High levels

[RainF]

I have been diagnosed with cirrhosis of the liver caused by auto immune hepatitis. I have been taking blood work every two weeks and noticed both my Alt and AST has been elevating. My ALT was 80 on the 5 of January, to 92 on the 19 of January. My AST was 162 on the 5 of January to 173 on the 19 of January. My bilirubin was 9.5 on the 5th to 11.0 on the 19. What does all this mean.

[RainF]

I thank all of you for your input. I have a doctors appt. this week and will keep you all posted.

[genotype1a]

I apologize for not mentioning this earlier. If you want to go to the web pages I posted. All you have to do is to copy and then paste the url link to another tab on top where the url addresses are usually found, and then click the reload symbol if it's showing or the X if it's showing next to the pasted url and then you will be sent to the appropriate web pages to view. I write this just in case there are folks that are not as familiar as some others are in how to get to the url's that posted in various threads in this forum and if you cannot go to the links directly by clicking the posted url.

All the best to you,
Henry

[genotype1a]

And I happen to be one of them in here and even though I'm new to posting in here, I am by no means new to HCV or other liver diseases and discussing them in forums online.

No disrespect but, I have known the difference between a Gastro doc and a hepatologist. I have been battling HCV knowingly, and I stress knowingly since 1987 when I was diagnosed with what was then called Non A - Non B hepatitis as opposed to someone finding out recently, and only learning what some people read online.

I was one of the very first patients that were treated on interferon mono therapy as an experimental drug way back in 1990. I have also relapsed nine times after reaching SVR with four of those times after my liver trans-lant in 1997. Just last year, I became SVR after participating in a clinical trial that was testing what is now called "Harvoni" so it took ten attempts before I can honestly think and believe that this time the virus is finally gone from my body completely.

Although the jury is still out on the newer DAA's these drugs like Harvoni will definitely improve outcomes with respect to patients that have prematurely ended treatment for a multitude of reasons including becoming physically unable to continue because of being on the tx for so long which was 36 to a year of tx compared to harvoni's 8 thru 24 week regimens making this combo extremely tolerable compared to the SOC prior to the introduction of the first generation DAA's - Telepravir and Bocepravir and combo therapy before that of Interferon and Ribavirin.

The other wonderful virtue of Harvoni is the slight to almost non-existent side effects compared to the previous tx regimens. And coming from someone who has treated with every therapy that was available prior to the second and third generation DAA's. Harvoni is such a vast improvement that when I look at it from my perspective I am saddened that these drugs and the research that went into developing them were not around when I first got sick. Because I sometimes think about all of those years I could have had in my life being HCV free and possibly avoiding a liver transplant and a multitude of hospitalizations and illnesses prior to and afterwards. And then I catch myself and say to myself: "Well, it could have been worse and i start screaming inside to get some gratitude in my attitude and the negative and depressing thoughts are literally chased out of my mind by my own consciousness

During one of what initially thought was to be a successful treatment episode, and an almost 5 year period of being so called SVR, I had not felt that the virus was totally eliminated from my body except for the antibodies which are benign to me, and sure enough on one of the yearly blood draws, I tested positive again! At that time is was generally thought  amongst the treating doctors that after 2 years of being SVR, they would consider one as being cured from HCV

The sources of knowledge I have are from real time experiences, sneaking into the University of Pittsburgh Medical library, and what some of the most reknowned Hepatologists, Gastroenterologists, and other specialists have taught me over the years so, I think I know a thing or two about HCV and Gastroenterology and Hepatology. So it's not necessary to inform me of the subtle differences between the two specialties and btw, Hepatology is no longer a sub specialty and is considered a specialty in it's own right. It used to be that Hepatologists prior to specializing in Gastroenterology were just that - Gastro docs. That is no longer the case since Hepatology is no longer considered a sub specialty of Gastorenterology for quite some time now.

