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186606 tn?1263513790

okay, i'm sure i'm driving everyone here crazy BUT

I posted the other day that I was told by my GI that I was coninfected by heptatitis B.

Something was niggling at my mind and so i went to quest and got a copy of my latest lab results...remember, the one with the nice 192 viral load?

I DO NOT have antibodies to hepatitis B. My viral load is correct, at lest he told me THAT right, but no hep B in addition to hep c.

this is driving me crazy. I did send an email to Dr. Gish as JMJM recommended (I think it was him!) at California Pacific yesterday and he emailed me back in the afternoon. He wanted to know dates for my labs and thought my geno 4 was..."interesting". He told me that if one hasn't cleared at 3 months, he treats. He said i could make an appointment.

So I'm thinking...what the HELL!!! not about Dr. Gish but what the hell is wrong with doctors in Las Vegas?

So now I'm more confused. I did talk to my internist yesterday who said he would pull a Heptimax next month to see if I cleared and also...without either of us knowing I had an email waiting from Dr. Gish, said that maybe we should look at docs in California.

I can't really afford to travel to San Francisco and how can I treat THERE if i try to live and work HERE?


thanks for your support and listening to my endless crapola here!

10 Responses
87972 tn?1322664839
Hi Deb;

I'm a patient with CPMC in Sacramento, and I remember noticing that their website showed two Las Vegas outreach clinic locations. These are from their site: http://www.cpmc.org/advanced/liver/physicians/outreach.html#Las%20Vegas

Las Vegas
Two Locations
Robert Gish, M.D.

Jami McDaniel
Desert Gastroenterology
3150 N. Tenaya #630
Las Vegas, NV 89128
Tel. 702/796-9111

Donna Johnson
Physician Foundation at California Pacific Medical Center
3006 S. Maryland Parkway #470
Las Vegas, NV 89109
Tel. 702/796-9111

Give them a call and see if they can help. They're a great outfit, by the way--

87972 tn?1322664839
I forgot to mention... call them back anyway. They are accustomed to working with other doctors in outreach participation-- for example they might consider working up a Tx plan, then work with your internist in NV and let him be the
Avatar universal
Sounds like Gish is willing to work with you. Face it, they get bored with your typical geno 1's and a geno 4 acute with a possible con-infection of Hep B can break up their day:) Unlike your local doc appears, he knows his stuff. My suggestion is to get copies of ALL bloodwork, procedures, etc, pre and during treatment and Fedex or fax them to Gish. You might then consider a single trip out to SF for a consultation. After that, you might be able to stay local, with Gish calling the shots and a local doctor taking care of the day to day. Of course, discuss this in advance via email with Gish before you decide to lug out there.

All the best,

-- Jim
96938 tn?1189803458
I had an old recollection that Gish saw pts in Las Vegas.  I remember thinking at the time, that it both made sense and didn't.
92903 tn?1309908311
Certaininy anybody in this game with his level of street cred (I've been wanting to use that expression for a while, thanks) is pretty good at identifying odds, and beating them a fair amount of the time.....
Avatar universal
Deb, so happy to hear you don't have Hep B.  There is a lot of confusion when it comes to ACUTE Hep C simply becuase there's not a lot of research/info out there on it.  General rule of thumb: treat if VL positive at 3 months (like Gish said), you could wait 4 but don't wait more than 5.  As you increase time it's in your body, you decrease your chances of getting rid of it, but you have to weigh the pros and cons of the situation.  You may not get a Dr. who understands your case and gives you definitive answers, but you CAN get what you need -- a Dr. who is willing to give you the meds... if, in fact, you need them.  I waited until week 17 and my starting VL was 140.  In your shoes, I'd wait a couple more weeks, until the 16th week -- only because your numbers warrant it and the tx is so challenging -- however if at week 16, no UND, I'd start tx ASAP.  That's my Un-MD'd but heavily researched opinion.  The jury is still out though as to if I obtain SVR, so the data from my own case is not yet complete.  All my best, Aiuta  
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