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Im 54 next wk, my dx(s) were 1yr ago. Long term intermittent drinker/drug use in past (non iv). Abstinence periods totaling 10 yrs total over the past 30 years. Longest stint 6yrs totally clean, ended in 2000. Last normal and documented liver panel was 2002. Fast forward, and now BLEAK outlook per Hep Specialist/Transplant. Weight is good, very minor swelling and flank tenderness in liver area. Plus the following, I welcome your thoughts.

No meld score "too low" to have one, AST 100, ALT 133, GGT 73, Platelets 225, Neutrophils 39, Lymphs 50, UIBC 65, Iron Saturation 82, Serum Ferritin 709. All other values are in normal range. Minor Ascites, benign lesions shown on ultras and 2 dif MRI. Due for CT, Endo, and Colonoscopy in 90 days (May 2012). Initially Fam Phy referred to local GI (who doesn't treat HEP C), GI referred to Hep Specialist/Transplant Surgeon to assess treatment of HepC. HepSpec will not treat until abstinent from alky 6 months, Im 35 days clean. Specialist insist I will need transplant & I have Cirrhosis. Insist that I get out of trying to figure things out or question dx. Need to get to AA for documented clean record which would be required to being considered for hepc treatment for future trans.

Fatigue primary consistent symptom which maybe related to depression or the fact I'm not working for the first time in 30 years (due to change in careers). I am religious about keeping low sodium diet and made adjustment and doing well. Only med is BP med ATENOL new prescribed and changed from Lisinopril that had been doing the job just fine. 600 of Milk Thistle he says is ok to drink.

Thoughts, Suggestions? I would have no hope if I didn't read your stories on these forums, he is NOT giving me any promise other than managing symptoms which will quickly be showing up. No way out of this other than i get the transplant "per him".

With no job I also have no medical insurance although recently I found the new health care reform act of 2010 will provide an option to purchase reasonably priced insurance ($300 mo) through Govt plan. If I take a new job that offers insurance then I wont be eligible for this insurance that at least on the surface seems as good or better than any smaller group plan, and guarantees coverage regardless of pre existing cond. Here is the link in the event you want to research for yourself. It has been suggested with my diagnosis that i apply for disability, don't see where that would help IF i could get approved. Right now I feel I can work fine, of course I say spending alot of my days in the bed.

Sorry for the novel, as usual no sleep tonight. Plenty of sleep though the day, days and night are reversed of late. Life all the others on the site I'm sure just wishing I would wake up from this new entertainment in my life.
Posted on 02/12/12, 06:43 am
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Reply #1 - 02/12/12  6:47am
" To clarify my madness rant, doc says I will need a transplant in 2 years or less time. "
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Reply #2 - 02/12/12  6:49am
" Second note..then IM DONE, dont type and think your brain works well at 5:45 with no sleep. Relating to Milk Thistle, "he said it is ok to TAKE, not DRINK, lol. "
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Reply #3 - 02/12/12  6:55am

This link is for KY, but at the bottom you can access your state info and the particulars. Thanks again, God bless you all. "
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Reply #4 - 02/12/12  7:02am
" Been suggested I attempt to get disability. The insurance plan requires you not have had insurance for 6 months and you have a preexisting condition whereby you were turned down by another company. Promise this is my last bit of dialogue taking up space on this site. Sorry for the funny typos, I really can spell and put sentences together although there is no evidence of it in my blogs. "
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Reply #5 - 02/12/12  1:19pm
" Tony, I've found a couple of mathematical formulas that are apparently reasonably good at predicting disease severity, specifically fibrosis level. They use your AST level, platelet level, age, etc. I was already planning to call you later today to say hello-hiyadurin' but will run these numbers first and let you know what they indicate.
Also, this (.....supposedly "needed within 24 months" business) sounds like they think yours is moving pretty fast. Do you know whether or not they've done any test to measure the inflammation - or necroinflammatory level? "
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Reply #6 - 02/12/12  1:33pm
" BTW, your platelet level of 225 is perfectly normal, albeit tilted toward the lower range of normal. Normal range is 150 to 400. "
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Reply #7 - 02/12/12  2:03pm
" Hep Guy Has Done No Test..

Im gonna be out of pocket today but will catch up with you later in the week. If possible send me that formula and I look forward to seeing what you find.

