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Avatar universal

I Found Thiis Article Annoying:

  http://medcitynews.com/2012/03/new-hep-c-meds-may-override-watchful-waiting-for-patients-with-no-symptoms/

  The Doctor writing the article left out so much pertinent imfo, and reminded me alot of my PCP.
I am always hearing this quote, "most people will not have symptoms for at least 20 years" etc.  Okay, we've been there, we've done that. Twenty years has gone by, and now we are at Stage 2, and our livers have fibrosis. Yes, many people have Stage 2 fibrosis, after 20 yrs of Hep C, and my liver enzymes just recently jumped up, and my platelets started sliding below normal range.  People whose platelets are TOO low, are often times unable to Treat.  Of course I am going into Treatment at Stage 2 (and who knows, my biopsy could be a stage off, I could have been at Stage 3!)
    It's articles like the above one, that make it very difficult to educate my father, on why I am choosing to Treat my Hep C!
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548668 tn?1394187222
Glad I gave you some confirmation - we go from strength to strength through this :-).   It sounds as though you're doing really well;  I'll be cheering from afar and watching your progress...  
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Avatar universal
Yes, wonderful!  I really do think my low platelets were a verybad sign, and so did my Treating Doctor. I am so glad you SVRed, and you give me hope : )
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548668 tn?1394187222
My bx was officially stage 2 but my hep specialist read it as Stage 3 possibly early 4 because of porta-portal bridging fibrosis (I also had an enlarged spleen and portal vein).    My platelets had started dropping to about 140 prior to tx, then dropped to 105.   Post tx they went back up to 140 then 170 (and have been higher since).   I treated in 2008 at age 53 - managed SVR - had contracted HVC 24 years earlier.
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2061362 tn?1353279518
I know this is off subject, but...My mom never had a colonocopy because she didn't have any issues down there untill it was too late. She was diagnosed with colon cancer 2 yrs ago, which had already spread to her liver and eventually to her bones. She passed a way a year later. What she went through, what no one should have to go through, was absolutely horrific for her and heart wrenching for my family. I have had my colonoscopy and am an advocate for anyone age 50 and over and for anyone who has a family history of colon cancer. Please get one done, it really is not too terrible and can potentially save your life.
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Avatar universal
I am extremely anally retentive. But i think Farrah died from something down there, so for my beautiful memory of Farrah, I will do it when I am 50 yrs old.
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446474 tn?1446347682
A medical explanation as to why my platelets were dropping?
I can[t say. There are many more illnesses than hep C and liver disease. A doc can find out what it is Like any condition or disease there are the likely suspects and then the rarer ones. But to get an answer you have to see a doc for it and get some tests.

'I'd like to see more research see more research on other peoples progression, from Stage 2~4, in my age group.'
There are literally thousand it not tens of thousand on that subject. It's the entire study of liver disease and its progression. And there is the subgroup of hepatitis C and how it causes liver disease.
What don't you understand about it in particular?

All people who are 50 years old and older should have a colonoscopy. As with most, if not all cancer early detection is critical. Colon cancer is, in many cases, a treatable disease if it is caught early. That is why they have screenings. Also like many cancers you don't feel it or notice anything wrong until it is in its moderate to advanced stage. Colorectal cancer is the 3rd most common cancer in women after breast and lung. Shouldn't women have mammograms to screen for breast cancer before it grows and more tissue needs to be removed? It is just seems like good preventative health to me. Why wait until people have moderate to advanced cancer if it can be caught early and treated more easily and survival rates are higher?

Ciao.
Hector

Helpful - 0
Avatar universal
Regarding a colonoscopy,the doc will usually sedate you if you ask...it is an uncomfortable procedure, painful for some but overall wasn't too big a deal for me.
About that popping of joints-I know!! It is really painful. I had experienced it in the past 6 months more than ever. I was walking with a cane most days and sometimes while driving my knee would pop and I had to pull over fast, it hurt too much to drive.
Uncledudeness had a great post about joint pain that explained it well for at least for those with hep. c. I agree it could also be a symptom relating to another health issue, but since our livers are rather stressed right now, I am pretty sure joint pain is related to hep.c and/or cirrhosis.
The pain is still present but the popping is less frequent this week.
Maybe it is the glucosamine sulfate or maybe it is wishful thinking...Good luck to you.
Helpful - 0
Avatar universal
" My Gastro had only treated a few people, he only did procedures like colonscopies, so I decided not to be treated by him...but he told me to come back next year when I'm 50 yrs old, for a colonoscopy....think I might wait a few more years,I'm feeling  good down dere."

