BJW:
Hello to all, I'm new here and this is my first post. I was diagnosed with Hep C and "possible" Cirrhosis about a month ago. I had an endoscopy and some blood tests, including AST (234)ALT(156) AFP Tumor Marker (157), PT 14.8 and Prothrombin Time INR (1.4). I know these results are all too high, and am not quite sure what to make of them, but as I'm sure other people on this forum know, this is some scary stuff when it just seems to come out of the blue. I had no symptoms that I recognized, except that I seemed to bruise easily. That is, until I woke up one morning with red swollen legs and feet. I have no idea how or when I contracted HEP C, as I have never injected drugs, had tattoos, etc. The only thing that possibly could have happened that I can think of is when I was a Medic in the Army way back in 1968, and have also been reading up on the "air guns" that they use to immunize us all back then, but that's a whole other story, dealing with the VA, etc. Anyway, I drank fairly heavily for about 35 years before quitting for two years totally starting in 2008 and then resuming moderate drinking (maybe five or six drinks a month, when going out to eat, etc.) So, in other words, I can understand the cirrhosis I guess, but not the HEP C. Sorry this is so long and I'm rambling, but am just looking for some answers from people who know more than I do about this stuff. Thanks
Lynn K:
Hi BJW and welcome,
I know most who have no idea how they may have contracted hep c find it frustrating to realize they may never know how, where, and when they may have contracted hep c but that is the case for a significant number of patients.
The evelated liver enzymes mean something is currently bothering your liver. Once your hep c is cured your liver enzymes will likely return to normal range. The bruising is associated with your elevated PTT/INR test results simply put it takes our blood longer to clot so we bruise more easily. Prolonged clotting times is a common symptom of liver disease.
The swelling in the lower legs is called pitting edema a common noticeable first symptom of cirrhosis. This can be treated by trying to minimize your sodium (salt) intake to less than 1,200 mg/day if that is not enough to alleviate symptoms your doctor may prescribe a diuretic.
The AFP tumor marker is used in conjunction with ultrasound to monitor for possible HCC (heptocellular carcinoma aka liver cancer) as we with cirrhosis are at an increased risk.
The good news is that with cure our risk of liver cancer drops significantly. My AFP was not quite as high about 57 but now is I believe 8 just one point above normal.
Right now other than having all testing recommended by your doctor the best you can do is to take the best care of your health you can. If you are still drinking stop. Try to eat healthy and get some exercise as tolerated and your doctor approved. If overweight try to get into normal range. Avoid all medication prescribed or otc as well as any herbal meds unless specifically approved by your hepatologist. Get vaccinated against hepatitis A and B if you are not and get your flu shot early every year.
I was in the Army. I believe I was infected in 1978 and was cured after being infected for probably 37 years but unfortunately I was diagnosed with cirrhosis after being infected for 30 years. I was cured about 3 years 6 months ago with my 5th treatment.
Let me know if you have any questions I can help you with
Best of luck Lynn
BJW:
Thanks so much for your reply Lynn, I've read through some of these questions and your replies. You obviously know what you're talking about, given your signature and battles you've gone through with various treatments, etc. I didn't mention that I'm on meds for my blood pressure, which has been on the high side for awhile, prescribed by my cardiologist, which is 50 mg a day of spironolactone and also 30 mg of propranolol, prescribed by my gastro doc. I did quit drinking as soon as I was diagnosed, no problem there, as I hadn't been drinking very much at all anyway by then, so it was an easy decision. I think I was looking for a reason to quit anyway, so it was a no-brainer. I try to drink plenty of water, and eating a lot of vegetables and fruit, don't have much of an appetite though, and have lost about 18 pounds over the last two months. Anyway, I've got an appointment with gastro doctor next week, so am hoping that I can learn a little more about what's going on and when I can start treatments, etc. I like this doctor personally, but sometimes I think it's hard to get ahold of him by phone, he's got a lot of patients I guess. Anyway, didn't mean to write a book here, lol. Thanks again, will be checking into this site often, there's a lot of useful info here
lporterrn:
Hi BJW, Good for you for stopping drinking. It sounds like you are getting a fast education on a subject most of us would rather avoid. Lots of experience here - feel free to ask anything.
Lynn K:
Ok so I was taking spironolactone for my edema and small amount of ascities. I was getting a lot of leg and foot cramps and decided I would rather live with my mild edema and anyway it seems my edema has improved a little post treatment. So if anything they could up your dose of spironolactone maybe to help with your edema.
I was found to have grade three esophageal varicies which we discussed the use of a beta blocker propranolol as that is a common treatment. The goal with using propranolol for varicies is to reduce blood pressure by slowing the heart rate to less than 60 BPM but as my resting heart rate is about 50 BPM that was not an option so I underwent multiple banding sessions to eridicate my varicies.
So anyway both of the meds you mentioned you are taking are also used with cirrhosis.
It does sound like you are on a good path health wise better than me lol I need to take some of my own advice about weight, diet and exercise :)
Let us know if you have any questions as you get further along in the process.