newly diagnosed

Question

Just diagnosed 6 weeks ago.ALT's and AST'S were just slightly elevated.Viral load is 5,190,000.Will know my genotype this wednesday and having biopsy on Friday.Doc says he doesn't think I will have much in the way of liver damage after seeing my ultrasound.He seemed a little leery of recommending treatment because I have had problems with depression in the past.Although I am aware that treatment is rough I would prefer to be clear of the virus.As I understand it a high viral load makes you more contagious(anyone heard of this?)I have been divorced for 3 yrs and would like to start a new relationship,but don't want to jepordize anyone elses health.Any suggestions.

HorseJudge · Answer

Hi there. The biopsy should be done with an ultrasound. Usually they want you to have someone with you and want you to be really careful for several hours.  Not often, but on occasion, you can have bleeding from the biopsy. Talk to your doctor.  Also, make sure the US tech is competant and is looking for any suggestion of a hemangioma (cluster of blood vessels that can be on the liver, kidneys, etc.)  I had one of these and was fortunate that they did not puncture it on the first biopsy.  I did not experience any real pain, but you feel wierd for awhile just thinking about it!

DebbieDo · Answer

Thanks so much for reply, somehow i knew this site would be helpful...I will keep you posted....I need friends right now who can relate...I am reading and trying to understand all the lingo here.....its new to me.....But, i will continue to learn..Thanks again......Deb

giddyup · Answer

Hi debbiedo, welcome to the med help hep forum.Don't be to scared of treatment, some people I've met said that they got through treatment with very little trouble.You can find other people here who can help you through the whole thing. For the most part the biopsy is quick and painless. They,ll hold you for a couple of hours to make sure there are no complications. It's always nice to have someone with you but you'll be fine on your own. It's really easy. The worry is the worst part.Let us know how it goes.Be well!

DebbieDo · Answer

Hi........Well, i got Hep 33yrs ago(52 yrs old now)....All i was told at the time is to get plenty of rest and take vitamins and dont drink Alcohol.  And so pretty much all my life i did exactly that, accept for a few drinks now and then, nothing major.Recently I was told that i have HEP C..I went to the doctors today to discuss things and now i have appts for blood work on Sept 3, Biopsy on Sept 10, and returning to the doctor on the 22nd for the results and to discuss treatment...I have read alot about the treatment of injections and pills.  It all seem so scarey.  I would appreciate any support I can get from this site.  I registered today and read alot of the posting and i think i will find it to be very helpful in the coming months.
Well, take care everyone......Debbie
PS...what can anyone tell me about the biopsy??? Is it painful, can I drive home?  I dont live far.....

Tim in Tenn · Answer

Thanks for all the info folks.Got my labwork results yesterday and everything was in the normal range.Will know my genotype tomorrow.Then Friday the biopsy.A little confused about how my hcv/rna levels can be so high and my other lab numbers in the normal range but I guess I'll learn as I go.Thanks again and gotta say I like this forum(lotsa good info)

CARUU · Answer

Thanks for the hair/pedicure info.  You might know I have appts. for both this week.  I will go to Sally Supply this week and consider how to tell my hair stylist as well.  I'm hanging in there, but it's driving me kind of nuts wondering what the genotype and load tests are going to show.  Even though I'm very busy, it's hard to focus and not spend work time surfing the web for info on Hepc.  Any suggestions on how to stay focused?

willing · Answer

the following article has quite a bit of information about sexual transmission of hcv. It mentions that "The titer of HCV RNA and HCV genotype do not appear to influence the risk of HCV transmission, but high-quality studies to assess these virological factors are lacking. The stage or clinical status of liver disease of the HCV-infected individual is also not predictive of transmission risk.". I agree with Lynnn - you really want to work with your dr on a plan for how to manage the depression just as if you had a history of anemia or another condition likely to flare up doing tx. I have a history of depression and suicidal tendencies and though it hadn't been an issue for ~30 years the lights started to get very dim once I started tx. I started 10mg Lexapro at about week 8 and in hindsight should have started earlier. It helps most of the time but not always - for example, I've been a vegetable for the last couple of days, doing better today. Following this forum helps a lot.

CARUU · Answer

Galen, sounds like you're a good person to ask about what to do next.  I'm wondering if I need to tell my hairdreser about the dx?  Also, what about pedicures.  Seems like it's no longer a good idea.  I still have so many questions. Thanks!

