Biopsy

[Guest guest]

that doesnt happen very often kc...but youve been the miracle man...Glad to hear it..and God Bless You brother..Pat

RE: Biopsy

Hey guy at least your liver healed a lot,so that is a blessing.

Gail

-----Original Message-----From: Hepatitis CSupportGroupForDummies [mailto:Hepatitis CSupportGroupForDummies ]On Behalf Of Sent: May 31, 2006 11:51 AMHepatitis CSupportGroupForDummies Subject: Biopsy

I got my biopsy report from my last biopsy in April after treatment.

I am now stage 2, grade 1. That is a drop in a stage and a grade. I was stage 3.

Treatment seems to either work really well or not at all.

I hope the day will come when there is something better for all of us. Although I still have that 6 month viral load to take,I would like to believe there is something better coming soon.

[Guest guest]

Great

news on the biopsy, !

De

Biopsy

I got my biopsy report from my last

biopsy in April after treatment.

I am now stage 2, grade 1. That is a

drop in a stage and a grade. I was stage 3.

Treatment seems to either work

really well or not at all.

I hope the day will come when there

is something better for all of us. Although I still have that 6 month viral

load to take,I would like to believe there is something better coming soon.

[Guest guest]

Hey guy at least your liver healed a lot,so that is a blessing.

Gail

-----Original Message-----From: Hepatitis CSupportGroupForDummies [mailto:Hepatitis CSupportGroupForDummies ]On Behalf Of Sent: May 31, 2006 11:51 AMHepatitis CSupportGroupForDummies Subject: Biopsy

I got my biopsy report from my last biopsy in April after treatment.

I am now stage 2, grade 1. That is a drop in a stage and a grade. I was stage 3.

Treatment seems to either work really well or not at all.

I hope the day will come when there is something better for all of us. Although I still have that 6 month viral load to take,I would like to believe there is something better coming soon.

[Guest guest]

Hi Barbara Yes, there are risks to having a biopsy, the worst one is bleeding. Your doc will check your clotting time and after they do it, you will need to lay on your right side for a couple of hours, over the puncture site. Yes, the biopsy is the only REAL way to tell the amount of damage you may have or do not have. There is a blood test called the Fibrosure that is supposedly able to tell the amount of damage you have but its only 'fairly' accurate at both ends of the scare,, so if you were stage 0 or 4 it seems to be fairly accurate but if you are stage 1-3, its not... I know ya dont want to have one, I didnt either...barbarac102 <barbarac102@...> wrote: Can liver biopsys do any harm to the liver and are there any other ways that the liver can be looked at or is a biopsy the only real way to detect damage? Is it then advisable for everyone with hepc to have one?Thanks Jackie

[Guest guest]

Hi Jackie, Thanks for your response. I know it's the only way to tell if you have damage. I'll probably eventually get it done. I guess it would be easier to do if I felt any inflammation or discomfort, which I don't. I am going for an ultrasound next week, so I am doing something and having more blood tests. Thanks again. BarbaraJackie on <redjaxjm@...> wrote: Hi Barbara Yes, there are risks to having a biopsy, the worst one is bleeding. Your doc will check your clotting time and after they do it, you will need to lay on your right side for a couple of hours, over the puncture site. Yes, the biopsy is the only REAL way to tell the amount of damage you may have or do not have. There is a blood test called the

Fibrosure that is supposedly able to tell the amount of damage you have but its only 'fairly' accurate at both ends of the scare,, so if you were stage 0 or 4 it seems to be fairly accurate but if you are stage 1-3, its not... I know ya dont want to have one, I didnt either...barbarac102 <barbarac102@...> wrote: Can liver biopsys do any harm to the liver and are there any other ways that the liver can be looked at or is a biopsy the only real way to detect damage? Is it then advisable for everyone with hepc to have one?Thanks Jackie

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[Guest guest]

LIVER BIOPSY Before treatment for chronic hepatitis B and to assess the progress of the disease it is generally recommended to have a liver biopsy as this is currently the only way to accurately assess the course of the disease and if the liver is found to have advanced cirrhosis or is decompensated then interferon or/and other treatments should be used with caution or not used. WHAT IS A LIVER BIOPSY? Liver biopsy is a diagnostic procedure used to obtain a small amount of liver tissue,

which can be examined under a microscope to help identify the cause or stage of liver disease. WHAT ARE THE DIFFERENT WAYS LIVER BIOPSY CAN BE PERFORMED? The most common way a liver sample is obtained is by inserting a needle into the liver for a fraction of a second. This can be done in the hospital, and the patient may be sent home within 3-6 hours if there are no complications. The physician determines the best site, depth, and angle of the needle puncture by physical examination or ultrasound. The skin and area under the skin is anaesthetised, and a needle is passed quickly into and out of the liver. Approximately half of individuals have no pain afterwards, while another half will experience

brief localised pain that may spread to the right shoulder. Another technique used for liver biopsy is guiding the needle into the liver through the abdomen or chest using various imaging techniques. This approach is used when there are localised tumours identified by ultrasound or computed tomography (CT). Either ultrasound or CT scanning is used to pinpoint the site of the tumour and guide the needle to this specific area through the abdomen or chest. After this procedure, the patient is usually allowed to go home the same day. Less commonly used biopsy techniques are laparoscopy, transvenous or transjugular liver biopsy, and surgical liver biopsy. With laparoscopy, a lighted, narrow tubular instrument is inserted through a small incision in the abdominal wall. The internal organs are moved away from the abdominal wall by gas that is introduced into the abdomen. Instruments may be passed through this lighted instrument or through

