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My Hepatitis C  GT2 - History - Biopsies - Blood Test - Other Conditions Before Treatment

Jan 05, 2014 - 3 comments
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Hepatitis

,

history

,

test

,

years

,

biopsy

,

Blood



Starting from 1980 Non A Non B acute exposure up to treatment start on April 3, 2014
Includes My Hepatitis C  GT2 - History - Biopsies - Blood Test - Other Conditions

Treatment Journal link SOV/RBV 12 weeks
http://www.medhelp.org/user_journals/show/1050903/SOV-RBV-GT2-Treatment-Journal-April-3--2014-?personal_page_id=28768590.

Update March 5, 2014   Waiting for Pharmacy ok and hope to start 2nd week in April.

Updated Feb 12, 2014
My VA doctor has approved me for Sovaldi 7 Riba for 12 weeks. But the VA is only providing Sovaldi for the most critical need patients at this time.  I was told hopefully treatment can start within the next 2 to 3 months.

I was infected in 1980 non A non B with strong acute symptoms which lasted about a week
1999  diagnosis HCV
2000 biopsy Stage 2 Grade 1  
!st Genotype showed 2a  second test showed 2a 2c

biopsy 27 Jun 2012
2 needle biopsies of tan to
yellow-tan, soft tissue each measuring less than 0.1 cm in diameter,
and ranging from 1.4 cm up to 1.6 cm in length.
Batts-Ludwig GRADE: 2 (Mild interface and/or lobular activity
involving some or all portal tracts, with little hepatocellular
damage/necrosis).
- Batts-Ludwig STAGE: 2 (Periportal or rare portal-portal septae).
- Other features: Steatosis: not identified.
Granulomas: not identified.
Iron accumulation: 1+ (minimal), in Kupffer cells.
- INTERVAL CHANGE: Comparison with previous biopsy SP-00-1402,
procedure date 05/03/2000 :
- ACTIVITY: no change.
- FIBROSIS: minimally increased.

2013 test
Date/Time Collected: 16 Jul 2013
ALANINE AMINOTRANSFERASE 111 High IU/L 0-55
ALPHA-2-MACROGLOBULIN 322 High mg/dL 110-276
APOLIPOPROTEIN A-I 139 mg/dL 110-180
BILIRUBIN 0.4 mg/dL 0.0-1.2 Details
FS-ACTIVITY GRADE* (V2) A3 - Severe activity "A0 - No activity"
FS-ACTIVITY SCORE* (V2) 0.73 High 0.00-0.17
FS-FIBROSIS SCORE* (V2) 0.64 High 0.00-0.21
FS-FIBROSIS STAGE* (V2) F3 - Bridging fibrosis many septa "F0 - No fibrosis"
GAMMA GLUTAMYL TRANSFERASE 48 IU/L 0-65
HAPTOGLOBIN 72 mg/dL 34-200
ALPHA-1-FETOPROTEIN 7.1 ng/ml (0-8.7) Final
ALBUMIN 3.2 Lowg/dl (3.4-4.5) Final
PLATELETS 94 Low K/mm3 (140-375) Final

December 23, 2013 Blood test results
ALANINE AMINOTRANSFERASE 185 High units/L 10-55
ALBUMIN 3.8 g/dl 3.4-4.5
ALKALINE PHOSPHATASE 74 units/L 50-136
ASPARTATE AMINOTRANSFERASE 118 High units/L 6-32
BILIRUBIN 0.6 mg/dl 0.1-1.0
CALCIUM 9.1 mg/dL 8.4-9.8
CARBON DIOXIDE 25 mEq/L 22-32
CHLORIDE 106 mEq/L 97-109
CREATININE 0.82 mg/dl .7-1.4
GLOMERULAR FILTRATION RATE.PREDICTED >60 mL/min >60
GLUCOSE 95 mg/dl 70-115
POTASSIUM 3.6 Low mEq/L 3.8-5.1
PROTEIN 8.0 g/dL 6.3-8.0
SODIUM 140 mEq/L 135-145
UREA NITROGEN 25.6 mg/dl 9-26
COAGULATION TISSUE FACTOR INDUCED 10.1 sec 9.0-12.0
COAGULATION TISSUE FACTOR INDUCED.INR 1.0
ERYTHROCYTE DISTRIBUTION WIDTH 12.8 % 11.7-14
ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN 33.1 High pg 27-33.0
ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION 36.4 High g/dl 32.6-34.7
ERYTHROCYTES 5.23 M/mm3 4.3-5.5
HEMATOCRIT 47.5 % 38-50
HEMOGLOBIN 17.3 High g/dl 13.5-17
IPF* (V2) 5.6 % 0.9-11.2
LEUKOCYTES 5.6 K/mm3 4.4-10.7
MEAN CORPUSCULAR VOLUME 90.8 fl 83-98
PLATELET MEAN VOLUME 11.5 fl 9.0-12.6
PLATELETS 95 Low K/mm3 140-375
ALPHA-1-FETOPROTEIN 8.1 ng/ml 0-8.7

