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Hi everyone -- wanted to update you on my discussion with the gastro. As a reminder, I am 53 F, contracted Hep-C probably 30 years ago from IV drug use, no symptoms, no elevated liver enzymes, liver fibrosis of 1 on 0-4 scale, no cirrhosis, genotype 2B. Dr. had said this type has a shorter treatment (6 mos) and better success rate, so we were meeting to discuss whether to go forward w/tx.

We got off on a weird note when he said, "You have the type that's hard to treat." I said, you told me I have the type that's EASY to treat! He then looked back at my chart and reversed himself. I think he was confused on why I was seeing him to begin with -- he had done an endoscopy on me a few weeks ago and we first discussed the results of that (negative for ulcer). So when I said, let's talk about the bigger problem, I really think he forgot the Hep-C was the reason I was there to begin with -- hence, the confusion on my genotype. (?)

OK, anyway, he said my genotype has a 75-80% success rate -- they consider success 6 months without the virus returning. Said I'd do weekly shots of "pegilated (sp?) interferon" (is that Peg-Intron?)and a daily pill of Ribovirin. Side effects can vary from mild to needing to go on disability. Said insurance will cover it. Didn't say anything about going on antidepressants or anything, but I forgot to ask.

Said no one can tell when the liver damage is from -- in other words, has that "1" been there 30 years? Or, is it just developing? Said no one can say for sure how long it would take for the damage to go from minimal to severe -- in other words, if I don't get treated, will it take 20-30 years to get to the severe stage? Definitely said alcohol magnifies the damage to the liver, and not just alcohol ABUSE -- any alcohol. Told him I quit drinking (it's been a whole week!)

He recommended I go for it, given I'm "51" (I'm 53) with a lot more years to live, and the success rate. Told him I can't afford to feel like crap at work. He said who can...he can't either -- but you know, my work situation's a little more precarious than his! Like, I start taking sick time, maybe they consider me dispensable the next time there's a "reduction in force".

Asked him why I can't just hold off and then do another liver biopsy in a few years. If the damage has progressed, I do treatment. He pushed back, really questioning why I would not just try it. He said if the side effects are unbearable, I can discontinue it.

My head was pretty much ready to explode by the time I was done. I couldn't write down his answers fast enough and I knew I'd have more questions once I left. I said I'd think about it.

I don't know what to do. I really don't want to do the treatment. The side effects sound brutal, especially the fatigue. The stress of my job is draining enough, without being even more wiped out from the tx. If I could take a medical leave, I would, but as I said, not in our current work environment. Although I did tell my boss (he was very empathetic) and he did say my health comes first.

Who's to say the "1" will never go any further? I guess no one can say that. He did say the tx does not reverse the liver damage -- just clears the virus. So what's the point of the tx? So the damage doesn't go any further, which it might with the HCV? Oh I forgot -- I asked him about my viral load, he said it's about 1M which he said is average.

At this point, I'd prefer to bury my head in the sand and ignore the whole thing. Monitor later and then decide. Would appreciate your thoughts/advice. Sorry for being so long-winded!





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