Have a good day! "
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Reply #8 - 02/12/12  5:16pm
" Hope it is ok if I chime in on this one. First and foremost, no doctor, be he/she hep specialist or just gp......can tell you that you need transplant UNTIL all the pertinent testing has been done so set your mind at ease that until the testing for transplant qualification and your MELD has been done, we shouldn't even be talking "transplant".
Next, once the formula for finding out the MELD (measure for end stage liver disease) has been determined, if your's turns out to be very low which I would guess from what you have said it will be low, then to even think transplant at this stage is not going to help you do much more than "worry". Your platelet count is fantastic as far as I can see.......the normal is 150-450. Mine has been as low as 25 and is now stable at 53. I bruise easily as a result and bleeding is something I do avoid. Needless to say, surgery is out of the question for me until they do platelet transfusion which I have had done 4 times with bad resulting side effects with 3 of those. Not worth it for minor stuff any longer as the "cure is worse than the disease" if you get my drift. It will take MRI/CtScan and possibly liver biopsy PLUS your blood workup to determine just how badly involved or cirrhosed you liver is. I would also hesitate to say your liver is in a decompensated state which is good. Now, I am not a doctor but I am thinking that "pre-existing" condition could not apply here since no "condition has been documented". Mere speculation doesn't count.
As for trying for SS disability, you won't get it just on your doctor's say so alone........there is a process by which you have to go to the doctors of their choice and then, if that/those doctors say you are disabled by such and such a percentage then and only then will you qualify. Sometimes you only qualify for a small percentage of disability and sometimes, depending on the severity of your disease/illness you could qualify for 100% total. You can, of course appeal their decision but I doubt it would do you any good until the degree of your disease has been thoroughly determined to be life threatnening. As for you nights and days being out of sync for sleeping/rest........many things can cause that including depression and the fact that you are worrying about all of this. Of course, cirrhosis of the liver can cause one to lose sleep and get their nights and days mixed up but it is not the only cause. Perhaps your doctor has seen something to indicate to him that you are in need of transplant in 2 years time but that won't mean a thing until it is documented with proper testing. It is but one man's educated opinion right now. So......I would say to stop worrying and find a way to go to a liver specialist who will run the tests to determine where you stand right now and then refer you to a transplant facility at that time if you indeed need a transplant. If insurance and money is a problem, look into clinics set up for those without insurance, in your community. Meantime, don't drink alcohol at all. I do know that they won't even talk to you at Cleveland Clinic about transplant until you have documentation that you have not had alcohol in any form for 6 months or longer. For me, not that alcohol is the sole cause of my liver problem but, I have not had a glass of wine or anything for 9 years. I got along just fine for 8 years before my liver began causing other organs to act up (decompensated liver at that point). Now that I have all of those other problems controled with meds, my liver inflamation is gone and I am back to low MELD and no where near transplant time. My liver was diagnosed 9 years ago as 65% cirrhosed or scarred beyond repair. Find a good diet and stay away from alcohol or even breathing fumes from anything considered bad for you. Don't smoke........easier said than done I know. I smoked for 30 years since a very young age but gag at the thought of cigarettes now 22 years since quiting. Do as much research as you can to keep up on what is happening inside your own body.....When any medicine is prescribed for you by doctor make sure he/she knows about your liver problem. And I have said it so many times.......prayer works wonders. There is a certain feeling of well being and healing with prayer and I don't know what I would do without having God to turn to. Sometimes, HE is the only one who will listen to me but I know HE will always listen and never leave me. This is a wonderful site to come to for support. Many who are going through just what you are going through now. There are no easy answers and here, one size doesn't necessarily fit all........we are all different. But one thing for this vastly rich and wonderful country we live in, no body should face a life altering/threatening illness without the reaization that they will be treated with the same care as the wealthiest of us. That is the one thing that has to be changed. Remember that when you go to the polls to vote this time. Nothing will ever change until everyone is treated the same, rich and poor alike. I do wish and pray for the best in your case and I will continue to remember you in my prayers. Hugs...CarolLentz "
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Reply #9 - 02/12/12  8:43pm
" Carol thanks so much for your input and as with yours I welcome anyone's 2 cents. I have read a number of your post to people which are always upbeat and encouraging, and it sounds with your first hand experience you are of great benefit people via your hands on situations, lol. I have added alot of info on the ramblings of this thread but to address a couple of things you mentioned; The Meld Score, through multiple labs order by my primary guy and gi here locally I had the variables to give me the Meld which is (5), hence no meld score as I understand? In terms of preexisting conditions the inferior insurance plan that I had the last 6 months of last year sent me a certificate stating that I did have a preexisting condition that allowed them to deny all test. I "assume" that PreX was the confirmed Hep C diagnosis that I got from the local GI who then eventually sent me to the Liver Specialist/Transplant guy. Having gone through decades of negative diagnosis experiences with my Mom, who is still kicking at 71 but was told to "get her affairs in order" 4 different times since She was 25 I know the power of prayer, positive thinking and actions, the fact that Drs arent the all knowing (there is only one of those people), and in some cases "Denial" is a good thing. I'm not in denial in terms of not trying to help myself by continuing to drink or keep the salt shaker going in high volumes, but I can't say I have let go of the denial that He is wrong. I also know that things seem to change on a dime and without warning, so I may have a sudden onslaught of negative circumstances any minute. Until and unless that happens I'm going to stay oblivious in terms of not buying into the negatives of what can happen and just try to live my life. At this point I'm just trying to put together a plan to deal with worst case scenarios and continuing to live my life as if decades rather than months as he seems to indicate. At least before I have to yank out the old organ and slide in a new one, lol. MANY questions, few answers but as we both share in belief GOD will show me the way. I didn't necessarily do one of the typical "fox hole" prayers for God to intervene this time as he seemed to do so many times in other life crisis in my family, but I did make the vow that for whatever time I'm blessed I would make a more concerted effort to live life the way I felt HE wanted me to. I know God works through other people and I'm glad although being new that I have found so many that can help me on sites like this one. The job, insurance, all the what if(s) I know will be addressed over time. TIME, funny there is that word again. Thanks so much for you kind and knowledgeable comments, I welcome them anytime. I said a prayer of comfort and healing for you as I write this mail. Talk to you again soon.

T OZ "
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Reply #10 - 02/12/12  9:59pm
" Tony I agree - Carol is a wonderful encourager; that gift of exhortation is worth its weight in gold in these circumstances that we're all dealing with. And I'm with you - neither you nor I have been through anything like what Carol and so many other courageous souls have soldiered through. I have to be 'out of pocket' for about the next 24 hrs, but will write you both again as soon as I can - "

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