separate puncture sites to obtain tissue samples from several different areas of the liver. Patients who undergo this procedure may be discharged several hours later. Transvenous or transjugular liver biopsy may be performed by a radiologist in special circumstances, e.g. when the patient has a significant problem with blood clotting (coagulopathy) or a large amount of fluid within the abdomen (ascites). With this procedure, a small tube is inserted into the internal jugular vein in the neck and radiologically guided into the hepatic vein, which drains the liver. A small biopsy needle is then inserted through the tube and directly into the liver to obtain a sample of tissue. Finally, liver biopsy may be done at the time a patient undergoes an open abdominal operation, enabling the surgeon to inspect the liver and take one or more biopsy samples as needed. WHEN IS A LIVER BIOPSY USED? Liver biopsy is often used to diagnose the cause of chronic liver disease that results in elevated liver tests or an enlarged liver. It is also used to diagnose liver tumours identified by imaging tests. In many cases the specific cause of the chronic liver disease is highly suspected on the basis of blood tests, but a liver biopsy is used to confirm the diagnosis as well as determine the amount of damage to the liver. Liver biopsy is also used after liver transplantation to determine the cause of elevated liver tests and determine if rejection is present. WHAT ARE THE DANGERS OF LIVER BIOPSY? The primary risk of liver biopsy is bleeding from the site of needle entry into the liver, although this occurs in less than 1% of patients. Other possible complications include the puncture of other organs, such as the kidney, lung or colon. Biopsy, by mistake, of the gallbladder rather than the liver may be associated with leakage of bile into the abdominal cavity, causing peritonitis. Fortunately, the risk of death from liver biopsy is extremely low, ranging from 0.1% to 0.01%. ARE THERE ALTERNATIVES TO LIVER BIOPSY? The primary alternative to a liver biopsy is to make the diagnosis of a liver disease based on the physical

examination of the patient, medical history, and blood testing. In some cases, blood testing is quite accurate in giving the doctor the information to diagnose chronic liver disease, while in other circumstances a liver biopsy is needed to assure an accurate diagnosis. DO LIVER BIOPSIES EVER NEED TO BE REPEATED? In most circumstances, a liver biopsy is only performed once to confirm a suspected diagnosis of chronic liver disease. Occasionally, liver biopsy is repeated if the clinical condition changes or to assess the results of medical therapy, such as drug treatment of chronic viral hepatitis with interferon or prednisone therapy of autoimmune hepatitis. Patients who have undergone liver transplantation often

require numerous liver biopsies in the early weeks to months following the surgery to allow accurate diagnoses of whether the new liver is being rejected or whether other problems have developed. BIOPSY RESULTS. After a few weeks they will have the result of your biopsy. Try to listen very carefully to what the doctor tells you, it may sound like gibberish but make notes then you can ask questions of your doctor, look things up in books ask on the support group etc later when you've had a chance to digest things. Ask your doctor if you can have a copy of your biopsy results for reference. If the biopsy was for hepatitis B infection depending on the results of the biopsy they may suggest you take interferon. WHAT DO I NEED TO DO IF I'M HAVING A BIOPSY. If your nervous about it ask your doctor for some valium or similar to take the night before and the morning before you go in (make sure the doctor doing the biopsy and the nurses looking after you knows if you've taken anything), also it's a good idea to have someone pick you up from the hospital. The procedure is simple, you lie on your side and a local anaesthetic is administered. A needle is inserted between your ribs and a core of liver tissue is removed. This is normally painless however some people get a pain in the right shoulder. After the biopsy you must lie on your side for about 4 hours to help stop any bleeding and your blood pressure is taken, If you need

pain killers ask for them. After this you can normally leave the hospital. When at home you should take it easy for the first week, generally sitting and sleeping to apply some pressure to the side with cushions or pillows as this aids healing, helps prevent bleeding and may be more comfortable. For 14 days after the biopsy you should remain within one hour of a major hospital and you should ensure the people with you know, or you should carry information to alert medical staff that you have recently had a biopsy. LIVER FUNCTION TESTS (LFT'S) A blood sample is taken, normally from the arm and sent to the laboratory for analysis and results are normally available with a few days. The term "liver function

tests" and its abbreviated form "LFT's" is a commonly used term that is applied to a variety of blood tests that assess the general state of the liver and biliary system. Routine blood tests can be divided into those tests that are true LFT's, such as serum albumin or prothrombin time, and those tests that are simply markers of liver or biliary tract disease, such as the various liver enzymes. In addition to the usual liver tests obtained on routine automated chemistry panels, physicians may order more specific liver tests such as viral serologic tests or autoimmune tests that, if positive, can determine the specific cause of a liver disease. Liver function tests measure various chemicals present in the blood and can

be useful in determining the extent of liver disease. There are two general categories of "liver enzymes." The first group includes the alanine aminotransferase (ALT) and the aspartate aminotransferase (AST), formerly referred to as the SGPT and SGOT. These are enzymes that are indicators of liver cell damage. The other frequently used liver enzymes are the alkaline phosphatase and gamma-glutamyltranspeptidase (GGT and GGTP) that indicate obstruction to the biliary system, either within the liver or in the larger bile channels outside the liver. ALT OR SGPT FROM - FOCUS: ON HEPATITIS C ALT, an enzyme appears in liver cells, with lesser amounts in the kidneys, heart, and skeletal muscles, and is a relatively specific indicator of acute liver cell damage. When such damage occurs, ALT is released from the liver cells into the bloodstream, often before jaundice appears, resulting in abnormally high serum levels that may not return to normal for days or weeks. The purpose of this blood serum test is to help detect and evaluate treatment of acute hepatic disease, especially hepatitis, and cirrhosis without jaundice. To help distinguish between mytyocardial (heart) and liver tissue damage (used with the AST enzyme test). Also to assess hepatotoxicity of some drugs.

