Super-fast rise in SGOT etc.

[daledrog]

I am new here, perhaps not sure how to use this forum - I have never been on any forum.  I posted this under someone elses existing question, or post but perhaps I am supposed to start my own question; here it is:
I have had hep C before they had a name for it - mid 70's they told me I had non-A non-B hepatitis. But I have always had tests just a few points above hi-normal -- for 30 years. Then 4 months ago I had 137 and last week around 500. I have had two biopsys in the past, 6 years ago it was normal and then 8 months ago there was very little damage -- not enough to call it a level anything. So now all of the sudden 137 and then 500. Any thoughts of this type of progression and what is in store?  I am seeing an MD in a few days and then will likely ask for a referral to a specialist.  I had seen a specialist for the biopsys - but was not comfortable with him.

[Kalio1]

That is great about not drinking, joi the club.....soda drikers that is.
I hope you saw Willow's post up in a higher thread about her doctor in the Seattle area, he sounds like he knows his stuff.

[daledrog]

just a thought -- anyone in the Seattle area that might be able to reccomend a good liver doctor -- or a place to find an excellent doctor?  thanks

[daledrog]

beagle and ny thanks for info.  I did drink - always knew I should not, but 30 years of blood levels staying normal just let me ignore it.  When I came back with the 135 range it concerned me but I figured maybe a fluke - now with one level arond 400 and the other around 500 (not sure which -  sgot etc) I figure it will stop the drinking in it's tracks.  Can't say for sure but don't think I will ever drink again - but after nearly 40 years of drinking who knows.  I was drinking 6 to 7 days a week around 12 beers a day - unfortunatley it did not have extreme adverse affects - no losing a job, no kicking the dog, no hangovers - no dwi's so no "slap in the face" reason to quit. -- but now there is.  BUT i am hoping some folks here have some experience with these kinds of levels and where things went from there???????????????  And if you can please tell me what tx and sx mean when used here.  Thanks so much, dale

[Penelope1911]

Here is a short list of abbreviations from a post awhile ago. Someone will add more if there are any missing. Welcome to this forum! And I hope you recieve the answers you are looking for about Hep C! Again, WELCOME!

PCR: polymerase chain reaction(viral count)this test we some times get at the 4 wk,12wk and 24wk during treatment to see how or if our viral load has gone down.
Tx: treatment
SX: side effects
BX: biopsy
HX: history
VL: viral load
EVR: early viral response
RVR: rapid viral response
SVR: This is what we all want = sustained viral response
AST & ALT: liver enzyme
WBC: white blood count

[Kalio1]

Welcome to the forum. It's confusing at first to figure out this board I had the same probem at first. You can post either in an opened thread like you did originally or open a thread. As you found out sometimes if you post in an open thread it gets missed so this way it is more likely to be seen but we are suppossed to limit how many new posts we open.

Have you added something new in the last 6 or 8 months to your diet? Did you start taking supplements or some other substance? DId you add a medication? Do you drink any alcohol? change foods in some way? It could be it's the virus acting up or something else going on. I wouldn't necessarily see it as a progression at this point, I'd definately get a doctor you are comfortable with who is saavy with Hep C if you can. Get some current testing done and go from there. I know when you have Hep C it is easy to blame everything on it and it might be the cause of the spike in enzymes but it could be some other factor too.

[daledrog]

(oh - and first thanks for the abbreviations) First -- that's funny revenire.  Second, thanks kalio -- above I described drinking -- just got the call yesterday on my 500 plus blood test so all new for the moment.  I quit drinking on the news and think I will never drink again -- but like I say - being an alcholic for 30 -35 years it may be hard.  No changes in life in the past 6 months or so -- drinking has very slowly progressed but it was not new, or no new extra drinking.  I don't take anything as far as meds or supplements so other than the drinking I don't know of anything that would cause this hughe jump in my numbers.  I also found out a couple of years ago that they now have divided Hep C into 3 different types (I think 3) and I have the one with the worst response to treatment.  I picked up C when I was 20 or 21 with drug use - now 54.  Only had a little jaundice for a few weeks back then.  Then when in the navy in the mid to late-seventies I was fatigued and they did a biopsy and told me I had non-A non-B hep, of course later identified as C.  But that was the end of any symptoms, AND NOW I have no symptoms -- no fatigue, no jaundice - nothing.  The nurse called me yesterday with the bad results (my appointment with that MD is Friday) becasue the MD thought I would not be feeling well  - so is that odd that I have no phyisical problems with blood levels in the 500 range?

[jmjm530]

Just to reinterate, elevated enzymes do not equate to liver damage in any point of time, nor do they equate to liver function -- in fact, liver "function" tests are a misnomber. A good hepatologist should be able to put everything in perspective for you because unfortunatly most GP's, and many GI's, just don't have the training  and experience for the kind of answers you will be seeking.

-- Jim

[NYgirl]

I agree with Mr. Beagle Bailey 100%.  Since you didn't have much damage when you had your last biopsy - it sounds like something is going on now that IS killing the cells in your liver.

That is the reason your liver enzymes rise you know - as the cells die they release the enzyme.  so you should have this checked out.

