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How to tell my dr. about my hep-c?
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How to tell my dr. about my hep-c?

Hello, I have hep-c, but I think I have been living in denial about it for some time now.  I was diagnosed with it when I was around 23; I will be 32 in July.   I have been thinking about it a lot lately, but I have a bit of a dilemma.  
When I was first diagnosed with it, I had insurance, but decided not to go with treatment.  There were a few years in between that I did not have insurance, but I do now.  I now live in another state and my current doctor (and insurance company) does not know that I have it.  
I have been having a lot of neck and back pain, so I have been taking a ton of Advil or Tylenol.  I am really starting to worry about this.  I had an MRI on my upper neck and there is a bone spur on it.  My doctor had given me a prescription for 30 vicodin to last for a month, but now he wants to put me on tramadol because he said they don’t prescribe narcotics for bone spurs.  My neck and upper back really hurt though.  When I take tramadol, I have to take three or four at a time.  I am starting to wonder if my pain is caused from hep-c?  Is that even possible?  
I don’t know how to go about this now.  Should I inform my doctor or just get a new doctor and start fresh?  Or does anyone else have any other suggestions.  Just an FYI: even though I have not been upfront with my doctor, anytime I have gone somewhere (i.e. dentist) I have always told them; I never have tried to put someone at risk.  Also, I hardly ever drink alcohol, the last time I had an alcoholic drink was around Christmas time.
Thanks for any help/advise you can give me.
18 Comments Post a Comment
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Avatar_f_tn
I'm not quite clear why you don't want to tell your doctor.  He probably has alot of patients with Hep C, it's not that shocking for them.  

I've had my doctor for many years,15 or 20 yrs maybe.  I just found out about the Hep C in November,  He was really nice about it, helped me get into my hep C doc quickly, ran some extra test for me so I would be more prepared before I saw the Hep C doc.
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2159080_tn?1336794002
lindsey i don't think that hep c has anything to do with neck spurs however i think that you should be up front with your dr and tell him that you have hep c and let him retest you.also you can get headaches and muscle and joint pain from hep c.and as for tramadol it doesn't work for anything when you are in pain have your dr prescribe you loritabs if you are not allergic.However i am not a dr just thought that i could help in some way.
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Avatar_f_tn
Well, I don't know why I didn't say anythink at first either.  Now, I feel like it's been so long (about 9 months) that I have been seeing him that now I just feel like I have been lying to him or something.
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Avatar_f_tn
Thanks Sherri,
Is that kind of pain normal for hep c, or is it not related?  What are loritabs?  Is it better to take that, than tylenol?
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1815939_tn?1377995399
Vicodan and Lortab are the same thing, just different brand name.

Generic Name: acetaminophen and hydrocodone (a SEET a MIN oh fen and hye droe KOE done)
Brand Names: Anexsia, Co-Gesic, Hycet, Liquicet, Lorcet, Lorcet Plus, Lortab, Maxidone, Norco, Polygesic, Stagesic, Vicodin, Xodol, Zamicet, Zolvit, Zydone

http://www.drugs.com/lortab.html
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766573_tn?1365170066
HCV is asymptomatic and it's unlikely you are experiencing pain as a result.

If you like the doctor and don't want to find another one then I think the first sentence you wrote in your post is what you should say. It is sincere, pragmatic and to the point.

I think people understand illness and denial and it really sounds like you have been in denial. I realize you have been open with other doctors but something is different with the doctor you are seeing now or maybe it is the stage you are in life. I


"I have hep-c, but I think I have been living in denial about it for some time now.  I was diagnosed with 9 years ago and I have been thinking about it a lot lately. It hasn't seemed real. I was hoping you could run a recent test to confirm I still have it and if I do, what my viral load and Genotype is"



*What with having the virus for 9 years or so tyou may want to eventually know the stage of fibrosis you are in. Just because the disease is largely without symptoms does not necessarily mean it is not progressing.
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163305_tn?1333672171
Your doctor needs to know about all or any conditions you have so as to accurately prescribe medications for you.You don't want to harm your liver.