ALT levels by a commonly used method range from 10 to 32 U/L; in women, from 9 to 24 U/L. (There does exist differing ranges used by various laboratories.) The normal range for infants is twice that of adults. Very high ALT levels (up to 50 times normal) suggest viral or severe drug-induced hepatitis, or other hepatic disease with extensive necrosis (death of liver cells). (AST levels are also elevated but usually to a lesser degree.) Moderate-to-high levels may indicate infectious mononucleosis, chronic hepatitis, intrahepatic cholestasis or cholecystitis, early or improving acute viral hepatitis, or severe hepatic congestion due to heart failure. Slight-to-moderate elevations of ALT (usually with higher increases in AST levels) may appear in any condition that produces acute hepatocellular (liver cell) injury, such as active cirrhosis, and drug-induced or alcoholic hepatitis. Marginal elevations occasionally occur in acute myocardial

infarction (heart attack), reflecting secondary hepatic congestion or the release of small amounts of ALT from heart tissue. Many medications produce hepatic injury by competitively interfering with cellular metabolism. Falsely elevated ALT levels can follow use of barbiturates, narcotics, methotrexate, chlorpromazine salicylates (aspirin), and other drugs that affect the liver. Be Aware: Serum liver enzymes can create confusion for both patients and physicians for these tests are highly sensitive, but very non-specific. Tests commonly referred to as liver function tests or LFT's do not actually determine liver function. Instead, they are static, primarily diagnostic parameters that serve to detect liver disease rather than quantitative liver function. Rather than liver function tests, it is more useful to refer to these tests as serum liver tests and to mentally categorise them according to the pathophysiologic processes they

truly reflect. AST One of the two main liver function blood serum tests (the other being the ALT test). The purpose of this blood test is to detect a recent myocardial infarction (heart attack); to aid detection and differential diagnosis of acute hepatic disease and to monitor patient progress and prognosis in cardiac and hepatic diseases. AST levels by a commonly used method range from 8 to 20 U/L although some ranges may express a maximum high in the 40s. (Check with your physician.) AST levels fluctuate in response to the extent of cellular necrosis (cell death) and therefore may be temporarily and minimally elevated early in the disease process, and extremely elevated during the most acute phase. Depending on when the initial

sample was drawn, AST levels can rise- indicating increasing disease severity and tissue damage- or fall- indicating disease resolution and tissue repair. Thus, the relative change in AST values serves as a reliable monitoring mechanism. Maximum elevations are associated with certain diseases and conditions. For example, very high elevations (more than 20 times normal) may indicate acute viral hepatitis, severe skeletal muscle trauma, extensive surgery, drug-induced hepatic injury, and severe liver congestion. High levels (ranging from 10 to 20 times normal) may indicate severe myocardial infarction (heart attack), severe infectious mononucleosis, and alcoholic cirrhosis. High levels may also occur during the resolving stages of conditions that cause maximal elevations. Moderate-to-high levels (ranging from 5 to 10 times normal) may indicate chronic hepatitis and other conditions. Low-to-moderate levels (ranging from 2 to 5 times normal) may indicate

metastatic hepatic tumours, acute pancreatitis, pulmonary emboli, alcohol withdrawal syndrome, and fatty liver (steatosis). BILIRUBIN Bilirubin is the main bile pigment in humans which, when elevated causes the yellow discoloration of the skin and eyes called jaundice. Bilirubin is formed primarily from the breakdown of a substance in red blood cells called "heme." It is taken up from blood processed through the liver, and then secreted into the bile by the liver. Normal individuals have only a small amount of bilirubin circulating in blood (less than 1.2 mg/dL). Conditions which cause increased formation of bilirubin, such as destruction of red blood cells, or decrease its removal from the blood stream, such as liver disease may result in an

increase in the level of serum bilirubin. Levels greater than 3 mg/dL are usually noticeable as jaundice. The bilirubin may be elevated in many forms of liver or biliary tract disease, and thus it is also relatively non-specific. However, serum bilirubin is generally considered a true test of liver function (LFT), since it reflects the liver's ability to take up, process, and secrete bilirubin into the bile. GGT (GAMMA GLUTAMYLTRANSFERASE) The purpose of this blood serum chemistry test is to provide information about hepatobiliary diseases, to assess liver function, and to detect alcohol ingestion. Another purpose is to distinguish between skeletal disease and hepatic disease when serum alkaline phosphatase is elevated. A

normal GGT level suggests such elevation stems from skeletal disease. Normal results in females under age 45, range from 5 to 27 U/L; in females over age 45 and in males, levels range from 6 to 37 U/L. Serum GGT values vary with the assay method used (colorimetric or kinetic). The sharpest increases in GGT levels indicate obstructive jaundice and hepatic metastasis. Elevations may indicate any acute hepatic disease, acute pancreatitis, renal disease, alcohol ingestion, postoperative status, and prostatic metastasis. This test is non-specific, providing little data about the type of hepatic disease. GGT is particularly sensitive to the effects of alcohol in the liver, and levels may be elevated after moderate alcohol intake and in chronic alcoholism, even without clinical evidence of hepatic injury. SERUM ALBUMIN Albumin is a major protein which is formed by the liver, and chronic liver disease causes a decrease in the amount of albumin produced. Therefore, in liver disease, particularly more advanced liver disease, the level of the serum albumin is reduced (less than 3.5 mg/dL). PROTHOMBIN TIME. The prothrombin time, which is also called protime or PT, is a test that is used to assess blood clotting. Blood clotting factors are proteins made by the liver. When the liver is significantly injured, these proteins are not normally produced. The prothrombin time is also a useful LFT, since there is a good correlation between abnormalities in

