Just diagnosed and confused

Hi,
About a month ago I tried to quit smoking with Nicoderm patch which within one hour almost paralyzed my left leg. Went to gp he had never heard of it. He took a blood sample and removed patch. Pain went away. Blood test came back elevated alt/ast 97/91 . Did liver work up come back positive HCV with a viral load only 14,000 Cat scan shows everything looking normal no abnormalities. My question is I have biopsy sheduled on 4/11 but can't see liver specialist till 4/23. My GP suggest waiting to see liver specialist before biopsy. If I cancel the biopsy it will be another for an appointment what would you do wait for liver specialist or do biopsy? I just don't know what to do.
          thanks for listening

[FlGuy]

Who scheduled the cat scan and the biopsy? Personally, I'd wait for the liver guy before going further.  And, just because you're seeing the doc does not necessarily mean he's the right one.  You should use the opportunity on 4/23 to interview the liver guy to see if he has enough expereince and knowledge to throw in with him.  A few questions you might ask; your geno type, his experience in treating hcv patients, whether it's a small part of his practice or a significant slice, his personal expereince in tailoring treatment or if he just flips the page open to 'what to do if a pateint shows up with hcv' and most important how many questions he answers as 'I don't know' or if he says 'I think the liver is somewher near the back or side but I know for sure it's pretty big and should be easy to find'

[Bill1954]

If you have been formally diagnosed with HCV, by all means, do the biopsy first. You can take the results to the specialist, and it will help him determine whether treatment is necessary at this time. I can’t imagine why the primary care doctor would ask you to wait; but perhaps I’m missing part of the picture here.

The MRI is an excellent tool for ruling out liver cancer, hemangiomas, etc, and can usually detect advanced cirrhosis but doesn’t tell us much regarding the middle stages fo fibrosis; nevertheless, it’s nice to know that nothing else has developed. The biopsy remains the gold standard for measuring fibrosis in liver disease.

To learn a little more about this process, take a look at ‘Janis and Friends’:

http://janis7hepc.com/’

By opening the section ‘other HCV information’ in the right-hand margin, you can look at ‘biopsy results’ to get a better understanding of how they stage and grade the results. Here’s the URL for the section:

http://janis7hepc.com/biopsy.htm

Good luck, and welcome to the discussion group!

Bill

[Bill1954]

LOL, as you can see, you’ll get varying opinions here :o). Hopefully, others will chime in and you can arrive at a consensus.

[rmc1123]

Thanks for the comments, my gp scheduled the cat scan and biopsy to try and have all test complete for the liver doc. I did a lot of research looking to make sure he had a lot of experience in hcv he is listed nationaly as one of the best in this area by Hepatitis C Information Central with great reviews and doesn't hand you of to a pa he sees you through everything. Here's a comment left about him.
He asks us a lot of questions, he answers any questions that we may have.
Anything that my husband needs he tries to get it for him.
They fax us his blood results etc.
I share any internet findings with their office,
especially regarding Vietnam Vets.

[FlGuy]

As Bill states, you can get varying opinions here and most will have validity.  It's one of the perplexing things about hcv, it's a little grayer than black and white.  Although I believe that a biopsy is a very important part of diagnosis and treament plannt (if it gets that far) the need for a biopsy can be negated, possibly.  When you and the doc get together it's possible that you might be able to, with some degree of certainty, the point of infection.  With surety and recency of infection you could conceiveably avoid it.  Probably not, but possibly.  Due to some of my own missteps along the way over the years I've also taken the 'ponderously slow and deliberate' approach to fact finding and decision making.  Not that anyone is suggesting rushing the process, but I happen to be a belt AND suspenders guy.

[rmc1123]

Since I posted my first question in April I have had a biopsy and seen by a hepatologist. The biopsy came back geno 1A very mild fibrosis stage 0/1 grade 1 viral load dropped to 9000 from 14000 ast and alt both in the 60's all other blood work is normal. The hep doc has advised me to not treat at this time because of my age and with new treatments that will be available with a shorter treatment time hopefully. Doc wants to do blood work every six months with another biopsy in about a year unless I start having problems. The only symptom I have now is fatigue. I spoke with my GP last week about if he thought a second opinion would be worth it, he didn't think it would but had no problem refering me to the U of W. I have been reading this site and others daily. Sure would like to hear what others think.
       thanks to all

[Gatrldy]

I just stated treatment 4 days ago. The worst day was when I took the shot and meds. But now I think it is the pills. I am sore all over, exhusted and no appetite. Does this get better with time??

[susan400]

I answered you over on the email side, okay?  I'll call you later. Keep your faith and keep your chin up and all of those things!  You can do this!  :)       Susan400