                  **************************************************************

Bo, even though you are "feeling good down there" you should really have a colonoscopy done at least for baseline purposes.  If my Hepa Dr hadn't insisted on me getting one, I probably would not have done so.  As I wrote in my journal I had 6 polyps and 1 was pre-cancerous.  And believe me I was "feeling good down there" also.  Regular bowel movements, no blood in movements, never abdominal pain, etc.  Felt great and had no clue.  So maybe you should re-think that decision based on what your GI recommended.  And don't worry, you won't feel a thing!  Just a little achy afterwards.  
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Avatar universal
Oh, I just read that low platelets can also be a sign, of rheumatoid arthritis. That would make sense, but I do notice a corrolation between Hep C and RA, also, so I am glad I dwelved into it.
    Coincidentally, I cant enjoy the day, due to the fact that my joints are popping out, and so I am unable to walk, with-out alot of intese pain!
    I am getting a real lesson in what it feels like, to be disabled, after being the one on the other side, for years!
Helpful - 0
Avatar universal
My Platelets dropped to 120,000 about 4 months prior to my Tx.  I started Tx at 120,000, and they have only dropped as low as 90,000, and sometimes they are as high as 105,000....not unusaula for Tx,ike you said.
   I would just like a medical explanation as to why my platelets were dropping, and at the same time, I was becoming very esily dehydrated, in hot weather. It may have been from a different medical problem...not sure.
   I dont think I am cirrhotic though, I agree with my biopsy. It is easier to go thru Tx and SVR rate is higher, for under 50 yrs, so I thought I'd treat now.
My AST/ALT were over ten times too high, and all my blood work had started getting outof normal range...even my WBC and RBC.
   I'd like to see more research on other peoples progression, from Stage 2~4, in my age group.  I consider it tragic, for that Stage 3 to slip by silently, and to have cirrhosis take people by surprise.
    My Gastro had only treated a few people, he only did procedures like colonscopies, so I decided not to be treated by him...but he told me to come back next year when I'm 50 yrs old, for a colonoscopy....think I might wait a few more years,I'm feeling  good down dere.
   I've never seen a Hepatologist, my Tx Doctor has been specializing in Treating people with Hep C, since 1998, so she does have 14 yrs experience, which made me feel more confident. But she is an Internal Medicine Doctor, and an Addiction Psychiatrist, not a Hepatologist.  
Helpful - 0
Avatar universal
    No, my platelets dropped to 120,000, in October of 2011. But my Trx wasn't started until Feb 7th, 2012. My Platelets had been 150,000 6 months prior to the drop.
  
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163305 tn?1333668571
Hector is correct about the platelets. It's from tx.

Now, remember there is nothing logical about hep C. This may be a bit of an overstatement but not much.
Just think when it comes to hep C, one size doesn't fit all.
You cannot assume anything, including how long it will take an individual to get to a particular stage of fibrosis.
It really doesn't matter right now what condition your liver is in,  what matters is getting rid of the virus.

Bo~ concentrate on your treatment, trying to stay upbeat, and enjoy your kids and the warm weather, if you can !
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446474 tn?1446347682
BoGal, aren't you treating?
Treatment (peg-interferon) causes the lowering of platelet counts. That is normal. Thrombocytopenia is caused by portal hypertension and its effects which only cirrhotics have so it is a mute point for person with lesser liver disease. Cirrhotics when treating hepatitis C can experience dangerously low platelet counts < 20,000 and will if treatment is not stopped, require transfusions to raise their platelet count or a very powerful drug. I can only think of less then a handful of posters that had ever needed this intervention on Medhelp.