coagulation measured by the prothrombin time and the degree of liver dysfunction. Prothrombin time is usually expressed in seconds and compared to a normal control patient's blood. PCR This test uses the Polymerase Chain Reaction or PCR to amplify the amount of DNA or RNA present in a sample. The test is highly sensitive and can detect minute quantities of DNA or RNA. With regard to hepatitis B the test comes in two forms:- QUALITATIVE PCR This test tests for the presence of hepatitis B DNA, it is highly sensitive and gives a

positive or negative result and is generally only used for research purposes. In someone who has never been exposed to hepatitis B a negative result would occur. In those with acute or chronic hepatitis B a positive result would be expected. In people who have successfully defeated a hepatitis B infection and developed antibodies to the surface antigen a negative result would be expected, however many positive results have been reported and this indicates that the hepatitis B virus is sometimes present, although in minute quantities, in those who have developed antibodies to the virus. QUANTITATIVE PCR This measures the quantity of hepatitis B DNA present in a sample. It is not as sensitive as qualitative PCR but does give an indication of

the number of copies of the virus present. This result is used to determine what is known as "viral load" or the number of copies of the virus present. This test is relatively expensive and generally only used for research purposes as other hepatitis B antigens can be used for diagnostic purposes. E.g. the presence of the "e" antigen indicates a high level of viral reproduction and so indicates a high viral load. However since mutant versions of hepatitis B do not always produce the "e" antigen this test can be used to determine viral load in those cases. Tim Parsons knoxville,tn 37931 865-588-2465 x107 work www.knoxville1.com

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[Guest guest]

I know Barbara,, but most ppl do NOT FEEL inflammation , remember the liver has NO pain receptors in it,, The ultrasound will only tell IF you have HCC, it cannot tell much about the Hep C virus or damage that it causes..Barbara <barbarac102@...> wrote: Hi Jackie, Thanks for your response. I know it's the only way to tell if you have damage. I'll probably eventually get it done. I guess it would be easier to do if I felt any inflammation or discomfort, which I don't. I am going for an ultrasound next week, so I am doing something and having more blood tests. Thanks again. BarbaraJackie on <redjaxjm > wrote: Hi Barbara Yes, there are risks to having a biopsy, the worst one is bleeding. Your doc will check your clotting time and after they do it, you will need to lay on your right side for a couple of hours, over the puncture site. Yes, the biopsy is the only REAL way to tell the amount of damage you may have or do not have. There is a blood test called the Fibrosure that is supposedly able to tell the amount of damage you have but its only 'fairly' accurate at both ends of the scare,, so if you were stage 0 or 4 it seems to be fairly accurate but if you are stage 1-3, its not... I know ya dont want to have one, I didnt

either...barbarac102 <barbarac102 > wrote: Can liver biopsys do any harm to the liver and are there any other ways that the liver can be looked at or is a biopsy the only real way to detect damage? Is it then advisable for everyone with hepc to have one?Thanks Jackie See the all-new, redesigned .com. Check it out. Jackie

[Guest guest]

What is HCC? I thought you could feel inflammation. Why did the doctor feel my liver and why did he asked if it hurt? I've heard others say their liver hurt and felt it inflammed. Now, I don't know why I'm having it done. It wasn't explained properly. Jackie on <redjaxjm@...> wrote: I know Barbara,, but most ppl do NOT FEEL inflammation , remember the liver has NO pain receptors in it,, The ultrasound will only tell IF you have HCC, it cannot tell much about the Hep C virus or damage that it causes..Barbara <barbarac102@...> wrote: Hi Jackie, Thanks for your response. I know

it's the only way to tell if you have damage. I'll probably eventually get it done. I guess it would be easier to do if I felt any inflammation or discomfort, which I don't. I am going for an ultrasound next week, so I am doing something and having more blood tests. Thanks again. BarbaraJackie on <redjaxjm > wrote: Hi Barbara Yes, there are risks to having a biopsy, the worst one is bleeding. Your doc will check your clotting time and after they do it, you will need to lay on your right side for a couple of hours, over the puncture site. Yes, the biopsy is the only REAL way to tell the amount of damage you may have or do not have. There is a blood test called the Fibrosure that is supposedly able to tell the amount of damage you have but its only 'fairly'

accurate at both ends of the scare,, so if you were stage 0 or 4 it seems to be fairly accurate but if you are stage 1-3, its not... I know ya dont want to have one, I didnt either...barbarac102 <barbarac102 > wrote: Can liver biopsys do any harm to the liver and are there any other ways that the liver can be looked at or is a biopsy the only real way to detect damage? Is it then advisable for everyone with hepc to have one?Thanks Jackie See the all-new, redesigned .com. Check it out. Jackie

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[Guest guest]

Hi Barbara,

I'm anne, the quiet moderator of the group. My partner Daryl lost his battle with Hep C in July '04.

