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Liver Transplantation - Past Present & Future Play doctor with HCV/diabetes patient Play doctor with Geno 1 + advanced fibrosis Are Black Patients With HCV Less Likely to Respond to TX Animation of Hep C Life Cycle I hope the links work. You must be registered at Medscape and ClinicalCareOptions but they're both free and easy. Mike

mikesimon · Answer

I'm sorry that I didn't respond. I got wrapped up in the transplant material and some real work too. I did well as a doc myself on both of my patients. Since you seem a bit compulsive like I tend to be I want to urge you to see the animation link on the life cycle of HCV if you haven't already. It's makes tangible the complex cycle of the virus. I found it a very good presentation. So take a look if you haven't. I hope all is well with you G/O. Mike

mikesimon · Answer

You'll need to copy and paste Foreseegood. Sorry.
News from the AMA:
U.S. Liver Transplant Programs Accept Patients With History of Alcoholism, Drug Addiction 

http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZSKPTMOJC&sub_cat=627

Mike

GrandOak · Answer

I played doctor with HCV/Diabetes patient and made optimal choices through quiz and SVR'ed the patient the first run through!

Now, if I could only do that on myself <G>

mikesimon · Answer

U.S. Liver Transplant Programs Accept Patients With History of Alcoholism, Drug Addiction Try again. Mike

mikesimon · Answer

Survival and risk of recidivism in methadone-dependent patients undergoing liver transplantation A matched comparison study of medical and psychiatric complications and anesthesia and analgesia requirements in methadone-maintained liver transplant recipients Liver transplantation for patients on methadone maintenance Methadone maintenance and chronic opioid analgesia in liver transplantation/Ethical/legal/financial considerations U.S.Liver Transplant Programs Accept Patients With History of Alcoholism, Drug Addiction Again, I hope the links work, Mike

friole · Answer

No haven't looked at the life cycle of the hep C virus -- hope I have time tonight.  Be well

forsee - so glad you have stepped in to help our sis again in her time of need.  I remember your posts of bringing your sister home and how she got so much better  - better than the doctors thought possible.  Remember tho, you can only to so much.  TAke care of yourself too

kathy

mikesimon · Answer

Here is an article on Methadone a liver transplant. It was co-authored by the shrink at my center - Andrea Di Martini
http://www.blackwell-synergy.com/doi/pdf/10.1046/j.1600-6143.2003.00217.x#search=%22methadone%20liver%20transplant%22
another article on methadone/Tp
http://hepcassoc.org/news/article55.html 

It appears that some centers till have policies that preclude methadone patients from transplantation. I hope that you find one that is beyond that.
Mike

Forseegood · Answer

Tracy: so good to see you, hope youre feeling better then the last we spoke...just my opinion (and God knows I'm full of em!) I'd get in touch with the younger sis...even when mine was in full bloom of using heroin and drinking, etc...I tried to at least keep a line of contact open, and let her know I was open to talk and that I wouldn't lecture her (boy, is that hard for me!!!) or give advice unless she asked for it...only tell her I cared for her, and that I loved her...no one was a bigger addict then my sister, she had no bottom, and yet she is still here, albeit in not the best of shape, she is still here asking me for more and more Ramones CD's, ha ha! 

Miracles can happen if youre just open to them, what I did is hope for the best, and I tried not to be too blown out if the worst did happen, and it served me well...best of luck with that...let us know what happens...

Mike: this stuff is really great for my needs, I figure if I can take some of this stuff with me, I can discuss these issues with the docs, and see if there's any chance they can tailor their policies to my sis a little bit...though I think since we're in California, they might be more liberal, but you never know...she does have the fact that she's been not drinking alcohol for 3 years now, which I figure can only help...I'm just hoping that she's well enough to handle the operation...though I know some other people from other boards, etc. that seemed more ill then she, you just never know I guess, we can only try...thanks soooo much!! Hope something lucky and good happens to you real soon... those Mitzvah's tend to bring good Karma, ha ha!

amirtracy · Answer

Hi there. I just wanted to tell you that i'm thinking of you and your sister. she's lucky to have you. my younger sister is hcv positive and has been an addict for 20 years. i don't know what king of shape she's in. she's been homeless and MIA and we haven't spoken in a long time, years in fact. I think i'll try to find her and tell her I love her. i'm wishing you the best.   tracy

amirtracy · Answer

Thanks for being so kind to me. I am feeling better. comes and goes but the procrits helping -(thankyoucuteus)- 
i think i'll take your advice too. i won't lecture her. i really don't have any room to talk just think i'm better 'cuz i cleaned up my act? i guess there aren't really levels are there? anyway, your sister's lucky to have you. i wish the best for you both.

Forseegood · Answer

I know exactly what you mean and I have to check myself for that continually...thanks...

mikesimon · Answer

I agree - you've got to be informed to get through this stuff and your Sister is fortunate to have you there to help. I wish you both good luck. Mike

Forseegood · Answer

Hey, thanks Mike Simon! Oddly enough, I've been consumed lately with her issues as far as docs, hospitals, clinics the whole shootin match...this stuff comes in really handy...funny how these pros pay more attention to you if you come in with some knowledge...some of them say, "oh, you've been researching huh?" and seem glad that youre taking such an interest, and of course, there are those who seem to be annoyed by the fact...but all I know is you are waaaay better off knowing what's going on...

(and having many knowlegable people at these sites to help one another is so great for us) thanks so much for this, hope you have a great weekend! Youve done me a real Mitzvah here...

honey11 · Answer

Thanks for the great links Mike!  I agree,,Medscape is well worth the visit and sign up!

mikesimon · Answer

Thanks. I'm hooked too. I think those pretend doctor tests show us how much we've learned about this disease and, when you consider that they're geared towards doctors, it's impressive that we patients do well. Did you view tha animation on the life cycle? I found that really helpful in understanding the virus. Stay well. Mike

friole · Answer

I did part of the quiz on the hepatitis C/ depressed patient this morning before work. What was interesting was when I made the wrong choice, instead of just saying "wrong,"   they offer new choices to get out of the situation you put yourself in. (for example the patient suffered from depression in the past and one of the choices was to begin with antidepresents prior to treatment.  I chose that one, and the patient started having bad episodes.  The solution (another set of multiple choice answers) was to take him off the ADs and monitor but not to reduce the hep C meds). I truly wish some of the doctors were tied into MedScape Clinical CAre Options -- they might learn something.

Mike you got me hooked on this sight and they email with new hepC updates and they are great.  Not just articles but learning modules for doctors.
frijole

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