I agree with Idyllic. If you like your doctor, tell him or her.
If you don't want to admit the truth, just say, you forgot to mention it.
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Avatar_f_tn
Thanks everyone.  I think in the next couple of weeks I am going to change doctors and be upfront with the new one.
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Avatar_f_tn
Not sure how old you are, but you can tell your current doc  you read that the CDC has suggested that all baby boomers get tested for Hep C and you want to get tested for it.  Just start from the beginning.
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Avatar_m_tn
(HCV is asymptomatic)

      I am not sure that this is supported by current medical research.
Some years ago that was the thinking in the medical community however as far back as 2002 it became clearer that HCV in patients did produce symptoms that could not be attributed to any other conditions.
      I was diagnosed in 2003 and went on with my merry life assuming
that if I showed no symptoms I was just fine. All of a sudden in 2006 I suddenly came down with major fatigue and low grade fever that I thought was the flu, the fever got better but the fatigue was enough to make me unable to do my job. With confirmation from the Center for liver dieases at
the University of Miami and Dr. Schiff it was determined I was symptomatic
with stage 2 and 38 million viral load. Could these symptoms be from knowing I had Hep c and therefore mental in origine, Possible but unlikely as I had not given it much thought or done any real research when I was diagnosed. However symptoms can and do originate both mentally which can cause a physical response being pain and also originate from a purely Physical origine.

Below is an interesting article from the HCV advocate that was written in late 2002.

lindsey:
  
  On a personal note, It is not likely the pain in your neck can be a symptom of HCV, you said bone spurs,, Yes I was recently diagnosed with
bone spurs and osteoartharitis (excuse my spelling) and a couple of months
ago prescribed Tramadol as well which did help but I developed a buzzing
in my ears and stopped the med, I just take presciption strength Ibuprofen ,
which gives limited relief. So I think surgery is an option but not without risk.
Myself I will not let anyone operate on my neck due to the risk.

     As for HEP C, there is no shame in having this disease, by all means
discuss it with a qualified DR. as to treatment options.
                     Good Luck

here is the link for the article which I found interesting,

  

www.hcvadvocate.org/hepatitis/hepC/symptoms.html

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Avatar_m_tn
Your neck pain most likely not from the HCV but it is possible. Joint pain and fatigue are the most common symptoms of HCV.
Agree with the others that it is important to have your doctor on-board with the HCV. Once you let a doctor know he can monitor blood work for any changes in LFT's, etc.

Since you posted you now have insurance now is a good time to treat with the new drugs. I would consult with a Hepatologist (liver specialist) for a plan moving forward.

Best of luck
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1840891_tn?1383280315
I agree with the others that your doctor needs to know about this, and pronto. Reading between the lines, I also picked up on another issue that no one else has commented on: the insurance coverage issue. How did you acquire your current insurance? If it was through a big employer and one with no limitations on pre-existing conditions, then you are in fine shape. However, if it is one you applied for individually or got through some small group, then you'd better read all the fine print about pre-existing conditions. If they might refuse coverage for a pre-existing condition, or cancel your insurance entirely because you omitted information on your application, then you'll need to think things through very carefully before proceeding.

I've got a long history of serious spinal problems and severe chronic pain, and actually acquired my HCV from a transfusion during spinal surgery in 1984. I started having serious joint pain rotating through various body parts about 2 years later and was diagnosed with non-A/non-B hep that year, which was refined to a diagnosis of HCV as soon as the test was available. I've had to use a lot of pain meds over the years, for a long time using OxyContin as my primary relief, with Vicodin for breakthrough pain. My hepatologist has given his okay for no more than 4 Vicodin tablets per day, due to the acetominophen in it. Once my liver disease progressed to cirrhosis I decided to quit taking the Vicodin and got my spine doctor to prescribe narcotic pain meds that don't contain any acetominophen. Taking any meds without the prescribing physician knowing about your liver disease can be dangerous though, so be cautious with what you take andget your doctor on board ASAP. Best wishes!
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408795_tn?1324939275
Just tell the dude!  You haven't done anything wrong except maybe you were ashamed or whatever but so what?  Now you're not and you need to tell your doctor.  If you like the doctor and if you think he really knows what he's doing then stay with him.  If not, get a new one.  Lastly, take it easy on the vicodin as all opiates cause your body to replicate the virus and it may not be a good thing to do long term or at all.  good luck!  

