Hepatitus C and Corrhosis

[t28driver]

On 12 June, 2002 I voluntarily entered rehab for alcoholism. Since I am an airline pilot, I was required to participate in an FAA approved program referred to as IPP (Impaired Professionals Program) for pilots, doctors, nurses, pharmacists, etc., normally a six month program (plus or minus, could be a lot longer, shorter, depending on improvement results, sobriety, etc.). My required Class I medical certificate was suspended at that time. I satisfactorily completed rehab in November, 2002 and re-applied for my first class medical certificate, and it normally takes six to ten weeks to process thought the bureaucracy.
Since my blood tests and symptoms showed gall bladder problems and gall stones, I elected to have my gall bladder removed in early February, 2003, so that I would be back ready for flight status when my medical certificate was renewed (unknown to me, my medical certificate was renewed in January, 2003, but I had not received it yet). The gall bladder was not

[new-sojourn]

Under britpeter's Mar 15 post I was talking about the drugs we take w/out knowing the side effects.  Delayed reaction time and driving or flying is what we were talking about and how many drugs cause that impairment-not just pot or alcohol.

It's kinda scary out there.  You never know who's on what, never mind who's on first!

[new-sojourn]

Do you have a genotype?  Are you treating the hep c?  That should be a major concern.  I've never heard 'passive dormant' and I thought I had heard it all on this forum.  I would be concerned about that dx, esp w/the presenting signs of liver failure.  The fluid build up can lead to terrible mental and memory problems-encephalitis.  The jury is out as to how much is permanent and how much is reversable.  And that goes to the serious damage already done to your liver.

One word of advice, keep all your insurance policies current, or you will get another nasty shock when you are refused b/c you have hep c!

[Indiana]

WHEW!!  You certainly have been through it all there. If that shunt is their biggest concern, there is a different proceedure that can be done to replace that with a different kind of redirectuin of the blood flow. Here is an excerpt from the article....
Bleeding from the veins into the esophagus can be treated by infusing sclerosing agents that work by scarring the veins closed (sclerotherapy). These agents are administered through a flexible tube which is visually placed through the mouth into the esophagus. Frequently several sessions are necessary to obliterate all the veins. When bleeding is uncontrollable, surgery may be necessary. This involves the creation of a bypass (shunt) to redirect blood away from the liver. Unfortunately, mental confusion can result although bleeding is controlled. More recently, non-surgical methods have emerged which allow the creation of a bypass through the liver that can be done through the veins in the neck. This procedure has also been successful in the management of severe fluid overload which also complicates cirrhosis.

If this is really a non-surgical proceedure it sounds like this may be a great option to discuss with your doctor.
Here is a link to the article I got this from.....
http://www.medicinenet.com/Cirrhosis/page1.htm
I am still worried by your comment that your HCV is "Passive/Dormant". There is no such thing as that when dealing with Hcv. If your doctor told you that then you really need a better doctor. We can explore that subject if you wish, but in the meantime talk to them about that by-pass of blood flow through the neck.
I wish you well................

[thanbey]

The answer is a definite maybe.

A recent Supreme Court case decision might apply to your circumstances.

If you are working with a lawyer, this will be of interest. It will also be interesting to see whether the issues translate to licenses. I think there is some potential.

<a href="http://www.hcop.org/hcvinfo/articles/index.cfm?articleid=186">Chevron vs Echabels</a>

***@****

[imkindly]

I just wanted to throw in some comments here... Some of these things you may already know.

The 3 main 'complications' of advanced cirrhosis are:
1. Ascites (fluid build-up in the abdomen) caused by portal hypertension and low albumin
2. Varices (internal varicose veins usually in the esophagus, stomach, duodenum, or intestine) caused by portal hypertension
3. Encephalopathy (mental changes) caused by toxins (especially ammonia) not being filtered properly by the liver

---The main danger of ascites is the risk of infection (peritonitis)

---The main danger of varices is the risk of them bursting and bleeding (hemorrhage)

---The main danger of encephalopathy is coma

Ascites is controlled with a low sodium diet, prescription diuretics, and when necessary paracentesis

Varices can be controlled by banding (tiny rubber bands) or sclerotherapy (injection of chemicals)..... and the doctor usually prescribes a beta-blocker to reduce the portal hypertension

Encephalopathy can be kept under control with Lactulose or Kristalose (laxatives that remove ammonia from the body)

____________________________________________________

Years ago, doctors discovered that they could install a surgical shunt (that would reduce portal hypertension).
Surgical shunts had their own risks--- the operation itself carried risks, and the shunts frequently clogged after surgery.

So in recent years--- the surgical shunt is rarely ever used anymore.
INSTEAD, they install a TIPS shunt (like you have).
TIPS is a non-surgical procedure. (It was installed on a guidewire through your neck....by a radiologist)

TIPS creates a direct path for the blood to travel from the portal vein to the hepatic vein.
Instead of the blood being filtered by the liver..... it quickly passes through the shunt. (The shunt is like a tube through your liver).

What you need to keep in mind is that the blood isn't being filtered properly (that's why you have to take Kristalose to remove toxins from your body)...
and that these shunts can clog (thrombosis) or move (stenosis)--- so you should have periodic ultrasounds done to make sure your TIPS is doing ok.
(They should be checking you AT LEAST every 6 months)

TIPS is usually used as a bridge to transplantation.

[imkindly]

One more thing---
Encephalopathy (even mild encephalopathy, what they call "subclinical") can cause 'delayed reaction time'.
That's the reason that some hepatologists tell patients taking lactulose (kristalose) not to drive a car.
(It may be some of the reasoning behind them not wanting you to fly a plane) (?)

[cuteus]

Since this is a mostly patient to patient forum not all the knowledgeable people are available at any given time.  Some of your concerns have been addressed here by various well informed individuals in other occassions.  Check back often and you will find a variety of links and data you can access.
With cirrhosis I don't know if any doctor can attest that your Hep c status is dormant and without side effects to your health.
Be well