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Medical Forum / Diseases and Disorders / Hepatitis / September 2008

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Doctor on 9/30. Questions I should ask?

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Otis T. - 28 Sep 2008 23:36 GMT
I am going to a doctor that specializes in liver problems, Hep, etc.
What are the specific questions I should ask him? Should I ask him
about Telaprevir
(http://www.hivandhepatitis.com/2008icr/easl/docs/042508_b.html) or
other treatments? Should I demand certain tests?

Your suggestions are greatly appreciated. In his possession will be
the results of blood work, especially liver things and about a year
ago, I had my gall bladder removed and I am sure the doctor did a
biopsy then and I will call his office tomorrow to make sure the
results are forwarded to this liver doctor.

Thanks,
Otis
Waterspider - 29 Sep 2008 00:30 GMT
>I am going to a doctor that specializes in liver problems, Hep, etc.
> What are the specific questions I should ask him? Should I ask him
[quoted text clipped - 10 lines]
> Thanks,
> Otis

Well, that's the first question, and the most important-- what's the result
of the biopsy?
If you've not had one, demand (ask nicely) a biopsy asap.

Maybe ask how soon you can begin treatment, and if he sees any problems for
you that may have showed up in other tests.
Maybe ask if he's going to send you for a viral load at 12 weeks (this is
the standard test to determine if the tx is working).
Maybe ask him to recommend a dietician to help you lose weight :-)

Good luck, Otis.
TX-012 - 29 Sep 2008 00:45 GMT
> I am going to a doctor that specializes in liver problems, Hep, etc.
> What are the specific questions I should ask him? Should I ask him
[quoted text clipped - 10 lines]
> Thanks,
> Otis

Otis---if you've already had a biopsy, the most important question you
ask may be: are you ready to commit yourself to treatment? If you are,
then by all means investigate the possibility of joining a clinical
trial:

http://www.vpharm.com/current-projects/Clinical-Trials.html

...If you are able to join one, go for it, if not, and you wish to
treat now, I would probably ask how your doctor deals with side
effects (in clinical trials there may be very little flexibility on
this front). Ideally, I would want to make certain that my doctor is
willing to aggressively treat any sides which arise (anemia,
neutropenia, pain, depression, insomnia), either on his or her own, or
by referral to a specialist (pain management specialist, psychiatrist,
etc.)...

While I believe, for example, most doctors these days will treat
anemia by adding large doses (40,000-60,000 IU/week) of EPO (Procrit
or EPOGEN) and not by cutting back on ribavirin (something you want to
avoid, if possible), some still cut not only ribavirin but also
interferon doses rather than adding EPO...Make sure you don't get one
of these people...

You might also wish to ask your doctor if he will consider extending
tx to 72 weeks if you do not respond optimally (as I am doing, Sat,
09-27-08 was my 1 year anniversary on tx) or consider increasing your
dosage(s) (less likely)...

Another question: how does your doctor feel about adding fluvastatin
to your drug soup (google it)
...

It is very important that your doctor is going to be someone who will
encourage and support you as you strive for a goal which can be
*extremely* challenging. This means that you need to feel confident
that he won't pull the plug on treatment if things get a little tough
(this happened with my first doctor; who initially cut my combo
dosages by 50% and then tried to yank me off tx when I experienced
anemia and neutropenia and pain; I switched to his superior, who
actually knew what he was doing and it's been fairly smooth sailing
ever since)...

Provided you feel comfortable with all the answers you get, you might
move on to "When can I start...how do I learn how to inject my
interferon, etc."
 
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