I am writing, not to frighten you, but to make you aware that Hep C can be doing irrepairable damage silently honey. Daryl didn't have ANY symptoms and we had no idea he had Hep C until he started sufferering ascites and was found to be already decompensating i.e at End Stage liver disease from the Hep. By that time it was too late for treatment.

So, I'm saying to you, that I understand how scary this disease is but you must, MUST get that biopsy done and if treatment is offered, grab it with both hands. Your life is so very precious, don't play russian roulette with it because you are afraid. We're here to support you all the way.

Love

anne

Re: Biopsy

Hi Jackie,

Thanks for your response. I know it's the only way to tell if you have damage.

I'll probably eventually get it done.

I guess it would be easier to do if I felt any inflammation or discomfort, which I don't.

I am going for an ultrasound next week, so I am doing something and having more blood tests.

Thanks again.

Barbara

[Guest guest]

Dear anne, Thanks for writing me. I am so sorry for your loss. You are right, I need to have that biopsy. Thanks for writing me the truth. My husband passed away in '96. He didn't want help and continued drinking knowing he had non a non b hep, I think that's what it was called then, and they didn't know much about it back then. Anyway, thanks for the wake up call. I forget or try to forget that it's a silent killer. Barbara anne <kanga2@...> wrote: Hi Barbara, I'm anne, the

quiet moderator of the group. My partner Daryl lost his battle with Hep C in July '04. I am writing, not to frighten you, but to make you aware that Hep C can be doing irrepairable damage silently honey. Daryl didn't have ANY symptoms and we had no idea he had Hep C until he started sufferering ascites and was found to be already decompensating i.e at End Stage liver disease from the Hep. By that time it was too late for treatment. So, I'm saying to you, that I understand how scary this disease is but you must, MUST get that biopsy done and if treatment is offered, grab it with both hands. Your life is so very precious, don't play russian roulette with it because you are afraid. We're here to support you all the way. Love anne Re: Biopsy Hi Jackie, Thanks for your response. I know it's the only way to tell if you have damage. I'll probably eventually get it done. I guess it would be easier to do if I felt any inflammation or discomfort, which I don't. I am going for an ultrasound next week, so I am doing something and having more blood tests. Thanks again. Barbara

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[Guest guest]

Hi Barbara HCC is Liver Cancer... well you can feel 'fullness' if your liver is enlarged. The liver itself has NO pain receptors but the capsule or sac that surrounds the liver does and it can feel stretching, fullness, sharp or dull pain. Im not sure what others are talking about other than perhaps they felt the sac being stretched,, but once again, the liver tissue itself have NO pain receptors.. My doc when he first palpated ( felt) my liver when I was diagnosed said my liver WAS enlarged, I felt NOTHING... but now my liver is of normal size.. I used to transport this man who was in end stage liver disease from alcoholic cirhosis and his liver was easy to feel and very hard and lumpy when I palpated it.. I dont know IF HE felt it, but I could feel it.. jaxBarbara <barbarac102@...> wrote: What is HCC? I thought you could feel inflammation. Why did the doctor feel my liver and why did he asked if it hurt? I've heard others say their liver hurt and felt it inflammed. Now, I don't know why I'm having it done. It wasn't explained properly. Jackie on <redjaxjm > wrote: I know Barbara,, but most ppl do NOT FEEL inflammation , remember the liver has NO pain receptors in it,, The ultrasound will only tell IF you have HCC, it cannot tell much about the Hep C virus or damage

that it causes..Barbara <barbarac102 > wrote: Hi Jackie, Thanks for your response. I know it's the only way to tell if you have damage. I'll probably eventually get it done. I guess it would be easier to do if I felt any inflammation or discomfort, which I don't. I am going for an ultrasound next week, so I am doing something and having more blood tests. Thanks again. BarbaraJackie on <redjaxjm > wrote: Hi Barbara Yes, there are risks to having a biopsy, the worst one is bleeding. Your doc will check your clotting time and after they do it, you will need to lay on your right side for a couple of hours,

over the puncture site. Yes, the biopsy is the only REAL way to tell the amount of damage you may have or do not have. There is a blood test called the Fibrosure that is supposedly able to tell the amount of damage you have but its only 'fairly' accurate at both ends of the scare,, so if you were stage 0 or 4 it seems to be fairly accurate but if you are stage 1-3, its not... I know ya dont want to have one, I didnt either...barbarac102 <barbarac102 > wrote: Can liver biopsys do any harm to the liver and are there any other ways that the liver can be looked at or is a biopsy the only real way to detect damage? Is it then advisable for everyone with hepc to have one?Thanks Jackie See the all-new, redesigned .com. Check it out. Jackie Groups are talking. We´re listening. Check out the handy changes to . Jackie

[Guest guest]

