Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 Good Morning Roy, My family wants me to go to uab but for now I want to stay with . He is in AA. So I would think he knows. I still have not gotten a biopsy done.. I do 11 shots a week. For wbc, rbc and platlets. Also the inferon. Let me know what you are going to do. Have a great day. MARYP Re: Liver Biopsy My gastroenterologist will NOT order a liver biopsy. He doesn't think it's indicated "at this time". He's ordered ultrasound (which showed a liver 'more nodular than we expected'), ordered endoscopy (to check for bleeding varices), and says that if a study I'm eligible for requires a liver biopsy, he'll do one.I'm being treated at the Kirklin Clinic in Birmingham, and UAB is supposed to know livers, but I worry. Especially since my liver is 'more nodular', I want to know what's going on. Is a liver biopsy such a bad thing?Roy in Alabama>> > Liver Biopsy> > > > Liver biopsy is not necessary for diagnosis but is helpful for grading> the severity of disease and staging the degree of fibrosis and permanent> architectural damage. Hematoxylin and eosin stains and Masson's> trichrome stain are used to grade the amount of necrosis and> inflammation and to stage the degree of fibrosis. Specific> immunohistochemical stains for HCV have not been developed for routine> use. Liver biopsy is also helpful in ruling out other causes of liver> disease, such as alcoholic liver injury or iron overload. HCV causes the> following changes in liver tissue:> > •Necrosis and inflammation around the portal areas, so-called> "piecemealnecrosis" or "interface hepatitis."> > •Necrosis of hepatocytes and focal inflammation in the liver> parenchyma.> > •Inflammatory cells in the portal areas ("portal inflammation" ).> > •Fibrosis, with early stages being confined to the portal tracts,> intermediate stages being expansion of the portal tracts and bridging> between portal areas or to the central area, and late stages being frank> cirrhosis characterized by architectural disruption of the liver with> fibrosis and regeneration.> > Grading and Staging of hepatitis by assigning scores for severity are> helpful in managing patients with chronic hepatitis. The degree of> inflammation and necrosis can be assessed as none, minimal, mild,> moderate, or severe. The degree of fibrosis can be similarly assessed.> Scoring systems are particularly helpful in clinical studies on chronic> hepatitis.> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 If I were you to be honest I woud get another doctor . Liver biopsies are the most accurate way to depict the damage in the liver . There is only so much a CT or Ultrasound can see , but a biopsy leaves the doctor with a tissue sample to put under the microscope . And that tissue is also a baseline for them to see if the disease progresses or if a tp is necessary. Biopsy also shows if there is iron saturation of the liver .But with your liver being nodular that is a clear indication of needing a biopsy . Biopsies and done as an outpatient thing and generally the patient is knocked out right when the needle is puncturing the liver . There is minimal pain afterwards but the benefits are worth it . It sounds like there may be lots of damage from cirrhosis , has he done tumor markers (blood test) ? Re: Liver Biopsy My gastroenterologist will NOT order a liver biopsy. He doesn't think it's indicated "at this time". He's ordered ultrasound (which showed a liver 'more nodular than we expected'), ordered endoscopy (to check for bleeding varices), and says that if a study I'm eligible for requires a liver biopsy, he'll do one.I'm being treated at the Kirklin Clinic in Birmingham, and UAB is supposed to know livers, but I worry. Especially since my liver is 'more nodular', I want to know what's going on. Is a liver biopsy such a bad thing?Roy in Alabama>> > Liver Biopsy> > > > Liver biopsy is not necessary for diagnosis but is helpful for grading> the severity of disease and staging the degree of fibrosis and permanent> architectural damage. Hematoxylin and eosin stains and Masson's> trichrome stain are used to grade the amount of necrosis and> inflammation and to stage the degree of fibrosis. Specific> immunohistochemical stains for HCV have not been developed for routine> use. Liver biopsy is also helpful in ruling out other causes of liver> disease, such as alcoholic liver injury or iron overload. HCV causes the> following changes in liver tissue:> > •Necrosis and inflammation around the portal areas, so-called> "piecemealnecrosis" or "interface hepatitis."> > •Necrosis of hepatocytes and focal inflammation in the liver> parenchyma.> > •Inflammatory cells in the portal areas ("portal inflammation").> > •Fibrosis, with early stages being confined to the portal tracts,> intermediate stages being expansion of the portal tracts and bridging> between portal areas or to the central area, and late stages being frank> cirrhosis characterized by architectural disruption of the liver with> fibrosis and regeneration.> > Grading and Staging of hepatitis by assigning scores for severity are> helpful in managing patients with chronic hepatitis. The degree of> inflammation and necrosis can be assessed as none, minimal, mild,> moderate, or severe. The degree of fibrosis can be similarly assessed.> Scoring systems are particularly helpful in clinical studies on chronic> hepatitis.> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 Roy, I will get on that when I go back tuesday. My family will be glad to hear that and really I'am too. Thanks for the info, P [Hepatitis_C_ Central] Re: Liver Biopsy My gastroenterologist will NOT order a liver biopsy. He doesn't think it's indicated "at this time". He's ordered ultrasound (which showed a liver 'more nodular than we expected'), ordered endoscopy (to check for bleeding varices), and says that if a study I'm eligible for requires a liver biopsy, he'll do one.I'm being treated at the Kirklin Clinic in Birmingham, and UAB is supposed to know livers, but I worry. Especially since my liver is 'more nodular', I want to know what's going on. Is a liver biopsy such a bad thing?Roy in Alabama>> > Liver Biopsy> > > > Liver biopsy is not necessary for diagnosis but is helpful for grading> the severity of disease and staging the degree of fibrosis and permanent> architectural damage. Hematoxylin and eosin stains and Masson's> trichrome stain are used to grade the amount of necrosis and> inflammation and to stage the degree of fibrosis. Specific> immunohistochemical stains for HCV have not been developed for routine> use. Liver biopsy is also helpful in ruling out other causes of liver> disease, such as alcoholic liver injury or iron overload. HCV causes the> following changes in liver tissue:> > •Necrosis and inflammation around the portal areas, so-called> "piecemealnecrosis" or "interface hepatitis."> > •Necrosis of hepatocytes and focal inflammation in the liver> parenchyma.> > •Inflammatory cells in the portal areas ("portal inflammation" ).> > •Fibrosis, with early stages being confined to the portal tracts,> intermediate stages being expansion of the portal tracts and bridging> between portal areas or to the central area, and late stages being frank> cirrhosis characterized by architectural disruption of the liver with> fibrosis and regeneration.