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Got results from Gastro Specialist today....finally.

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Posted 7/21/2011 9:55 PM (GMT 0)
Hey Everyone!!! I know I have been missing in action for the past two weeks. I've been waiting for today. As usual, I am dazed, confused, and blazed my way to this forum where I can get some good input.

My ultasound showed "One" nonmobile gallstone measuring 0.3 cm.
The echotexture of the liver is increased, consistent with fatty infiltration, hepatocellular disease. No focal liver lesions or intrahepatic dilated ducts. There is hepatopedal flow in the portal vein.(what does this mean)?

The bloodwork is another story:
These are the abnormal bloodmarkers:

Glucose 102H Range 65-99
Bilirubin, Direct 0.3H Range <OR =0.2mg/dl
ALT 70 H Range 6-40 U/L
MCH 34.4 H Range 27.0-33.0pg
Platelet Count 132 Range 140-400Thousand/ul
and, last but not least....
AFP Tumor Marker 6.7H Range <6.1ng/ml

My genotype is 1a. My viral load is <43.

He recommended that I come back in three months. He wants to see if AFP marker elevates. At that time I will schedule biopsy. After biopsy results, decide on treatment.

Here is my biggest question: Does the slightly elevated AFP marker mean I have liver cancer, I am on my way to having liver cancer, or what?

I appreciate your input and advice. A big hug to my buddies, Connie, Mick, David, and Ziffle. A little hug to those of you I don't know yet!!!
Mitzi
Posted 7/21/2011 11:26 PM (GMT 0)
Hi zelDDa,
I wondered where you'd taken off to. Did you ever try my chicken recipe?
Posted 7/22/2011 12:17 AM (GMT 0)
Hey, David!!!!! I know, I have been MIA. Depressed and anxious over life's challenges. No, I haven't tried the chicken recipe yet but I have it written down. I go shopping for the month on Aug 11th. I will buy what I need and try it. I have to lose at least the 20lbs I have gained since December so I will be eating lean and mean! How are you doing? I'll be checking in every day now that I have that appt behind me.
Hugs
Mitzi ( ZelDDa) yeah
Posted 7/22/2011 12:27 AM (GMT 0)

ZeLDDa, there is some concern because there is a somewhat elevated AFP, ALT, etc., they want to keep an eye on it....which is what they did with me, long before the lesion showed up as a cancerous tumor on MRI with Gadolinium contrast.  I was only having scans every 6 mos.  It didn't grow for about 3 yrs., then the AFP and liver enzymes started to creep upwards.  During that time, I was only having a scan and labs every 6 mos.  When it started to grow, it was by leaps and bounds.  My liver enzymes and other labs also started to rise.  It was in April this year that I finally started having transplant evaluation, and the tumor was treated this past Mon.  My viral load was 38,000 for a long time, but jumped to 68,000 just before treatment of the tumor.  I'm also 1a.

Pedal pulses are those in your feet.  I'm not sure about the rest of that.   In general, don't be too concerned about labs that are 2 or 3 points out of range either way. 

Your next step, though, would be to get a CT with contrast or an MRI with Gadolinium (preferable.)  I know that insurance is an issue.   See what you can do about Medicaid.

Big hugs,

Connie


Posted 7/22/2011 1:12 AM (GMT 0)
Hi ZelDDA,

Your labs don't seem that awfully out of range to us. Yes, the 1a genotype isn't any fun and will need attention. But nothing seems DIRE.

Good luck with follow ups. Be sure to keep in touch!

Carol (and Mike too)
Posted 7/22/2011 2:44 AM (GMT 0)
Connie,

What lesion??? I am confused. Do I have a lesion? My test didn't indicate a lesion unless it is worded a different way. Does the AFP being slightly elevated indicate a lesion? My ALT is coming down from October. The last three test it has steadily declined. What are pedal pulses? Was that in my results. I am totally confused. Help me out here, friend.
Hugs
Mitzi smhair
Posted 7/22/2011 3:38 AM (GMT 0)

"There is hepatopedal flow in the portal vein."   Hepato means liver and pedal (long e, like eee) pulses are in your feet.  The portal vein is one of those attached to your liver.  Put them all together and I'm not sure what it means.  Your AFP should be 6.1 or less and is 6.7.  Sorry about the reference to "lesion."  I was clearly thinking of myself and what they said when my AFP became elevated.  It was never entirely within normal range after the first cancer...and there was an area they were keeping an eye on.

