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Medical Forum / Diseases and Disorders / Hepatitis / January 2007Katie again
My original post is not showing up on my news server but I could go into Google Groups and read your responses as did Katie. Thanks so much again for helping us look at different sides of the DX. We both truly appreciate all of your help. She spoke with the head nurse today and asked her about co-infection and the nurse told her it was impossible. I think she needs to ask the doctor about this before she starts treatment for 3A. She has a consultation tomorrow to schedule the biopsy. If any of you remember when she was first diagnosed they found a mass on her liver through an ultrasound. This scares me a little and will be with her when she has the biopsy. I'll keep you all posted. Thanks again to all who responded here and to my personal e-mail. I am so glad I found you. You have kept me sane for a lot of years now. LTF's????? Don't know where that came from. Mom Hi Mom, If the NP who told you HCV infection with multiple genotypes is impossible got that info from the MDs s/he works with, I would definitely advise Katie to go to another doctor before she begins treatment. There is a big difference between tx for 1a and 3a. Co-infection with different genotypes has been well known for years. Most of the initial investigations along these lines involved hemophiliac children - but the information is applicable to anyone having a blood-to-blood exposure. If you Google "HCV multiple genotypes" you'll find more info than you'll want to read. Here are just a few of the links from my reference files: http://www.blackwell-synergy.com/doi/abs/10.1111/j.1572-0241.1999.01298.x?cookie Set=1&journalCode=ajg http://www.hivandhepatitis.com/hiv_hcv_co_inf/aa/120804_c.html http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1 0445555&dopt=Abstract Good luck dear, and let us know what you find out. Thom  Signature{formerly known as Firestar} > My original post is not showing up on my news server but I could go into > Google Groups and read your responses as did Katie. [quoted text clipped - 18 lines] > > Mom > Hi Mom, > If the NP who told you HCV infection with multiple genotypes is impossible [quoted text clipped - 39 lines] >> >> Mom Thank you Thom. I'll pass these on. She has her first biopsy scheduled for next Monday. I'm back to "worried Mom". Mom Mom, Ask Katie to get copies of her lab work. Iron saturation is a specific lab value, rather than a diagnosis. Look for tests like Iron (aka Fe), TIBC (aka IBC), Ferritin, Folate and various Vitamin levels. All are necessary in evaluating a person's iron load. Don't freak out if you see extremely high or extremely low results in the report. All of these things are in a state of dynamic equilibrium in the body. Each is dependent upon the other. In any event, routine iron load disorders are fairly common and easily treatable. When Katie has her liver biopsy they will do a special iron stain on a portion of the biopsy material. This is routine for any liver evaluation. Thom {formerly known as Firestar} >> Hi Mom, >> If the NP who told you HCV infection with multiple genotypes is [quoted text clipped - 44 lines] > > Mom >My original post is not showing up on my news server but I could go into >Google Groups and read your responses as did Katie. [quoted text clipped - 5 lines] >nurse told her it was impossible. I think she needs to ask the doctor about >this before she starts treatment for 3A. [...] The head nurse is an uneducated moron. One can only pray she isn't an indicator of the quality of care one could expect from that office... /greyhackles The head nurse is an uneducated moron. /greyhackles ///////////// What a ya expect from a nurse whose specialty is 'head'? :-) elmo twenty dollar co-pay required, tho http://community.webtv.net/elmoemerson/DocElmosHepFile http://community.webtv.net/elmoemerson/TheFamilyAlbum > The head nurse is an uneducated moron. > [quoted text clipped - 5 lines] > >Only Elmo would think of that one. ;-) Katie mentioned another thing I have never heard of. Apparently her iron level is up. I think the exact phrase the doctor used was "iron saturated". Can anyone help me understand this one? Mom > http://community.webtv.net/elmoemerson/DocElmosHepFile > > http://community.webtv.net/elmoemerson/TheFamilyAlbum >Katie mentioned another thing I have never heard of. Apparently her iron >level is up. I think the exact phrase the doctor used was "iron saturated". >Can anyone help me understand this one? Sounds like it could be "iron overload", having too much iron for the carrying-capacity of the body. Iron overload is not good for anyone, but it's especially not a good thing to have when HCV is involved, as high iron tends to accelerate liver damage due to increased oxidation in liver cells, caused by an increase in free radicals in the liver from the HCV. The human body has no physiological way to eliminate iron (something I always found rather