Aa
eligibility for treatment
the Dr. I'm seeing says I'm not a candidate for treatment for the hep c , and he also says I have Cirrhosis of the the liver. When I confronted him on how he knew this without a liver bio being done, he said because of the varicose veins on my esophagus and the angina
As long as you have not had a transplant, the Mayo Clinic may help you in Phoenix, but we just had a HORRIBLE experience with them there. Just saying . . . It was a huge let down and I really don't want anyone else to experience what we did. It was so difficult and depressing . . .
Your doctor may have diagnosed you correct but as so many have said ONLY a hepatologist can assess the degree of liver damage and tell you what options are available to you.
As Bill said seek care at liver transplant center near you. These are the only doctors that are qualified to manage patients with cirrhosis. They do it every day.
Cirrhosis is divided into three separate classes. Child-Pugh Classes A -C. Depending on what class off liver damage will determine your options including if your liver is still healthy enough for you to try hepatitis C treatment. Also the more extensive your liver disease is the harder it is to clear the hep C virus.
A correction on the term you are using.
The complication you have from your cirrhosis is "esophageal varices". they are dilated veins in the lower part of the esophagus or in the upper section of the stomach. Not "varicose veins". Varicose veins is pooling of blood in the legs.
Angina is not a complication of symptom of cirrhosis so I am not sure what your doctor is talking about. Maybe he meant something else?
The main thing is to get a good hepatologist and they will work with you to keep you healthy as long as possible.
That is all that can be deduced from your anecdotal story.
Good luck to you!
Hector
As Bill said seek care at liver transplant center near you. These are the only doctors that are qualified to manage patients with cirrhosis. They do it every day.
Cirrhosis is divided into three separate classes. Child-Pugh Classes A -C. Depending on what class off liver damage will determine your options including if your liver is still healthy enough for you to try hepatitis C treatment. Also the more extensive your liver disease is the harder it is to clear the hep C virus.
A correction on the term you are using.
The complication you have from your cirrhosis is "esophageal varices". they are dilated veins in the lower part of the esophagus or in the upper section of the stomach. Not "varicose veins". Varicose veins is pooling of blood in the legs.
Angina is not a complication of symptom of cirrhosis so I am not sure what your doctor is talking about. Maybe he meant something else?
The main thing is to get a good hepatologist and they will work with you to keep you healthy as long as possible.
That is all that can be deduced from your anecdotal story.
Good luck to you!
Hector
I'm 6 months plus into triple tx (presently Interferon/Ribo, previously including Incivek) and I became undetectable at around 10 days. I have cirrhosis and varices and was supported by my experienced hepatologist 100 %.......My professional background includes many years of hospice interventions (some cirrhosis-ESLD related). Take advantage of today while you have it: Please seek the wisdom and discrimination of a hepatologist: If you require more than lab and symptom reading to ascertain your cirrhosis you can request an MRI (always choose one with the most sophisticated magnets) with contrast: The radiologist in consultation with your hepatologist will interpret what is visualized (complete with splenic measurements) and you will live with less of a question mark....My best. d
There probably isn’t really any good reason to perform biopsy at this juncture; frank cirrhosis can be readily identified by symptoms such as varices, ascites, portal hypertension, etc. Additionally, biochemical markers such as serum albumin, platelets, bilirubin and PTT/INR are diagnostic of severe liver disease. Furthermore, needle biopsy can be problematic with cirrhosis; low platelets can affect coagulopathy, preventing clotting as a result of trauma or invasive procedures.
Decompensated cirrhosis has traditionally prevented HCV therapy; interferon can exacerbate this condition and can increase morbidity/mortality rates. However, some doctors are apparently now cautiously treating select patients with careful monitoring.
As mentioned above you’ll want to be involved with a knowledgeable and qualified MD; a large, teaching institution preferably associated with a university medical center might be preferable.
Have you discussed MELD (Model End stage Liver Disease) score with your doctor? This might give you some idea as to the progression of your liver disease; at MELD 15 or so most centers begin consideration and assessment for liver transplant.
Good luck and welcome to the discussion group,
--Bill
Decompensated cirrhosis has traditionally prevented HCV therapy; interferon can exacerbate this condition and can increase morbidity/mortality rates. However, some doctors are apparently now cautiously treating select patients with careful monitoring.
As mentioned above you’ll want to be involved with a knowledgeable and qualified MD; a large, teaching institution preferably associated with a university medical center might be preferable.
Have you discussed MELD (Model End stage Liver Disease) score with your doctor? This might give you some idea as to the progression of your liver disease; at MELD 15 or so most centers begin consideration and assessment for liver transplant.
Good luck and welcome to the discussion group,
--Bill
I was told the same thing. Get to a liver specialist. W losodium diet for ascites n Nadolol for varices, im finishing tx now.
You got some good advice above: find a specialist now! Karen :)
You got some good advice above: find a specialist now! Karen :)
Oh, and I have cirrhosis, including a history of Varices, and I'm 21 weeks into triple therapy with incivek. I am treating at a transplant center.
In understand the Varices indicating cirrhosis, but what is the connection with angina? Never heard that one.
I agree with the above posters.
You should be seeing a hepatologist.
If you are already seeing hepatologist, get a second opinion from another hepatologist, preferably at a large medical center (maybe in Phoenix).
Just because you have cirrhosis (if your doctor is correct in his diagnosis) does not automatically knock you out of being a candidate for treatment. There are many on this forum with cirrhosis and they are doing treatment.
In fact, if you have cirrhosis (unless there is some other medical problem prohibiting you from treating) you need to act sooner rather than later. You need to act now before your liver disease gets even worse.
Keep us posted. There are some very knowledgeable people on this forum and most are very helpful.
You should be seeing a hepatologist.
If you are already seeing hepatologist, get a second opinion from another hepatologist, preferably at a large medical center (maybe in Phoenix).
Just because you have cirrhosis (if your doctor is correct in his diagnosis) does not automatically knock you out of being a candidate for treatment. There are many on this forum with cirrhosis and they are doing treatment.
In fact, if you have cirrhosis (unless there is some other medical problem prohibiting you from treating) you need to act sooner rather than later. You need to act now before your liver disease gets even worse.
Keep us posted. There are some very knowledgeable people on this forum and most are very helpful.
I'm not a health professional but I would still want a second opinion. Maybe not spring for the bio immediately but talk to a different doctor to see if a bio would be beneficial.
Best of luck to you!
Best of luck to you!
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