> > Grading and Staging of hepatitis by assigning scores for severity are> helpful in managing patients with chronic hepatitis. The degree of> inflammation and necrosis can be assessed as none, minimal, mild,> moderate, or severe. The degree of fibrosis can be similarly assessed.> Scoring systems are particularly helpful in clinical studies on chronic> hepatitis.> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 Fibrosure is only accurate when there is cirrhosis or when there is no damage at all . It isn't accurate for the stages in-between lol Re: Liver Biopsy Be sure to ask Your doctor/s about the Fibrosure liver test, it's 'supposed-to-be' accurate as far as sensing the level/s of liver-damage.Here's a Google-Search URL about the Fibrosure test.http://tinyurl.com/449znaAs far as a Liver-Biopsy goes, I had no problem with mine.Just around 3-4 hours recovery time, and they send one home,....as long as there aren't any complications. Here is a Needle Biopsy Video, it's 'pretty-much' how mine went as well.Video of a 'typical' Needle Biopsy of the Liver http://www.tinyurl.com/2daof7--- In Hepatitis_C_Central , "Roy" wrote:>> My gastroenterologist will NOT order a liver biopsy. He doesn't think > it's indicated "at this time". He's ordered ultrasound (which showed > a liver 'more nodular than we expected'), ordered endoscopy (to check > for bleeding varices), and says that if a study I'm eligible for > requires a liver biopsy, he'll do one.> > I'm being treated at the Kirklin Clinic in Birmingham, and UAB is > supposed to know livers, but I worry. Especially since my liver > is 'more nodular', I want to know what's going on. Is a liver biopsy > such a bad thing?> > Roy in Alabama> > > > >> > > > Liver Biopsy> > > > > > > > Liver biopsy is not necessary for diagnosis but is helpful for > grading> > the severity of disease and staging the degree of fibrosis and > permanent> > architectural damage. Hematoxylin and eosin stains and Masson's> > trichrome stain are used to grade the amount of necrosis and> > inflammation and to stage the degree of fibrosis. Specific> > immunohistochemical stains for HCV have not been developed for > routine> > use. Liver biopsy is also helpful in ruling out other causes of > liver> > disease, such as alcoholic liver injury or iron overload. HCV > causes the> > following changes in liver tissue:> > > > •Necrosis and inflammation around the portal areas, so-called> > "piecemealnecrosis" or "interface hepatitis."> > > > •Necrosis of hepatocytes and focal inflammation in the liver> > parenchyma.> > > > •Inflammatory cells in the portal areas ("portal inflammation").> > > > •Fibrosis, with early stages being confined to the portal tracts,> > intermediate stages being expansion of the portal tracts and > bridging> > between portal areas or to the central area, and late stages being > frank> > cirrhosis characterized by architectural disruption of the liver > with> > fibrosis and regeneration.> > > > Grading and Staging of hepatitis by assigning scores for severity > are> > helpful in managing patients with chronic hepatitis. The degree of> > inflammation and necrosis can be assessed as none, minimal, mild,> > moderate, or severe. The degree of fibrosis can be similarly > assessed.> > Scoring systems are particularly helpful in clinical studies on > chronic> > hepatitis.> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 Thanks Liz for pointing this out,, Fibrosure is not accurate except for noting total cirrhosis or no damage.. you got that right!JackieSubject: Re: Re: Liver BiopsyTo: Hepatitis_C_Central Date: Saturday, May 31, 2008, 5:56 PM Fibrosure is only accurate when there is cirrhosis or when there is no damage at all . It isn't accurate for the stages in-between lol [Hepatitis_C_ Central] Re: Liver Biopsy Be sure to ask Your doctor/s about the Fibrosure liver test, it's 'supposed-to- be' accurate as far as sensing the level/s of liver-damage.Here's a Google-Search URL about the Fibrosure test.http://tinyurl. com/449znaAs far as a Liver-Biopsy goes, I had no problem with mine.Just around 3-4 hours recovery time, and they send one home,....as long as there aren't any complications. Here is a Needle Biopsy Video, it's 'pretty-much' how mine went as well.Video of a 'typical' Needle Biopsy of the Liver http://www.tinyurl. com/2daof7> >> > > > Liver Biopsy> > > > > > > > Liver biopsy is not necessary for diagnosis but is helpful for > grading> > the severity of disease and staging the degree of fibrosis and > permanent> > architectural damage. Hematoxylin and eosin stains and Masson's> > trichrome stain are used to grade the amount of necrosis and> > inflammation and to stage the degree of fibrosis. Specific> > immunohistochemical stains for HCV have not been developed for > routine> > use. Liver biopsy is also helpful in ruling out other causes of > liver> > disease, such as alcoholic liver injury or iron overload. HCV > causes the> > following changes in liver tissue:> > > > •Necrosis and inflammation around the portal areas, so-called> > "piecemealnecrosis" or "interface hepatitis."> > > > •Necrosis of hepatocytes and focal inflammation in the liver> > parenchyma.> > > > •Inflammatory cells in the portal areas ("portal inflammation" ).> > > > •Fibrosis, with early stages being confined to the portal tracts,> > intermediate stages being expansion of the portal tracts and > bridging> > between portal areas or to the central area, and late stages being > frank> > cirrhosis characterized by architectural disruption of the liver > with> > fibrosis and regeneration.> > > > Grading and Staging of hepatitis by assigning scores for severity > are> > helpful in managing patients with chronic hepatitis. The degree of> > inflammation and necrosis can be assessed as none, minimal, mild,> > moderate, or severe. The degree of fibrosis can be similarly > assessed.> > Scoring systems are particularly helpful in clinical studies on > chronic> > hepatitis.> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 , please talk with Liz about phlebotomies, they DO WORK... and if your iron overload is high enough, it could really compromise your treatment..they can give you procrit and neupo to increase your rbcs and wbcs if you should need them... In any case , Liz has hemochromatosis and has to keep doing the phlemotomies and she knows alot about it.. hugsjaxJackieSubject: Re: Liver BiopsyTo: Hepatitis_C_Central Date: Saturday, May 31, 2008, 7:07 PM Hi Roy, I have been going to the Mayo Clinic in ville, Florida for 6 months now. I have had every test imaginable except a liver biopsy. With a serum Ferritin blood test you could tell I had Iron over load but the Mayo Doctors say that's normal and phlebotomy's don't work to correct it. Personally I think there is some liability issues but oh well I am kinda at the mercy of these Doctors My Doctor said he did not want to remove the iron because it will reduce my WBC count and he wants me to start treatment in September. When I asked why no liver biopsy he said from the 2 weeks of tests they ran they got all the information they need and a biopsy IS dangerous. Anytime they do invasive surgery there are risks especially if you are End