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    Old 12-13-2007, 01:31 PM   #1
    smp1977
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    Liver Biopsy - Hep C

    Well, I just left my initial appt w/ the Gastro. For those of you that don't know my story...Tested positived for Hep C, found out through blood donation, no symptoms, no previous drug use, 30 years old. Had blood tranfusion when born prematurely in 1977. Lead pretty healthly life. Gastro ordered more blood work to determine geno-type and wants me to get a liver biopsy and follow up in 6 weeks. Doctor said he has never had a case like this where can't pin point a specific way of contacting virus. He thinks I should have symptoms by now. Had CT scan done and liver came back normal. Liver enzymes are normal as well. He almost gave me the impression that he thought I was lying about drug use. Ughhh!!! Anyways any comments on the above. Also, has anyone ever had a liver biopsy that can inform me on what to expect?

     
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    Old 12-15-2007, 03:03 PM   #2
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    Re: Liver Biopsy - Hep C

    what does he mean? You had a blood transfusion.
    It doesn't matter HOW you got it...only that fortunately, you found out and you're taking care of it.
    I also had no symptoms at all and found out from giving blood.
    Why are you having a biopsy? It seems un necessary to me??? They know you have it-Blood work will determine genotype-
    My doctor just did an ultrasound to have a look at my liver and it was fine pre treatment. I'm not a doctor but a biopsy is invasive-I would ask him why.

     
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    Old 12-27-2007, 03:23 PM   #3
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    Re: Liver Biopsy - Hep C

    still awaiting to have my liver biopsy, but I did find out that I am genotype 2b.

     
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    Old 12-28-2007, 06:42 PM   #4
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    Re: Liver Biopsy - Hep C

    Hey that's great that you're 2B-That's the "best" genotype for the TX I've been told.
    Still getting the biopsy? Did the doc say why you needed the biopsy?

    Last edited by eyesworld; 12-28-2007 at 06:43 PM.

     
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    Old 01-12-2008, 08:20 AM   #5
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    Re: Liver Biopsy - Hep C

    A liver biopsy is the only way to accurately tell the condition of your liver....an ultrasound is typically used as a preview kind of thing, and to find the best location for the biopsy. It can't tell the actual condition,a nd a biopsy is what is used to determine the extent of liver damage. It will take a few weeks probably to get the lab results back.

    I've had 2 biopsies...Thye are a little scary but over with in seconds, but then they make you lay on your side for a few hours afterwords just to make sure the bleeding has stopped. It's a pretty simple thing and is necessary. They keep you conscious for the procedure, because they need you tpo take a deep breath and hold it while they take the sample...It's literally like a 1 second thing, and it;s basically a larger spring loaded syringe they poke you with. Then afterwords you'll be sore for about a day...nothing major though.

    your doctor probably did not believe you never used drugs, because most people that have Hep c got it that way, and they lie to the doctor about it....not that it really matters anyways how you got it, but it would be odd that if you got it 30 years ago from a blood transfusion you wouldn't have symptoms by now, but maybe your healthy lifestyle and strong immune system have kept it in check.

    There are lots of other ways you can get it too, mainly from direct blood to blood connection, and can even get it from sharing a razor or toothbrush.

    Good luck with the biopsy, and i hope you don't have any serious liver damage. The good news is it is now curable in most people. I had genotype 1a, the most difficult type to treat, and am now 5-6 years post TX and the virus is undetectable. I'm considered cured, and although my liver will never repair itself, my liver function tests all come back normal now, so it must be working pretty good!

    mano

     
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    Old 01-12-2008, 04:56 PM   #6
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    Re: Liver Biopsy - Hep C

    I don't mean to be nieve but I was told a liver biopsy was only as good as the piece of liver that was biopsied. Is this true or should I be asking for one when I see my specialist.
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    Old 01-12-2008, 07:26 PM   #7
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    Re: Liver Biopsy - Hep C

    They really have to do a liver biopsy to accurately see the extent of the damage. It's in deciding your treatment and dosage.

    Your liver can actualy regenerate itself to a certain degree, they take the biopsy from a certain area that usually has the highest content of disease.

    Have they explained that the treatment almost always causes very severe depression at some point during treatment?

     
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    Old 01-13-2008, 07:31 AM   #8
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    Re: Liver Biopsy - Hep C

    cleo, that is true, the biopsy isn't totally accurate, because some parts of your liver can be worse than others, but by looking at the liver with an ultrasound first, they can determine a good place to get a sample from, and then by looking at the cells under a microscope they can determine the extent of damage quite accurately. Supposedly there is no correlation between how long you've had the disease, or how high your viral load is and what your liver condition might be, so they really have to do a biopsy....not everyone will be recommended to have treatment, because treatment in itself is brutally hard on the body. If for example, they determine you were infected 20 years ago and have no liver damage, or just minimal, they may recommend waiting on treatment, and monitor you closely until you do need tx. Some people have strong immune systems that suppress the disease, and some people have even cleared the disease on their own, but it's a small percentage. There are many new drugs in testing that promise an easier cure, so i think that is partly why they have some people wait.

