JB, i always have to look away when they stick me.... i keep one eye out at first to see where they're going then turn away

a little stick is ok when i know it's giving me good news

i'm glad you got yours done without fainting

Oh it's working alright JB!, epclusa is a most powerful thing - lucky you, your virus is not long for this world.  

I am glad you remained upright for labs, you can be uptight, as long as you remain upright I say - nice lab etiquette. 

We can't wait for you to get some happy feedback in the right direction too! Betting you will see a much happier ALT by now in these labs.  : ) C.

Blood work went well. No feeling of faint. The nurse joked and said she thinks I just like to get myself worked up for nothing. Probably true.

The doctor said it's hard to say anything about the "thing" seen on the liver during the MRI until I get a second MRI in 3-6 months. If it grew, it'll be concerning. If it stayed the same, that's good and we'll keep an eye on it. If it's gone, well, that's great.

Regarding the "thing" on my back -- she suggested I see my primary care physician because it's not her area of expertise. However, it won't be the area of expertise of a primary care physician, so I'm not sure what to do. I think she feels like I can start with him -- and let him refer me to a spine specialist if he feels it is necessary.

Now -- wait a few days for blood results and pray the epclusa is working.

JB

Hey JB,

Congrats - 1/3 done coming right up! 

Woozy is worth it, for a 4 week draw. For finding out your VL and LFT's, and whatever routine bloods they may draw ... it's very worth knowing! A draw is the ony way you will find out where you are at, and with good news coming your way, look forward to it! Tell the lab person about your woozy hx ahead of time, don't watch the draw, bring muzak and those ear buddy thingies and ask if you can plug in, just before they do the deed to try and distract yourself from the task. If they say no, no muzak/ear buds, well then, I suggest you plan to hum (in your head) the most unexpected off the wall tune you can can come up with ... like ... (sorry UK, nothing personal! you just happen to be kinda far removed from the situ, but, stiff upper and all that, so i picked you!) ... https://www.youtube.com/watch?v=l65_1S3qNBw .  I would be surprized if the labby would object to you bringing and playing some kind of muzak via ear buds, but if they did, then I might be tempted to hum (out loud) for them " Rule Britannia" for their benefit! 

Yes, I would fast 12 hours - but do NOT fast the water, drink lots of water the night before (we assume you ARE already drinking lots of water anyway) - being fully tanked up on water the night before, and on the morning of a draw, will only help the draw go well/easier. Stay warm the morning of your draw, don't get stuck in some dreadful cold waiting room parked in front of a A/C and get chilled/cold before the draw, bring a jacket or sweater with you. Keep yourself comfortably warm for your draw. Most people miss having their morning tea or java, so, on my fasting blood work days, I usually treat myself to a couple mugs of hot steamy boiling water instead for the morning of the draw - better than nothing and (oddly) surprizingly comforting.

Glad you get your labs and your doc visit as well on Monday - I know you have questions for your doc re: your imaging - and we'll be waiting right here, for you to share what more you find out. Knowledge is power, having your actual imaging reports now and being able to read them yourself (versus carrying around "verbals" only in your head), helps to better clarify things, subtle diffences between words, (semantics) broken blood vessel in back (not really) - hemangioma is the correct name for what the radiologist is best-guessing he sees at your vertebrae, and hemangiomas happen (generally) to be notoriously benign things, so, all good to know. I am sure you are going to have a better opportunity to suss things more now with your doc on Mon. 

No one likes having to have a blood draw, but I sure learned to appreciate them (and what news and info they brought me as I went through my trial and beyond)! I am pretty good at them now, and they usually go fairly well, using all the self defense tactics I have learned to muster up along the way - even having to get a needle can  have it's bright side! You are about the witness some "epclusa power" !

Hey, are you a 3a or a 3b, do you know?