Stage like me. His only concern was my mental state....I kind went a little crazy when I was told I was dying and needed a liver transplant Thanks to Celexa I am doing much much better! My Psychiatrist agrees so I began TX in September and man am I scared! So I guess it depends on allot of thing why some would request a biopsy. I have been told by more than one person biopsy's are old news and a unnecessary risk. But taking interferon and ribivir is not??? I gave up trying to make sense of this disease and just go with the flow altho I do research and ask allot of questions which they happily answer for me in a VERY condencending way. Like how dare a lay person like you question me Ack I hate traditional medicine but its all I got that works. So I guess the point of my long winded post is get on some anti depressants, question what they tell you and research it AND most important don't worry about stuff until your told you need it done or you'll end up crazy as a bed bug like I did 53 years old, diagnosed in December 2007, with End Stage liver disease Geno 3 with a low viral load of 255,000. Heart, lungs, pancreas, colon, stomach, kidneys all in excellent shape. Everything else is junk Decompensated Cirrhosis, Esophageal varices, portal hypertension, encephalopathy, periumbilical hernia, ascites, edema and just a little non obstructive calculus in a kidney. Tired all the time, peeing my brains out and lost allot of muscle due to muscle wasting. Geez cannot wait for liver transplant!! !!! > [Hepatitis_C_ Central] Re: Liver Biopsy > > > My gastroenterologist will NOT order a liver biopsy. He doesn't think > it's indicated "at this time". He's ordered ultrasound (which showed > a liver 'more nodular than we expected'), ordered endoscopy (to check > for bleeding varices), and says that if a study I'm eligible for > requires a liver biopsy, he'll do one. > > I'm being treated at the Kirklin Clinic in Birmingham, and UAB is > supposed to know livers, but I worry. Especially since my liver > is 'more nodular', I want to know what's going on. Is a liver biopsy > such a bad thing? > > Roy in Alabama > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 I TOTALLY Agree with you Liz,,, and if her liver is 'nodular', it sounds like she has advancing damage and there is just no other way to see what is going on in there... Im shocked that he only would do an ultrasound,, they cannot and do not see what is going on inside at the cellurlar level,, I'd find another doc if it were me too..JackieSubject: Re: Re: Liver BiopsyTo: Hepatitis_C_Central Date: Saturday, May 31, 2008, 8:00 AM If I were you to be honest I woud get another doctor . Liver biopsies are the most accurate way to depict the damage in the liver . There is only so much a CT or Ultrasound can see , but a biopsy leaves the doctor with a tissue sample to put under the microscope . And that tissue is also a baseline for them to see if the disease progresses or if a tp is necessary. Biopsy also shows if there is iron saturation of the liver .But with your liver being nodular that is a clear indication of needing a biopsy . Biopsies and done as an outpatient thing and generally the patient is knocked out right when the needle is puncturing the liver . There is minimal pain afterwards but the benefits are worth it . It sounds like there may be lots of damage from cirrhosis , has he done tumor markers (blood test) ? [Hepatitis_C_ Central] Re: Liver Biopsy My gastroenterologist will NOT order a liver biopsy. He doesn't think it's indicated "at this time". He's ordered ultrasound (which showed a liver 'more nodular than we expected'), ordered endoscopy (to check for bleeding varices), and says that if a study I'm eligible for requires a liver biopsy, he'll do one.I'm being treated at the Kirklin Clinic in Birmingham, and UAB is supposed to know livers, but I worry. Especially since my liver is 'more nodular', I want to know what's going on. Is a liver biopsy such a bad thing?Roy in Alabama>> > Liver Biopsy> > > > Liver biopsy is not necessary for diagnosis but is helpful for grading> the severity of disease and staging the degree of fibrosis and permanent> architectural damage. Hematoxylin and eosin stains and Masson's> trichrome stain are used to grade the amount of necrosis and> inflammation and to stage the degree of fibrosis. Specific> immunohistochemical stains for HCV have not been developed for routine> use. Liver biopsy is also helpful in ruling out other causes of liver> disease, such as alcoholic liver injury or iron overload. HCV causes the> following changes in liver tissue:> > •Necrosis and inflammation around the portal areas, so-called> "piecemealnecrosis" or "interface hepatitis."> > •Necrosis of hepatocytes and focal inflammation in the liver> parenchyma.> > •Inflammatory cells in the portal areas ("portal inflammation" ).> > •Fibrosis, with early stages being confined to the portal tracts,> intermediate stages being expansion of the portal tracts and bridging> between portal areas or to the central area, and late stages being frank> cirrhosis characterized by architectural disruption of the liver with> fibrosis and regeneration.> > Grading and Staging of hepatitis by assigning scores for severity are> helpful in managing patients with chronic hepatitis. The degree of> inflammation and necrosis can be assessed as none, minimal, mild,> moderate, or severe. The degree of fibrosis can be similarly assessed.> Scoring systems are particularly helpful in clinical studies on chronic> hepatitis.> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 Roy,As Liz said, I would encourage you to get a different doc,, YOU NEED a BIOPSY!!!! an ultrasound willnot and cannot tell whats really going on in your liver.. and with it being 'nodular', well you need to find out what is going on and what stage of damage you are...jaxJackieSubject: Re: Liver BiopsyTo: Hepatitis_C_Central Date: Friday, May 30, 2008, 10:59 PM My gastroenterologist will NOT order a liver biopsy. He doesn't think it's indicated "at this time". He's ordered ultrasound (which showed a liver 'more nodular than we expected'), ordered endoscopy (to check for bleeding varices), and says that if a study I'm eligible for requires a liver biopsy, he'll do one. I'm being treated at the Kirklin Clinic in Birmingham, and UAB is supposed to know livers, but I worry. Especially since my liver is 'more nodular', I want to know what's going on. Is a liver biopsy such a bad thing? Roy in Alabama > > > Liver Biopsy > > > > Liver biopsy is not necessary for diagnosis but is helpful for grading > the severity of disease and staging the degree of fibrosis and permanent > architectural damage. Hematoxylin and eosin stains and Masson's > trichrome stain are used to grade the amount of necrosis and > inflammation and to stage the degree of fibrosis. Specific > immunohistochemical stains for HCV have not been developed for routine > use. Liver biopsy is also helpful in ruling out other causes of liver > disease, such as alcoholic liver injury or iron overload. HCV causes the > following changes in liver tissue: > > •Necrosis and inflammation around the portal areas, so-called > "piecemealnecrosis" or "interface hepatitis." > > •Necrosis of hepatocytes and focal inflammation in the liver > parenchyma. > > •Inflammatory cells in the portal areas ("portal inflammation" ). > > •Fibrosis, with early stages being confined to the portal tracts, > intermediate stages being expansion of the portal tracts and bridging > between portal areas or to the central area, and late stages being frank > cirrhosis characterized by architectural disruption of the liver with > fibrosis and regeneration. > > Grading and Staging of hepatitis by assigning scores for severity are > helpful in managing patients with chronic hepatitis. The degree of > inflammation and necrosis can be assessed as none, minimal, mild, > moderate, or severe. The degree of fibrosis can be similarly assessed. > Scoring systems are particularly helpful in clinical studies on chronic > hepatitis. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 Your doctors are incorrect about the iron overload . Unless you have the genetic hemachromatosis and even then there is treatment for it . And phlebotomies do help and they even lower the viral load ..There is also a new medication called Exjade and it can remove excess iron from the blood . But more than likely your high iron is caused by your hepatitis c and removing it by either phlebotomies or the medication can help prevent your liver from further damage . Also iron overload can cause damage to the heart and kidneys too. Removal of excess iron also increases the hep c treatments rate of success . Getting rid of the hep c can stop the iron from happening ... Re: Liver Biopsy> > > My gastroenterologist will NOT order a liver biopsy. He doesn't think > it's indicated "at this time". He's ordered ultrasound (which showed > a liver 'more nodular than we expected'), ordered endoscopy (to check > for bleeding varices), and says that if a study I'm eligible for > requires a liver biopsy, he'll do one.> > I'm being treated at the Kirklin Clinic in Birmingham, and UAB is > supposed to know livers, but I worry. Especially since my liver > is 'more nodular', I want to know what's going on. Is a liver biopsy > such a bad thing?> > Roy in Alabama> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 I would think that the first thing they did would be to order a biopsy especially after they found nodules on ultrasound . [Hepatitis_C_ Central] Re: Liver Biopsy My gastroenterologist will NOT order a liver biopsy. He doesn't think it's indicated "at this time". He's ordered ultrasound (which showed a liver 'more nodular than we expected'), ordered endoscopy (to check for bleeding varices), and says that if a study I'm eligible for requires a liver biopsy, he'll do one.I'm being treated at the Kirklin Clinic in Birmingham, and UAB is supposed to know livers, but I worry. Especially since my liver is 'more nodular', I want to know what's going on. Is a liver biopsy such a bad thing?Roy in Alabama>> > Liver Biopsy> > > > Liver biopsy is not necessary for diagnosis but is helpful for grading> the severity of disease and staging the degree of fibrosis and permanent> architectural damage. Hematoxylin and eosin stains and Masson's> trichrome stain are used to grade the amount of necrosis and> inflammation and to stage the degree of fibrosis. Specific> immunohistochemical stains for HCV have not been developed for routine> use. Liver biopsy is also helpful in ruling out other causes of liver> disease, such as alcoholic liver injury or iron overload. HCV causes the> following changes in liver tissue:> > •Necrosis and inflammation around the portal areas, so-called> "piecemealnecrosis" or "interface hepatitis."> > •Necrosis of hepatocytes and focal inflammation in the liver> parenchyma.> > •Inflammatory cells in the portal areas ("portal inflammation" ).> > •Fibrosis, with early stages being confined to the portal tracts,> intermediate stages being expansion of the portal tracts and bridging> between portal areas or to the central area, and late stages being frank> cirrhosis characterized by architectural disruption of the liver with> fibrosis and regeneration.> > Grading and Staging of hepatitis by assigning scores for severity are> helpful in managing patients with chronic hepatitis. The degree of> inflammation and necrosis can be assessed as none, minimal, mild,> moderate, or severe. The degree of fibrosis can be similarly assessed.> Scoring systems are particularly helpful in clinical studies on chronic> hepatitis.> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 no kidding,, I really hate to sound like Im denigrating someones doc, but whew,, I'd be wanting one asap,,Jackie From: elizabethnv1 <elizabethnv1@ earthlink. net>Subject: Re: [Hepatitis_C_ Central] Re: Liver BiopsyTo: Hepatitis_C_ Central@yahoogro ups.comDate: Saturday, May 31, 2008, 8:00 AM If I were you to be honest I woud get another doctor . Liver biopsies are the most accurate way to depict the damage in the liver . There is only so much a CT or Ultrasound can see , but a biopsy leaves the doctor with a tissue sample to put under the microscope . And that tissue is also a baseline for them to see if the disease progresses or if a tp is necessary. Biopsy also shows if there is iron saturation of the liver .But with your liver being nodular that is a clear indication of needing a biopsy . Biopsies and done as an outpatient thing and generally the patient is knocked out right when the needle is puncturing the liver . There is minimal pain afterwards but the benefits are worth it . It sounds like there may be lots of damage from cirrhosis , has he done tumor markers (blood test) ? [Hepatitis_C_ Central] Re: Liver Biopsy My gastroenterologist will NOT order a liver biopsy. He doesn't think it's indicated "at this time". He's ordered ultrasound (which showed a liver 'more nodular than we expected'), ordered endoscopy (to check for bleeding varices), and says that if a study I'm eligible for requires a liver biopsy, he'll do one.I'm being treated at the Kirklin Clinic in Birmingham, and UAB is supposed to know livers, but I worry. Especially since my liver is 'more nodular', I want to know what's going on. Is a liver biopsy such a bad thing?Roy in Alabama>> > Liver Biopsy> > > > Liver biopsy is not necessary for diagnosis but is helpful for grading> the severity of disease and staging the degree of fibrosis and permanent> architectural damage. Hematoxylin and eosin stains and Masson's> trichrome stain are used to grade the amount of necrosis and> inflammation and to stage the degree of fibrosis. Specific> immunohistochemical stains for HCV have not been developed for routine> use. Liver biopsy is also helpful in ruling out other causes of liver> disease, such as alcoholic liver injury or iron overload. HCV causes the> following changes in liver tissue:> > •Necrosis and inflammation around the portal areas, so-called> "piecemealnecrosis" or "interface hepatitis."> > •Necrosis of hepatocytes and focal inflammation in the liver> parenchyma.> > •Inflammatory cells in the portal areas ("portal inflammation" ).> > •Fibrosis, with early stages being confined to the portal tracts,> intermediate stages being expansion of the portal tracts and bridging> between portal areas or to the central area, and late stages being frank> cirrhosis characterized by architectural disruption of the liver with> fibrosis and regeneration.