity to cause toxicity to the liver. He replied that even though it is metabolized in the liver, the amount is nothing to worry about. I watched the anesthesiologist inject me with two large syringes of Propofol. I saw the firs one go in intravenously, but was knocked out before the second one was administered.

The next thing I saw was an RN leaning over me in recovery. There is pain to be sure. some from gas, the rest from the banding. You cannot eat meat or bread for three days. I took two Oxycodone 7.5mg pain pills about an hour ago. The pain has been reduced by 50% and is acceptable.

In conclusion, please ask your Gastro regarding this very important examination, of which many Heppies never think about. My Gastro is very proficient and always on guard. He also mentioned that in the latest study he read, Telaprevir has a 50% chance of clearing non-responders like myself. This is a much better percentage than the current 15-20% with traditional drugs. At any rate, I thought I would pass this important information along because the Gastro mentioned EVERYONE who has Hepatitis C should be checked for Verices every 6 months...

Magnum

[Bill1954]

Thanks for the heads up, Magnum; sorry to hear you’re dealing with all this, too. Hopefully, it won’t be too much longer until they can offer you something that you’ll respond to and put this behind you once and for all.

My limited understanding of esophageal varices is that they develop as a result of portal hypertension; this is rather common with cirrhosis, but doesn’t normally occur in those whose livers are staged F0-F3.

I had stage 3-4 fibrosis with some signs of early cirrhosis. At my request, the GI doc performed an EGD at my last colonoscopy, and found trace signs of one varix. I have since achieved SVR and they assume that no further progression will occur.

Good thing they’re watching your back (or in this case your front) and took care of that.

Be well and recover soon—

--Bill

[frijole]

How very good that your doctor is on top of this.  As I have not understood esophogeal varies before, I am grateful for the information.  I hope these PIs open up soon.
frijole

[nygirl7]

Magnum I am so sorry.  We've been through so much in the past years and hearing this is just well heart breaking.

I don't kow anything about it.  Are there signs or things we should look for aside from being late stage? I know nobody ever tested me for this. I know I'm obsessive and paranoid about this disease but......

God you just need a BREAK magnum just one damn break at this point. All my heart is praying for you.

[spectda]

You really have a lot on your shoulders. It seems you've made a lot of friends here over the years. Good luck with everything and I hope you get the drugs you need ASAP-Dave

[copyman]

Hey Mag sorry you are going through this. Hang in there new meds will cure you once and for all.

Are you saying someone with Hep C should be scoped every 6 months? I cannot see insurance companies paying for this procedure to be done that often. Besides, I'm not sure how many people would want to be put under that often. Not sure if you are put to sleep for this procedure?

Anyway hope you feel better soon

[Magnum]

My Gastro is a very thorough doctor who some may see as over cautious, but maybe it's in cases like mine, because he wants to do the test again in three more months and also did a biopsy today to make sure nothing is malignant.

I would rather have a doctor pile on more attention to my problem instead of not enough. As everyone knows, doctors are not all the alike. Some may be more aggressive than others.

I want to thank all that responded for their thoughts and well wishes...

Magnum

[Magnum]

Yes, I was put under, but woke up a mere half hour later. Propofol is a short duration anesthesia. There is a question as to repeating this test for verices every 6 months. Again, my doctor is agessive and determined to cure me. Perhaps other doctors would require the test once a year. Remember, there are no symptoms as to whether or not you have verices.

Magnum  

[HectorSF]

Hi Magnum.

I just want to express how very sorry I am to hear about your latest experience with esophageal varices. I am so glad your doc is on top of this and monitoring you closely.

Thank you for sharing your experience as frightening as it is. Hearing you talk about it, has helped me to better face a banding procedure should I need to. As it is just a matter of time the way my illness is progressing. This disease seems like an endless array of  challenges. Just when we think our health is stable, wham, something happens and reminds us there is no escape from the progression of our liver disease until we rid ourselves of the virus or get a new liver. It also reminds me why I am taking my Nadolol every night.

As you said, there is a high risk that the busting of varices can be fatal. In fact in the last few weeks I meet someone who didn't know he had cirrhosis until he started throwing up blood. Luckily he was able to get a transplant and has been living in good health for a number of years now.

Please take care of yourself, rest up and stay strong mentally. And pat yourself on the back for your courage facing all the challenges this illness has thrown your way.

All the best-
Cheers, my friend!
Hectorsf

[child24angel]

You seem familiar.......
get out of here ...leave.....troll !!!!!

[child24angel]

Magnum,
I"m sure everyone appreciates your valuable input.
Thank you for the update, still pulling for you

[spectda]

a response is what strawberry wants, read his posts. let's not give it to whoever!

[child24angel]

I already did:( darn it !! :(

[banarep]

magnum,

so sorry to hear about the variacies.  going in soon for a look at the other end, i will ask if he can do the top half as well.

hoping you get better.

[jacksb0923]

I have a question. When I finished my trial and was undetected, I asked my hepatologist how I should followup. He said I should have an ultra sound every six months for the rest of my life and a endoscopy as a baseline. My endo was fine. Are you saying I should repeat this every year?(endosc)
I am SVR
Thanks
Barb  

[Bill1954]

Hi Barb—

Do you have cirrhosis? Generally, esophageal varices are limited to cirrhotic patients.

--Bill

[jacksb0923]

I had beginning stage of cirrhosis with my last biopsy.I finished the vertex trial a year ago. Found out I was in the placebo group. I was in the phase 3 trial.

[jacksb0923]

By the way, I loved the propofol. No sides and felt fine right away.

[Bill1954]

Ah; I just saw you achieved SVR too; I don’t know how I missed that earlier. They will probably want to monitor you for primary liver cancer for life with U/S scans and possibly AFP blood testing every six months. It’s hard to imagine you’d require more than an initial endoscopy; once you achieve SVR, you’d think that portal hypertension would begin to subside; that’s what is responsible for causing the varices to begin with. Best to check with the doc, though.

Good luck— it sounds like you’re a winner!

Bill

[merryBe]

my hep guy hasn't mentioned this once, so I'll bring it up this month with him.
I've been kinda reluctant to even ask for another sneak peak after the fiaco in Las Vegas with the endoscopes.

Just curious, have you been on any meds or have other conditions that could have contributed to this...like Nsaids, aspirin, high blood pressure etc. or is it just the hcv doing it?

thanks for the heads up!!

[mikesimon]

It's the result of portal hypertension associated with cirrhosis. The underlying cause of the cirrhosis may be HCV or any other liver disease.

Aspirin may make bleeding more likely as  it may in any disorder where a risk of bleeding exists but I doubt that aspirin contributes to the varices themselves.

Beta blockers are usually the treatment choice for attempting to control esophageal varices. Propanalol is frequently prescribed.

Mike

[Magnum]

I just take the standard Hep C supplements as many other do and when I have an active day, I take a 800mg Ibuprofen and that's it. I think pain pills should be avoided if possible since they are chemicals in essence. The doctor feels that the Cirrhosis has something to do with the verices, but then again everyone is different. Luckily I have a doctor who is very conscientious about this and does timely follow-ups.

I still think everyone should ask their Gastro because Cirrhosis can creep in unknowingly, especially if you haven't had a recent biopsy or even an ultrasound. It's good to have excellent insurance, otherwise I would be in dire straits financially...

Magnum