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Tired of well-meaning people
This isn't a question, just venting some frustration.

I was being pre-screened for a colonoscopy last week. First you sit through a presentation then you meet with a nurse. At the end of the session you can schedule a colonoscopy if you want one.

I wrote that I was HepC positive on the information sheet and that in the last 30 days all I'd taken was Tylenol. When the nurse saw that, she gave me a lecture in a round-about way. Said her husband had a friend who had HepC and nearly died and then got a liver transplant and is now HepC free. (Ya - I pointed out that getting a new liver doesn't eliminate the virus cause it is in your blood.) The nurse went on to say that this person would never take anything like Tylenol cause he is sooooo careful about his liver (implying I'm not.)

I told her my doc told me to take Tylenol and stay away from Ibuprofen - and then she went on about Ibuprofen being bad for you liver AND your kidneys. (Which I knew)

I know she was well meaning but I really don't need to hear any horror stories. I feel bad enough already and she made me feel worse. And I'm now avoiding Tylenol, which I really need this week.

Oh well . . .

rk
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Avatar universal
   I was always so confused about the whole, "it's okay to use Tylenol while on Tx" thing, because a few years ago, they were tellingusit was bad for our livers, but now My Doctor recommended it, instead of Ibuprofen, and she said,  "no more than 4 per day, as in one every 6 hrs.
       Well,  right before I started my Tx, I had a head-ache, so I did an experiment, and tried taking a Tylenol (which I found hard to even find, at the drug-store, everything now seems to be motrin or aspirin)  I ended up getting horrible muscle cramps, just like I did, in 2011,  from Ibuprofen.
   I had always tolerated Ibuprofen, before 2011, so I guess it had to do with the fact that I had so much inflammation in my liver, right before Tx.
    How are your liver enzymes, are they elevated?   If they are normal, then I dont think taking a Tylenol would be harmful, if you dont feel bad, aftwr taking one. Many people on Tx do take Tylenol, which is what is recommended to us, for Interferon aches/fever, etc.  I think that well-meaning Nurse was just not up on the most recent recommendations.
    
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446474 tn?1446351282
First, this is a nurse. I love my nurses....but she is not qualified to prescribe treatment to you. She hasn't studied gastroenterology never mind hepatology. We'll assume she was trying to help. That is nice and all. But ignore her! She is clueless as far as hepatitis C, liver disease and what drugs can be used by different patients. Obviously from what you said she said she is not familiar with standard treatment protocols.

Second, what analgesic a person with hepatitis C can take is ONLY dependent of the amount of liver disease they have (assuming no other medical issues).
Do you have Cirrhosis? Stage 4 liver disease? If you don't you can take whatever you want within the dosage, time limits on the drug.
You can take your pick.

Of course no alcohol ever with NSAIDs or Tylenol at all as it speeds up liver damage and can also cause acute damage.

Okay, now if you have CIRRHOSIS then you should ONLY take Tylenol. Unless for some reason particular to you your doctor prescribes something else. Very, very rare.

NSAIDs can cause internal bleeding and kidney failure in patients with cirrhosis and portal hypertension.

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446474 tn?1446351282
So if you need a pain reliever it is fine if you take up to either 1,500 or 2,000 mg (take less than six 325 mg tablets each day) of Tylenol per day. This should only be for a short period of time. Not week after week, month after month. Ask you doctor what is the maximum dose per day.

"And I'm now avoiding Tylenol, which I really need this week. "
Don't avoid Tylenol based on the nurse's opinion. You doctor is in charge of treating you not a nurse. If you have any questions call your doctor. They know your health history and current health status the nurse of us don't. That is why the best source of information about your illness is your doctor. assuming you have a qualified doctor treating you.

I have had cirrhosis for over 5 years and been seeing a internationally known hepatologist at a transplant center. So I know this first hand beside reading it in every medical paper regarding care of cirrhotic patients.

Good luck!
Hector
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766573 tn?1365170066
That poor nurse is misinformed if she thinks her husband's friend will remain HCV-free indefinitely. The odds are not in his favour. You were courteous to not point out that:
Gastroenterol Hepatol (N Y). 2012 January; 8(1): 56–59.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3277201/1

How common is hepatitis C virus infection in liver transplant recipients?==>If a patient has active hepatitis C virus (HCV) infection at the time of liver transplantation, the infection will recur in almost all patients. Given that HCV infection is the most common indication for liver transplantation, this scenario is quite common in clinical practice.

Is infection due to preexisting HCV infection in the host or HCV transmitted from the donor? ==> Infection is always due to preexisting HCV in the host. However, HCV-positive allografts can be used for transplantation to an HCV-positive recipient. Patients typically consent to receive an HCV-positive allograft at the time of listing for transplantation. The donor liver is then biopsied prior to transplantation to check for fibrosis, and many transplant centers will use the organ as long as there is no fibrosis. There are several reports, mainly in abstracts, showing that using an HCV-positive graft is safe. Genotype 2 or 3 HCV-infected recipients are not listed to receive HCV-positive allografts.
_____________________
J Viral Hepat. 2012;19(1):1-8. © 2012 Blackwell Publishing
http://hepatitiscresearchandnewsupdates.blogspot.com/2012/01/immunosuppression-liver-injury-and-post.html#.ULiZIO8bt8F

...Chronic infection with HCV is a major cause of end-stage liver disease and a leading indication for orthotopic liver transplantation (OLT) worldwide. However, re-infection of the graft by HCV particles present in the blood stream is almost universal and at least 25% of patients will develop liver cirrhosis after transplantation within 5–10 years
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Thanks for your replies. I am at stage one and six weeks ago, my ALT's were at 17. Ultrasounds and fibroscans show mininal liver damage and no inflammation.

So I'll take Tylenol as directed. You folks are right, I should listen to my own doctor. The nurse was well meaning. She just didn't go about expressing her concerns very well.

Thanks again for your help. This is such a great resource. I really appreciate the fact I can go online almost any time of day and get a response. I don't feel so all alone.

Cheers,
rk
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