I was transplanted where liver transplants first became successfully in the long term after Dr. Thomas Starzyl's liver transplant program was discontinued @ the University of Denver where he left to continue his work @ The University of Pittsburgh which is where I had my transplant performed by one of the original transplant surgeons who left after my surgery but not because of me lol.

But he left UPMC to go back to his home country of Argentina to open up a transplant center in Buenos Aires. And what I remember most about him was as I was recovering in the ICU, and getting better and awake after almost 48 hours of being unconscious,. Dr Casavilla called the ICU via satellite phone from Machu Picchu in Peru and he was telling me to hurry up and get better so I could join him on one of his adventures to that very special place where I did eventually visit seven years after my transplant and with my good friend Dr Adrian Casavilla, who led me up another stairway to heaven!

Here are some of the papers he co-authored with some of the very best fellow transplant surgeons in the world including Dr. John Fung who was instrumental in developing tacrolimus and was director of the transplant center @ UPMC during that time and treated me and monitored me after Dr. Casavilla left for Argentina:

http://www.ncbi.nlm.nih.gov/pubmed

Note: if the page doesn't automatically show up with his papers then just type in his name: "Adrian Casavilla" and it should lead you to the papers.

A book recommendation for you is titled "The Puzzle People - Memoirs of a Transplant Surgeon" which is sort of an Autobiography of Dr Thomas E. Starzyl, the "Father of Transplantation." Who btw, still conducts research at his Starzyl Transplantation Institute. Btw, he was very instrumental in the eventual establishment of Hepatology as it own separate specialty from Gastroenterology. here is an online readable digital edition of the book from the University of Pittsburgh Press:

http://digital.library.pitt.edu/cgi-bin/t/text/text-idx?idno=31735038285288;view=toc;c=pittpress

Well, nice talking to you Lynn and I hope you enjoy the book.

[flyinlynn]

As far as your rising liver enzymes liver enzymes are released when your liver is being injured they are released as your liver tries to heal. The higher the numbers the more injury is occuring. However elevated liver enzymes do not correlate to extent of damage. Some can have only slightly elevated levels but extensive liver damage while others could have highly elevated liver enzymes with minimal damage.

http://www.mayoclinic.org/symptoms/elevated-liver-enzymes/basics/definition/sym-20050830

I hope that helps

[flyinlynn]

It often helps to have someone go to appointments with you to help you keep the details straight. Also as you think of questions write them down and take them with you for your appointment.

If you have questions you can ask them here and we will do our best to translate for you. Liver transplant is a major undertaking and I am sure the process and all the information can be overwhelming. We have several transplant survivors here. Ask any question you want and we will try to help.

Good luck
Lynn

[RainF]

Thank you flyinlynn. I do see a Hepatologist. He has placed me on the liver transplant list and I'm currently in the processe of locating a living donor. It's just sometimes when my doctor speaks I get lost. I thought someone could break it down a little easier for me to understand.

[flyinlynn]

A gastroenterologist is a physician who specializes in diseases of the digestive system, also called the gastrointestinal (GI) tract. Gastroenterologists have extensive training in the diagnosis and treatment of conditions that affect the esophagus, stomach, small intestine, large intestine (colon), and biliary system (e.g., liver, pancreas, gallbladder, bile ducts). Gastroenterology is a subspecialty of internal medicine.

A hepatologist is a specialist in the branch of medicine called Hepatology, which includes the study of body parts such as the liver, the biliary tree, the gallbladder and the pancreas. A hepatologist manages disorders in these areas. Hepatology was traditionally a subspecialty of gastroenterology, but recent advances in the understanding of this subspecialty have made it a field of its own.


Hepa refers to the study of the liver it is a sub speciality of Gastroenterology

[RainF]

Thank you Henry.

[genotype1a]

Hi RainF,

Are you seeing a Hepatologist, otherwise known as a GI doctor who specializes in liver diseases? Because if you are, then your specialist will be able to answer your question as they know their patients better than anyone in here could know about your present condition. Give them a call tomorrow and find out if the doctor or they're on staff RN is available to answer your questions.

Henry