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4507179 tn?1355632892

CT Scan Early Cirrhosis

Still awaiting referral to hepatologist based on CT scan "mildly undulated and nodular contour of the liver suggesting early cirrhosis w/o findings of focal arterial enhancing lesions. Vascular anatomy is standard with left/right heptatic arteries arising from the common hepatic artery. Portal, SMV and splenic veins are patent and normal in caliber."  Feel blessed that this was found early cuz I had CT cuz I  tested positive for Hep C, but viral load is 0 right now (this has to be a recent transmission since I was a regular blood/plasma donor up til June 2008, then rejected several times due to anemia) otherwise I am asymptomatic right now, a blood work is all within normal ranges...from what I've read on some posts, that this probably isn't cirrhosis but early stage liver disease? I have taken heavy doses of ibuprofen for the last 20 years due to herniated discs and recent arthritic hip disease...coupled with drinking. Thoughts? I'v learned more from ya'll than the medical community as of yet...thanks Bev
Best Answer
446474 tn?1446347682
COMMUNITY LEADER
The only true test for staging liver disease is a liver biopsy. Not an ultrasound.

“this probably isn't cirrhosis but early stage liver disease?”
No. Cirrhosis is late stage liver disease. Cirrhosis normally take 20 to 40 years to develop.

Surface nodularity in cirrhosis is caused by the combination of fibrosis and regenerating nodules. Cirrhosis is stage 4 liver disease not early liver disease. (stages 0, 1. 2. 3) Unless you know the cause of your liver disease and can stop the injury cirrhosis leads to serious life-threatening complication and you will need a liver transplant to stay alive.

“I tested positive for Hep C, but viral load is 0 right now”
- You can’t be chronically infected with hepatitis C and have a 0 viral load. Maybe you have antibodies to hepatitis C and where never infected.
-      Find out if you are infected with hepatitis C by having the HCV RNA viral load test. If you have a viral load of zero you are NOT in effected.

Being asymptomatic doesn’t mean you don’t have cirrhosis of the liver. It is common for early cirrhotics to have no symptoms. There is why it is many people don’t know they have cirrhosis until major complications appear.

Ibuprofen for the last 20 years and drinking can cause liver damage. Having cirrhosis you should never take Ibuprofen. It can lead to kidney failure and internal bleeding.

People with cirrhosis should avoid consuming substances that can further damage the liver. The most common of these is alcohol. You should talk to your healthcare provider before taking any new medication (including prescription and non-prescription drugs, herbs, vitamins, or dietary supplements).

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and aspirin can damage the liver and should be avoided if you have cirrhosis

“A patient with symptoms and/or signs suggesting liver dysfunction, or with abnormal liver test values, should be evaluated for evidence of the development of a more severe hepatic reaction while on therapy with MOTRIN (ibuprofen) tablets. If clinical signs and symptoms consistent with liver disease develop, or if systemic manifestations occur (e.g., eosinophilia, rash, etc.), MOTRIN (ibuprofen) tablets should be discontinued.”

You need to see a hepatologist at a liver clinic or transplant center ASAP!
Whoever your doctor has been obviously knows little to nothing about hep C or liver disease as you have a lot of misinformation and are not being cared for properly. Cirrhosis not managed properly can lead to poor outcomes including death. So that is seriously. Advance cirrhosis is nothing anyone would ever want to experience as you will become sicker and sicker and more disabled.


Call Methodist Specialty & Transplant Hospital
Get an appointment with the Gastroenterology Department.
They have doctors experienced with testing for and if need be treating hepatitis.
For patient information call 210-575-7100
For patient information at Methodist Texsan Hospital call 210-736-6700

Liver Transplant Program
The Liver Transplant program is one of fewer than 100 in the U.S. to earn certification from both Medicare and Medicaid, which is the highest quality indicator for a transplant program. For the last three years, the liver transplant program has consistently attained the best liver transplant patient survival outcomes among all liver transplant centers in Texas. More than 200 liver transplants have been performed since the program started in 2001. An end-stage liver failure clinic offers a variety of services, including Interferon treatments, chemoembolization and radio frequency ablation procedures utilizing the Nano Knife.

