first g.i. oppt

Question

ok i have my first g.i. doc oppt tomorrow,any advice on what quetions  i'm supposed to ask and what  tests i should ask for ??and maybe how i can not be soo nervouse ,,
                                                   ty

Bill1954 · Accepted Answer

Hi skyler411,

I guess you can ask him to confirm active, RNA infection as well as genotype first, just in case.

I’d then ask:

If a biopsy is indicated. Biopsy is the gold standard for determining the degree of scaring, or fibrosis that might have developed during the course of your disease. The results of the biopsy can help determine the urgency to undergo antiviral therapy.

•	I’d also see what other blood tests might be a good idea to do at this time; some thoughts would be an iron study to see if iron stores are an issue for you. Tests to check if auto-immune issues are present or a factor could be a good thing as well. Be sure to also make sure your thyroid function (T4) is in order as well.

•	If you have little fibrosis at this point, discuss therapy with the doctor. It might be prudent to postpone treatment in favor of more efficacious drugs in clinical trial right now; but this decision will probably require biopsy results as well as other info like genotype to arrive at a proper conclusion.

•	You might discuss which interferon he prefers and why; there are two manufacturers involved and they each have their own product; if treatment seems like a good idea right now, then you might want to know which drug he uses, and why. The two drugs are ‘Pegintron’ and ‘Pegasys’.

•	How is your personal support level? Are you in school right now, how are your finances, health insurance etc. In other words would you be in a better place to do treatment in six months? Two years?  Better now, perhaps? These are all real factors as well, and should be considered too, in addition to liver damage and other direct health issues.

Others will likely stop in and add to this list, but it’s something to start with. Good luck with the appointment, and try not to be nervous; it’ll all work out in the long run—

Bill

nutpea · Answer

I thought that was funny about your doctor throwing his hands in the air. On my first apointment with my GI at question #2 my gi said hum there  use to be a group for hep C people.  Get on the internet! (keep in mind I had no computer, was internet illiterate, poor and a computer cost 500 on up?) So all I had was a small town library (they got pissed off at me once because they had to help me get on internet) (once I got to where I wanted to be I printed off a page and heard shes looking for a maritime/jones act lawyer as soon as I hit the print button) and I sure did'nt want to look up hep C there.  So some months later. This sept I think. I went and saw GI... Looking back I could of saved me and my ins co doe because this forum already gave me my results of lab and ultra sound and biopsy( I got my copies and posted since I went to see him and he was probally out golfing or I mean absent from our apt. so I just took my copies.  Besides he did'nt offer me any treatment or advice when I did see him) And this forum gave better detail to the results.... They explained stage 0 grade 1 and vl around 231000. I thought I was gonna have to wait a month to find out I was nearly dead with a viral load that hi . hehe...  When I saw my doc, he did'nt remember me or know how many months it had been since I had seen him. Apperantly he did'nt  remember telling me to look on the internet. Because when I told him I've been on the internet and learned about hcv he dismissed it. like nonesence. Now I feel ripped off. Because I did'nt get a coloring book like you did. teehee

skyler411 · Answer

uhh loggerheads???

portann · Answer

That's interesting, throwing his hands up like that!!

Truth is for me, I found this forum more helpful than my doc and I love my doc, who's an amazing pro at what he does. 

Docs can only do so much, though.

To be fair to your doctor, there's much misinformation on the internet about everything in the universe, so it's up to you to sort out HCV information and pass your ideas by him or find a new one, if you come to loggerheads.

Best,

Susan

skyler411 · Answer

thanks again ,yeah this doctor answered all my questions and he seemed to know what he was talking about,it's just i wonder if he's just running by the book becouse all my lab work has come back fine he said theres no sign of any damage w hcv but said becouse i'm genyo type 1b I still need biopsy,also when i mentioned this forum he actually threw his hands up and said oh no",no", Then handed me some booklet that looks like a coloring book ,i'm not even kidding ''and said read this!!

Bill1954 · Answer

Hi skyler411,

Your bilirubin results are fine. If they become dramatically elevated, a person can develop jaundice, one of the classic symptoms of liver disease where the eyes and sometimes skin turn bright yellow. That’s not your worry; you’re results are towards the lower end of the reference range—

Bill

skyler411 · Answer

also bilirubin direct was 0.09 on a scale range of 0.00-0.40 is this normal??

skyler411 · Answer

thank you for your answers ! I'm going to ask about  everything you mentioned:)
I have another question ,I'm reading my hepatic function test ,,what is bilirubin,total mine is 0.3 on a scale of 0.0-1.2 what does this mean ?everything else is in normal range

Bill1954 · Answer

Hi skyler411--

Another thought is if it’s determined that treatment might be a good idea, you can ask the doc about clinical trial participation too, and if there are any in progress you might benefit from. There are lots of benefits as well as risks involved in trial participation, so make sure you ask lots of questions. And, remember that you’re not usually in a rush with this disease; it’s often possible to wait a month, or two or even a couple of years if needed.

Bill

Cory255 · Answer

You could ask for your baseline #'s.  And then get copies of your labwork along the way.  Also, you could get your Hep A/B vaccine, if you haven't already.  

Cory.

Bill1954 · Answer

I’m sorry, the TSH test is generally used for thyroid screening; I don’t know why T4 popped into my head. It’s used as past of a thyroid panel, but not usually for initial screening purposes—

Bill

Anne1717 · Answer

Oh please don't be nervous.  I found the more you know, the better you will be able to understand the doctor and converse with him or her about your condition.  t is very important to do your homework before you go.  If possible it might be good to have someone else along in case you miss something.  Bring a note pad and don't be afraid to write down what is said.

As far as the test to ask for, I found the doctor told me what  the course of action was to be.  But I already knew ahead of time that he was to be trusted and was an HCV expert. 

Again,  the  more you educate yourself, the more proactive you can be.

Good luck to you.