I don't know how to verbalize this well but Cuteus does - just because your last biopsy didn't show much damage doesn't mean that NOW you haven't progressed.  Liver damage can go on for a long time with nothing happening and then just JUMP all of a sudden.

Something is killing your liver - and the HepC sure isn't helping at all.

If you are drinking that is probably a good cause - alcohol and us heppers dont' mix at all so I'd stop if I was you.

But either way - please get it checked out asap.

[jmjm530]

Your story is similar to mine. Geno 1, acute stage (jaundice), infected more than 30 years ago. Although it may not appear that way, you have a lot going for you except the sticky geno 1, b ut then again most of us have that genotype.

Being having an acute infection (jaundice, etc) and being infected at a relatively young age are both positive factors in terms of how fast/slow your liver disease will progress and also in terms of treatment response, although not 100% sure on the latter. The fact that you still have minimal liver damage seems to bear this out. (In my case I've had Hep C for 36 years and was probably between stage 2 and 3 when I started treatment which is considered "moderate" damage.)

As to your elevated enzymes, changes in ALT and AST are not linear. In other words "500" is not twice as bad as "250", in fact some doctors don't pay much attention to enzyme changes once a certain threshold is reached. Still -- especially in your case -- you want to see a liver specialist (hepatologist) to go over your file and who has the training and experience to understand the subtle nuances your case seems to present. Keep in mind, that like people here, some hepatologists are more pro treatment than others and in the end you're the one who should be calling the shots here.

Back to the enzymes, I also had a flare in enzymes a couple of years before I treated and best guess is that this happened either because of some Chinese herbs, the Hep B vaccine, or a combination. Others have reported similar flares that may have been caused by too much exercise. In my case the flare lasted several months and enzymes did return back to baseline which like yourself, was slightly elevated. The point here, I guess, is not to jump to any conclusions that your liver right now is being damaged because of what may be a temporary enzyme spike. At least that is what my doctor told me.

All the best luck moving forward, and again, try not to worry. Your stats are very encouraging for someone who has Hep C.

-- Jim

[Kalio1]

Sorry I missed the part about alcohol. My mind functions on about half power nowadays. I thinnk maybe you just reached a "tipping point" where the booze cant be handled any more. I know my sis in law had super high enzymes and it turned out to be a clogged bile duct i her liver and they fixed it. You wont know until the doc evaluates it but stopping alcohol is really a MUST at this point. This is a HUGE red flag. You know alcohol is like pourihng jet fuel on the Hep C fire and with something shooting those enzymes up it is critical you avoid alcohol at all costs but you know that. You know there is help available, the hard part is availing yourself of it! Hang in there.

[daledrog]

thanks for the help - sure helps out to get info from people in the same boat.  thanks

[NYgirl]

In the olden days I would have challenged you to a drink off but now that I know what is what with my liver = I've been forced to stop ahhhh.  All that practicing for nothing!  ;)

Seriously, with all of the addictions that I used to have it's a miracle I was only diagnosed at stage 3.  I know how lucky I was the day it was discovered cause I would have continued to party myself into a very early grave.

Since you've known you have this since it was non-A, non-B you are sort of lucky because you get rid of the shock affect that just seems to destroy some people.  I'd say it's time for you to check out what is going on.  You might still be lucky and not killed off too much of your liver. If that is the case = at least you know and can decide one way or the other and have peace.

Treatment isn't any fun for sure (and we LOVE to whine about it so I am sure it sounds even worse) but it IS doable for most of us.  I've been working fulltime for the past 50 weeks I've been on treatment and I am going for a full 72 weeks to make sure this sucker is gone for good!  

I wish you the best and hope you get started, asap.  It's just too easy to put it off. Make an appt NOW so you are locked in. Those liver enzymes are really high so SOMETHING is up for sure.

[Kalio1]

Hey Dale, I believe Willow is in that area and she speaks highly of the doctor she recently began working with. Aso I thik James is i the area too so maybe his doctor is takig patients. I put their names in the title in the hopes she/he will see it and pass the names onto you. Keep in mind most doctors will not treat you at all if you are drinking. Many require you to be clean and sober for at least 6 months prior to treating if you have a history of a problem with alcohol. Drinking is couterproductive (and counterintuitive) to treating. You might be able to start sooner if you stop drinking but you can not drink on treatment at all and you really really should not drink if you are  Hep C positive. I am not trying to nag, but your health and life are worth the effort to put down. You can do it! I remember that day I found out and realized no more cocktail parties and I worried it wouldnt be easy but it really was so suprisingly easy to do, much easier to do than it was to think about doing it.

[daledrog]

thanks for the info  -- no more drinking for me -- i always have to add that who knows -- 35 years of drinking ???? but thanks  i have quit and will stay off

[Mister beagle bailey]

Welcome and yes you need to see a specialist for hep c.  It would appear that the virus is taking hold now but there are many things that cn make your AST and ALT rise, so it needs to be checked out first.  First see what your dr has to say and if you didn't like the dr that did your biopsy, then find one that you feel comfortable with.  Try not to worry and  let us know how you make out.

Beagle