hepatoligist or gastrologist

[rpooo]

Hello Dr. Schiano,

I am currently living in El Paso TX. and at the end of the month moving to Nashville TN. to be closer to family. I was diagnosed with stage C cirrhosis on 03-23-10. Everything has been going pretty good. I have some levels out of range such as:

Bilirubin- 2.3
AST-43
Monocytes- 14
Platelets- 71
Ammonia- 51

MELD- 11

I have splenomegally, Hiatal and umbilical hernias, HE, Gall stones, neuropathy and grade 3 varices. I think that about covers everything. I feel real good most of the time. I have an exell spreadsheet with all of my labs and charts for monitoring my progress but I was unable to attach it.

My question is after my move should I continue seeing a gastrologist or switch to a hepatologist?

Thank you, Randy
My gastrologist feels I will need a transplant in the next 5 years. He has done a really good job looking out for me.

[rpooo]

Thank you very much Dr. Schiano! have a great day!

Randy

[Thomas D Schiano, MD]

the lab tests look fairly good so based on them you do not seem like you need a transplant right now.  i would still get hooked up with a transplant center in your area.  U of memphis (Dr satapathy or dr nair) or Vanderbilt are both outstanding. no problem with taking a MVI.

[rpooo]

Hello again doctor. Here is a link to my medical information I was talking about in my original post. I wonder if in your opinion will I be in need of transplant. I understand there are a lot of varibles so it may be hard to say.

http://www.medhelp.org/user_photos/list/1475202?personal_page_id=1830091

Randy

[rpooo]

Currently I have an ultrasound done every 6 months. Lab work and a follow up visit with my Gastrologist every three months.

I see they have a transplant center right there in Nashville so that will be nice. I have always had concerns about vitamin deficiencies although I take a multi-vitamin without iron (senior) and B-complex. How will the liver transplant program help? Will they just have a more educated understanding of liver function? Also will they collaborate with each other?

[Thomas D Schiano, MD]

i think that when you relocate you should hook yourself up with a liver transplant program, as well as to have a local gastroenterologist.  You need regular surveillance for HCC.