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Medical Forum / Diseases and Disorders / Hepatitis / August 2004Biopsy result - I need help please.
Hi All, I had my biopsy yesterday and they told me it usually takes 3 days for the results. My doc must have put a rush on it because I just got the results on my fax. My doc is gone till 8/19. I know these results mean I need to start Tx. I'm just not sure how long it can wait Do I need to start in a week or a month or can this wait till spring? I'm still shaking after reading this so please forgive any misspelling. Here are the results: Final Diagnosis: Chronic Hepatits (Grade 3, Stage 3) Portal Tracts: Portal Inflamation (Severity): Moderate Portal Inflamation (Inaflammetory Cell Type): Predominnantly lymphocytic Portal Tract Edema: None Cholangitis: None Periductale Fibrosis: None Ductular Proliferation: Mild Ductal/Ductular Cholestasis: None Interface of Portal Tracts and Lobules: Interface Hepatitis (Piecemeal Necrosis) Moderate Pseudoxanthomatous Change / Biliary Piecemeal Necrosis: None Lobules: Lobular Disarray: Moderate Lobular Inflammation (Severity): Moderate Lobular Inflammation (Location): Focal Lobular Inflammation (Inflammatory Cell Types): Predominnantly lymphocytic Confluent Necrosis: Focal bridging necrosis Necrosis Location: Focal Acidophilic Bodies: Few Hepatocyte Ballooning Degeneration: Mild Hepatocellular Atrophy: None Fatty Change: Mild macrovesicular Hepatocellular/Canalicular Cholestasis: None Other Hepatocellular Changes of Cholestasis: None Sinusoids: Unremarkable Central Veins: Hepatitis around central veins Mallory's Hyaline: None Alpha 1 Antitrypain Globules (PAS with diastase stain): None Siderosis (Iron Stain): None Fibrosis (Trichrome & Reticulin Stains): Stage III portal with bridging, progrssing to cirrhosis Other Findings: None Comment: This histology is consistant with Hepatitis C. I'm still shaking even though it took me about 20 minutes to type all that. As alway your help and support is greatly appreciated. Dan > Hi All, > [quoted text clipped - 56 lines] > > Dan I'm sorry Dan. Sorry the news wasn't better and sorry that you had to get the news without having the doctor around to tell you what's next. I have 0 medical knowledge so I can't help...but there were a lot of "none's" on that list. :-) Hang in AG On Fri, 06 Aug 2004 22:44:47 GMT, "Dan Perlman" <dan@dpci.NOSPAM.us>, >I had my biopsy yesterday and they told me it usually takes 3 days for the >results. My doc must have put a rush on it because I just got the results on [quoted text clipped - 4 lines] >I'm just not sure how long it can wait >Do I need to start in a week or a month or can this wait till spring? I only understand part of your results but it looks like starting tx in the not too distant future is a good idea. A week or a month shouldn't make a difference. Waiting till Spring probably wouldn't either but who can say for certain? The bit on your biopsy report that caught my eye was "......... progressing to cirrhosis". I understand that cirrhosis isn't normally reversible so it's probably better to arrest this disease sooner rather than later. This is usually a very slow progressing disease as you know.  SignaturePaul Use the reply by email facility in your newsreader to send email Paul, Do you happen to know if Fibrosis can be reversed? Thanks, Dan > On Fri, 06 Aug 2004 22:44:47 GMT, "Dan Perlman" <dan@dpci.NOSPAM.us>, > [quoted text clipped - 15 lines] > better to arrest this disease sooner rather than later. > This is usually a very slow progressing disease as you know. Dan, relax. Most of your liver damage can be reversed as long as you beat the dragon. Elmo /////////////////// Paul, Do you happen to know if Fibrosis can be reversed? Thanks, Dan "Paul" <dontspamme@westgreen.freeserve.co.uk> wrote in message news:j348h050sa47dsu5b9q1fabbghfm38mjj1@4ax.com... On Fri, 06 Aug 2004 22:44:47 GMT, "Dan Perlman" <dan@dpci.NOSPAM.us>, in message ID <zRTQc.11158$9Y6.728@newsread1.news.pas.earthlink.net>, in the newsgroup alt.support.hepatitis-c wrote: I had my biopsy yesterday and they told me it usually takes 3 days for the results. My doc must have put a rush on it because I just got the results on my fax. My doc is gone till 8/19. I know these results mean I need to start Tx. I'm just not sure how long it can wait Do I need to start in a week or a month or can this wait till spring? I only understand part of your results but it looks like starting tx in the not too distant future is a good idea. A week or a month shouldn't make a difference. Waiting till Spring