BTW - now that you have the actual fibroscan data, we could update your sig line - and show you are F3 only (not F4), being that your kPa's were at 11.1 (thus just another nice indicator showing you are not, according to kPa's, in the F4 cirrhotic range), unless of course you had other tests or other seperate blood tests which were supporting a possible F4 range, then you should include all results, by all testing methods - and, maybe we could squeeze it into your sig. line, add to the sig. line, (after the MRI bit) that the MRI also showed (aside from no cirrhosis) that there is likely no fatty liver as well (as was first suspected via your U/S).

I like your docs' thoughts/terminology ... "artifacts"! Could be! Could be just minor nuisance dinosaur dung, just what similar unexplainable kind of shat/abnomalities came (and went) in some of my imaging, of "perhaps" some upset "lymph gland something" cruising by in my imaging, then, a "perhaps" calcified granuloma thingy (which has not been seen for a while) ... hide and seek/history ... it could be same for you too. Try not to fret, you need more time/assessing for full info. Good you had the MRI WITH contrast, sometimes they can first do them without, so, you are ahead in info on the imaging front. I like the sounds of your doc BTW! I am interested if she thinks she IS going to send you to somebody else about the vertebral thing.

Keep us posted. Can't wait to hear your good news 4 week lab results!  C.

Hi JB,

I do recommend that you fast after midnight. My lab suggests 8-12 hours before the blood draw. Generally they allow you to take required medications with a sip of water, but anyone using insulin related (diabetic) medications should discuss that ahead of time. I imagine you’ll be having a liver profile, CBC and maybe a PCR at week 4. Long story short, yes, fast after midnight. When they do the blood draw, think about them sucking the life out of that Dragon, not you, lol! You’re proving to both you and that Dragon who’s in charge. This is the eviction notice, go into it with Sheriff Epclusa by your side! (Okay, corny, but you get my drift, lol)

Woohoo is right! One down and two to go. You’re on your way, Bro!

Hi JB,

Glad the name change worked! 

Have you had the opportunity to talk about your results with your doctor? We’re not docs and aren’t able to interpret these reports. Sounds to me like they aren’t recommending anything except some repeat imaging in the near future. The radiologist will pass these results along to your liver specialist and you’ll be advised of the results and future tests. Anytime they recommend watching something in our livers, it’s important to do so. It can be nothing or something that needs to be investigated on a timely basis. This is why we all go through this stuff on a periodic basis and some of us will do it every 6 months for life. When do you get to speak with your doctor again? Let us know what his/her impression is.

I received the official report of my MRI today and thought I'd share. Still pretty nervous about things. Glad there is no cirrhosis visible, but concerned about the other things. I don't know what much of this language even means, to be honest. 

Impression
1. No MRI evidence of cirrhotic hepatic morphology or sequela of portal
hypertension. Patent portal vein.
2. Query 1.4 x 0.6 cm arterial enhancing focus within the hepatic dome
versus volume averaging with the right hemidiaphragm; if a true lesion
this would be characterized as an LR-3. Recommend attention to this
finding on follow-up imaging within 3-6 months.
3. 1.5 cm vertebral body lesion at the thoracolumbar junction, likely
T11, as above. In the absence of a known malignancy, vertebral body
hemangioma favored. Attention on follow-up recommended.


PROCEDURE: MRI ABDOMEN WITH AND WITHOUT CONTRAST

HISTORY: Abnormal liver function tests. Chronic hepatitis C.

COMPARISON: None

TECHNIQUE: Multiplanar and multisequence magnetic resonance imaging of
the abdomen was performed both prior to and following the administration
of 13cc of MultiHance contrast. There were no reported immediate
complications.

FINDINGS:
Please note examination mildly limited secondary to patient respiratory
motion.

Lung bases are predominantly clear. Heart size normal, no pericardial
effusion. GE junction unremarkable.

MRI ABDOMEN WITHOUT CONTRAST:
No significant hepatic iron or lipid deposition.