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1603777/
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1394098_tn?1385963734
I don't think you can say that Hep C is completely asymptomatic for everyone. I had symptoms and that's why I went to the Dr. I had no idea what was making me feel bad. The fatigue was the worst thing. I know you are trying to be encouraging, but the truth is that some ppl find out they have this because they have symptoms. I've talked to several ppl on this forum in the past that were complaining about symptoms but had not started tx yet. Sorry if I sound cranky. I'm on week 43 of tx and I feel rotten. I should probably get off the forum for now. Everything irriates me right now. Sorry
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Avatar_m_tn
I was diagnosed a year ago, my mother had it. She went through the treatment and she believe it went dormant and I believe it eventually attributed to her suicide 3 years ago, I found her and was diagnosed with PTSD, I suffer from chronic depression as well as chronic back pain. Now I am indigent and couch surfing. I have county health care and they do not cover and pain killers that do not contain Tylenol. I know this is very bad for my liver but in pain I have no quality of life, there is a prior authorization to get and updated MRI as well as non formulary meds, but my doctors officer is not willing to work to save my life, also I am in South Florida and anyone aware of the epidemic down here would know they have now made it impossible to find narcotic pain meds. so I feel that between the doctor not doing their job the insurance not caring for the indigent and the pharmacies discriminating something very illegal is going on. I am not chasing a dragon. I am trying to live a normal life and they are all making it impossible to get decent health care,. Yes I can find another doctor and will after December cause this quack is not going to take my insurance anymore, but am fearful that the next doctor will not give me the medications I need with what seems like a triple diagnosis. Is this Illegal? Who can I contact? Does anyone know of anywhere I can reach out or have suggestions?? It would help a lot
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1840891_tn?1383280315
Welcome! Your question seems complex and it would be much better if you created a new post with this instead of tacking it into a pre-existing one. Just go to the top of the page a click on the orange "Post a Question" button. Many more people will respond to a new question. You can copy what you already wrote and paste it into the new question, but it would be best to add some additional information, including what you know about your exact diagnosis: if you have Hepatitis C, what is the genotype and what other tests have been performed. Have you had a liver biopsy yet, and what were those results? Have you ever treated your Hepatitis C? What are the pain meds for and what exactly are you being given? Tylenol is perfectly okay for Hepatitis C patients as long as the dosage (totaled from all the different meds that contain any of it) is limited to 2,000mg per day. It's a very common fallacy that Tylenol is dangerous, because overdosage of it is extremely toxic to the liver, but up to 2,000mg per day is very safe, and is the only over the counter pain med allowed to patients with serious liver disease.

I'll look forward to seeing your new post!
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568322_tn?1370169040
Hep C CAN cause degenerative joint disease because it causes chronic inflammation.  Here's something on the topic...

http://www.ncbi.nlm.nih.gov/pubmed/22378270

As for telling your doctor, you may want to consider that if you tell him when you were diagnosed he will write it in your chart and your insurance company will consider it a pre-existing diagnosis and may not cover treatment if you ever want to treat.  I would just say you want to be tested and take it from there.

Co
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Avatar_m_tn
I agree HCV is not asymptomatic, yes many people go years and don't know they have it but the virus is causing an immune response as in inflammation of the liver, what happens when one is subject to chronic inflammation? it can cause other things to go out of whack, even if the symptoms are mild, some even attribute them to "getting older" I know I did. If one wants to study about a body suffering from chronic inflammation you will see all the other things, this affects and you will say hey...I have that! I have this! its an eye opener!
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