I am treatment naive  -was offered 2008 but declined treatment and again in 2012 after biopsy. I had friends who had real bad experience with iNf and riba. I live alone and didn't want to deal with it

My doctor is a Gastroenterologist at the Buffalo VA and a Clinical Professor at University at Buffalo.

2012
Mar 1 cataract removed
April Also had a 1 parathyroid removed
Aug 4 stents put in my heart  

2013
Sept Stress test  I reach 11.1 mets 139 % of a normal 66 year old
Using and compliant CPAP for sleep apnea  7 hours daily ave use.
On blood pressure meds hydrochlorothiazide  usual range below 140 /80

More recent blood test in comments to this journal

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Avatar_m_tn
by JimmyMose, Feb 09, 2014
2014  Jan 29 Blood test Results
ALANINE AMINOTRANSFERASE 219 High units/L 10-55 Details
ALBUMIN 3.9 g/dl 3.4-4.5 Details
ALKALINE PHOSPHATASE 61 units/L 50-136 Details
ASPARTATE AMINOTRANSFERASE 132 High units/L 6-32 Details
BILIRUBIN 0.8 mg/dl 0.1-1.0 Details
CALCIUM 8.9 mg/dL 8.4-9.8 Details
CARBON DIOXIDE 22 mEq/L 22-32 Details
CHLORIDE 108 mEq/L 97-109 Details
CHOLESTEROL 158 mg/dl 0-200 Details
CHOLESTEROL.IN HDL 41 mg/dL Details
CHOLESTEROL.IN LDL 104 mg/dL 60 mL/min >60 Details
GLUCOSE 83 mg/dl 70-115 Details
POTASSIUM 3.7 Low mEq/L 3.8-5.1 Details
PROSTATE SPECIFIC AG 0.54 ng/ml 0.0-4.0 Details
PROTEIN 7.7 g/dL 6.3-8.0 Details
SODIUM 141 mEq/L 135-145 Details
TRIGLYCERIDE 144 mg/dl 30-150 Details
UREA NITROGEN 17.6 mg/dl 9-26 Details


BASOPHILS 0.0 K/mm3 0-0.3 Details
BASOPHILS/100 LEUKOCYTES 0.2 % 0-2 Details
EOSINOPHILS 0.0 Low K/mm3 0.1-0.5 Details
EOSINOPHILS/100 LEUKOCYTES 0.6 Low % 0.7-6.6 Details
ERYTHROCYTE DISTRIBUTION WIDTH 12.8 % 11.7-14 Details
ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN 32.8 pg 27-33.0 Details
ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION 36.2 High g/dl 32.6-34.7 Details
ERYTHROCYTES 5.21 M/mm3 4.3-5.5 Details
HEMATOCRIT 47.3 % 38-50 Details
HEMOGLOBIN 17.1 High g/dl 13.5-17 Details
LEUKOCYTES 4.8 K/mm3 4.4-10.7 Details
LYMPHOCYTES 1.7 K/mm3 1-3 Details
LYMPHOCYTES/100 LEUKOCYTES 35.5 % 16-40 Details
MEAN CORPUSCULAR VOLUME 90.8 fl 83-98 Details
MONOCYTES/100 LEUKOCYTES 11.2 % 5.5-13.5 Details
MONOCYTES/100 LEUKOCYTES 0.5 K/mm3 0.3-0.8 Details
NEUTROPHILS 2.5 K/mm3 2.4-6.8 Details
NEUTROPHILS/100 LEUKOCYTES 52.5 % 45-72 Details
PLATELET MEAN VOLUME 11.5 fl 9.0-12.6 Details
PLATELETS 90 Low K/mm3 140-375 Details
HEMOGLOBIN A1C/HEMOGLOBIN.TOTAL 5.4 % 4.3-6.1 Details




Avatar_m_tn
by JimmyMose, Feb 09, 2014
FEB 5 2014
GI Outpatient f/u: Chronic Hep C
HPI: Patient is a 66 y/o WM following up for chronic HCV (genotype 2) with cirrhosis, not received any treatment due to refusal of Interferon therapy in the past. He was diagnosed in 1980's, likely due to IV drug abuse. Patient
without any symptoms of decompensation. Reports vague right sided abd discomfort that he describes having for years, denies any associated symptoms.
Also, reports occasional nausea. Denies any vomiting, hematemesis,hematochezia, melena, diarrhea. He reports occasional constipation.
He has a significant family h/o colon cancer. His last colonoscopy was in Oct 2010 that reported severe sigmoid diverticulosis, and three hyperplastic polyps. His next colonoscopy is due for next year, 2015.