probably wouldn't either but who can say for certain? The bit on your biopsy report that caught my eye was "......... progressing to cirrhosis". I understand that cirrhosis isn't normally reversible so it's probably better to arrest this disease sooner rather than later. This is usually a very slow progressing disease as you know. SignaturePaul Use the reply by email facility in your newsreader to send email http://community.webtv.net/elmoemerson/DocElmosHepFile >[...] >Fibrosis (Trichrome & Reticulin Stains): Stage III portal with bridging, >progrssing to cirrhosis That's a result no one wants to see, especially not without a doctor present to explain options and prognosis. You're right that you have few options now - there's no alternative to treatment. Whether you can wait till spring is something to discuss with your doc, he knows your history, and might have an idea how fast things are progressing. If it were me, I probably wouldn't want to wait, but if you have more pressing things to take care of first, it might not make that much of a difference. But I don't have a crystal ball... A mild, beginning cirrhosis can potentially be reversed with a successful treatment. Even an unsuccessful one may help in repairing at least some of the damage. Your liver may not return to a completely normal state, but progression to cirrhosis is likely to halt. Thomas SignatureTo reach me, complete my last name in the address. best get on the bus Dan. were here for you! good luck SignatureRuss Remove "NOSPAM" for replies. > Hi All, > [quoted text clipped - 56 lines] > > Dan Dan, you certainly need to start tx soon, rather than later. But it can wait til the 19th of this month, it took you awhile to get to this point. Don't freak out, you don't have cirrhosis yet and most of the damage can be reversed if you do the tx and win. Please give serious thought to daily Infergen and not settle for the standard Peg. You CAN beat it!! You haven't received a death sentence by any stretch of the imagination. Try to relax, please. I know the news must be eating at you. The two weeks will give you a chance to get your affairs in order so that you will be ready for tx when the doc gets back from vacation. Get all your dental work finished, including a good teeth cleaning done. Elmo http://community.webtv.net/elmoemerson/DocElmosHepFile Thank You Elmo, You mentioned Infergen. My genotype is 3a and my viral load was something like 327,000. I have read a lot here about the side effects of Infergen. Knowing that I'm type 3a would you still tell me to consider Infergen? Thanks again Elmo. Dan > Dan, you certainly need to start tx soon, rather than later. But it can > wait til the 19th of this month, it took you awhile to get to this [quoted text clipped - 9 lines] > > http://community.webtv.net/elmoemerson/DocElmosHepFile Your chances with Peg are about 85%, considering your genotype. I haven't seen any numbers for success with Infergen, so I can't say. Personally, I'd stick with Infergen for a month or so, til you became undetectable, then switch to Peg. For us type 1's that have had no success with Peg, Infergen is deadly to the virus. Discuss it with your doc when he comes back from vacation. I'd go with whichever type of interferon that gave me the best chance of beating it with only one round of tx. You're lucky in that you have a chance to beat it before you get cirrhosis in addition to being a type 3. I'd be happy for that if I were in your shoes. Elmo //////////// Thank You Elmo, You mentioned Infergen. My genotype is 3a and my viral load was something like 327,000. I have read a lot here about the side effects of Infergen. Knowing that I'm type 3a would you still tell me to consider Infergen? Thanks again Elmo. Dan <elmoemerson@webtv.net> wrote in message news:3038-41142F39-448@storefull-3251.bay.webtv.net... Dan, you certainly need to start tx soon, rather than later. But it can wait til the 19th of this month, it took you awhile to get to this point. Don't freak out, you don't have cirrhosis yet and most of the damage can be reversed if you do the tx and win. Please give serious thought to daily Infergen and not settle for the standard Peg. You CAN beat it!! You haven't received a death sentence by any stretch of the imagination. Try to relax, please. I know the news must be eating at you. The two weeks will give you a chance to get your affairs in order so that you will be ready for tx when the doc gets back from vacation. Get all your dental work finished, including a good teeth cleaning done. Elmo http://community.webtv.net/elmoemerson/DocElmosHepFile