    Another reason the biopsy is useful is to monitor progression of the disease. My first one showed mild scarring....five years later I got really sick, and a 2nd biopsy was done....My liver had progressed to stage 2 grade 2 disease, and that told me at that rate of progression I would be dead in another 5 years if i didn't do tx, and i was already so sick I couldn't take it any more. I truly thought I was dieing, prepared my will, cleaned out my house, sold investment properties, all to make it easier for my family when i croaked...Welll here I am, still kicking and feeling pretty good again.

    And yes, treatment does cause severe depression in most. Most doctors insist you get on an anti depressant before you begin treatment. I refused, after trying 3-4 different ssri types that made me feel horrid, even after giving them an adjustment period. I was very strong emotionally, but these meds made me crumble....a sad commercial on TV could make me break down and sob....but that's just one of many many side effects. TX is very difficult for most....Kind of like the worst flu of your life. I use to crawl into bed fully clothed with the electric blanket on high every day, and Advil & immodium AD were my best friends!

    Some genotypes require 48 weeks of tx while others only require 24 weeks. I THINK 2b is only (lol only) 24 weeks.

    The one thing I would recommend is finding a Dr. who has treated MANY people for hep c, and about the best way to do that is to ask for some referrals from your local hospital. A good GI Dr. will know how to treat the many side effects that come along with treatment, and give you a better success rate.

    As far as the liver regenerating, in a healthy non hep infected liver it will regenerate itself quickly. They now do living transplants of the liver, where they take 1/2 of a healthy donors liver, and that liver will grow back to normal in about a month or two. A person with hep c damage will not regenerate itself much if at all i was told. I would actually like to have another liver biopsy now, 5 years after tx. to see if there has been any improvement. I can say most of the symptoms I was having before tx are gone or very minimal now. and my liver function tests have come back prefect ever since tx.

    mano

    Last edited by moderator2; 01-13-2008 at 10:38 AM.

     
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    Old 01-14-2008, 09:04 AM   #9
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    Re: Liver Biopsy - Hep C

    Thank you for the info No one has explained anything to me I was dx in October and my appt for the specialist isn't until March at the St Louis center for advanced medicine. The only place insurance will send me. My general practioner is the one who specifically requested this hospital. You mentioned you cry at the simplist comercial I already to that. I not only have hep c but I suffer from severe migrains and have rhumatoid Arthritis That I chose not to take the meds for treatment because the manufactures say if you have liver disease not to take the meds. Whats scary with all this is that the first time I had a high liver count was almost 10 years ago and no further testing was done. When I had back sx a year ago I started getting the migrains but all my testing came out normal until my last blood test when my liver count was elevated again 10 years later.
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    Last edited by moderator2; 01-14-2008 at 09:09 AM. Reason: please don't clog the thread with a huge quote

     
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    Old 01-14-2008, 09:58 AM   #10
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    Re: Liver Biopsy - Hep C

    Hi Cleo,
    It sounds as you will be getting good care and treatment, going to a center for advanced medicine. They will most likely schedule a biopsy and lots of blood work, and like i said before, the biopsy is really nothing to get worked up about...It's not much worse pain wise than getting an IV started really, with some tenderness for a day afterwords. The doctor will talk to you about depression, and will want to start you on an AD or maybe try a different one if need be. And you might not even need treatment yet. Many people don't feel symptoms from treatment either, at least for the first few months. The 1st time I did treatment, when i was in my late 20's, I worked full time right through the entire year of TX. The 2nd time was much worse for me, but probably in part because i was older, about 40, and was very sick pre treatment, and also had a lot of stress in my life between a bad relationship breakup and a 70 hour a week work schedule. I did cut my work down to about 20 hours a week while on TX the 2nd go round....and it's all just a distant memory now.

    mano

     
    Old 01-15-2008, 08:46 AM   #11
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    Re: Liver Biopsy - Hep C

    I am thirty one and was on tx this time last year. It did cause major depression and lexapro was a huge life saver during that and I only wish I had started it and got through the akward period earlier. I have had a biopsy and it really was not a big deal for me. They did drug me up at some point. I do remember it hurting but they drugged me up so fast after that it was like a dream that I had had. I was sore that day though. My husband and I both have done the treatment. It sucked but was not terrible for us. It was not fun though....we were tired a lot and just had not energy which gets really old fast. But it worked for both of us so far. He is like two years post and still testing negative and I am over six months post tx and still testing negative. And gen 2 is a very good one to have as far as success rates for tx. You probably will only have to do twenty four wks of tx too. I actually cut mine short by about ten wks. I took a little gamble after doing research and being sick of the tx. It was stupid but I did it and it is over now and so far so good. Good luck. We are in Louisville so you are not all that far away from us. Get on anti- depressants now seriously....if you are planning on doing the tx here soon my major advice is to get on ad's a month or two before. It will make your life a lot better while on the tx. Yes they make you feel weird for a few days but it is better to know what side effects are coming from what rather than start all that crap at once and not have a clue.

