Re: Im finally goin to have my first liver biospy. Im scared :(

[Guest guest]

Hi Latoya,

I had my first one about 4 weeks ago. It was not bad at all. The worst thing was some tightness in my upper body and what felt like some pressure on my chest. I did get a tad bit anxious (or rather had a moment of fear re: the whole hep C thing).... but I went out to dinner the same night.

I'll keep you in my thoughts!

le

When our eyes see our hands doing the work of our hearts, the circle ofcreation is completed,Inside us, the doors of our souls fly open and love steps forth to healeverything in sight."- Bridge

-----Original Message-----From: Hepatitis C [mailto:Hepatitis C ]On Behalf Of LatoyaSent: Tuesday, February 20, 2007 12:09 PMHepatitis C Subject: Im finally goin to have my first liver biospy. Im scared

Hey everybody i totally forgot that my biospy was so near its tomorrow. Im a lil nervous I know my mother told me it doesnt hurt much but I guess im still scared of the pain and if something goes wrong. So just give me some shouts so I know it'll be ok Latoya

[Guest guest]

latoya your in my prayers. i go for pre labs cats etc tomorrow.they get easier each time.its not the labs as much as the waiting for me.the biospy is something they wont give me.they said i dont need it. Latoya <blackat2010@...> wrote: Hey everybody i totally forgot that my biospy was so near its tomorrow. Im a lil nervous I know my mother told me it doesnt hurt much but I guess im still scared of the pain and if something goes wrong. So just

give me some shouts so I know it'll be ok LatoyaTim Parsons knoxville,tn 37931 865-588-2465 x107 work

www.knoxville1.com

Food fight? Enjoy some healthy debatein the Answers Food Drink Q&A.

[Guest guest]

I've had two, LaToya. They didn't hurt and I just had to lie still for several hours. They are soo necessary to find out where you are with the disease, that the small risk is acceptable, to me. Both times I was sedated, so lying still was nooo problem.

Sharon

Im finally goin to have my first liver biospy. Im scared

Hey everybody i totally forgot that my biospy was so near its tomorrow. Im a lil nervous I know my mother told me it doesnt hurt much but I guess im still scared of the pain and if something goes wrong. So just give me some shouts so I know it'll be ok Latoya

[Guest guest]

OH OH should i have told my GI i wanted to be sedated or I wait until

tomorrow and the that dr does it???

>

> I've had two, LaToya. They didn't hurt and I just had to lie still

for several hours. They are soo necessary to find out where you are

with the disease, that the small risk is acceptable, to me. Both

times I was sedated, so lying still was nooo problem.

>

> Sharon

[Guest guest]

The doc who does the job does the anesthetizing, DO tell him. I think they do it anyway, but I've heard of some who weren't.

Sharon

Re: Im finally goin to have my first liver biospy. Im scared

OH OH should i have told my GI i wanted to be sedated or I wait until tomorrow and the that dr does it??? >> I've had two, LaToya. They didn't hurt and I just had to lie still for several hours. They are soo necessary to find out where you are with the disease, that the small risk is acceptable, to me. Both times I was sedated, so lying still was nooo problem.> > SharonIt's a pleasure having you join in our conversations. We hope you have found the support you need with us. If you are using email for your posts, for easy access to our group, just click the link-- http://groups/group/Hepatitis C/Happy Posting

[Guest guest]

Or, the doc doesn't do it, the anesthetician does it. lol

Re: Im finally goin to have my first liver biospy. Im scared

OH OH should i have told my GI i wanted to be sedated or I wait until tomorrow and the that dr does it??? >> I've had two, LaToya. They didn't hurt and I just had to lie still for several hours. They are soo necessary to find out where you are with the disease, that the small risk is acceptable, to me. Both times I was sedated, so lying still was nooo problem.> > SharonIt's a pleasure having you join in our conversations. We hope you have found the support you need with us. If you are using email for your posts, for easy access to our group, just click the link-- http://groups/group/Hepatitis C/Happy Posting

[Guest guest]

Hi Latoya,

I've had three biopsies (or was it four - brain fog is kicking in this evening

lol) - but I

didn't have any problem with any of them, didn't hurt - just as Sharon said,

lied still for a

few hours afterwards and took it easy for a day or two after.