MRI ABDOMEN WITH CONTRAST:
Liver normal in size/contour and homogeneous in enhancement. No evidence
of cirrhotic morphology. 1.4 x 0.6 cm focus of apparent arterial
enhancement within the hepatic dome image 8 series 10 is not identified
on any other sequence. Specifically, no evidence of washout or
associated T2 signal abnormality.

Hepatic veins, portal vein, SMV, and splenic vein are patent.

No intra-/extrahepatic bile duct dilation. Gallbladder unremarkable. No
wall thickening or gallbladder calculi.

Spleen normal in size and without suspicious focal lesions. Bilateral
adrenal glands normal.

Pancreas demonstrates preserved precontrast T1 signal intensity and
normal enhancement. No suspicious focal pancreatic lesions or pancreatic
ductal dilation.

The kidneys enhance symmetrically. No hydronephrosis, solid enhancing
renal lesions, or perinephric fluid collections. 6 mm cyst inferior pole
left kidney image 8 series 2 and image 26 series 3.

No abdominal aortic aneurysm. No ventral abdominal hernia. No free or
organized abdominal fluid collections. No pathologically enlarged
abdominal lymph nodes.

Imaged loops of abdominal large/small bowel are nonobstructed and
without wall thickening.

1.5 x 1.5 cm T2 hyperintense enhancing focus near the thoracolumbar
junction image 6 series 5 and image 6 series 2.

Some labs, depending (on where you are and where the lab is located), go by 8 OR 10 ng/mL - yep, yer AFP looks really good and low to me and lamassu, and as any kind of "marker" it is a handy, good "rough" guide to use, but it is not the "be all and end all", all of you is taken into account wholistically by your docs (from ALL of your labs/tests, to your imagings, to your physical exams with them). 

These labs tho always drive me batty, complicated language they use and tests to understand, and then they always seem to be changing things up or down too! Like the cut-offs and such! Calling sometthing one thing in one country and another in an other! Using dif measurements. sigh. But luckily, AFP levels and measurements are pretty universal - and a fairly useful tool at times too!  C.

Hi JB1407,

Canuck posted as I was typing this. An AFP level of less than 10 ng/mL is normal for adults. An extremely high level of AFP in your blood: greater than 500 ng/mL could be a sign of liver tumors. So your AFP is great. Once the Hep C virus is cleared we have members who have seen their kPa decrease in 6 months as liver inflammation decreases and repair begins.

Hey JB,

Good to start your very own 'On Treatment" thread, altho we were talking and sharing over on the prior thread, this will be a very good place to do so too!. Great job on the sig. line as well (if I do say so myself - heehee)! Makes conversing, recalling details, so much easier.

Thanks for so dutifully getting back to us about your MRI results and keeping us updated - so far, so good I would say. Try not to fret - I think you are very lucky, not only are your getting a stellar treatment with epclusa, but it sounds like you are getting the best of care - your doc sounds very diligent and thorough. When ANYTHING turns up from the "usual" lab blips we find in HCV to other minor malfunctions (once they are discovered) of course we fret (some or a LOT, depending on the folk involved - I always labour over every lab thingy, until it gets put in it's place, and then ... I don't anymore - that's just me -  you can fret over the treatment (but that will be a waste of time - as this stuff WILL cure you and set you free from your viral infection, and your body will thank you mightly for it). And, you can fret over the MRI, until they find out it is likely just "one of those" nothing benign things appearing just to confound us. Murphies law. The wait and see tac on your doc part is telling. Wait and see is a good plan, next time around it may not be there! Maybe they will do another further kind of imaging test on you, next time, or sometime in the future (with dye) just to help further define it, should it still be there. (You didn't have any dye with this MRI, right?) Maybe they will do a dye CAT next time around, or at some point if necesaary.

