Need Help With Post Treatment Please / Promote Fibrogenisis

[WelcomeHome1]

God bless you all first and for most, thank God for my cure, so far since Feb. 2016, from the Harvoni & Ribivarin, thanks to scientific medical breakthrough technology that couldn't have been done without God, regardless. Ok, for those who want to read how it all happened to me you can read my past posts, and thank you all for your valued time. So anyways I've been going through regular appointments since then and since I have U.G.I. Type 2 Diabetes, Liver Cirrhosis caused by Hep C, Portal Hypertention I have to take propranolol forever at least till if ever my body heals in time with the right diet & treatments, holistic treatment, but I think Thermal Ablation might be a more better procedure for my liver damage.

Please bear with me, I'm asking for anybody's advise for futher future surgeries, procedural treatment, diets, medicines, hebal medicines, elixars, not crazy sweat lodge, drink the cool aid, shahman medicine man type shit either, lol.

So as you can see there are lesions/nodules that have gotten larger as well as my spleen/ splenomalgoly And I need to know what direction to go in. My M.E.L.D. score is 7 right now.

US LIVER

General Information
Collected:
10/25/2016

Impression
1. Cirrhotic liver. There are two indeterminant hypoechoic nodules in the liver, nodule in the left lobe is unchanged whereas the nodule in the right lobe was not visualized on the prior. Findings would be better evaluated with MRI of the liver.
2. Borderline splenomegaly.
3. No ascites.
4. Cholelithiasis.

FOLLOW-UP RECOMMENDATIONS: Per clinical team.

Narrative
EXAM: US LIVER

HISTORY: 43 years -old Male with cirrhosis, next due in October

TECHNIQUE: Survey ultrasound imaging of abdomen was performed focused on the liver, bilinary system, and spleen, as well as the abdominal cavity for free fluid, with color Doppler of the main portal vein. Representative images were obtained.

COMPARISON: None

FINDINGS:
Statements: None.

Liver:
Image quality: Acceptable.
Right hepatic lobe length: 9.7 cm
Parenchyma/Contour: Parenchymal echotexture is heterogeneous with architectural changes suggestive of cirrhosis. The contour is nodular.
Focal lesion: 1.3 cm hypoechoic nodule in the dome of the right lobe which was not visualized on the prior and 1.2 cm hypoechoic nodule in the dome of the left lobe (unchanged from prior).
Main portal vein: Patent with normal (hepatopetal) flow. Peak velocity: 16 cm/s. Diameter: 1.0 cm.

Biliary ducts: No intrahepatic or extrahepatic biliary dilation. Common duct measures 4 mm in diameter at the porta hepatis.
Gallbladder: Cholelithiasis. No focal tenderness over the gallbladder.

Spleen:
Size: 12.0 cm in length. Splenic volume: 290 cc.
Focal lesion: None.

Ascites: None.

Other: None.
---------------------------------------------------------------------------------------
US LIVER

General Information
Collected:
06/05/2017 12:12 PM

Impression
1. Cirrhotic liver with prominent spleen. Stable 1.2 cm hypoechoic nodule in segment two which was not seen on four-phase CT. A few additional subcentimeter nodules in the liver are too small for further evaluation with MR or CT.
2. Gallstones


FOLLOW-UP RECOMMENDATIONS: Per clinical team.

For more information regarding the American College of Radiology Liver Imaging, Reporting & Data System (ACR LI-RADS) for Screening and Surveillance, please visit: https://hs.swmed.edu/communities_collaboration/radpoint/ultrasound/Pages/US-LIRADS.aspx.

Narrative
EXAM: US LIVER

HISTORY: 44 years -old Male with cirrhosis evaluate for HCC

TECHNIQUE: Survey ultrasound imaging of abdomen was performed focused on the liver, biliary system, and spleen, as well as the abdominal cavity for free fluid, with color Doppler of the main portal vein. Representative images were obtained.

COMPARISON: Prior liver sonogram from October 25, 2016 and CT of the abdomen with and without IV contrast from December 14, 2016.

FINDINGS:
Statements: None.

Liver:
Visualization score: A - No or minimal limitations unlikely to meaningfully affect exam sensitivity.
Right hepatic lobe length: 12 cm
Morphology/Parenchyma/Contour: Parenchymal echotexture is heterogeneous with architectural changes suggestive of cirrhosis. The contour is nodular.
Focal lesion: Stable 1.2 cm hypoechoic nodule in segment two. A 8 mm echogenic nodule in the posterior aspect of the lateral segment of left lobe of liver is seen. Several additional subcentimeter hypoechoic nodules in the right lobe.
Main portal vein: Patent. Hepatopetal flow. Diameter: 0.8 cm. Peak velocity: 22.7 cm/s.