I just asked for a little sedation on the day of the biopsy - and reminded them

a couple of

times while waiting that I really did want that. It was no problem at any of

the three.

Let us know how it goes. It will be worth the information that you will get

back from it.

hugs, karen

> >

> > I've had two, LaToya. They didn't hurt and I just had to lie still

> for several hours. They are soo necessary to find out where you are

> with the disease, that the small risk is acceptable, to me. Both

> times I was sedated, so lying still was nooo problem.

> >

> > Sharon

>

[Guest guest]

Latoya, tell your doc you want conscious sedation,, you will be awake and able to follow the commands to be still and hold your breath when they tag that piece of liver but you will not remember anything of it.. its amazing! DEMAND it... Latoya <blackat2010@...> wrote: OH OH should i have told my GI i wanted to be sedated or I wait until tomorrow and the that dr does it??? >> I've had two, LaToya. They didn't hurt and I just had to lie still for several hours. They are soo necessary to find out where you are with the disease, that the small risk is acceptable, to me. Both times I was sedated, so lying still was nooo problem.> > SharonJackie

[Guest guest]

EVERYONE needs a biopsy,, you CANNOT tell how much damage you have without one Tim..Hillbilly Tim <knoxweb1@...> wrote: latoya your in my prayers. i go for pre labs cats etc tomorrow.they get easier each time.its not the labs as much as the waiting for me.the biospy is something they wont give me.they said i dont need it. Latoya <blackat2010 > wrote: Hey everybody i totally forgot that my biospy was so near its tomorrow. Im a lil nervous I know my mother told me it doesnt hurt much but I guess im still scared of the pain and if something goes wrong. So just give me some shouts so I know it'll be ok Latoya Tim Parsons knoxville,tn 37931 865-588-2465 x107 work www.knoxville1.com Food fight? Enjoy some healthy debatein the Answers Food Drink Q & A. Jackie

[Guest guest]

HAAAAAAAAAAAAAAAAA LOL Thanx Sharon

>

> Or, the doc doesn't do it, the anesthetician does it. lol

[Guest guest]

THANX EVERYBODY FOR THE INFO. Conscious Sedation I guess i will leave

earlier just to make sure.

> > >

> > > I've had two, LaToya. They didn't hurt and I just had to lie still

> > for several hours. They are soo necessary to find out where you are

> > with the disease, that the small risk is acceptable, to me. Both

> > times I was sedated, so lying still was nooo problem.

> > >

> > > Sharon

> >

>

[Guest guest]

Good girl, it makes it very easy and you just stay there for a few hours to make sure the sedation wears off,, and you gotta lay on that side for awhile anyway, might as well sleep,, lolLatoya <blackat2010@...> wrote: THANX EVERYBODY FOR THE INFO. Conscious Sedation I guess i will leaveearlier just to make sure.> > >> > > I've had two, LaToya. They didn't hurt and I just had to lie still> > for several hours. They are soo necessary to find out where you are> > with the disease, that the small risk is acceptable, to me. Both> > times I was sedated, so lying still was nooo problem.> > >> > > Sharon> >>Jackie

[Guest guest]

