Alcohol Induced Cirrhosis or Hep C Cirrhosis vis a vis transplant

David,

You said you were dropped by Pratt, but are you still able to see Hertl?
I know Richard has a lot of confidence in him, he puts him on par with Dr. Rosser at Mayo.

Michelle, I took you up on the cupcake thing (actually was a hunk of fudge bar cake with cream cheese filling from Publix) and a cuppa....you're right, things are looking upwards, especially the bathroom scale :)

Sandia, Ziff is busy honing his disco skills for the long-awaited "Saturday Night Swine Fever Gala" down at the County Barn in 2 days.

Peace out homies \/

I took Ziff as a 2 step kind of guy.

David,

No I know what you mean, the protocol is different after TP, I just hope he can see Hertl again after he starts with his GP, who is also at Mass General.

How are you doing with the Lyme disease, is it very debilitating? I know it's a really hard diagnosis to make in some cases.

You're a very lucky man, David, in the scheme of things :)

 Eat mor ckikn !!!

 Syxx , I don't two step but if it helps to ease your mind or at the very least perpetuate the stereotype I did learn to Square Dance as a young piglet . It was part of school curriculum back then .

 Ziff 

 Syxx , You just opened up a whole new can of worms . Pleeeeease tell me your blind or something , Just what was you thinkin ......... Oh !! Never mind .

 Ziff

Generally, the chemical used to spray for ticks, kills all other cold blooded creatures. I'm not a fan of indiscriminate killing, as some of the animals killed are good to have around. Part of the reason we have so many ticks is because they used to spray the entire island for mosquitoes and it killed off most of the predators of ticks. That and the fact that we have too many white footed mice, rabbits (cottontails, varying hares and jack rabbits) and deer. All of them provide food (blood) for ticks.

Nantucket is 14 miles by 4 and our deer herd is over 2,000, the highest per acre ratio in MA., much less anywhere in the world. We are the perfect storm for ticks. Growing up in NC. as a kid we were warned about ticks (Rocky Mountain Spotted Fever). For all the time spent outdoors, I picked up less than 10 ticks through the 20 years living there. I've had days here when I picked up dozens of ticks walking a couple hundred yards. That's not common, but when conditions are right and walking in tall grass, it can happen. I'm very careful, but the 3 times I've gotten Lyme Disease, I hadn't been in bad spots.

Most people here have their dogs inoculated against Lyme Disease. Cats don't get it, but they do bring ticks in the house. When I had dogs and cats, I treated then with Frontline to rid them of ticks and fleas.

Pigs aren't a problem, as once they're cooked, the ticks are long gone. I've heard that ticks are allergic to barbeque sauce.

A lot of how Lyme goes, depends on who and how it's treated. Docs here are on top of it and aggressive about treatment. Often, people get it here, go home and their local docs don't know much, if anything about the disease, or how to treat it.

Hi Kierstin,
He's really a great guy and tremendous surgeon. What is your status as far as why you need a transplant and how close you are to getting one? Mine was a total surprise, as I didn't know where I was on the list and they never told me. It was better that way. No worrying about if, or when. Who's your hepatologist at MGH?

HI Kierstin

My brother, recently transplanted at Mayo, Jax, was originally listed at Mass General, which as you know is a fantastic and highly rated hospital. We also were very impressed with Dr. Hertl, he just exudes competence and confidence.

Yes the MGH and BWH are closely affiliated, they even share the patient gateway which we often use to look at lab results etc. My other brother has been to Chinwe Okamadu at Brigham's too, and we loved him as well. Small world.

The reason we went to Mayo was because it was highly recommended by someone at MGH, though we were already considering it. Brother's MELD went from low teens to 18 quite rapidly so we had to look at other options due to MGH transplanting in low 30s. We couldn't imagine waiting that long, or getting that sick.

My brother was fortunate that I was able to devote the time needed to hunker down in Jax during the wait because he needed so much care, always with the ascites build-up, HE, dehydration, etc and his wife needed to stay put in Mass due to her work.

We got to Jax in early November when his MELD was about 20ish, and by the time we was re-evaulated and his insurance issues were resolved (out-of-state HMO), oh, and he had another 2-week wait due to a Shingles vaccine they gave him, he was listed 1/2/2013 with a MELD of 23, I believe. He was transplanted 11 days later. He is progressing nicely, only needed a stent in the hepatic artery post TP, so far so good.

He has been back home in Mass for a couple of weeks now, and his weekly labs get sent to Mayo, where they make any adjustments to meds. I have to say I'm very impressed with Mayo, they have streamlined everything from start to finish, so organized there.

Good luck to you.
Mae

Kierstin,

Yes, 3 years ago my younger brother, while an inpatient due to an infarct and heart bypass at Brigham’s, found out from the doctor who said “Were you aware you have Hep C?” Of course he hadn’t been, and then just a few days later I had to get doctor’s permission (him being on a heart monitor) to break the news to him that his girlfriend just passed away from liver cancer. That’s when he first saw Chinwe, but not really showing any cirrhosis symptoms at the time.

Unfortunately he wouldn’t be a candidate for any transplant because of his alcoholism, past cocaine usage, and emphysema from smoking. To this day, even after having seen my other brother’s grueling battle with cirrhosis (before TP), he still smokes and gets drunk nearly every day. He only misses the days that he is too sick to drink. The doctor gave him 5 years or so even after his bypass, and that was when he was sober for a couple of months just after surgery.

If that’s not bad enough, I have third brother who died at 50 from a heart attack at work. He had Hep C too, but he was SVR at the time, due to treatment. Not sure how he contracted it but he did join in on a “tattoo night” in his teens where his friends all used same needles. That was really hard on us all, the heart attack out of nowhere. Sadly no one found him lying there until it was too late for resuscitation.

But, have 3 more brothers and 2 sisters who DON’T have it so I'll knock on wood and hang on to that.

Mae

Thanks, yes he's actually back at the office, trying to rescue his business. From being gone 4 months, his son didn't do the best job at the helm, I'm afraid.

Richard, got it from a tainted transfusion after a car accident in his teens, second brother from a tattoo, and my other brother apparently got it from his girlfriend who died from it, though it's possible he got it from past cocaine snorting (tainted straw?).

Sad, in any case.

Mae