I thought the ultrasound showed the size and shape of the liver, indicating inflammation. I did not know that it would detect cancer. BarbaraJackie on <redjaxjm@...> wrote: Hi Barbara HCC is Liver Cancer... well you can feel 'fullness' if your liver is enlarged. The liver itself has NO pain receptors but the capsule or sac that surrounds the liver does and it can feel stretching, fullness, sharp or dull pain. Im not sure what others are talking about other than perhaps they felt the sac being stretched,, but once again, the liver tissue itself have NO pain receptors.. My doc when he first palpated ( felt) my liver when I was diagnosed said my liver WAS enlarged, I felt NOTHING... but now my liver is of normal size.. I used to transport this man who was in

end stage liver disease from alcoholic cirhosis and his liver was easy to feel and very hard and lumpy when I palpated it.. I dont know IF HE felt it, but I could feel it.. jaxBarbara <barbarac102@...> wrote: What is HCC? I thought you could feel inflammation. Why did the doctor feel my liver and why did he asked if it hurt? I've heard others say their liver hurt and felt it inflammed. Now, I don't know why I'm having it done. It wasn't explained properly. Jackie on <redjaxjm > wrote: I know Barbara,, but most ppl do NOT FEEL inflammation , remember the liver has NO pain receptors in it,, The ultrasound

will only tell IF you have HCC, it cannot tell much about the Hep C virus or damage that it causes..Barbara <barbarac102 > wrote: Hi Jackie, Thanks for your response. I know it's the only way to tell if you have damage. I'll probably eventually get it done. I guess it would be easier to do if I felt any inflammation or discomfort, which I don't. I am going for an ultrasound next week, so I am doing something and having more blood tests. Thanks again. BarbaraJackie on <redjaxjm > wrote: Hi Barbara Yes, there are risks to having a biopsy, the worst one is bleeding. Your doc will check your clotting time

and after they do it, you will need to lay on your right side for a couple of hours, over the puncture site. Yes, the biopsy is the only REAL way to tell the amount of damage you may have or do not have. There is a blood test called the Fibrosure that is supposedly able to tell the amount of damage you have but its only 'fairly' accurate at both ends of the scare,, so if you were stage 0 or 4 it seems to be fairly accurate but if you are stage 1-3, its not... I know ya dont want to have one, I didnt either...barbarac102 <barbarac102 > wrote: Can liver biopsys do any harm to the liver and are there any other ways that the liver can be looked at or is a biopsy the only real way to detect damage? Is it then advisable for everyone with hepc to have one?Thanks

Jackie See the all-new, redesigned .com. Check it out. Jackie Groups are talking. We´re listening. Check out the handy changes to . Jackie

See the all-new, redesigned .com. Check it out.

[Guest guest]

Yes, Barbara, an ultrasound does show the size and shape of the liver and it will show IF the liver is grossly enlarged too.. IT also can show cancer lesions or tumors.. its an important part of diagnosis but it wont show the damage down to the cellular level..unfortunately...Barbara <barbarac102@...> wrote: I thought the ultrasound showed the size and shape of the liver, indicating inflammation. I did not know that it would detect cancer. BarbaraJackie on

<redjaxjm > wrote: Hi Barbara HCC is Liver Cancer... well you can feel 'fullness' if your liver is enlarged. The liver itself has NO pain receptors but the capsule or sac that surrounds the liver does and it can feel stretching, fullness, sharp or dull pain. Im not sure what others are talking about other than perhaps they felt the sac being stretched,, but once again, the liver tissue itself have NO pain receptors.. My doc when he first palpated ( felt) my liver when I was diagnosed said my liver WAS enlarged, I felt NOTHING... but now my liver is of normal size.. I used to transport this man who was in end stage liver disease from alcoholic cirhosis and his liver was easy to feel and very hard and lumpy when I palpated it.. I dont know IF HE felt it, but I could feel it.. jaxBarbara

<barbarac102 > wrote: What is HCC? I thought you could feel inflammation. Why did the doctor feel my liver and why did he asked if it hurt? I've heard others say their liver hurt and felt it inflammed. Now, I don't know why I'm having it done. It wasn't explained properly. Jackie on <redjaxjm > wrote: I know Barbara,, but most ppl do NOT FEEL inflammation , remember the liver has NO pain receptors in it,, The ultrasound will only tell IF you have HCC, it cannot tell much about the Hep C virus or damage that it causes..Barbara <barbarac102 > wrote: Hi Jackie, Thanks for your response. I know it's the only way to tell if you have damage. I'll probably eventually get it done. I guess it would be easier to do if I felt any inflammation or discomfort, which I don't. I am going for an ultrasound next week, so I am doing something and having more blood tests. Thanks again. BarbaraJackie on <redjaxjm > wrote: Hi Barbara Yes, there are risks to having a biopsy, the worst one is bleeding. Your doc will check your clotting time and after they do it, you will need to lay on your right side for a couple of hours, over the puncture site. Yes, the biopsy is the only REAL way to tell the amount of damage you may have or do not have. There is a blood test

called the Fibrosure that is supposedly able to tell the amount of damage you have but its only 'fairly' accurate at both ends of the scare,, so if you were stage 0 or 4 it seems to be fairly accurate but if you are stage 1-3, its not... I know ya dont want to have one, I didnt either...barbarac102 <barbarac102 > wrote: Can liver biopsys do any harm to the liver and are there any other ways that the liver can be looked at or is a biopsy the only real way to detect damage? Is it then advisable for everyone with hepc to have one?Thanks Jackie See the all-new, redesigned .com. Check it out. Jackie Groups are talking. We´re listening. Check out the handy changes to . Jackie See the all-new, redesigned .com. Check it out. Jackie

