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Hi Leah;

Please have them check Robbie's platelet count and blood clotting

(prothrombin time) before having the liver biopsy:

Bleeding problems in patients with liver disease

Ways to manage the many hepatic effects on coagulation

Sabah Sallah, MD; Bobzien, MD

VOL 106 / NO 4 / OCTOBER 1, 1999 / POSTGRADUATE MEDICINE

http://www.postgradmed.com/issues/1999/10_01_99/sallah.htm

" Liver biopsy is often necessary in liver disease, and clotting

abnormalities make the procedure potentially hazardous. PT and

platelet count are the best guides to risk. Bleeding time has not

been a reliable predictor of the likelihood of bleeding after biopsy

(1,13,14).

As a general rule, liver biopsy may be safely performed when the

platelet count is more than 50,000/mm3 and PT and PTT do not exceed

1.1 to 1.5 times the mid-range of normal (13). Fresh frozen plasma

should be infused to correct prolonged PT and PTT. "

Best regards,

Dave

(father of (21); PSC 07/03; UC 08/03)

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Hi Leah

What a stressful time you are having. Its interesting that they think

Robbie could well have had PSC for many years, he must be very fit and

healthy to overcome the symptoms.

Do follow 's advice and them check Robbie's platelet count and

blood clotting (prothrombin time) before having the liver biopsy.

I agree with -joy, try to put cholangiocarcinoma on the back

burner (huh.... easy for me to say!!!!) and concentrate on getting the

biopsy done and what the results are.

Best wishes big hugs to you, Robbie and your little ones.

over the ditch in New Zealand

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I'm sorry to hear that Robbie maybe getting worst. I just thought that it might help you to know that an enlarged spleen is not neccessarily a problem. My spleen was also very large (so much so that it hurt when the doctors pushed on it) but that it shrank back down after I had my transplant. It was enlargened from the time I was diagnosied to the time I got the transplat. That was 5 years. Pat (CA) UC-1991, PSC-2000, Tx-2005prichsy wrote: Just back from doc appnt

(top hepatologist in sydney) and he said he is very worried about Robbie's liver health. Also on physical examination he said he could feel a very enlarged spleen. Further blood tests aren't as good (after 2 ercps ) as he would have hoped.HE wants us to have an urgent Biopsy done of the liver. I kept asking about C-carcinoma minitoring methods and he said that he didn't think Robbie's liver will last so long for us to worry about cholangiocarcinoma...Don't know what to think...On persisting with my line of questioning (cause I know that carcinoma is the time-bomb), doc said there is no reliable method of monitoring and that we should just keep monitoring the blood tests for sudden elevations...I AM NOT HAPPY WITH THIS DISCUSSION AT ALL.At this moment focusing on getting an appointment to have biopsy next week.Can't believe life was 'NORMAL' 3 months back.He also thinks we have had PSC

for years ,just never been diagnosed.Leah

Everyone is raving about the all-new Yahoo! Mail beta.

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I'm sorry to hear that Robbie maybe getting worst. I just thought that it might help you to know that an enlarged spleen is not neccessarily a problem. My spleen was also very large (so much so that it hurt when the doctors pushed on it) but that it shrank back down after I had my transplant. It was enlargened from the time I was diagnosied to the time I got the transplat. That was 5 years. Pat (CA) UC-1991, PSC-2000, Tx-2005prichsy wrote: Just back from doc appnt

(top hepatologist in sydney) and he said he is very worried about Robbie's liver health. Also on physical examination he said he could feel a very enlarged spleen. Further blood tests aren't as good (after 2 ercps ) as he would have hoped.HE wants us to have an urgent Biopsy done of the liver. I kept asking about C-carcinoma minitoring methods and he said that he didn't think Robbie's liver will last so long for us to worry about cholangiocarcinoma...Don't know what to think...On persisting with my line of questioning (cause I know that carcinoma is the time-bomb), doc said there is no reliable method of monitoring and that we should just keep monitoring the blood tests for sudden elevations...I AM NOT HAPPY WITH THIS DISCUSSION AT ALL.At this moment focusing on getting an appointment to have biopsy next week.Can't believe life was 'NORMAL' 3 months back.He also thinks we have had PSC

for years ,just never been diagnosed.Leah

Everyone is raving about the all-new Yahoo! Mail beta.