Biliary ducts: No intrahepatic or extrahepatic biliary dilation. Common duct measures 3.4 mm in diameter at the porta hepatis.
Gallbladder: Gallstones present. Gallbladder otherwise unremarkable. No focal tenderness over the gallbladder.

Spleen:
Size: 13.3 cm in length. Splenic volume: 529 cc.
Focal lesion: None.

Ascites: No ascites.

Other: None.

I want my life back, to at least be able to try and heal my body to a more healthier state than it is now. I need to know is there any possible, probable chance for my liver to somehow run/work a lil longer so that I can live with my family for a few more days, weeks, months, to years, maybe another decade. And here's my recent letter to my doctor.
Oh yeah, right now I'm on county hospital care here in Dallas, but now I just got approved for Medicare here within the next month or so for better treatment & care, doctors as well.

Hello Dr.******, I have a proactive question to my long term treatment for my liver fibrosis/cirrhosis. Are there medical treatments like Thermal Ablation that could remove the two lesions/nodules hypoechoic, echogenic and several subcentimeter nodules? Is there any thing that can regenerate, create or promote fibrogenesis? At some point I know there is potential for liver failure, or the lesions to turn cancerous,or a transplant. But I need to know how far along is my liver, at what percentage level of function is my liver operating at? Please I need to know so that we can take action as soon as possible. Thanks to medical technological advances that have already saved and prolonged my life for now, I need to know. There are also clinical trials, please what is it that can be done. Can you please either schedule a follow up or email so that we can discuss my ongoing liver treatment. Thank you for your time as it is greatly appreciated.

Anybody care to start a conversation, and I will reply as soon as I can, thank you for your valued time as it's greatly appreciated here on HepMag, anywhere.

[gnatcatcher]

Hi, WelcomeHome1 --

I've skimmed your previous posts and compared your two ultrasounds side by side; things seem to be essentially stable except for your bigger spleen. How is your platelet count? If it has been getting a lot lower than the normal range, then your spleen might be eating too many healthy platelets (a doctor should look into that). Keep in mind that none of us on this site is a doctor (or plays one on TV).

I've got gallstones (cholelithiasis), too; my doctor doesn't plan to do anything about them unless they become painful. As we get older, ultrasounds, CT scans, etc. are going to show more abnormal this's and thats, but as long as they're benign, they just need to be watched. Fibrosis/cirrhosis levels above F2 have to be monitored with an ultrasound every six months; AFAIK, there's currently no better way to check for the possibility of HCC*. Some of us have been lucky enough to have our F scores go down, but western medicine doesn't currently know how to make everyone lucky. What western medicine can do is measure the F score periodically with a special kind of ultrasound called a fibroscan, which is pleasant (just some gentle thumps from the wand), unlike the biopsies of old. So you could ask your doctor about getting a fibroscan periodically.

Perhaps others will have better advice. Meanwhile, you're cured of hep C, so I hope you can put your physical and emotional energy into living every day fully.

Gnatty

* P.S. I forgot to mention that the alpha-fetoprotein (AFP) blood test is somewhat useful in looking for possible HCC, but an elevated result can also be benign: http://www.tc-cancer.com/tumormarkers.html

[WelcomeHome1]

I appreciate everything you had to offer gnatcatcher, yeah as you can tell I'm concerned even though I'm cured. I have to stay ahead and as I can only try to stay proactive in finding a way to heal my liver in some way lucky or not. And I am one of the lucky ones, I know that. Where there's a will there's a way, I have to keep trying, fighting to get healthier, to heal my liver and as for my spleen, well if I can get tougher on my diet, if my health improves, then it's a likely possibility that it too will heal. I've done alot of research myself, I saved my own life by initiating a treatment before any doctors consulted me. I know there are no doctors here, but what I do know is there are a whole bunch of us that are fighting, trying different treatments, going through the same thing I'm going through. I hope to hear more from others as well.
Is there anybody here that can tell me anything in relation to treating the liver, getting treatment here or anywhere in the world that would promote fibrogenesis to a damaged liver? Thanks again.

[gnatcatcher]

Hi again, WelcomeHome1. I just looked up MELD scores and see that they range from 6 in a healthy person all the way up to 40 in a very unhealthy person. Yours is only 7, so your liver is doing very well. You don't have ascites, and your main portal vein is patent (open and free from obstruction), so the eradication of hep C plus the propranolol and dietary changes have been very helpful.

As for the hypoechoic nodules, the fact that the 1.2 cm hypoechoic nodule in segment two is stable suggests that it's probably benign. Thermal ablation is used if there's actual cancer. You are being carefully monitored.