> > Grading and Staging of hepatitis by assigning scores for severity are> helpful in managing patients with chronic hepatitis. The degree of> inflammation and necrosis can be assessed as none, minimal, mild,> moderate, or severe. The degree of fibrosis can be similarly assessed.> Scoring systems are particularly helpful in clinical studies on chronic> hepatitis.> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 LOL I love bagging on some doctors cause most of em are ignorant unless they specialize in hepatology [Hepatitis_C_ Central] Re: Liver Biopsy My gastroenterologist will NOT order a liver biopsy. He doesn't think it's indicated "at this time". He's ordered ultrasound (which showed a liver 'more nodular than we expected'), ordered endoscopy (to check for bleeding varices), and says that if a study I'm eligible for requires a liver biopsy, he'll do one.I'm being treated at the Kirklin Clinic in Birmingham, and UAB is supposed to know livers, but I worry. Especially since my liver is 'more nodular', I want to know what's going on. Is a liver biopsy such a bad thing?Roy in Alabama>> > Liver Biopsy> > > > Liver biopsy is not necessary for diagnosis but is helpful for grading> the severity of disease and staging the degree of fibrosis and permanent> architectural damage. Hematoxylin and eosin stains and Masson's> trichrome stain are used to grade the amount of necrosis and> inflammation and to stage the degree of fibrosis. Specific> immunohistochemical stains for HCV have not been developed for routine> use. Liver biopsy is also helpful in ruling out other causes of liver> disease, such as alcoholic liver injury or iron overload. HCV causes the> following changes in liver tissue:> > •Necrosis and inflammation around the portal areas, so-called> "piecemealnecrosis" or "interface hepatitis."> > •Necrosis of hepatocytes and focal inflammation in the liver> parenchyma.> > •Inflammatory cells in the portal areas ("portal inflammation" ).> > •Fibrosis, with early stages being confined to the portal tracts,> intermediate stages being expansion of the portal tracts and bridging> between portal areas or to the central area, and late stages being frank> cirrhosis characterized by architectural disruption of the liver with> fibrosis and regeneration.> > Grading and Staging of hepatitis by assigning scores for severity are> helpful in managing patients with chronic hepatitis. The degree of> inflammation and necrosis can be assessed as none, minimal, mild,> moderate, or severe. The degree of fibrosis can be similarly assessed.> Scoring systems are particularly helpful in clinical studies on chronic> hepatitis.> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 My Meld is around where yours is, . Was in the low 20's but kept dropping, as all my blood tests slowly got better. Yeah, I was inelgible then, too. I always said I'd have to get worse to get better, and now I have my dream! Geno is 1A. SVR attained only during treatment, then shot back up immediately after my 3 tx's. It seems that your Meld score could remain that low area for quite awhile, That's why 6 month ultracounds and CT scans should be used. They're the best way I know of to find something new, luke a tumor. My blood test for tumor marker is normal! Reading my blood tests, most Doc's would not jump to the conclusion that I have HCV and end stage liver disease, now with a tumor. I was happy that my blood numbers kept getting better, and knew that this would prevent me from getting on the tp list. That also began to worry me. O.K., I feel fine now, so that's when the proverbial turd balls always hits the fan. I was truly hoping for earlier rather than later. I'm 62 now, and the idea of a tp at age 70 is really scary and iffy. Guess I got my wish! Now better than ever! So, I think you have to be patient, and ask you Docs how often they wish to schedule ultrascans and CT's. Yearly is too long, as tumors can mastecize quickly. Re: Liver Biopsy Hi Rick thanks for the encouraging words {{{{HUGS}}} to you and good luck with your TP. I am only a MELD 11 so not on the list yet but with the crap care I seem to be getting I'll probably get there soon. Oh don't you just LOVE the brain fog Getting worse every month and I am now up to a 77 ammonia level which is still not that bad but I am so terrified about when it does get up into the 200 range what that will be like. Will I be a drooling vegetable laying in bed all day :)What Geno type are you and did you achieve SVR with treatment? Do you have the ascites and edema? From what I keep reading its like a REAL long shot that it will work with a decompensated liver and all the medication I am on now and according to the Mayo I could possibly die or end up on the transplant list real quick. My hepatologist words were "It is not going to be a cake walk" The only reason I agreed to it was because I was a Geno 3a with a very very low viral load and I can quit whenever I want to.>> Hi, ! You're going to one of the top tp hcv centers in the > world. I think you have to give their Docs more credit. Always good > to have and ask questions, but I haven't had a biopsy in a few years, > yet I'm about to get on the tp list at Lifelink of Tampa. I live in > Fort Myers, otherwise I too would go to the the Mayo in Jax. See my > Post above. I also had high iron content a few years ago, and the > Docs wouldn't give me anything. They simply said to watch my diet a > liquids. My iron levels have gone way down to normal. Looks like > we're in the same boat, my friend! And don't be scared of the tx. > It'll help prolong your liver for a better chance a tp. You must keep > your physical and mental states in line. The Celexa also works well > for me. This whole trip is a roller coaster ride. Highs and lows, > thrills and fright. However, the coaster always ends where you got > on! (If that doesn't make sense, blame my hepper brain, lol!).> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 Oops almost forgot ... get a referral to see a hematologist and have him treat you ,., Re: Liver Biopsy I know all this Liz but how do you get Doctors who refuse to write a script for phlebotomies to write one? Maybe I am not that high to warrant it? Could not find a answer to that on the net so wondering if you know. My Serum ferritin was 615 in December of 2007. As soon as I saw that I requested treatment and was ...ignored and patronized to the point I got another Gastro Doctor. So I researched IOD and requested a test for genetic hemochromatosis. Thankfully that test was negative. So I completely eliminated all ferrous sulfate (iron) from foods. My Iron did go down to 460 in February. If you have any other tricks you know of other than blood draws PLEASE let me know. What I am doing seems to be working but dang I know how very very very bad all this iron in my liver is Sadly I seem to be the only one who cares. >> Your doctors are incorrect about the iron overload . Unless you have the genetic hemachromatosis and even then there is treatment for it . And phlebotomies do help and they even lower the viral load ..There is also a new medication called Exjade and it can remove excess iron from the blood . But more than likely your high iron is caused by your hepatitis c and removing it by either phlebotomies or the medication can help prevent your liver from further damage . Also iron overload can cause damage to the heart and kidneys too. Removal of excess iron also increases the hep c treatments rate of success . Getting rid of the hep c can stop the iron from happening ... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 , I have a dr. that seems not want to do biopsy. Because of my blood count. What about that, he thinks because I could bleed to death. Let me know something. We are have storm so I,am going to cut till it passes. P [Hepatitis_C_ Central] Re: Liver Biopsy I know all this Liz but how do you get Doctors who refuse to write a script for phlebotomies to write one? Maybe I am not that high to warrant it? Could not find a answer to that on the net so wondering if you know. My Serum ferritin was 615 in December of 2007. As soon as I saw that I requested treatment and was ...ignored and patronized to the point I got another Gastro Doctor. So I researched IOD and requested a test for genetic hemochromatosis. Thankfully that test was negative. So I completely eliminated all ferrous sulfate (iron) from foods. My Iron did go down to 460 in February. If you have any other tricks you know of other than blood draws PLEASE let me know. What I am doing seems to be working but dang I know how very very very bad all this iron in my liver is Sadly I seem to be the only one who cares. >> Your doctors are incorrect about the iron overload . Unless you have the genetic hemachromatosis and even then there is treatment for it . And phlebotomies do help and they even lower the viral load ..There is also a new medication called Exjade and it can remove excess iron from the blood . But more than likely your high iron is caused by your hepatitis c and removing it by either phlebotomies or the medication can help prevent your liver from further damage . Also iron overload can cause damage to the heart and kidneys too. Removal of excess iron also increases the hep c treatments rate of success . Getting rid of the hep c can stop the iron from happening .... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 Are you a hemophiliac ? If so your doctor has a valid concern , but if not then look for a doc not afraid . What blood values is he worried about ? [Hepatitis_C_ Central] Re: Liver Biopsy I know all this Liz but how do you get Doctors who refuse to write a script for phlebotomies to write one? Maybe I am not that high to warrant it? Could not find a answer to that on the net so wondering if you know. My Serum ferritin was 615 in December of 2007. As soon as I saw that I requested treatment and was ...ignored and patronized to the point I got another Gastro Doctor. So I researched IOD and requested a test for genetic hemochromatosis. Thankfully that test was negative. So I completely eliminated all ferrous sulfate (iron) from foods. My Iron did go down to 460 in February. If you have any other tricks you know of other than blood draws PLEASE let me know. What I am doing seems to be working but dang I know how very very very bad all this iron in my liver is Sadly I seem to be the only one who cares. >> Your doctors are incorrect about the iron overload . Unless you have the genetic hemachromatosis and even then there is treatment for it . And phlebotomies do help and they even lower the viral load ..There is also a new medication called Exjade and it can remove excess iron from the blood . But more than likely your high iron is caused by your hepatitis c and removing it by either phlebotomies or the medication can help prevent your liver from further damage . Also iron overload can cause damage to the heart and kidneys too. Removal of excess iron also increases the hep c treatments rate of success . Getting rid of the hep c can stop the iron from happening ... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 , Ihave not been told, but all my white, red and platlets are very low. I take 11 shots a week. For someone 55 well 56 wenesday, this is getting harder. Thanks for the info. P [Hepatitis_C_ Central] Re: Liver Biopsy I know all this Liz but how do you get Doctors who refuse to write a script for phlebotomies to write one? Maybe I am not that high to warrant it? Could not find a answer to that on the net so wondering if you know. My Serum ferritin was 615 in December of 2007. As soon as I saw that I requested treatment and was ...ignored and patronized to the point I got another Gastro Doctor. So I researched IOD and requested a test for genetic hemochromatosis. Thankfully that test was negative. So I completely eliminated all ferrous sulfate (iron) from foods. My Iron did go down to 460 in February. If you have any other tricks you know of other than blood draws PLEASE let me know. What I am doing seems to be working but dang I know how very very very bad all this iron in my liver is Sadly I seem to be the only one who cares. >> Your doctors are incorrect about the iron overload . Unless you have the genetic hemachromatosis and even then there is treatment for it . And phlebotomies do help and they even lower the viral load ..There is also a new medication called Exjade and it can remove excess iron from the blood . But more than likely your high iron is caused by your hepatitis c and removing it by either phlebotomies or the medication can help prevent your liver from further damage . Also iron overload can cause damage to the heart and kidneys too. Removal of excess iron also increases the hep c treatments rate of success . Getting rid of the hep c can stop the iron from happening ... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 Hmm I am gonna have to check with my hepatologist and see what he has to say , cause I am not sure if your blood values being low would prevent biopsy . Have a great birthday in case I forget on Wednesday [Hepatitis_C_ Central] Re: Liver Biopsy I know all this Liz but how do you get Doctors who refuse to write a script for phlebotomies to write one? Maybe I am not that high to warrant it? Could not find a answer to that on the net so wondering if you know. My Serum ferritin was 615 in December of 2007. As soon as I saw that I requested treatment and was ...ignored and patronized to the point I got another Gastro Doctor. So I researched IOD and requested a test for genetic hemochromatosis. Thankfully that test was negative. So I completely eliminated all ferrous sulfate (iron) from foods. My Iron did go down to 460 in February. If you have any other tricks you know of other than blood draws PLEASE let me know. What I am doing seems to be working but dang I know how very very very bad all this iron in my liver is Sadly I seem to be the only one who cares. >> Your doctors are incorrect about the iron overload . Unless you have the genetic hemachromatosis and even then there is treatment for it . And phlebotomies do help and they even lower the viral load ..There is also a new medication called Exjade and it can remove excess iron from the blood . But more than likely your high iron is caused by your hepatitis c and removing it by either phlebotomies or the medication can help prevent your liver from further damage . Also iron overload can cause damage to the heart and kidneys too. Removal of excess iron also increases the hep c treatments rate of success . Getting rid of the hep c can stop the iron from happening ... