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Enlarged spleen
My last echo showed i have an enlarged spleen.
The only comment i got from my doctors secretary is
that it is normal when you have cirrhosis and hep c.
Next visit is now planned for half a year later.
Is this a normal course of action?
I already had 2 treatments that both failed and am now waiting for sofosbuvir treatment to be approved in Holland.
The only comment i got from my doctors secretary is
that it is normal when you have cirrhosis and hep c.
Next visit is now planned for half a year later.
Is this a normal course of action?
I already had 2 treatments that both failed and am now waiting for sofosbuvir treatment to be approved in Holland.
Thank you very much for taking the time to answer my
question so thoroughly.
Understanding what is going on in my body somehow also helps me
dealing with my hepatitis c.
My doctor shares very little information with me.
Thank you Hector.
question so thoroughly.
Understanding what is going on in my body somehow also helps me
dealing with my hepatitis c.
My doctor shares very little information with me.
Thank you Hector.
"Normal" means different things. What is "normal" in a ill person may not be normal in a healthy person. Which is the case. When the liver disease has advanced to cirrhosis ("stage 4" liver disease) the anatomy of the liver itself and the surround blood system is physically changed from what a "normal" healthy person or even a person with lesser liver disease stages 0, 1, 2 or 3.
An enlarged spleen (splenomegaly) is just one of many complications of cirrhosis (scarring of the liver) although people with early cirrhosis may not have an enlarged spleen because the liver cells are not completely scarred and the blood can still filter through the liver without too much back pressure. An enlarged spleen happens as the liver becomes so scarred that the blood flow through the liver and around it is altered. This is called "portal hypertension".
The liver's blood system carries the blood from the GI tract and spleen through the portal vein to the liver. The blood then saturates it's way through the liver tissue (where the blood is filtered and cleaned) and then exits via the hepatic vein before it enters the heart and then goes back into the general circulation. This is needed because this blood has nutrients from the digestive system and absorbed toxins and bilirubin from the red blood cells that need to be destroyed in the spleen.
The liver is in charge of processing these substances.
When scar tissue in the liver (cirrhosis) interferes with that blood flow--- pressure can build in the portal vein ("portal hypertension"). Portal Hypertension can cause the spleen to enlarge and varices to form in the GI tract.
---> As the spleen enlarges-- platelets are trapped in the spleen. (The platelet count in the bloodstream falls.) (Platelets help our blood to clot. So as the platelet count falls... bleeding time is increased.) (A low platelet count ( Varices (internal varicose veins in the esophagus, stomach, or intestine). are dangerous because there's a risk that they can burst and bleed (hemorrhage).
---> Portal Hypertension can cause complications like "Ascites" (fluid build-up in the abdomen) and hepatic encephalopathy (HE) which are both pretty common complications of cirrhosis.
Since you will not be seen for 6 months that would be reasonable if you have early cirrhosis. That would be appropriate as that is what I did when I had few symptoms and was still able to work and had a low MELD score under 15. Some people are sicker even when they MELD score doesn't reflect it but I am speaking about in general. Meaning no ascites, large varices and other complications that must be watch closely as would someone who's cirrhosis is so advanced that they are put on a liver transplant waiting list. I assume you are having an ultrasound and AFP liver cancer screening every 6 months?
You should treat your hepatitis C as soon as possible because there is always a risk that your liver disease could suddenly get worse (decompensation) and because you have cirrhosis you are now at a higher risk of developing liver cancer (HCC).
"SOF as a single agent was granted marketing authorization in the European Union on January 16, 2014 under the tradename Sovaldi®, and is available in the United Kingdom, Ireland, Germany, France, Austria, Sweden and Finland. Sovaldi is also approved in the United States, Canada, New Zealand and Switzerland."
I hope Sovaldi/sofosbuvir treatments become available soon so you can stop the progression of your liver disease and not have to have a liver transplant like I needed to. My advice is to keep your own parts for as long as possible.
Best of luck with your treatment.
Hector
An enlarged spleen (splenomegaly) is just one of many complications of cirrhosis (scarring of the liver) although people with early cirrhosis may not have an enlarged spleen because the liver cells are not completely scarred and the blood can still filter through the liver without too much back pressure. An enlarged spleen happens as the liver becomes so scarred that the blood flow through the liver and around it is altered. This is called "portal hypertension".
The liver's blood system carries the blood from the GI tract and spleen through the portal vein to the liver. The blood then saturates it's way through the liver tissue (where the blood is filtered and cleaned) and then exits via the hepatic vein before it enters the heart and then goes back into the general circulation. This is needed because this blood has nutrients from the digestive system and absorbed toxins and bilirubin from the red blood cells that need to be destroyed in the spleen.
The liver is in charge of processing these substances.
When scar tissue in the liver (cirrhosis) interferes with that blood flow--- pressure can build in the portal vein ("portal hypertension"). Portal Hypertension can cause the spleen to enlarge and varices to form in the GI tract.
---> As the spleen enlarges-- platelets are trapped in the spleen. (The platelet count in the bloodstream falls.) (Platelets help our blood to clot. So as the platelet count falls... bleeding time is increased.) (A low platelet count ( Varices (internal varicose veins in the esophagus, stomach, or intestine). are dangerous because there's a risk that they can burst and bleed (hemorrhage).
---> Portal Hypertension can cause complications like "Ascites" (fluid build-up in the abdomen) and hepatic encephalopathy (HE) which are both pretty common complications of cirrhosis.
Since you will not be seen for 6 months that would be reasonable if you have early cirrhosis. That would be appropriate as that is what I did when I had few symptoms and was still able to work and had a low MELD score under 15. Some people are sicker even when they MELD score doesn't reflect it but I am speaking about in general. Meaning no ascites, large varices and other complications that must be watch closely as would someone who's cirrhosis is so advanced that they are put on a liver transplant waiting list. I assume you are having an ultrasound and AFP liver cancer screening every 6 months?
You should treat your hepatitis C as soon as possible because there is always a risk that your liver disease could suddenly get worse (decompensation) and because you have cirrhosis you are now at a higher risk of developing liver cancer (HCC).
"SOF as a single agent was granted marketing authorization in the European Union on January 16, 2014 under the tradename Sovaldi®, and is available in the United Kingdom, Ireland, Germany, France, Austria, Sweden and Finland. Sovaldi is also approved in the United States, Canada, New Zealand and Switzerland."
I hope Sovaldi/sofosbuvir treatments become available soon so you can stop the progression of your liver disease and not have to have a liver transplant like I needed to. My advice is to keep your own parts for as long as possible.
Best of luck with your treatment.
Hector
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For me it is reassuring when I know where I stand. Then I can make adjustments in what I do and/or how I think about my situation.
Good luck at World Cup on Sunday.
Be well!
Hector