[Guest guest]

c I'm learning.. Should have years ago but....anyway.. Thanks Jackie. Barbara Jackie on <redjaxjm@...> wrote: Yes, Barbara, an ultrasound does show the size and shape of the liver and it will show IF the liver is grossly enlarged too.. IT also can show cancer lesions or tumors.. its an important part of diagnosis but it wont show the damage down to the cellular level..unfortunately...Barbara <barbarac102@...> wrote: I thought the ultrasound showed the size and shape of the liver, indicating inflammation. I did not know that it would detect cancer. BarbaraJackie on <redjaxjm > wrote: Hi Barbara HCC is Liver Cancer... well you can feel 'fullness' if your liver is enlarged. The liver itself has NO pain receptors but the capsule or sac that surrounds the liver does and it can feel stretching, fullness, sharp or dull pain. Im not sure what others are talking about other than perhaps they felt the sac being stretched,, but once again, the liver tissue itself have NO pain receptors.. My doc when he first palpated ( felt) my liver when I was diagnosed said my liver WAS enlarged, I felt NOTHING... but now my liver is of normal size.. I used to transport this man who was in end stage liver disease from alcoholic cirhosis and his liver was easy to feel and very hard and lumpy when I palpated it.. I dont know IF HE felt it, but I could feel it.. jaxBarbara <barbarac102 > wrote: What is HCC? I thought you could feel inflammation. Why did the doctor feel my liver and why did he asked if it hurt? I've heard others say their liver hurt and felt it inflammed. Now, I don't know why I'm having it done. It wasn't explained properly. Jackie on <redjaxjm > wrote: I know Barbara,, but most ppl do NOT FEEL inflammation , remember the liver has NO pain receptors in it,, The ultrasound will only tell IF you have HCC, it cannot tell much about the Hep C virus or damage that it causes..Barbara <barbarac102 > wrote: Hi Jackie, Thanks for your response. I know it's the only way to tell if you have damage. I'll probably eventually get it done. I guess it would be easier to do if I felt any inflammation or discomfort, which I don't. I am going for an ultrasound next week, so I am doing something and having more blood tests. Thanks again. BarbaraJackie on <redjaxjm > wrote: Hi Barbara Yes, there are risks to having a biopsy, the worst one is bleeding. Your doc will check your clotting time and after they do it, you will need to lay on your right side for a couple of hours, over the puncture site. Yes, the biopsy is the only REAL way to tell the amount of damage you may have

or do not have. There is a blood test called the Fibrosure that is supposedly able to tell the amount of damage you have but its only 'fairly' accurate at both ends of the scare,, so if you were stage 0 or 4 it seems to be fairly accurate but if you are stage 1-3, its not... I know ya dont want to have one, I didnt either...barbarac102 <barbarac102 > wrote: Can liver biopsys do any harm to the liver and are there any other ways that the liver can be looked at or is a biopsy the only real way to detect damage? Is it then advisable for everyone with hepc to have one?Thanks Jackie See the all-new, redesigned .com. Check it out. Jackie Groups are talking. We´re listening. Check out the handy changes to . Jackie See the all-new, redesigned .com. Check it out. Jackie

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[Guest guest]

The radiologist told me my liver looked

great on the ultrasound, but he explained it this way:

You can see a car sitting on the street

that’s shiny and looks great……..but it may run poorly or not

run at all.

[Guest guest]

Understood, so my next question is, if you are going to have a biopsy, why bother with an ultrasound? BarbaraDorothy <dorv@...> wrote: The radiologist told me my liver looked great on the ultrasound, but he explained it this way: You can see a car sitting on the street that’s shiny and looks great……..but it may run poorly or not run at all.

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[Guest guest]

EXACTLY.... it can only tell the very 'gross' details of your liver,, not the stuff at the 'cellular level'.... but Im glad he didnt see any lesions or tumors etc,, that is good news!Dorothy <dorv@...> wrote: The radiologist told me my liver looked great on the ultrasound, but he explained it this way: You can see a car sitting on the street that’s shiny and looks great……..but it may run poorly or not run at all. Jackie

[Guest guest]

Heck if I know,, I would have the biopsy first and then talk with the doc about HIS reasoning for the ultrasound.. when I had mine done after 2 years post tx,, the radiologist wrote on my results that ultrasound is NOT the right or best way to see the state of the liver and it is only good at detecting large abnormalities... Barbara <barbarac102@...> wrote: Understood, so my next question is, if you are going to have a biopsy, why bother with an ultrasound? BarbaraDorothy <dorvoptonline (DOT) net> wrote: The radiologist told me my liver looked great on the ultrasound, but he explained it this way: You can see a car sitting on the street that’s shiny and looks great……..but it may run poorly or not run at all. Music Unlimited - Access over 1 million songs. Try it free. Jackie

[Guest guest]

Hi Fibrosis is the first stage of cirrhosis,,Fibrosis is reversable, cirrhosis is supposedly not,, so at stage 3 Fibrosis he has signifiant damage and really should think about treating... BEFORE he gets to Cirrhosis!!,, the inflammation is 'grade',, not stage,, and the grade of inflammation is sort of a scale to tell how fast it is moving along,, so grade 0-1 is practically no active virus,, but grade 3 is alot and means it is moving quickly as there are only 4 grades,,, I hope this helps honrogkatlev <rogkatlev@...> wrote: Hi guys,I hope this finds you all well. We are dong OK. got his biopsy results back. Stage 3 fibrosis and stage 3 inflammation. We were hoping for better news (of course)! What is the difference between fibrosis and cirrhosis. Are they the same? Aren't they both scarring of the liver. Maybe I'm missing something. Dr said he would be a good candidate for treatment. He also mentioned that if the treatment doesn't work then that would be that. At what stage do you qualify to be put on the transplant list? I know questions questions!! Again thanks to you all for all of your help. starts treatment (Pegasys and Copegus) the 23rd of August.Thanks, Jackie

[Guest guest]

