Your liver is on your right side. The liver has no pain receptor nerve endings.
I am assuming you mean a Fibroscan score. Were you given a test with a machine? If not what methodwas used to determine what you refer to as a fibrosis score of 4?
If you google Fibroscan score card images you will see the scale for the Fibroscan goes from 0 to a max of 75
The lowest possible result for fibrosis caused by hep c is in the 0 to 6 range which is a score of F1 the lowest score possible.
For reference my Fibroscan score is 33 which is F4 cirrhosis that starts at a score of about 15 for hep c.
My liver cirrhosis was diagnosed by liver biopsy in 2008.
The fibrosis score from a liver biopsy is as follows:
F0 = no fibrosis
F1 = portal fibrosis without septa
F2 = portal fibrosis with few septa
F3 = numerous septa without cirrhosis
F4 = Cirrhosis
So I need to know which test you took that provided you the score.
Did you have a liver biopsy where they the insert a needle into your liver a take a sample? Did you have a Fibroscan using a machine? Or did you have a blood test called a fibrosure
Of course you really should be asking your doctor this question
I did find this on stages of cirrhosis
Stage 1 Cirrhosis
Stage 1 is the earliest stage of cirrhosis and is characterized by the absence of two significant complications known as varices and ascites. Varices are dilated, ballooned veins. They are most often located in the lining of the esophagus and/or stomach. Acsites refers to an accumulation of fluid in the abdominal cavity. Both varices and ascites develop primarily because of obstructed blood flow through the liver, a condition known as portal hypertension. While people with stage 1 cirrhosis have extensive liver scarring, it is not severe enough to cause substantial portal hypertension and its complications.
Stage 1 cirrhosis is considered compensated cirrhosis. This means that despite extensive damage, the liver is not yet so severely scarred that clinically apparent signs of liver failure have developed. People with stage 1 cirrhosis generally do not experience many symptoms other than perhaps lack of energy and fatigue. Stage 1 cirrhosis is potentially reversible if the underlying cause of the cirrhosis is eliminated or cured.
Stage 2 Cirrhosis
Stage 2 cirrhosis is marked by the development of esophageal varices, due to worsening portal hypertension, but without the presence of ascites. While the development of esophageal varices indicates worsening cirrhosis and an increased risk of dying in the next 12 months, stage 2 cirrhosis is still considered compensated cirrhosis. There remains the potential for at least partial reversal of liver damage if the underlying cause of cirrhosis is eliminated or cured.
Stage 3 Cirrhosis
Stage 3 cirrhosis is marked by the development of ascites, with or without the presence of varices. The volume of ascites varies from being detectable only with imaging tests, such as abdominal ultrasound, to obvious bloating of the abdomen. The development of ascites signals worsening portal hypertension due to advancing liver scarring and deterioration of liver function. Stage 3 cirrhosis signals decompensated cirrhosis, meaning the liver is failing. Once decompensated cirrhosis develops, liver scarring is irreversible and evaluation for liver transplantation is generally recommended. A variety of signs and symptoms may be present with stage 3 cirrhosis, including:
pale and/or yellowish skin
weight loss and loss of appetite
shortness of breath
persistent, widespread itchiness
swelling of the feet, ankles and lower legs
wasting of the muscles of the arms and legs
Stage 4 Cirrhosis
The defining feature of stage 4 is gastrointestinal bleeding, usually from ruptured varices in the esophagus or stomach. This type of bleeding can be immediately life threatening if not controlled. Even if bleeding stops or is medically controlled, however, individuals with stage 4 cirrhosis still face a high risk of dying within 12 months. Persons with stage 4 cirrhosis have end-stage liver disease and urgent evaluation for possible liver transplantation is necessary. Signs and symptoms that might develop include those that may occur with stage 3 cirrhosis as well as others, such as:
confusion, personality changes and/or extreme sleepiness
reduced urination, which may indicate kidney failure
high fever, signalling infection of the abdominal cavity
For post treatment follow up the AASLD recommends that those with less than F2 fibrosis wontbrequire any special follow up after cure.
But for those patients with F3 fibrosis or F4 cirrhosis they recommend abdominal ultrasounds and AFP (alpha fetoprotine a tumor marker) blood testing every 6 months to monitor for early signs of heptocellular carcinoma (HCC) aka liver cancer because those of us with cirrhosis are at increased of developing liver cancer. Although with cure that risk is greatly reduced.
Although with cure we are much less likely to develop greater amount of liver disease and decompensation there is still some risk especially if you have any fatty liver issues.
I assume you have stopped drinking.
From the AASLD
“Surveillance for hepatocellular carcinoma with twice-yearly ultrasound examination is recommended for patients with advanced fibrosis (ie, Metavir stage F3 or F4) who achieve SVR.
A baseline endoscopy is recommended to screen for varices if cirrhosisa is present. Patients in whom varices are found should be treated and followed as indicated.“
I had grade 3 esophageal varicies back in 2012 so I was having annual upper endoscopies until last year and now my hepatologist said we can go to every two years. I have an abdominal ultrasound and AFP test every six months.
When I was diagnosed with cirrhosis in Jan 2008 my doctor had me get vaccinated for hepatitis A and Hepatitis B. I have been advised to get my flu shot as soon as it becomes available every year because those of us with cirrhosis and advanced liver disease are considered medically fragile like those with other chronic diseases.
A biopsy every six months is excessive. I never heard of anyone having such frequent biopsies. I would seriously question this if I were you. Liver biopsies are not without risks, and furthermore are notoriously unreliable for various reasons: the specimen comes from the periphery of the liver (HCV-related fibrosis is not homogeneous throughout the liver), the size of the specimens can vary widely, there is great discrepancy in observation (operator-dependency), etc. Biopsies are usually done when HCV is diagnosed, and then prior to a trial. They are not required or recommended before or after Tx. If someone is scheduling you for bi-annual biopsies they have to have a very special reason for doing so. I believe that a second opinion, from a hepatologist specializing in HCV, would reject them.