http://community.webtv.net/elmoemerson/DocElmosHepFile Dan, I found several sites on biopsies. This one may have to much info but its pretty good stuff. http://janis7hepc.com/biopsies.htm The longer you wait the harder it may be to treat, so the sooner the better. buster > Hi All, > [quoted text clipped - 56 lines] > > Dan Dan, as a genotype 3 you've got an excellent chance to rid your body of HCV and your liver should still heal. It is truly a remarkable organ. The sooner you start tx, the sooner your liver gets a chance to recover. Not the best results, but not the worst either. With that low viral count you'll probably be undetectable by your 12th week. I'd say it was time to kill that dragon. Thanks Don! I agree. I believe it is time to kill the dragon. My big problem is that I am self employed and my busy season runs from about September through March. I am a programmer and fortunately I work in my basement. Brain fog is going to be a huge problem. My normal hours in the busy season can be 16 a day 7 days a week. I'm thinking maybe I'll hire a part time secretary to help keep me organized. Best to you and yours, Dan > Dan, as a genotype 3 you've got an excellent chance to rid your body > of HCV and your liver should still heal. It is truly a remarkable > organ. The sooner you start tx, the sooner your liver gets a chance to > recover. Not the best results, but not the worst either. With that > low viral count you'll probably be undetectable by your 12th week. > I'd say it was time to kill that dragon. >Thanks Don! > [quoted text clipped - 10 lines] > >Dan Bad timing I see. However, at 6 weeks I haven't had brain fog associated with tx. Maybe my natural brain fog gives me some immunity :). But 16 hours a day may prove difficult. In the grand scheme of things, your health is far more important than making a few bucks. Hire a secretary and get started on tx. Elmo http://community.webtv.net/elmoemerson/DocElmosHepFile > Bad timing I see. However, at 6 weeks I haven't had brain fog > associated with tx. Maybe my natural brain fog gives me some immunity > :). But 16 hours a day may prove difficult. After 18 weeks of therapy, I had to take a leave of absence from work. I'm a phone tech and I could not longer concentrate on solving customer's computer problems over the phone. The constant fatigue, intermittent fevers and nausea all contibuted to my brain fog. Hope this clears up soon... > > Bad timing I see. However, at 6 weeks I haven't had brain fog > > associated with tx. Maybe my natural brain fog gives me some immunity [quoted text clipped - 4 lines] > problems over the phone. The constant fatigue, intermittent fevers and > nausea all contibuted to my brain fog. Hope this clears up soon... This really has caught me by surprise. I thought I understood the side effects and how they work but for some reason I assumed the very worse would be in the beginning and it would slowly get better each week. Doesn't work that way :-) Logically I should have realized the constant side effects would add up. The headache itself is not what's bad, had headaches before. It's the fact that it never goes away. Same thing with the fevers. You can survive a fever but 12 weeks of being over heated comes with it's own set of problems. I'm an engineer. I only start new projects before noon. After that, anything that looks like it might require more than a nominal amount of concentration gets set aside or handed off. I also take naps at work :-) I go out to my car, find a shady spot and just sleep for 20 or 30 minutes (an hour and a half last week, someone finally got worried). Luckily I have the kind of job that will allow me some leeway and have been there 10 years so they know this isn't the norm. I don't know how people with really demanding jobs do it. Impressive. AG On Wed, 11 Aug 2004 08:52:13 -0700, "Agua Girl" <uknown@spamblock.net>, in message ID <kYCdnTkpw_Lf3IfcRVn-qQ@adelphia.com>, in the newsgroup alt.support.hepatitis-c wrote: >This really has caught me by surprise. I thought I understood the side >effects and how they work but for some reason I assumed the very worse >would be in the beginning and it would slowly get better each week. >Doesn't work that way :-) This seems to be a common misconception - probably because it has come from the medical industry itself. I can't be sure but I suspect that this is old information which was based on the interferon monotherapy. At that time it was usually correct, but with the introduction of ribavirin (and an extra battery of side effects) the info became