I had a "thing" found, quite long after I was cured, not visualized by anyone prior, via U/S/imaging, in just showed up to make me ponder, it might have been there for some time, just no one could visualize it, in the end it turned out to be a nothing but a benign "granuloma" in my liver - an aftermath thingy resultant of my prior long-standing HCV infection and complaining liver trying to do something ineffectual about it - my cure took care of the viral infection, my body (on it's own) freed to do it's work "better" than ever (in decades), had created and then decided I also did not need the granuloma anymore - it has not been seen since, gone now as far as we know!

This may happen to you too (thingies here today, and gone tomorrow). People get weirdness thingies in their livers, hemanginomas, granulomas, etc. etc, and they are most often just gloriously benign creations that rarely cause ANY real harm to you or themsleves, and they may just sit there OR vamoose.

Don't waste any worry. Your AFP is grand, nice and low, low, low.

Good your fibroscan is showing 11.1 kPa's, keeps you firmly down in the F3 range estimate.

The blood vessel bleed in back/spine is a weirdness too, sounds unrelated and strange - I suppose they will give that more thought too.  Glad she will help you get checked out on that front too.

It is EX-ellent she is taking such good care of you with imagings, seeking concensus opinions and a plan to make sure you are well followed - this is a good doc in my book. Lucky you! Don't waste any worry. They would tell you when to worry, until then you are getting some mighty-fine care there! It is a GOOD thing that she looks and finds these things, then everyone knows what is there, able to check it out, and rule out any it importance it may hold. Bet ya a bundle both things turn out to be nuttin's! But now you and they will have opportunity to check things out. The extra stuff will only help to keep you busy, distracted and pre-occupied!   C.

hi JB, cool that you got your own thread going now , it sure has helped me thru the tx to blog a bit and also get friendly visitors to my thread 

as well as great info that helped me to get thru some days

Hi JB1407,

Welcome to the forum! Do you have the kPa value from your FibroScan? A kPa over 12.5 usually indicates some cirrhosis. Also it is usual for your hepatologist to order an AFB Tumour marker blood test. Knowing those results might ease your concerns. The three months of Epclusa will pass quickly don't be surprised if you have some fatigue as a side effect. I sure did but my starting viral load was much higher and older patients seem to be more prone to fatigue. Your viral load is on the low side; anything over 800,000 IU/mL is usually considered high. I was over 11,000,000 before treatment and two weeks of Epclusa reduced my viral load to 50 IU/mL.

Remember to take your daily Epclusa with a meal (helps absorption rate) same time each day (I chose dinner), keep a log so you are certain you do not skip a pill and drink a full gallon of water a day. The full gallon of water is key to minimizing side effects. I filled a gallon jug in the morning and made sure it was empty by 10 PM. Best wishes for undetectable viral load at end of treatment!

Hello friends! I thought I'd also go ahead and create my own thread since I am no longer "alone and scared" (well maybe just a little scared still). 

I started the Epclusa on May 27 for gt3. At the time, I wasn't sure what my viral load was, but I just asked my doctor and she said it was 653,000 (seems pretty low, right?). 

So far so good on the meds. No major side effects, but the occasional headache. Hopefully I continue down this seamless path. 

I had an MRI on Tuesday. They wanted to do that to make sure I didn't have any cirrhosis due to the genotype and because my fibroscan came in around F3/F4. The doctor called today and sort of freaked me out a little. The good news is that they didn't see any cirrhosis on the liver. She also mentioned that no fatty liver was detected (initially they said "some" fatty liver). Also good news. Now, the part that she doesn't seem too worried about right now. They said there was something on the liver 1.4cm x 0.6cm. She said that in the report they were waffling with even calling it a lesion because she said it could be just a random artifact. She wants to review with some other members on her team that are radiology experts, I guess, and said that they'd likely want to do another MRI in 3-6 months. 

Another odd thing they discovered was a broken blood vessel on my spine - or near my spine. I'm not sure what the deal is with that. She said she's not an expert in the spine area, but may want to see a specialist. Great. Just another thing to worry about.