I missed your question about transplant,, well a person has to be fully cirrhosed BEFORE they can even be considered for tp.. that would be stage 4 and he would have to be decompensated,, a person can live with cirrhosis for years before they might need tp... so by 's treating NOW, he can prevent this whole thing... hopefully he will have a successful tx and never get any worse and actually , if he gets the virus erradicated, his liver can and will regenerate... in time...rogkatlev <rogkatlev@...> wrote: Hi

guys,I hope this finds you all well. We are dong OK. got his biopsy results back. Stage 3 fibrosis and stage 3 inflammation. We were hoping for better news (of course)! What is the difference between fibrosis and cirrhosis. Are they the same? Aren't they both scarring of the liver. Maybe I'm missing something. Dr said he would be a good candidate for treatment. He also mentioned that if the treatment doesn't work then that would be that. At what stage do you qualify to be put on the transplant list? I know questions questions!! Again thanks to you all for all of your help. starts treatment (Pegasys and Copegus) the 23rd of August.Thanks, Jackie

[Guest guest]

Welcome to the group! A biopsy is pretty safe and a good diagnostic tool for the

doctor (you should learn what stage of the disease you're in). My first one hurt

a lot.

I expected it to hurt bad when I got the second one; it wasn't bad at all. I

guess it could depend on the doctor who does it. I keep expecting them to tell

me I need another one (it's been several years) but they haven't....

chengsh02 <chengsh02@...> wrote:

Hi, I am new here!

I am suspected to have Primary biliary cirrhosis,

slightly elavated liver test, AMA positive, fatigue,

and headache, sensitive to sound.

Doctor want me to do liver biopsy, is it really

safe? Thx

Sherry

[Guest guest]

Hi there! A biopsy is pretty much painless. The liver feels no pain, the

capsule surrounding it does but a good doc numbs it up before he/she pokes you.

A biopsy is the only way to tell the extent of liver damage from any liver

disease. You might feel pain -- varying degrees -- after the procedure in the

right shoulder/arm. Ask for something to dull it -- Percocet works great. I

hope it goes well and you have very little damage. --

[Guest guest]

Thanks a lot for the inf.

Sherry

--- WOOTTEN <lindawootten@...> wrote:

> Welcome to the group! A biopsy is pretty safe and a

> good diagnostic tool for the doctor (you should

> learn what stage of the disease you're in). My first

> one hurt a lot.

> I expected it to hurt bad when I got the second

> one; it wasn't bad at all. I guess it could depend

> on the doctor who does it. I keep expecting them to

> tell me I need another one (it's been several years)

> but they haven't....

>

>

> chengsh02 <chengsh02@...> wrote:

> Hi, I am new here!

>

> I am suspected to have Primary biliary cirrhosis,

> slightly elavated liver test, AMA positive, fatigue,

> and headache, sensitive to sound.

>

> Doctor want me to do liver biopsy, is it really

> safe? Thx

>

> Sherry

>

>

>

>

>

>

> [Non-text portions of this message have been

> removed]

>

>

__________________________________________________

[Guest guest]

Hi all,

I agree with Rick. I had my first biopsy last week at the Univ. of

Washington. No Problem! First they did blood work (INR and CBC), then an

Ultrasound marker, then the biopsy process: first lidocaine to numb the outer

skin,

then deeper lidocaine, then the biopsy in one place only (did not feel it).

Had to stay on my side for 4 hours, then two more hours of sitting, eating,

etc. No lifting for days (helpful husband) and I'm fine.

One problem not resolved yet. Dr. Kowdley, according to his

scheduler, doesn't have time to see me for months! I'm still fighting this

battle.

Nina in Spokane, WA Dx PBC 4/05 PMR 4/06 Age 63

Leave your organs here on earth,

HEAVEN knows we need them!

SUPPORT ORGAN DONATION

[Guest guest]

You should be able to get in to see the doctor at least for the results...be

firm. Hmmmm...you mentioned the deeper lidocaine...I think I remember them

giving me the shot also to help with the big needle going in. There have been

some who have said they did not have the ultra sound before and it seems rather

risky for someone to do a biopsy without it...the doctor who does mine always

uses ultrasound...but dang! That needle going in is a real trip!!!! WHOA!

After the procedure, I gasped and said... " That needle is 8 inches long isn't

it? " He said, " Yes, it is, but I don't use the who thing! " Yeah right! I

thought for sure the thing was going to go right through me! I laugh now....oh

well....life goes on.

We lived in Ritzville for 2 years...our daughter was born there. But eventually

I changed doctors and went to Spokane. I liked the hospitals there and I had a

wonderful doctor once who ended up becoming a state senator. He was indeed a

good man!

You are blessed to live in Spokane...we would like to move north. My brother

lives in Coeur d' Alene, and Spokane is such a beautiful city!!!

Debby

[ ] Re: Biopsy

Hi all,

I agree with Rick. I had my first biopsy last week at the Univ. of

Washington. No Problem! First they did blood work (INR and CBC), then an

Ultrasound marker, then the biopsy process: first lidocaine to numb the outer

skin,

then deeper lidocaine, then the biopsy in one place only (did not feel it).

Had to stay on my side for 4 hours, then two more hours of sitting, eating,

etc. No lifting for days (helpful husband) and I'm fine.

One problem not resolved yet. Dr. Kowdley, according to his

scheduler, doesn't have time to see me for months! I'm still fighting this

battle.

Nina in Spokane, WA Dx PBC 4/05 PMR 4/06 Age 63

Leave your organs here on earth,

HEAVEN knows we need them!

SUPPORT ORGAN DONATION