Hep C Discussion Forum

Tig · Admin

RE: Labs show ALT up...

hrsetrdr · Guru

Hey You guys, good to see ya all, good to be amongst my fellow Dragon Slayers. Regarding the endoscopy- just got an appointment today for Dec 11. In addition to the bi-yearly check of my esophageal varices the doc will be taking a biopsy of the benign tumor they found in my stomach.

After 3 years of retirement, and HepC treatment & post tx issues- going back to work full time was an exciting prospect, albeit challenging to be sure. But, it has been like therapy for me, and has accomplished the intended goals.

As is the case with all prison/jail/detention populations around the world- about 40% of the inmates housed where I work have Hepatitis C. There is a dedicated Hepatitis C clinic there, in their medical facility. There is an opportunity for employees to participate in after-hours programs, as lay-person type group mentors...sharing their life experiences. At some point I would be interested in joining a group discussion there with the inmates, hoping to contribute in some way a positive word or two that perhaps might help someone go and continue in the right direction.

wmlj1960 · Moderator

Good to hear from you Tim. I hope your platelet level is good with that aim. I avoid acetaminophen. There are more liver friendly options available. Take care... and don't stay gone so long next time. biggrin

Greg D · Senior Member

Hi Tim,

Glad to hear your getting back to your old self! Happy to report, that I am too. Stay safe.

Tig · Admin

Hey Tim,

Nice to see you on the boards again! I'm glad that work has been treating you right, i would love to do the same. Enjoy it! I'm looking forward to some more of those inspiring discussions, so sharpen your pencil!! smile

hrsetrdr · Guru

mallani wrote:
Hi Tim,
Long time no hear mate!
Glad all is good and that you're enjoying work.
An ALT of 40 is fine. Are you having a followup gastroscopy to check on your 'neoplasm' ?
The NSAIDs are OK in small doses. One or two per week won't worry your liver. I now don't need Mobic at all.
Sorry to hear about your thumb- physical work is dangerous! Cheers.

Yes, I'm trying to get the EGD procedure rescheduled, but there's a great deal of confusion as I had to cancel this year's biyearly appointment due to the start of my job, which has a probation period where taking time off is not allowed. They keep trying to schedule me for a "follow up" office appointment to the EGD procedure that didn't take place.

mallani · Guru

Hi Tim,

Long time no hear mate!

Glad all is good and that you're enjoying work.

An ALT of 40 is fine. Are you having a followup gastroscopy to check on your 'neoplasm' ?

The NSAIDs are OK in small doses. One or two per week won't worry your liver. I now don't need Mobic at all.

Sorry to hear about your thumb- physical work is dangerous! Cheers.

hrsetrdr · Guru

Update:

Hi all,

Well, I've worked my new job with CDCR for going on seven months now; I feel so much more like the "myself" I used to be. I still do struggle with some sleep and anxiety issues, but I'm just doing better, I feel. Except...that I broke my thumb a work(doing metal construction/fabrication) and went to the doctors and got it splinted. That was 3 weeks ago, and the thumb nail looks ugly, but functionality of my opposable thumb is coming back.

When I visited my primary care DR for follow up on the thumb, he hadn't forgotten about the previous abnormally high ALT so he ordered a re-test.

This ALT lab showed a value of 40, which looks to be pretty mid-range normal.

I think what drive up my previous ALT was likely the Acetaminophen that I had been relying on for pain relief, as my gastro doc said to avoid NSAIDs.

hrsetrdr · Guru

Thanks Malcolm, they did specify a benign neoplasm, I guess that's supposed to sound less alarming than "tumor".

I hadn't mentioned it, just another one of my non HCV medical problems. I need them to schedule this ASAP, as I have two job offers that I have to deal with. The part time job is pretty much in the bag, have already passed the background investigation, just have a routine medical exam next week(checking for 2 eyes, two arms, two legs, etc). The full time job is with California State, and is the real 'brass ring'. I'd hate to start a full time job, then have to ask for time off, especially during the probationary period.

mallani · Guru

Hi Tim,

If you posted that info before I must have missed it. Sorry. Don't use the word neoplasm!- I know it's supposed to mean both benign and malignant lesions, but medicos invariably take it mean the latter.

I understand about the medical insurance issues. Fortunately we don't have that problem here.

Best of luck with the biopsy- hope it's a leiomyoma etc. Cheers.

hrsetrdr · Guru

Hi Malcolm,

The gastro doc detected a neoplasm a couple years ago when they did an endoscopy to check for esophageal varices. They said that a biopsy was taken and showed benign. They did another endoscopy a couple weeks ago, but feel that a Endoscopic UltraSound will yield more information about the tumor.