fascinating). So any condition that significantly increases absorption or sequestration of iron as a chronic condition can cause problems if left untreated. And, for whatever reason, HCV tends to increase sequestration of iron in the blood and certain organs. Additionally, there is a fairly common hereditary disorder called Hemochromatosis which increases iron absorption, usually well above normal ranges. It isn't uncommon to discover this underlying, genetically-controlled condition when investigating hepatitis, as the first order marker (serum ferritin) is usually tested at some point in the diagnostic process. Phlebotomy is the usual treatment mechanism for iron overload, and if done correctly can get the iron load back in the normal range and keep it there indefinitely, without undue side affects, and resulting in a normal life expectancy. But this throws a bit of a wrench in the HCV treatment perspective. High iron is bad, period, HCV+ or not, and from the reading I've done on the topic, treatment should commence upon diagnosis. And as anemia is almost always present while on HCV therapy, obviously you really can't treat both conditions at the same time without taking on risk. Because iron load is one of the more significant factors in treatment success (one of the top five metrics, after g-type, gender, VL and BMI) I think the condition should be resolved first, before the first Peg shot is taken. Depending on the body-stored iron levels, that could take months, or even longer. I sure hope the doctor treating Katie has experience in dealing with this kind of problem... /greyhackles >>Katie mentioned another thing I have never heard of. Apparently her iron >>level is up. I think the exact phrase the doctor used was "iron [quoted text clipped - 51 lines] > > /greyhackles Thank you Grey. She didn't tell me "how high" her iron levels were and I don't want to bother her with this tonight so close to bedtime but I will definitely talk to her about this tomorrow. I have read a little further on this now and you are right..............this should be addressed "before" treatment. I guess we'll see just how much this guy knows now. Thanks again for your help. It means so much. Mom >>>Katie mentioned another thing I have never heard of. Apparently her iron >>>level is up. I think the exact phrase the doctor used was "iron [quoted text clipped - 60 lines] > Thanks again for your help. It means so much. > Mom Mom, I have hemochromatosis and the treatment for it is very simple, phlebotomies until the iron levels drop. This had nothing to do with my contracting Hep-C, but together they can cause problems. I have type II diabetes that in all likelihood was caused by the damage to the pancreas by too much iron. Hemochromatosis is more prevalent than most people think and probably one of the most undiagnosed problems you can have. I was told 20 years ago that I had non-A, non-B Hep, but nothing was really said about it at the time. In 1992-93 I was found out for sure that I had Hep-C, Hemochromatosis, type II diabetes, and after two liver biopsies I had cirrhosis as well. Wasn't one of the best times of my life. If the iron levels are kept in check, they shouldn't cause any problems with Katie doing tx. I hope she doesn't have Hemochromatosis, but if she does she's young enough that if she keeps on top of it, it shouldn't cause any probes. Your both in my prayers. Dwight > > The head nurse is an uneducated moron. > > [quoted text clipped - 11 lines] > > Mom Has she been checked for hemochromatosis? http://preview.tinyurl.com/ysfxlf >> > The head nurse is an uneducated moron. >> > [quoted text clipped - 16 lines] > > http://preview.tinyurl.com/ysfxlf No, Tom she hasn't been tested but I am going to mention this to her tomorrow. Ever since Katie was young she has suffered from occasional joint pain especially in her knees. We always figured it was "growing pains". I think it was mentioned to her pedatrician but no testing was ever done. Hopefully it wasn't this. I didn't realize how many complications could occur so early in Hep-C. Geez. Thanks, Mom > >> > The head nurse is an uneducated moron. > >> > [quoted text clipped - 25 lines] > > Thanks, Mom It didn't show in me till I was 55. I go in 2/3 times a year and have a unit of blood taken off and that controls my ferritin overload. Actually a pretty simple treatment in my case. I'd have the disorder even without the Hep-C. Smiling Wickedly, elmoemerson@webtv.net answered: > > [quoted text clipped - 5 lines] > elmo > twenty dollar co-pay required, tho Muwahahahah er.. I don't get THAT kind of service. :-) Signature*..· ´¨¨)) ¸.·´ .·´¨¨)) ((¸¸.·´ .·´-:¦:-((¸¸.·´(º·.¸(¨*·.¸ ¸.·*¨)¸.·º) «.·°·. Michael .·°·-:¦:- >>My original post is not showing up on my news server but I could go into >>Google Groups and read your responses as did Katie. [quoted text clipped - 15 lines] > > /greyhackles My thought exactly Grey. Thanks for your help. Mom |
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