Vitals WT: 277, BP: 137/77, HT: 73, P: 65, R: 20, T: 96.9
PHYSICAL EXAMINATION:
GE: Alert, oriented x 3, obese, NAD,
HEENT: NC/AT, Neck supple, moist mucosa. No scleral icterus.
Chest: Unlabored, Clear to auscultation B/L. No wheezing/rhonchi/rubs.
CVS: RRR, S1,S2 heard, No murmur.
P/A: distended due to obesity, soft, NT, ND, BS+ x 4. No sigmata of liver
disease.
Ext: No edema, palmar erythema, flapping tremor.

ASSESSMENT AND PLANS:
Patient is a 66 y/o WM following up for chronic HCV (genotype 2) with cirrhosis, not received any treatment due to refusal of Interferon therapy in the past. Patient is ready and anticipating to receive sofosbuvir and ribavarin therapy. Plan is to start him on sofosbuvir and ribavarin within 2 weeks. He will be referred to be seen by Amy from pharmacy and Pat in the Hepatitis Clinic.

02/06/2014 ADDENDUM STATUS: COMPLETED
Long-standing genotype 2 HCV with clinical progression to cirrhosis (although recent liver biopsy was F2). He, despite many efforts to start him on interferon based treatment, never 'pulled the trigger". He is extremely well read in HCV
and is fully aware of the risks benefits and alternatives of the new treatments.

Current Meds
1) ASPIRIN 81MG
2) HYDROCHLOROTHIAZIDE 25MG TAB
3) OXYCODONE HCL 5MG TAB/CAP 1 TAB MORNING 1 TAB AFTERNOON 2 AT BEDTIME AS NEEDED FOR PAIN
4) CALCIUM 600MG/VITAMIN D 400UNIT TAB ONE DAILY
5) POTASSIUM CITRATE 1080MG SA TAB 2 TABS AM 2 TABS PM
6) SIMVASTATIN 20MG TAKE 1/2 TAB AT BEDTIME FOR CHOLESTEROL

Update on problem list for the past 9 months
Carpal Tunnel, Degeneration,Cervical Spine, Osteoarthrosis involving the spine L4-L5 -S1 NOTE: Sciatica little back pain but more right leg thigh to ankle when doing a lot of walking. From May 2013 to Sept 2013 I traveled and worked with a Carnival Midway show in NY, NJ and stood up and walked miles every day. I  really needed my pain pills to deal with it. it.days. Also developed Lymphedema and wore compression stockings.  Since Sept those problems almost disappeared or a lot less. Since then my bottle of 120 5mg oc last me 2 or 3 months. Fortunately not addicted and stop when the pain isn't too bad.
History of calculus of kidney Sleep Apnea,Thrombocytopenia, CAD, Hypertension

Good News I will finally get to start treatment in a couple of weeks.



Avatar_m_tn
by JimmyMose, Apr 10, 2014
Additional limited prior ULTRASOUND and 3D CT abdominal related        
21 Feb 2014  ULTRASOUND EXAM AAA SCREEN Impression: Nonvisualization of the proximal aorta. Mild ectasia of of the bifurcation. No evidence for abdominal aortic aneurysm.
16 Nov 2011 ULTRASOUND ABDOMEN COMPLETE Impression: No appreciable focal hepatic lesions. Suboptimal study as the patient ate prior to the study. Gallbladder and pancreas not visualized. Left renal cyst.
13 Nov 2010. 3D RENDERING CT abdomen and pelvis obtained without oral or IV contrast. Comparison made to exam of
Overall no interval change. Lung bases are clear. The heart is not enlarged. The pericardium is normal. No pleural effusion. The liver, gallbladder, spleen, adrenal glands and pancreas are normal in appearance.
Impression:
Similar-appearing tiny bilateral renal calcifications, nonobstructing. 2. Simple appearing lower pole left renal cyst
unchanged. 3. Minor sigmoid diverticulosis. 4. L3-L4 and L5-S1 disc space narrowing.

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