The term "cirrhosis" covers a wide span, and yours seems to be at the healthier end of the range. Interestingly, my ultrasound reports never mentioned cirrhosis until a fibroscan put me at F4 and "cirrhosis" got listed on my active conditions list. After that, the ultrasound reports started saying things like "heterogeneous" and "consistent with the history of cirrhosis." Three different doctors said the radiologists, having seen "cirrhosis" on the active conditions list, were just covering their butts. Ironically, even when we get healthier, certain diagnoses have to stay on the active conditions list so that insurance will cover the monitoring. If your doctors seem less worried by things in the ultrasound reports than you are, this could be why.

Re-reading your pre-treatment post about those horrible experiences you had that led to the diagnoses of hep C and all the other problems the hep C caused, I can see that subconsciously it must be hard to trust that you're going to be okay. You might feel safer if your liver could somehow become perfect, but your liver is plenty healthy enough to keep you going for many more years. The true villain, hep C, is dead! Your health has improved considerably from when you had those frightening crises.

Every good wish,

Gnatty

[Lynn K]

Hi

I was diagnosed with cirrhosis back in Jan 2008 with liver biopsy. Finally cured 2 years ago on my 5th treatment 24 weeks Harvoni and 15 weeks ribavirin. I have had esophageal varicies in 2012 that required banding. And some lower leg edema since 2009. I had gall stones also and ended up having painful gall bladder attacks so I had my gall blader removed I think it was late 2008.

My MELD has been stable at 7 for many years. My platelet count was about 80'to 90 before treatment and has risen to now 110 still below 150 min normal but a big improvement.

I have blood work including AFP and abdominal ultrasound every 6 months to monitor for HCC. Because of my history of esophageal varicies I have an annual upper endoscopy.

My understanding is the only way to heal the liver is to give it time. Other than that we are in watchful waiting.

Congrats on your cure and good luck

[WelcomeHome1]

Goodmorning, wake, shake and bake folks! Thanks Gnatty again for the support, yeah my platelets had returned to normal range, and yeah I'm gonna always be concerned about my health more than before I got sick, but even just reading up on research of different kinds of treatments or healing processes just gives me more positive energy to keep up the fight to healthier living.

[gnatcatcher]

Oh, okay, great -- whatever motivates you. Glad your platelets are normal.

Interestingly, because in my case the hep C probably came from transfusions I received during surgery, and because I'm allergic to some common things (aloe vera, Zantac), I avoid treatments, medicines, etc. unless they seem absolutely necessary. So you and I are opposites in that regard. You're on a roll finding interesting studies.

[WelcomeHome1]

yeah, i have had this fuckin disease excuse my language has ravaged family members of mine, my dad at 35 years of age HepC/cirrhosis back in 1990, then my grandpa with cirrhosis the following year, then 1 of my uncles in 1999 with HepC/cirrohosis, then a few years later another uncle of mine my dad and their brother. Then 1 one my aunts who didn't drink got Nash and had to have a liver transplant, thank God she's alive. But yeah, it fucked me up all around mentally too, and sO I still do my diligence by trying to keep up with medical break through technology discoveries or just eating a plant based diet, anything I can do to keep myself humble about life, I've been spared more times in my life than I can count on both hands. Nobody fault or blame but me, all in my past. So yeah if whatever I share with others helps them with their own search for help in their fight for life, just wanna pay it And move it forward for all. I'm only 1 man with limited means who's just taking it one step day by day, thanks and holler anytime, peace.

[WelcomeHome1]

sorry about the shake and bake comment folks, lol, ya see, I 'm a bit comical in nature because I like to joke around, laugh at a funeral type things, slapstick, or sarcasm, and well when I said wake and bake part I meant what wake&bake means. Now I read this to my mom, who also survived the dragon, but with the old treatments 4 times for 14 years until the dragon was slayed. But anyways, I read it to her, and when I read back the shake and bake part, she said look at me with a smirk on her face and almost laughed because she knew I didn't know what it meant. Now her and me not laughing, but I didn't know that the doctors called a treatment for a type of rejection medicine given to transplant patients and they called it the Shake and Bake because the treatments is high doses of steroids to regulate anti-ejection drugs. She told me they were very painful treatments, so I just wanted to apologize for those who might have went through these treatments. My moms husband had died regardless of all he went through, God rest his soul. Well, keep fighting the fight for life, and slay the beast within, peace.

[spitzbar]

...re. "Is there any thing that can regenerate, create or promote fibrogenesis"...

.....your previous treatment with a DAA has put to on the correct path to answering your question

.......and firstly have a little faith and be continuously thankful

http://freepdfhosting.com/27cb156e2e.pdf?platform=hootsuite

............many blessings

[spitzbar]

"...has put YOU on the correct path..."