     
    Old 01-17-2008, 04:10 PM   #12
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    Re: Liver Biopsy - Hep C

    I had 2 liver biopsies prior to liver transplant and 5 post transplant. First of all, I agree the best way to know the true status of your liver (cirrohsis free) is by a biopsy, but if your enzymes are normal and there are no other indications of liver problems I would opt out of the biopsy. Just remember Drs. will and can help but the ultimate choice about your body is yours. If the biopsy would make you feel better then maybe it is worth getting but it is invasive no matter how it is done and there is always risk of infection. Anyway here is my experience.... I have had a liver biopsy performed in three manners. One is what my transplant Dr. calls the blind method, basically he/she goes to your right side, counts up either 3 or 4 ribs (can't remember exact number), gives you a local anesthesia injection and then asks you to exhale deeply and hold it (gets your lung out of the way), they then insert the biopsy needle. Small amount of pain. The second manner which I experienced was basically the same as above but they used an ultrasound to locate my liver. Drs. usually do not use either of these methods if you have fluid on you abdomen (I'll say why in a minute). The third and last manner which I experienced was they put you in "la la" land and go through the artery in your neck, down into your liver. This is the safest (any bleeding remains in your liver and is processed out of your body) and most enjoyable method if you have to have a biopsy. After a biopsy using the first two methods I described, expect to recover by laying on your right side for 2 hours (weight of liver and internal organs put pressure on biopsy site and stop any residual bleeding, if there is fluid in abdomen bleeding may be harderl to stop). They monitor your blood pressure during all of this to ensure there is no abnormal bleeding. After the third method....I don't remember...I stayed in "la la" land for awhile. Hope this helps. If it needs to be done by all means, do it but if it does not, skip it. I gotta go in March to get another biopsy because TX did not work for me and I had to stop after 12 weeks, Hep C still very active and Doc wants to see how its affecting my new liver (had it for 13 months now). My prayers are with you.

     
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    Old 01-19-2008, 10:55 PM   #13
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    Smile Re: Liver Biopsy - Hep C

    I have a friend who has been HIV and HCV positive for at least 25 years. Very athletic guy in perfect shape who drinks more than most but has the energy of a bull. 1b genotype. No inflammation, portal hypertension, fibrosis or detectable HCV in the blood (under 400). Now that is very rare in HIV co-infection but maybe not so rare in HCV mono-infection. I still believe that many people die with HCV infection without ever even knowing it, and without ever having symptoms from the disease.

    I agree about the value of a biopsy. I've had three, the first one done by a doctor with what looked like a little harpoon. He got a great sample and was shocked my liver was an F1. Two years later, a biopsy with scanning technology was like a very quick jab in the liver that I didn't even feel. Two hours later I was at home. I refused the pain killers because I didn't even need them. I didn't lift weights or any heavy objects for a couple of days. But the results were an F3 and treatment was recommended. I tried it and it did not work. So who knows.

    With that genotype 24 weeks of treatment without the need for a biopsy is pretty standard at this point. Let's not forget that procedures like this can make money for those performing them, and their institutions. I'd get a second opinion before the biopsy.

     
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    Old 01-22-2008, 02:01 PM   #14
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    Re: Liver Biopsy - Hep C

    [QUOTE=mano2008;3387086]A liver biopsy is the only way to accurately tell the condition of your liver....an ultrasound is typically used as a preview kind of thing, and to find the best location for the biopsy. It can't tell the actual condition,a nd a biopsy is what is used to determine the extent of liver damage. It will take a few weeks probably to get the lab results back..."

    Hi, I just read your post. When I went to ER for a bad reaction to a sulfite drug/troubleshooting (prior ****) was when they did a slew of tests. I was under the impression the ultrasound was sufficiant in determining the condition of my liver. They couldn't find a thing...yet one fellow remarked that it's all they could see was all the hep c floating around!!The doctor on call pretty much determined it was the drug I was given for a kidney infection.

    Now, I've had every symptom in the book...which finally led to my discovery of the hep c just a few years ago which I'd been carrying for just over twenty five years. Is this true though, I'd really need a biopsy to determine the true condition of my liver? Thanks-

     
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    Old 01-22-2008, 05:32 PM   #15
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    Re: Liver Biopsy - Hep C

    There is a blood test that is supposedely 80% accurate as conpared to 90% for a biopsy. This is what my Dr. used and was comfortable with. Some insurance companies may require a biopsy before authorizing treatment. Mine did not. I could have requested one but did not. I'm sorry I don't know the name of the test, but I know it is not uncommon.

     
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