This is a big part of my motivation in seeking return to full time employment, so as to have access to health care through an HMO plan that's on a employee group discount rate. I don't know what the future will be for the Affordable Care Act, nor what to expect from Social Security's Medicaid, but both face cuts should there be a major shift politically after the 2016 election.

mallani · Guru

Tim,

What 'neoplasm' in your stomach ?????! Have you had a gastroscopy and biopsy?

I've only heard of EUS (Endoscopic UltraSound) biopsies being done for gastric carcinoma, for staging. More info mate.

hrsetrdr · Guru

Thanks guys! Yesterday my gastro doc called, wants to do a ultrasound guided endoscopy procedure, to get a better look(and biopsy) of a neoplasm in my stomach. I told him let's git 'er done, because I have too much stuff I need to do!

Posted from rom my iPad.

Tig · Admin

Tim,

Good news buddy! I know you let out a big sigh of relief. I just did too. We all care about each other and their health. Your SVR is pretty solid IMO! Now get to work, you're gonna be late! Good luck...

Tig

Groupergetter · Guru

Hi Tim, my alt/ast were both up 5 points on my last labs. I too was concerned. Got my viral load back and it still showed UND. :) I have been taking naproxen on occasion at bedtime to help with some of the aches and pains. Guess the elevation could be attributed to that. Important thing is that we remain und. Whew, what a relief.

mallani · Guru

Good one, Tim.

Relax and get to work. Cheers.

hrsetrdr · Guru

This morning, a message from the NP that managed my treatment:

Great news, your Hep C viral load remains non-detectable.
Mild elevation in ALT can be caused by other factors such as medications including OTC Tylenol or Motrin, alcohol use,herbal medications.

Nice to get confirmation, but I really wasn't expecting a return of the dragon. I'll just stay away from the Tylenol, and keep the Motrin use to a minimum, like I've been doing.

Actually, doing more 'normal' physical activity like shoveling, raking, doing outdoors chores doesn't cause the burning nerve pain. I'm changing my gym routine, avoiding too much repetitiveness...gotta keep moving though!

Tig · Admin

Hey TIm,

It's difficult to say why but whatever the cause, I know you'll get it under control in quick order. So many things could be responsible, but I feel your concern considering the path we have all traveled. I hope the VL is returned soon and those results are able to put your mind at ease. I know you'll let us know as soon as you hear something. We'll be sending positive vibes your way!

Tig

Fireman Rob · Senior Member

Hi Tim,

It sounds like you're doing everything right. My fingers are crossed for you. Keep us posted.

-Rob

hrsetrdr · Guru

Update

Got a phone call from a someone on behalf of my GP, they told me that my ALT value is high...as I reported a week ago. She said that I should avoid Tylenol and instead use Ibuprofen. O.K., GP says use Ibuprofen, Gastroenterologist says use Tylenol. ??? Anyway, they want another ALT check in two months. No mention of AST values, maybe it doesn't need checking...

Still waiting to hear VL results.

hrsetrdr · Guru

Thanks Malcolm, I went and got the blood draw for the VL this morning; results should be available late next week. Deja vu, eh?

mallani · Guru

Tim,

I'm sure your ALT would be higher than that if you'd relapsed.

The NSAIDs can cause some rise in enzymes. Glad you're getting the VL for peace of mind. Let us know the result. Cheers mate.

hrsetrdr · Guru

I discovered that posted in my Health Manager on the Kaiser Permanente site, after my routine labs yesterday. Today I had my biennial endoscopy in the Gastroenterology dept. My gastro doctor make mention of the ALT rise, and told me that he's ordering a VL, which I'll go get drawn shortly. I did not see an AST lab result, I don't know if my GP ordered it in my routine labs, or if it is not published for the patient to see.

My lifestyle hasn't changed, I still drink water like a madman, haven't had a drop of alcohol, and exercise every day like I'm going to get rich by it. I do have an almost constant pain(a burning, nerve pain) down from my neck following my spine. For easing the pain I use a warm compress, heating pad, which works great when I'm sitting on the couch. A lot of twisting, stretching and bending helps as well. But, several times a week I'll take either: 1000mg acetaminophen once a day. Meloxicam(7mg), and might use it once a week. My GP said I could use 600mg Motrin, which I might use occasionally.

It's my theory that the use of NSAIDs could perhaps be the culprit for the sharp rise in my ALT value. I was a bit surprised that my Gastro doc would order a VL, but actually am glad so as to ease the uncertainly. Guess we'll see.

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