labwork should be done Compensated Cirrhosis-during TX on New DAA Epclusa

[MommaT]

Hi-
I am to see Dr today and saw some guidelines for follow up labwork with New DAA Epclusa no ribavirin . I am treatment naive and compensated cirrhosis. I only get wk 4, 8 and 12 Viral loads. No Hepatic function ALT/AST TSH etc. I see a local Gastro who I worry is sub par. What can I ask to change for peace of mind, that they will follow up better with me? Seems some here have Hepatologist and Blood specialist. They seem more knowledgeable and follow up with better Labwork protocol.

Thanks!

[Steve76]

From my own experience on Harvoni which I was on for 24 weeks.
1. Before Treatment Ultrasound-need to be done at 6month intervals
2. Complete blood work-Liver panel-Viral load-genotype-tested for Hepb and A exposure.
3. Hep b vaccine-Hep A vaccine-Not doing Alpha FetaProtein (spelling?)Tumor marker because it is not very good diagnostically.
4.Check for varices-Upper EGD

 My Gastro guy did the Viral load check at 4 weeks-12 weeks and end of treatment 24 weeks. Post treatment I was checked at 15 weeks(supposed to be 12-out of town could not do it).  No liver function tests at all.  I wondered about that as well, I  just got my 3rd ultrasound and asked him about blood work since it has been a year and he ordered that.  All of my liver blood work was in the normal range I was worried about platelets because he did not check those the year before(had not been done for 5 years-I was staying away from doctors). My Platelets were 189(which was about the same as 5 years prior)

I think a gastro doc can handle compensated cases(my doc is at a major med center and goes to the liver meetings every year. 

Have you had all of the pre-diagnostic work ups before treatment? 

[Steve76]

Possible others can chime in and give you some advice. If you are uncomfortable with your doctors level of expertise/experience I would get a new doc.  Though many are taking these meds unsupervised(generics). 

[MommaT]

Thank you Steve!
I sure needed another prospective and pep talk on my labwork! I do not see your profile info at the bottom which helps so much! but wish I could talk to a Compensated Cirrhosis person, which maybe you are?

I worry about things and am a detail oriented person which can bog me down. Over analytical to say the least. In business it is in my favor! And I could advocate for others health and welfare easily. But when it comes to my own well, it is hard!

I await more replies, you may be my only one and Thank you SO MUCH!

[Steve76]

My liver is in the same condition as yours.  I just haven't entered my stats yet. I understand the anxiety you are going through been there and still there. 

I was on the 24 week Harvoni protocol for treatment experienced patients.

I just received my blood work it has been a year since it was done.

Ast 27
Alt 19
Platelets 189
All of my blood work is in the normal range.

You will get there as well.  My Fiboscan was 14 or 16 when taken last year before treatment. 

I told my wife I wish sometimes I was totally ignorant and she looked at me like I was crazy, and I replied "Ignorance is bliss" no frigging worries or stress about my health.

I guarantee you your blood work has improved, likely dramatically ...These drugs work, you will be cured and move on from this. 

There are a lot of people that have Compensated Cirrhosis on this board just like we do.  Hopefully a few of them will chime in and give you some support as well.

[Lynn K]

Hi MommaT

Compensated cirrhosis since Jan 2008

After treatment I get liver function CBC and AFP testing along with abdominal ultrasound every 6 months. I also have an annual upper endoscopy because I had esophageal varicies that required banding back in 2012. They weren't bleeding yet just enlarged to grade 3.

I see a hepatologist associated with a liver transplant center. We at least I used to see the hepa now I just see the nursing staff and they report to the hepa to review my results. I only go in to the office once a year.

most recent labs 10/30/2016

ALT 26
AST 23
AFP 8.8
Platelets 102

Prior to recent treatment from 08/02/2013

ALT 74
AST 51
AFP 26.6
Platelets 93

Anything else I can help with? There are several others here with cirrhosis