So I would say that ML is right--there is nothing to be greatly concerned about.  It's GREAT that they are having you retested in 3 months.  At least until then, relax and watch some good movies!  VERY sorry if I scared you.  I'm not altogether "with it" this week, and probably shouldn't have posted about your results at all.  In fact, I'm going to edit out a part of it.  Is there any chance that you can be treated for hep C?

Hugs,

Connie


Posted 7/22/2011 3:57 AM (GMT 0)
Connie,
I count on you to post what you think. So please if you don't want to post here, send me an email. You are my back up, girlfriend!!! He said he was going to look at bloodwork again in three months, then schedule for biopsy if all is well, then consider treatment when the results of biopsy are in. I am not sure about biopsy, though. This can cause cells to seed. So if there is any cancer, the biopsy could cause it to spread. I just read that on a medical website. It said ultrasound, bloodwork and a ct scan, possibly an MRI would be diagnostic for HCC. Before the doctor treats the Hep C, I know he will want the biopsy. I am at a loss right now. My understanding was that if the AFP was higher than either 10 0r 20, it was a concern. Over 500 indicates definite HCC. That is what I am reading. Please correct me if I am wrong. I am downloading Nurse Jackie, The Big C right now. Yippee!!!
Hugs
Mitzi
Posted 7/22/2011 4:04 AM (GMT 0)
Connie,
I just looked up Hepetopedal flow. That means normal flow.
Hugs
Mitzi
Posted 7/22/2011 4:06 AM (GMT 0)
Carol and Mike,
Thanks so much for your input. I count on the Guru Blazers to let me know the real deal. I was concerned about my AFP being elevated slightly.
Hugs
Mitzi
Posted 7/22/2011 4:42 AM (GMT 0)

Mitzi, I think that your doc is very much on the case.  It pleases me that he wants to do f/u in 3 mos.  I was never really comfortable that Mayo was doing mine every 6 mos.  They did do it (meaning bloodwork, MRI or CT scan, both with contrast, every 3 mos. for the first year after I'd had the first tumor treated and the rt. lobe removed, and then went to every 6 mos at one year clear.  And then the AFP and liver enymes started to elevate, but it was only since March, when the tumor, enzymes, and viral load started elevating that they decided to do all the testing every 3 mos.)  And here I am now needing transplant.

All of which means to do the scans and blood work every 3 mos, as your physician has recommended.

Thanks for the definition of hepatopedal flow!     smilewinkgrin     didn't even think to check Google, as they are not always correct.

Hugs,

Connie


Posted 7/22/2011 6:34 PM (GMT 0)
Connie, Thanks!!
You are always great with your answers. By the way, The Dr only ordered bloodwork to be done prior to next appt in 3 months. He didn't order any further diagnostic test. Do you think that is significant?
I sent you an email
Hugs
Mitzi
Posted 7/22/2011 7:48 PM (GMT 0)

Mitzi, it's significant only in the fact that he seems secure in not scanning more than every 6 mos.  That's okay, as long as scans are done with contrast.  Also, you should request an MRI with Gadolinium the next time he orders a scan.  I was told that any possible cancers with that contrast would "light up like a Christmas tree."

I'm going to answer your e-mail now.

Hugs,

Connie

Posted 7/22/2011 8:14 PM (GMT 0)
Thanks Connie. I am copying your answers and saving them to a file in MWord. That way, before I go to the doctor I can list what I need to remember like the scans. I appreciate your help. Look forward to your email.
Hugs
Mitzi
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