outdated. Please note that I am basing this guess on things that people have told me who did the old monotherapy. SignaturePaul Use the reply by email facility in your newsreader to send email > On Wed, 11 Aug 2004 08:52:13 -0700, "Agua Girl" > <uknown@spamblock.net>, in message ID [quoted text clipped - 14 lines] > Please note that I am basing this guess on things that people have > told me who did the old monotherapy. That's probably on target. Combo therapy wasn't even available in the US when I was first diagnosed..which of course is when I first delved into it. Knowing it was on the way is one of the reasons I delayed. It's almost 10 am..I am supposed to be at work..I still plan on going in ..sorta..but to be honest I don't feel the energy to make the drive. I will take #12 on Friday..half way point..I thought I would have had that "adjustment" they talked about by now :-) No worries. I made it the last 12 weeks, surely I can make it 12 more. Now if I could just get up :-) AG On Wed, 11 Aug 2004 09:55:38 -0700, "Agua Girl" <uknown@spamblock.net>, in message ID <L7KdneNjLaqCzYfcRVn-pw@adelphia.com>, in the newsgroup alt.support.hepatitis-c wrote: >That's probably on target. Combo therapy wasn't even available >in the US when I was first diagnosed..which of course is when I first >delved into it. Knowing it was on the way is one of the reasons >I delayed. It's more unpleasant doing combo, I'm told, but at least there is a better chance of it clearing the virus > It's almost 10 am..I am supposed to be at work..I still >plan on going in ..sorta..but to be honest I don't feel the energy to >make the drive. I will take #12 on Friday..half way point..I thought >I would have had that "adjustment" they talked about by now :-) >No worries. I made it the last 12 weeks, surely I can make it 12 >more. Now if I could just get up :-) Please don't take this as discouragement, but I, personally, have found the second half of the tx harder than the first (like you, I am on a 24 weeker). That's not a guide as it's different for everyone and it's still been very doable. SignaturePaul Use the reply by email facility in your newsreader to send email "Paul" <dontspamme@westgreen.freeserve.co.uk> wrote in message > Please don't take this as discouragement, but I, personally, have > found the second half of the tx harder than the first (like you, I am > on a 24 weeker). That's not a guide as it's different for everyone > and it's still been very doable. 24 weeker here, too. The first couple of weeks were OK, followed by 3 weeks of nausea hell. Then I was fine for a couple of months. After that the symptoms (headaches, fevers, nausea) started again with increasing frequency. I have maybe two good days a week now. 5 weeks to go. The doctor says there's no reason for this, but I think this therapy is so new that the facts are not all in yet. Good luck and hang in there; hope it's better for you. On Fri, 13 Aug 2004 03:50:37 GMT, "Flytrap" <flytrap@asm.org>, in message ID <hUWSc.2172$_f3.1286@newssvr22.news.prodigy.com>, in the newsgroup alt.support.hepatitis-c wrote: >24 weeker here, too. The first couple of weeks were OK, followed by 3 weeks >of nausea hell. Then I was fine for a couple of months. After that the [quoted text clipped - 3 lines] >new that the facts are not all in yet. >Good luck and hang in there; hope it's better for you. Oh yes. I'll be hanging in there alright. I only have 2 weeks of this madness to go. SignaturePaul Use the reply by email facility in your newsreader to send email You go girl! 12 more. I know you can do it! Dan > > On Wed, 11 Aug 2004 08:52:13 -0700, "Agua Girl" > > <uknown@spamblock.net>, in message ID [quoted text clipped - 26 lines] > > AG > On Wed, 11 Aug 2004 08:52:13 -0700, "Agua Girl" > <uknown@spamblock.net>, in message ID [quoted text clipped - 12 lines] > ribavirin (and an extra battery of side effects) the info became > outdated. I think they're just lying to you. I think that denial can be useful in the first few weeks. I can't imagine not having the thought "this is going to get better" to hold onto. Dan, Elmo hit it right on the head. While it means you must start treatment soon, you've got a few pluses there. Type 3A, not cirrhosis yet. 24 weeks of treatment sure is a nicer option than 48. And the success rate with 3a is very good. And you really should deal with your teeth quickly. You don't want to go to the dentist while you're on treatment. Like Russ said, get on the bus now. Keith >Hi All, > [quoted text clipped - 56 lines] > >Dan |
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