Dr Schiano

[PaulaAnn]

Had my first appt at the Cleveland Cinic w/Dr Barnes. Took months to get in.  CC is awesome..Dr Barnes ordered labs, 13 vials.  Labs came back prety good.  I do have rheum arth, sjogrens, raynauds etc etc.  I have been telling my rheumy that I have lupus but my bloodwork never showed it except for this time...and its Systemic lupus. SLE so a new disease to add to my list.  

I go for a cat scan on Friday. I know Dr B mentioned something about "vascular" testing also.

Ultrasound in Aug showed mild hetergeneous diffuse echocencity and this past US in March showed hetergeneous coarse echotexture. Two diff drs read the US.  I hope that my liver didnt get bad after 6 months. Is this quite a difference?   He was not concerned about the cysts.  

Labs have all been normal except ALT and AST,just a couple numbers above normal.  The CMP  was  normal..protime, etc all good. Even my platelets which run between 90-105,000 for yrs was normal at 164,000.  Dr Barnes could not feel my spleen.    

I see why a hepatologist is so important.  Dr Barnes upped the beta blocker that my pcp prescribed for me.   He ordered lots of labs so he could omit some diseases and go from there.My previous gastro did not order a beta blocker saying that they dont order them unless there is a bleed.  REALLY?  he told me that  "your varices will not bleed". Gr 2 non bleeding. So, I made an appt w/ my pcp to get a beta blocker which the hep increased.  .  

Glad that the CC is not that far from me..about 1 1/2 hours.  

still trying to come to terms with this disease,.  Only one questions about the different terminology used in the 2  US's.

Thank you...Paula



Paula
OH

[Thomas D Schiano, MD]

overall a good outcome paula.  for grade 2 varices the BB is warranted in my opinion.  Ultrasounds are very operator-dependent--there are not major discrepancies between the 2 readings frankly.

[PaulaAnn]

Thank you..will ask my hep about it.

THANK YOU FOR YOUR TIME AND EXPERTISE.  

Paula

[Thomas D Schiano, MD]

the AZA is probably better than long-term prednisone.

[PaulaAnn]

Thank you..the 2nd final report sounded worse to me.  Thank you for clearing that up for me.  My hep, Dr Barnes, mentioned that I may be out of the age limit for a transplant if I hit 73 or 74.  

Just dont want surprises on the cat scan.  Going on Friday..I moved it up..waited long enough and want to know what's up.

I couldnt understand the hesitance in prescribing a beta blocker.  I think they try to keep the pulse under 60, correct?  I'm taking my pulse a few times a day to regulate the dosage if needed per my Hep.  

Dont know what they will do about the SLE systemic lupus erth.... meds for that is immuran or prednisone and I am only on a small dose of pred 5 mg a day.  I'll call the hep today or tomorrow.  

Thanks so much....have a nice week and hope you had a nice Easter.  

Paula
OH