CARUU · Answer

Thanks to all for the insight and support.  It's still so early in the process, but I am a planner (and a survivor) so I'll be able to manage what ever it is I'm faced with next.  Of course, I'm not saying I think it will be easy.  The practice I'm working with uses Pegasys.  This is going to be a hard week waiting to hear the results of the viral load and genotype tests. I have lots to do so that will help to keep my mind off of things. Again, thanks for being here for me.

minneapolis · Answer

i don't agree with being dishonest with your doctor. only my opinion. lynn

Galen · Answer

As far as manicures and pedicures, you need to provide your own implements and if there are any open sores on your hands and feet, cancel the appointment.  If your salon doesn't provide these kits, you can get one yourself at your local beauty supply.  Sally Beauty Supply is nationwide and open to the public.  Your hairdresser could be told if you are comfortable with that, especially if he/she is over 45 or so.  Most of us have worked with hairstylists who had AIDS and/or had clients with it and have broader acceptance.  If your stylist is an older gay man, he is even more likely to be understanding.  We use sharp implements (to state the obvious) and is is not unusual for us to cut ourselves.  Here again, you will need to cancel your appointment if there are open sores on you head.  I rarely nick myself any more, but when I do, I stop what I am doing, wash the cut apply pressure until the bleeding stops and apply a waterproof bandaid.  I keep a bottle of bleach water at my desk and clean up my hands and scissors with that.
To date, I have lost only 3 clients since I told them all what I was going through.

indyjo · Answer

Sorry to hear that you have a hx of depression. Are you currently taking an AD? The docs want to cover their asses, and might be reluctant to treat you if your depression was severe. I think that I would minimize the depression, unless you are unable to determine when too much is too much. Ask for an AD that you know works for you and see if it works for you. If not then be honest and stop treatment. As far as viral load determining how contagious you are... I have never read anything suggesting that there is any relationship. But remember also, it really isn't that contagious if you are careful.

quak · Answer

The point is don't talk to your doctor about being depressed.  Say that you've had slight depression in your past ask him to put you on a good antidepressent.  This will work, the minute that my doctor heard I was very depressed he wanted me to stop the meds.  No way since I'm this far.  You go!

Lori

Galen · Answer

Like Lori said, we each are different.  I am on week 42 and have managed to only miss 2 days of work so far.  I work full-time as a self-employed hairdresser.  It was particularly rough for the first couple of months, but eased off after that.  I am on Peg-Intron which reports say is rougher in the first few months.  After that the sides seem to equal out.  If you are able to get Pegasys you may have an easier time of it.  
Hang in there and persevere!

CARUU · Answer

I'm also newly diagnosed. So far only know that enzymes are elevated and second Hep C test is positive.  I will know on August 18 about viral load and genotype. I outlined some of the events leading up to this diagnosis in a message here yesterday. I am feeling run down, fatigued, dark circles under the eyes and have some problems with not being able to remember things.  I have a very demanding job and volunteer responsibilities.  I'm interested in hearing the comments of other's regarding how they handle tx and work/life.  My doc has already begun talking to me about some of the tx possibilities.  He currently has 20 patients on tx and says 99% are working, but that it is rough for some.  He's also mentioned the possibility of starting AD before tx.  I'm not on them currently and wonder if that presents another whole set of problems.  I really want to get some clarity of thinking back.  Any suggenstions to help reduce the "mind fog"?

Revenire · Answer

Tim,

Depending on the results of the biopsy you will have a clear picture of whether to treat or not. I would treat. I don't know your age, history, etc. and tx is not easy but the virus will continue to damage your liver without stopping it, that is one thing that's certain.

You found a good place.

Best,

Scott

Galen · Answer

Sorry you had to join our club, but welcome to the board.
Unfortunately, normal liver enzymes are not a good indicator of liver damage, just of ongoing inflamation at the moment.  Likewise, and ultrasound, while it may show really severe damage, is not a good indicator.  A biopsy is still the gold standard, but there is a new blood test coming called FIBROSpect by Prometheus Labratories that may one day replace it.  You have a fairly high viral count, but as you probably already know, genotype will determine the length of tx.
A history of depression used to be a contraindicator for tx, but not anymore.  You will have to monitor the situation and probably up your anti-depressents.  I am assuming you are already on one, if not, get on one before starting tx.
Sexual transmission of HCV is rare - less than 3% in couples who have been married for over 20 years - but is more common in promiscuous people or those who engage in more'hazadous' sexual behavier.  That being said, few people want to go into a relationship with someone who has this disease.  Put yourself in their shoes.  Not only that, but if you decide to go on tx, you can pretty much figure your libido will disappear for the duration.
My own personal advice, go for it.  Tx is hard and harder still as you get older and have other health problems.

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