Treatment on Harvoni

Hi themiz, Happy New Year to you, too!

Sorry it has taken this long to reply. I was in Naples for the holidays and just flew home last night. I don't have any definitive proof about the grade or stage of Cirrhosis. Only bloodwork, a ct scan that shows, "trace" of ascities.

I appreciate your help. I had to convert several bloodmarkers but will also include the conversions. Here they are:

Total Bilirubin 0.8 mg/dl conversion 13.68 umol/L
Albumin 3.8 g/dl
INR 1.1
Ascities Medically controlled with diuretics
No Encepelopathy
Above for Child Pugh Score

Creatinine 0.70 mg/dl conversion 61.88 umol/L
Bilirubin 0.8 mg/dl conversion to 13.68 umol/L
INR 1.1
Sodium 139 mmol/L
Above for Meld or Meld NA Score

I recently saw a Child Pugh Classification that included the PT. It could have been one that is no longer used. However, my PT is 11.8 seconds. My platelets are at 91,000. That's what I don't understand. The only markers that are not normal are the platelets, and the PT.

I did this four times and my son calculated it also. We both came up with Meld of 8, Meld Na of 7, and Child Pugh Classification class A.

I am sitting here after being handed a very poor prognosis of living 2 years with 50% chance of complications in the next year.

Please let me know what you come up with or any input you may have. I am severely depressed over this. Is my liver so far gone that they are not bothering with a biopsy or fibroscan?

This is what the recent CT Scan stated about my liver: The liver is within limits of normal in size and contiues to demonstrate minimal lobularity suggesting the possibility of cirrhosis. No discrete hepatic mass is noted. There is no intrahepatic ductal dilatation. Previous identified small amount of perihepatic ascites has resolved Then further down on the ct results, it states, Trace ascites is again noted. It also states the mass in my kidney has not changed in size. 2.5 cm solid density mass projecting laterally from the mid right kidney.

Let me know when you can. Very much appreciated. This forum has remained to keep me sane. I thank everyone.
Big Hugs
Mitzi

Thanks Barry. I appreciate the input and I agree. Themiz posted that she would do my
meld score and child Pugh if I posted my bloodmarkers, which I have done in post prior to yours. How do I get a message top her, letting her know I have done this? I need some help here before I take proactive steps.oh, and the doctor is stating I am decompensated because of trace of ascities.
Thanks,
Mitzi

Hey, Barry,

Thanks for the input. My platelets are 91,000, still low. According to the reference range, the PT is 9.0 to 11.5. Mine is 11.8. Not much above the norm. What I was asking, was for someone in Healing Well to do my Meld Score and Child Pugh Score. The bloodmarkers I listed were for those two calculations. That is the problem I am having. The hepatologist stated my Meld was 26 and Child Pugh Class B. With these bloodmarkers, I did both and came up with Meld of 8 and Child Pugh Class A. I just had this bloodwork done three weeks ago. The platelets of 91,000 are post treatment. The doctor states I am decompensated because of trace ascites. From my understanding, the liver can regenerate if you are Compensated. I believe I posted this in my thread.

My treatment went well. No problems to speak of. Constipation really bad, and a few minor headaches.
Unfortunately, because I was undetectable without any treatment for so many years and couldn't get treatment because of this. In April of 2014, my viral load jumped from undetectable to 800,000. It elevated significantly in the next year getting approved for treatment. I am posting this to let people know that treatment doesn't stop the progress of Cirrhosis. Or at least it continued to this point for me. And yes, I am frustrated and angry over this. I have been very proactive to no avail. According to the hepatologist, I am at the end of my life. I feel bad, but not bad enough to think I am going to die within the next year. Besides......I haven't lost a pound!!! Still love food.

So in closing, is there someone that can do my Meld Score and Child Pugh Classification?

Thank you so much, themiz!! I knew I had calculated it correctly when converting the dg/l to umol/L.
You have given me relief and certainty that I am on point.

To answer your question about what he based this on. The fact is all he had in front of him was the CT scan. I posted what it stated concerning my liver. I hadn't had my first labs done so he had nothing much to go by.
However, after leaving me with no hope, telling me I had 2 to 3 years best, with 50% chance of complications within the next year, he called me the next morning and told me he had new information(probably saw that my bloodwork was not that bad), that he presented my case to the transplant team and they would consider eligibility for the waiting list. This was complicated because of RCC in right kidney.

Even though he is at Shands, a little voice is telling me to get a second opinion. I am livid that he would not order a Fibroscan as he stated, "We already know you have cirrhosis." He also based it on trace amount of ascities seen on CT scan. That floored me. I have no idea what stage or grade. Never had any test with exception to the Fibrosure blood test which showed F4, advanced scarring..cirrhosis.

I am one who wants definitive proof. I have been told so many different things by all these doctors. The one I laugh over is," Well, you have been undetected all these years without treatment...your immune system beat the virus. You never have to worry about Hep C." LOL, that was a good one. After 17 years of knowing damage was being done to my liver, I finally got treatment in February of 2015. Unfortunately, it looks like it is too late. The damage is done.

I am a fighter, I just need some help processing this, gaining information so that I can make the right choices in fighting my battle.

Thank you, themiz, for helping me with this. Do you know if you can go from decompensated to compensated?
Big, big hug
Mitzi

I think a 2nd opinion is a good idea, Mitzi. It can't hurt. You do want to be comfortable with your care team. Big Hugs

Okay, then!!! I knew I could count on my HW team to give sound advice and their objective opinions.

Just curious, Barry. Why would you be furious with my set of circumstances? You know, at times, we all check ourselves to confirm our line of thinking is on point. With my journey, time and time again, I have questioned the medical profession. I have had to stay on top of the doctors, hospitals, insurance, preventing things from falling through the cracks. So, yes, I have a low trust level.

Yes, I do want to know why you would be furious if you were me with what has transpired. I am thinking about the last five years........the only consistent resource and support I have had is through Healing Well and all of you. Of course I have support from my family and friends but they don't understand a lot of it.

Let me know your spin, Barry. I value everyone who takes the time and effort to give me advice, support, and at times humor! Where is Ziffle and David anyway? Ziffle gave me a nickname I have never forgotten. I think he saw a photo. I have seen them cut up many times. I always enjoyed the banter.
Hugs,
Mitzi

David, it shows you I have a good memory...it's just short. David!!! That's right, Ziff is the one that retired from the show, Green Acres! LOL.

Does Mike and Karen still stop by?

I promise I won't forget it was you who gave me that nickname..
Big DD hug
Mitzi

Barry, thank you so much for the input and advice. My hep Dr stated I most likely have mild portal hypertension as my spleen is enlarged.

He ordered an endoscopy and a colonoscopy. The soonest I could get that scheduled is February 17th. I see my urologist on the 19th.My urologist is going to present my options in removing the tumor in right kidney. It will most likely be a choice of robotic surgery, open surgery, or one of the ablations. I will progress from there and make a choice. The hep Dr.stated I am at high risk for the surgery to remove the KIDNEY tumor because of liver.

At this point I am going to get a second opinion from another hepatologist, probably in Orlando.

It's obvious we are warriors...I will fight this battle I am faced with. Thanks Barry. Any other input or sharing ideas is most welcome. Wish we could have a convention!!
Big hug
MITZI