https://www.aasld.org/eweb/docs/Hepatitis C.pdf for the whole article www.medscape.comUtility of Liver BiopsyThe role of liver biopsy in the management of patientswith chronic hepatitis C is currently being debated. In theinitial treatment trials of hepatitis C, a liver biopsy wasregarded as an important parameter in helping to guidemanagement and treatment, particularly at a time whenresponse to treatment was low. More recently, with theimprovement of treatment effectiveness, the value of theliver biopsy has been questioned because of the potentialrisks of the procedure and the concern of sampling error.39 This has prompted some to challenge the need forbiopsy and to suggest that the procedure may not be necessaryas a prelude to treatment. However, since currenttherapy is effective in clearing virus in only about one halfof those treated, and since treatment is associated withcosts and adverse events, there are likely many individualsin whom therapy can be safely deferred.The liver biopsy furnishes information about the stagingof fibrosis and the degree of hepatic inflammation,histopathological features that are helpful to both the patientand the provider for predicting the natural history ofdisease and thus the relative urgency of therapy.40–42Three scoring systems for defining the degree of inflammation(grading) and the extent of fibrosis (staging) havebeen devised, 2 of which—the Metavir scoring system43and the Ishak grading system44—have received the greatestattention. The components of these systems are shownin Table 5. Using the degree of fibrosis as one componentof the basis for therapy, treatment is generally advised ifthe liver biopsy displays aMetavir score of2 or an Ishakscore of 3. Some experts, in considering the need forTable 5. Histological Scoring SystemsStage Metavir System* Ishak System†0 No fibrosis No fibrosis1 Periportal fibrosis expansion Fibrous expansion of someportal areas, with orwithout short fibroussepta2 P-P septae (1 septum) Fibrous expansion of mostportal areas, with orwithout short fibrousseptae3 P-C septae Fibrous expansion of mostportal areas withoccasional P-P bridging4 Cirrhosis Fibrous expansion of portalareas with markedbridging (P-P or P-C)5 — Marked bridging (P-P or P-C)with occasional nodules(incomplete cirrhosis)6 — CirrhosisAbbreviations; P-P, portal-portal; P-C, portal-central.*Data from Bedossa and Polynard.43†Data from Ishak et al.441150 STRADER ET AL. HEPATOLOGY, April 2004treatment, also assess the intensity of liver inflammation.However, there are no established guidelines for how tocombine the degrees of liver fibrosis and inflammation.Moreover, measurement of liver fibrosis, and especiallyliver inflammation, can be compromised by sampling errorand by difficulties in the histopathologic interpretation.In most studies, the extent of liver fibrosis is anindependent predictor of treatment response. Patientswith milder degrees of fibrosis generally respond morefavorably to treatment than do patients with more advancedfibrosis (bridging fibrosis or cirrhosis).45,46 However,the need for treatment in such patients is lower thanit is for those with advanced fibrosis. The cost-effectivenessof treating patients with no liver fibrosis has beenquestioned, since the prognosis even without therapy isexcellent, further underscoring the importance of accuratelystaging the severity of liver disease.47 Clinical, laboratoryand radiological findings can identify manypatients with cirrhosis, but not those with lesser degrees offibrosis.48 Thus, in persons without strong clinical evidenceof cirrhosis, a liver biopsy is useful in providinginformation about the extent of liver damage associatedwith chronic infection, the feature that remains the bestpredictor of prognosis. Although liver fibrosis markers arecommercially available, they are currently insufficientlyaccurate to support their routine use.49 Until sensitiveserum markers can be developed that will define all stagesof fibrosis and mirror the information derived from liverbiopsy, the procedure remains the only means of definingthe severity of damage from HCV infection in many patients.After weighing the risks, benefits and costs of existingHCV treatments and of liver biopsy, most experiencedclinicians routinely obtain a liver biopsy in patients withHCV genotype-1 infection to guide recommendationsfor treatment. Patients infected with HCV genotypes 2and 3, however, have a high likelihood of response and,therefore, some advocate treating all such patients regardlessof severity of liver disease without resorting toliver biopsy. For patients with no or little fibrosis (i.e.,Metavir score 2 or Ishak score 3), in whom treatmentis often deferred, liver biopsy can be used tomonitor progression of liver disease. An interval of 4 to5 years between biopsies may be needed to measurechange in such patients.50Although the spectrum of liver fibrosis tends to beworse in persons with elevated blood levels of aminotransferasesthan in those with normal aminotransferase levels,51 14% to 24% of persons with persistently normalvalues have more-than-portal fibrosis on liver biopsy.These persons may have progressive liver disease over timedespite persistence of