hector

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Avatar universal
Yeah, I would just stagger them until you see the hepatologist who can tell you definitively what he/she recommends regarding red meat, spinach, and kale (or other iron rich foods).
Keep us posted.
Advocate1955
Helpful - 0
4507179 tn?1355632892
Good point...but if I'm doing them in lieu of red meat (which i've eliminated) ? i'll stagger them...my blood tests are good still
Helpful - 0
Avatar universal
There are varying thoughts regarding raw kale and spinach due to the high iron content.  My husband and I juice fruits and vegetables too.  We also make a lot of fresh salads.  I try to limit raw kale and spinach to 1-2 times per week, because of the varying thoughts about these two veggies.  
Advocate1955
Helpful - 0
4507179 tn?1355632892
thanks everyone...I have had to be pro active, depending on the internet and people with experience, since the cogs of medical bureaocracy churn slowly...I have been following research of Dr Berkman and am taking alpha lipoic acid, selenium, milk thistle, vitamen E, garlic and B complex vitamins...I am also juicing 1-2 of my meals daily....beets, kale, spinach, apples, carrots, ginger and green tea....at least until I get to see a specialist who tells me otherwise...I haven't had anything to drink (excluding one token egg nog on Christmas) and 0 pain meds or sleep aids...I appreciate allof ya'lls input, time, and knowledege...I am currently reading The Inflammation Syndrome as well and gleaning what I can from that...I wish all of ya'll well and strength through your treatments
Helpful - 0
Avatar universal
Good for you for following up so quickly.  As others have advised, you need to be followed by a hepatologist, one who can determine more about your Hep C (whether it's acute or chronic) and possible Hep C treatment options, if needed, still available since you have Cirrhosis.  A hepatologist can also help you determine which supplements and over the counter/prescription medications are OK for you to take and which are not.  Additionally a hepatologist will help you figure out a liver friendly diet and other things that you can do to help your liver while you make decisions with your doctor regarding possible treatment for Hep C, if needed.  As others have said, do not take Tylenol or Ibuprofin or pain medications that have Tylenol, do not take vitamins with Iron, and do not take another drink of alcohol (not even one).  If you need help stopping pain medications with Tylenol or alcohol, ask your hepatologist to refer you for help. It is very important that you comply with all of your hepatologist's orders regarding medications, drugs, and/or alcohol, as he/she may not treat your Hep C (if you need treatment) and Cirrhosis if you are not compliant with these things.
Do not wait.  At your stage of Cirrhosis, you may still be able to treat your Hep C, if needed, but if your Cirrhosis progresses too far, you may not.
You will probably need to be tested for HIV and vaccinated against Hep A and Hep B as well.  Coinfection with any of these viruses create an extra burden on your liver as well.  Ask your hepatologist.
Advocate1955
Helpful - 0
223152 tn?1346978371
Hector has laid it out pretty straight forward.

Looks like you need a liver biopsy and you need that RNA test.  I have early cirrhosis which, like Hector said is late in the game in liver disease.  Mine was from hep C and probably has been progressing for 40 years.  Now that I have (it looks like) successfully treated and cleared the Hep C, the liver may heal somewhat, but it cannot heal entirely .  My hepatologist said I have slowed the progression.  That is a good thing and I will probably die from something else, not liver disease.  

Sounds like the drinking and the ibuprofen have got to go.  You will need to make sure now that you check all medications to determine if they are liver friendly as you don't want to do any more damage.

Good luck on the journey.  If you are hep C active, there is a large forum you can participate in.  It is interesting that you were donating plasma until 2008 though.  It may indicate your cirrhosis is more likely from the drinking and the medicines.

frijole
Helpful - 0
4507179 tn?1355632892
Thanks Hector...been on the phone and trying to rattle cages these past couple of days...finally got ahold of a live person in the Hep Clinic of University who said that I was missing my second RNA test for Hep for confirmation (she said I was to have it at 4 weeks after the first)...so Thursday I have 7 labs to be run including a liver panel, a full metabolic and the RNA
Helpful - 0
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