A properly done biopsy is not going to be more than a stage off. That is why biopsy is 'the gold standard' for measuring fibrosis. ALT and AST have nothing to done with the degree of liver disease. FibroSure I have never had, but if you had a biopsy doctors go by the biopsy results. Because it is the most accurate measure we have. If you had cirrhosis you would know it. Assuming your doctor is a gastro with hepatitis and liver disease experience or hepatologist.

Hector
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446474 tn?1446347682
Irritation is also a very common side effect of living. ;-))

Seriously I agree with you. Turn off the negatively and enjoy life. There is no better time than now.

Hector
Helpful - 0
Avatar universal
  It is so darned tricky, to catch this Hep C just at the right time!
    Now....I wonder why the heck my platelets were slipping to 120,000, if my bx showed me at a Stage 2 fibrosis?  I still havent examined that Bx myself, and I am going to request to see it next tuesday.
    My fear is, that  Stage 0~2 takes 20 yrs, but that once I was at Stage 2, and having problems with my electrolyte balance, and my Sugar was climbing higher, and I certainly wasn't feeling very healthy, for age 48 yrs, that my liver would start scarring faster. There is also evidence that menopausal women, and men, have a higher incidence of cirrhosis, than women in their child-bearing years. Apparently Estrogen, among other things, protects our liver.
    By the way, my FibroSure test had me at .77, a cirrhotic score,on by their graph, so I think my low platelets and high AST/ALT tilted that blood test score.
Helpful - 0
163305 tn?1333668571
Irritation is a very common side effect of interferon tx.
I found multiple things annoying while on tx.
Finally, I learned to turn off the news, switch on good music and watch comedies
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446474 tn?1446347682
Most persons with hepatitis C are asymptomatic. Which is why most people that are infected with hepatitis C have no idea they are infected.

The reason most people will not have symptoms for at least 20 years is not because of the hepatitis C, it is the amount of liver damage. It typically takes 20-40 for an infected person to develop cirrhosis of the liver. Which is why we see the baby boomers now being the vast majority of liver transplant patients. The 'symptoms' are complications of decompensated cirrhosis. CTP class B cirrhosis. Advanced cirrhosis. Not compensated cirrhosis which is CTP class A. This is when a person will develop ascites, encephalopathy, bleeding varices etc.etc. By this point the persons liver disease is so advanced they are unable to treat their hepatitis C as their liver is too damaged to handle treatment. Therefore their only option is a liver transplant.

Side notes related to your comments:
* Platelet count is only effected be liver disease when a person reaches stage 4 cirrhosis. This is due to the accompanying portal hypertension which causes the spleen to enlarge and sequester platelets that would normally be in circulation.

* With the two and three drug hep C treatment therapies it is only when a patient's liver disease reaches stage 3, and then much more so stage 4, that the effectiveness of treatment is diminished. This is why person with lesser liver disease can wait for future treatments. Waiting doesn't effect outcomes for person with stage 0-2 liver disease.

One PCP docs point of view. Why post it? In my opinion this is more noise than substance. Isn't there enough misinformation, false information and myths about hepatitis C already? He is no expert on hepatitis or liver disease. I hope people have a better understand of risk vs benefit then the simplification of the issue that is presented in this blog article.

Hector
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Avatar universal
Yes, exactly. I can only blame myself, for not getting a biopsy done in 2008, when it was recomennded by my Gastro.
    When we feel very healthy, it is hard to see the "good" in an invasive procedure. But the catchis, so many of us feel "good" until we are almost a Stage 2, thus the nick-name, The Silent Killer~
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179856 tn?1333547362
Watchful being not ignore the disease but monitor it's progress via biopsies or fibros and blood work.
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179856 tn?1333547362
Boce this is why it is called watchful waiting.  Some people never get to stage 2 and remain in stage 0/1 - there is no need for them to treat with interferon if they remain watchful and see if the all orals pan out.

Even at stage 2 there is room to watch and wait.
Helpful - 0
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