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 well 'some' docs really deserve it,, they're arrogant and dont believe that anyone else knows anything about this disease and you and I and janet have a medical background so we know more than 'most' about this disease plus we've all treated and most docs have never treated... and of course their arrogant belief that no one on the internet could possibly know anything,, THAT gets me the most...especially since they, the docs rely on the drug companies to define disease,illness and what normal parameters are....and we know that most of their definitions are so that they can sell more drugs..Jackie From: elizabethnv1 <elizabethnv1@ earthlink. net>Subject: Re: [Hepatitis_C_ Central] Re: Liver BiopsyTo: Hepatitis_C_ Central@yahoogro ups.comDate: Saturday, May 31, 2008, 8:00 AM If I were you to be honest I woud get another doctor . Liver biopsies are the most accurate way to depict the damage in the liver . There is only so much a CT or Ultrasound can see , but a biopsy leaves the doctor with a tissue sample to put under the microscope . And that tissue is also a baseline for them to see if the disease progresses or if a tp is necessary. Biopsy also shows if there is iron saturation of the liver .But with your liver being nodular that is a clear indication of needing a biopsy . Biopsies and done as an outpatient thing and generally the patient is knocked out right when the needle is puncturing the liver . There is minimal pain afterwards but the benefits are worth it . It sounds like there may be lots of damage from cirrhosis , has he done tumor markers (blood test) ? [Hepatitis_C_ Central] Re: Liver Biopsy My gastroenterologist will NOT order a liver biopsy. He doesn't think it's indicated "at this time". He's ordered ultrasound (which showed a liver 'more nodular than we expected'), ordered endoscopy (to check for bleeding varices), and says that if a study I'm eligible for requires a liver biopsy, he'll do one.I'm being treated at the Kirklin Clinic in Birmingham, and UAB is supposed to know livers, but I worry. Especially since my liver is 'more nodular', I want to know what's going on. Is a liver biopsy such a bad thing?Roy in Alabama>> > Liver Biopsy> > > > Liver biopsy is not necessary for diagnosis but is helpful for grading> the severity of disease and staging the degree of fibrosis and permanent> architectural damage. Hematoxylin and eosin stains and Masson's> trichrome stain are used to grade the amount of necrosis and> inflammation and to stage the degree of fibrosis. Specific> immunohistochemical stains for HCV have not been developed for routine> use. Liver biopsy is also helpful in ruling out other causes of liver> disease, such as alcoholic liver injury or iron overload. HCV causes the> following changes in liver tissue:> > •Necrosis and inflammation around the portal areas, so-called> "piecemealnecrosis" or "interface hepatitis."> > •Necrosis of hepatocytes and focal inflammation in the liver> parenchyma.> > •Inflammatory cells in the portal areas ("portal inflammation" ).> > •Fibrosis, with early stages being confined to the portal tracts,> intermediate stages being expansion of the portal tracts and bridging> between portal areas or to the central area, and late stages being frank> cirrhosis characterized by architectural disruption of the liver with> fibrosis and regeneration.> > Grading and Staging of hepatitis by assigning scores for severity are> helpful in managing patients with chronic hepatitis. The degree of> inflammation and necrosis can be assessed as none, minimal, mild,> moderate, or severe. The degree of fibrosis can be similarly assessed.> Scoring systems are particularly helpful in clinical studies on chronic> hepatitis.> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 Hahaha true , when my doc has a med student in the room ....FRESH MEAT lol I grind em up with questions and then I give them the recent answers from research . They walk away from me with a clear understanding about patients and the disease lol [Hepatitis_C_ Central] Re: Liver Biopsy My gastroenterologist will NOT order a liver biopsy. He doesn't think it's indicated "at this time". He's ordered ultrasound (which showed a liver 'more nodular than we expected'), ordered endoscopy (to check for bleeding varices), and says that if a study I'm eligible for requires a liver biopsy, he'll do one.I'm being treated at the Kirklin Clinic in Birmingham, and UAB is supposed to know livers, but I worry. Especially since my liver is 'more nodular', I want to know what's going on. Is a liver biopsy such a bad thing?Roy in Alabama>> > Liver Biopsy> > > > Liver biopsy is not necessary for diagnosis but is helpful for grading> the severity of disease and staging the degree of fibrosis and permanent> architectural damage. Hematoxylin and eosin stains and Masson's> trichrome stain are used to grade the amount of necrosis and> inflammation and to stage the degree of fibrosis. Specific> immunohistochemical stains for HCV have not been developed for routine> use. Liver biopsy is also helpful in ruling out other causes of liver> disease, such as alcoholic liver injury or iron overload. HCV causes the> following changes in liver tissue:> > •Necrosis and inflammation around the portal areas, so-called> "piecemealnecrosis" or "interface hepatitis."> > •Necrosis of hepatocytes and focal inflammation in the liver> parenchyma.> > •Inflammatory cells in the portal areas ("portal inflammation" ).> > •Fibrosis, with early stages being confined to the portal tracts,> intermediate stages being expansion of the portal tracts and bridging> between portal areas or to the central area, and late stages being frank> cirrhosis characterized by architectural disruption of the liver with> fibrosis and regeneration.> > Grading and Staging of hepatitis by assigning scores for severity are> helpful in managing patients with chronic hepatitis. The degree of> inflammation and necrosis can be assessed as none, minimal, mild,> moderate, or severe. The degree of fibrosis can be similarly assessed.> Scoring systems are particularly helpful in clinical studies on chronic> hepatitis.> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 maybe her platelets and or INR??JackieSubject: Re: Re: Liver BiopsyTo: Hepatitis_C_Central Date: Sunday, June 1, 2008, 1:13 PM Are you a hemophiliac ? If so your doctor has a valid concern , but if not then look for a doc not afraid . What blood values is he worried about ? [Hepatitis_C_ Central] Re: Liver Biopsy I know all this Liz but how do you get Doctors who refuse to write a script for phlebotomies to write one? Maybe I am not that high to warrant it? Could not find a answer to that on the net so wondering if you know. My Serum ferritin was 615 in December of 2007. As soon as I saw that I requested treatment and was ...ignored and patronized to the point I got another Gastro Doctor. So I researched IOD and requested a test for genetic hemochromatosis. Thankfully that test was negative. So I completely eliminated all ferrous sulfate (iron) from foods. My Iron did go down to 460 in February. If you have any other tricks you know of other than blood draws PLEASE let me know. What I am doing seems to be working but dang I know how very very very bad all this iron in my liver is Sadly I seem to be the only one who cares. >> Your doctors are incorrect about the iron overload . Unless you have the genetic hemachromatosis and even then there is treatment for it . And phlebotomies do help and they even lower the viral load ..There is also a new medication called Exjade and it can remove excess iron from the blood . But more than likely your high iron is caused by your hepatitis c and removing it by either phlebotomies or the medication can help prevent your liver from further damage . Also iron overload can cause damage to the heart and kidneys too. Removal of excess iron also increases the hep c treatments rate of success . Getting rid of the hep c can stop the iron from happening ... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 Prolonged prothombin time maybe [Hepatitis_C_ Central] Re: Liver Biopsy I know all this Liz but how do you get Doctors who refuse to write a script for phlebotomies to write one? Maybe I am not that high to warrant it? Could not find a answer to that on the net so wondering if you know. My Serum ferritin was 615 in December of 2007. As soon as I saw that I requested treatment and was ...ignored and patronized to the point I got another Gastro Doctor. So I researched IOD and requested a test for genetic hemochromatosis. Thankfully that test was negative. So I completely eliminated all ferrous sulfate (iron) from foods. My Iron did go down to 460 in February. If you have any other tricks you know of other than blood draws PLEASE let me know. What I am doing seems to be working but dang I know how very very very bad all this iron in my liver is Sadly I seem to be the only one who cares. >> Your doctors are incorrect about the iron overload . Unless you have the genetic hemachromatosis and even then there is treatment for it . And phlebotomies do help and they even lower the viral load ..There is also a new medication called Exjade and it can remove excess iron from the blood . But more than likely your high iron is caused by your hepatitis c and removing it by either phlebotomies or the medication can help prevent your liver from further damage . Also iron overload can cause damage to the heart and kidneys too. Removal of excess iron also increases the hep c treatments rate of success . Getting rid of the hep c can stop the iron from happening ... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 There isn't a doctor I have met yet that uses the fibrosure , but then again I have only seen about 20 and there are thousands more out there lol Re: Liver Biopsy There seems to be some variance in the thinking about the accuracy of the Fibrosure test regarding the detection of intermediate stages as of yet.Don't ask ME,...I don't know, but here is a Google Search for:+"fibrosure" +"intermediate stages"http://tinyurl.com/435x2m> > >> > > > > > Liver Biopsy> > > > > > > > > > > > Liver biopsy is not necessary for diagnosis but is helpful for > > grading> > > the severity of disease and staging the degree of fibrosis and > > permanent> > > architectural damage. Hematoxylin and eosin stains and Masson's> > > trichrome stain are used to grade the amount of necrosis and> > > inflammation and to stage the degree of fibrosis. Specific> > > immunohistochemical stains for HCV have not been developed for > > routine> > > use. Liver biopsy is also helpful in ruling out other causes of > > liver> > > disease, such as alcoholic liver injury or iron overload. HCV > > causes the> > > following changes in liver tissue:> > > > > > .Necrosis and inflammation around the portal areas, so-called> > > "piecemealnecrosis" or "interface hepatitis."> > > > > > .Necrosis of hepatocytes and focal inflammation in the liver> > > parenchyma.> > > > > > .Inflammatory cells in the portal areas ("portal inflammation").> > > > > > .Fibrosis, with early stages being confined to the portal tracts,> > > intermediate stages being expansion of the portal tracts and > > bridging> > > between portal areas or to the central area, and late stages > being > > frank> > > cirrhosis characterized by architectural disruption of the liver > > with> > > fibrosis and regeneration.> > > > > > Grading and Staging of hepatitis by assigning scores for > severity > > are> > > helpful in managing patients with chronic hepatitis. The degree of> > > inflammation and necrosis can be assessed as none, minimal, mild,> > > moderate, or severe. The degree of fibrosis can be similarly > > assessed.> > > Scoring systems are particularly helpful in clinical studies on > > chronic> > > hepatitis.> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 2, 2008 Report Share Posted June 2, 2008 A prolonged prothobin time would be a valid issue [Hepatitis_C_ Central] Re: Liver Biopsy I know all this Liz but how do you get Doctors who refuse to write a script for phlebotomies to write one? Maybe I am not that high to warrant it? Could not find a answer to that on the net so wondering if you know. My Serum ferritin was 615 in December of 2007. As soon as I saw that I requested treatment and was ...ignored and patronized to the point I got another Gastro Doctor. So I researched IOD and requested a test for genetic hemochromatosis. Thankfully that test was negative. So I completely eliminated all ferrous sulfate (iron) from foods. My Iron did go down to 460 in February. If you have any other tricks you know of other than blood draws PLEASE let me know. What I am doing seems to be working but dang I know how very very very bad all this iron in my liver is Sadly I seem to be the only one who cares. >> Your doctors are incorrect about the iron overload . Unless you have the genetic hemachromatosis and even then there is treatment for it . And phlebotomies do help and they even lower the viral load ..There is also a new medication called Exjade and it can remove excess iron from the blood . But more than likely your high iron is caused by your hepatitis c and removing it by either phlebotomies or the medication can help prevent your liver from further damage . Also iron overload can cause damage to the heart and kidneys too. Removal of excess iron also increases the hep c treatments rate of success . Getting rid of the hep c can stop the iron from happening ... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 4, 2008 Report Share Posted June 4, 2008 Interesting Re: Liver Biopsy I just found out today from my dr that the transjugular biopsy does not go thru the heart. It goes from the jugular into the hepatic vein and into the liver. This form of biopsy is used mostly for people with low platlet counts or who are facing the first part of rejection after transplant or who are in rejection. It gives a clearer view of exacally what is happening in the liver. The biopsy from the side or thru the ribs causes excessive bleeding and is no longer recommended for people in rejection or with low platlet counts. Ask your dr if this could be an alternative for you. Steve B... Quote Link to comment Share on other sites More sharing options...
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