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I'm sorry to hear that Robbie maybe getting worst. I just thought that it might help you to know that an enlarged spleen is not neccessarily a problem. My spleen was also very large (so much so that it hurt when the doctors pushed on it) but that it shrank back down after I had my transplant. It was enlargened from the time I was diagnosied to the time I got the transplat. That was 5 years. Pat (CA) UC-1991, PSC-2000, Tx-2005prichsy wrote: Just back from doc appnt

(top hepatologist in sydney) and he said he is very worried about Robbie's liver health. Also on physical examination he said he could feel a very enlarged spleen. Further blood tests aren't as good (after 2 ercps ) as he would have hoped.HE wants us to have an urgent Biopsy done of the liver. I kept asking about C-carcinoma minitoring methods and he said that he didn't think Robbie's liver will last so long for us to worry about cholangiocarcinoma...Don't know what to think...On persisting with my line of questioning (cause I know that carcinoma is the time-bomb), doc said there is no reliable method of monitoring and that we should just keep monitoring the blood tests for sudden elevations...I AM NOT HAPPY WITH THIS DISCUSSION AT ALL.At this moment focusing on getting an appointment to have biopsy next week.Can't believe life was 'NORMAL' 3 months back.He also thinks we have had PSC

for years ,just never been diagnosed.Leah

Everyone is raving about the all-new Yahoo! Mail beta.

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's spleen was so big it took up most of his abdomen and know it has shrunk down to almost normal size. I was the cause of most of his abdomenal pain Martipat jones wrote: I'm sorry to hear that Robbie maybe getting worst. I just thought that it might help you to know that an enlarged spleen is not neccessarily a problem. My spleen was also very large (so much so that it hurt when the doctors pushed on it) but that it shrank back down after I had my transplant. It was

enlargened from the time I was diagnosied to the time I got the transplat. That was 5 years. Pat (CA) UC-1991, PSC-2000, Tx-2005prichsy <prichsyyahoo (DOT) co.in> wrote: Just back from doc appnt (top hepatologist in sydney) and he said he is very worried about Robbie's liver health. Also on physical examination he said he could feel a very enlarged spleen. Further blood tests aren't as good (after 2 ercps ) as he would have hoped.HE wants us to have an urgent Biopsy done of the liver. I kept asking about C-carcinoma minitoring methods and he said that he didn't think Robbie's liver will last so long for us to worry about cholangiocarcinoma...Don't know what to think...On persisting with my line of questioning (cause I know that carcinoma is the

time-bomb), doc said there is no reliable method of monitoring and that we should just keep monitoring the blood tests for sudden elevations...I AM NOT HAPPY WITH THIS DISCUSSION AT ALL.At this moment focusing on getting an appointment to have biopsy next week.Can't believe life was 'NORMAL' 3 months back.He also thinks we have had PSC for years ,just never been diagnosed.Leah Everyone is raving about the all-new Yahoo! Mail beta.

Everyone is raving about the all-new Yahoo! Mail beta.

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's spleen was so big it took up most of his abdomen and know it has shrunk down to almost normal size. I was the cause of most of his abdomenal pain Martipat jones wrote: I'm sorry to hear that Robbie maybe getting worst. I just thought that it might help you to know that an enlarged spleen is not neccessarily a problem. My spleen was also very large (so much so that it hurt when the doctors pushed on it) but that it shrank back down after I had my transplant. It was

enlargened from the time I was diagnosied to the time I got the transplat. That was 5 years. Pat (CA) UC-1991, PSC-2000, Tx-2005prichsy <prichsyyahoo (DOT) co.in> wrote: Just back from doc appnt (top hepatologist in sydney) and he said he is very worried about Robbie's liver health. Also on physical examination he said he could feel a very enlarged spleen. Further blood tests aren't as good (after 2 ercps ) as he would have hoped.HE wants us to have an urgent Biopsy done of the liver. I kept asking about C-carcinoma minitoring methods and he said that he didn't think Robbie's liver will last so long for us to worry about cholangiocarcinoma...Don't know what to think...On persisting with my line of questioning (cause I know that carcinoma is the

time-bomb), doc said there is no reliable method of monitoring and that we should just keep monitoring the blood tests for sudden elevations...I AM NOT HAPPY WITH THIS DISCUSSION AT ALL.At this moment focusing on getting an appointment to have biopsy next week.Can't believe life was 'NORMAL' 3 months back.He also thinks we have had PSC for years ,just never been diagnosed.Leah Everyone is raving about the all-new Yahoo! Mail beta.

Everyone is raving about the all-new Yahoo! Mail beta.

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