Wait, what? This was supposed to be a sequel, not a trilogy!

In five days, I will be finished with the Harvoni treatment. Much to the relief of my friends, I will no longer wait for my alarms of Taylor Swift's" Trouble When You Walked In" everyday at 6:50-7:05 PM.

I will no longer wait for weekly results on my blood tests. In five days I will have my end of treatment blood test.
Whose results rest my future. Will I have ten years left? Twenty? Fifty? Will I wait in line for a liver transplant, only to re-infect the organ and return to my level of damage within a few years?

And what happens when I reach the coveted SVR12 (Sustained Viral Response, the point of "cured")? If I can clear it, if in this game of life-or-death tic tac toe I manage to avoid a fifth cat's game...what does that mean for my liver? What does recovery look like?

I am the extreme, What happened to me at the age of twenty is more likely to happen to someone after forty to fifty years of infection. I am lucky, I came from a tiny likelihood of vertical transfer, and at less than 5% I beat the odds, and live with a decompensated liver so early in life... I have been in study after study since I was sixteen. Most studies bulk young people in an under 40 bracket. Inherently, a twenty year-old and a forty year old have wholly different recovery abilities, which only makes data harder to find/interpret.

What research can I find to help me understand what my future looks like?

Almost none. As most of the F4 and decomp patients are considerably older there is simply not enough data to provide more than a strong inference.
Even the classifications (F0-F4) themselves have been recently been looked at.


Where I sit now, the majority of my liver is...well... to say garbage would be an improvement. How my body chooses to handle the different parts of my liver is the subject of debate.


Whatever parts are near healthy will recover in around a year, the early stage fibrosis areas will recover within a few years. But the worse off the fibrosis is, the less likely it will recover. The last chunk of my liver, is the cirrhotic bit, which probably isn't going anywhere.


While there are some RXs for helping the fibrosis, the level of damage to the remainder of my liver has already been done. It is, most likely irreversible.

This is why I'm so insistent on testing, on looking at your options early. Early detection can prevent situations like mine.

I say a lot of probablys and likelys in this situation, because as I said before, I am the extreme.


So true to my nature, I hope to be the extreme here too, and recover in the dramatic flair that has engulfed my treatments.

Know More Hepatitis

Be #hepaware

If this title were a pattern it would be damask.

There is a long list of terrible health issues most doctors will tell you regarding the health factors of smoking cigarettes.

If the varieties of cancer, lung, heart, and throat problems sound terrible, there is one other organ that is constantly affected by smoke.

The liver. Smoking with liver disease isn't a good idea and dramatically raises your chances for liver cancer, but what about it's affects on other liver related issues?

For a time, i smoked cigars, not really realizing the full extent of the damage it was causing.
It's not hard to see that the liver would be adversely affected by smoking, as it filters your blood.

Assumptions are great, but it's better with facts.

The study looks at Cigarette smoking's affect on the liver, as well at its affect on a compromised liver (NAFLD/NASH)

Cigarette smoking, in the short term:

"...these results indicate that smoking does not cause acute effects on the liver."

Short exposure to cigarette smoke doesn't have a huge impact on the liver, which can imply that occasional/short exposure, to second hand smoke will have a similar result.

But what about the long run? 

"...These results show that (cigarette smoking) induces profibrogenic gene expression in the liver, yet does not induce liver fibrosis per se."

What the shit does this mean.

Well it means that cigarette smoking doesn't cause the fibrosis, but it can help fibrosis along if it already exists. So while i do not advocate smoking, and encourage quitting ASAP...

If you aren't cirrhotic( AKA are at F0 coming up on F1) you can slowly ease off smoking and it won't have much impact as if you were to cut it off cold turkey.

The F0-4(6 in some countries) indicates the level of liver fibrosis/cirrhosis in a liver.

F0 .	No fibrosis	You should probably stop smoking.
F1 .	Portal fibrosis without septa (mild)	You need to stop smoking.
F2 .	Portal fibrosis with rare septa (moderate)	If you haven't already, stop smoking, as you're now hindering your liver, and will result in faster liver damage.
F3 .	Numerous septa without cirrhosis (severe)	Don't smoke. see that shit up there^^ it's worse down here.
F4 .	Cirrhosis.	Don't smoke, risk not getting a transplant, smoking and alcohol can decrease your likelihood of getting a liver in time.

Additionally, as cigarette smoking is not typically accounted for in FDA approval(On page 5 are drug interactions for Harvoni) for liver RXs, there is no telling what odd side effects you may encounter.

ASIDE:
If you've recently had a physical, blood work, or check up, i recommend this handy chart. (Usually blood work has normal ranges written in, but if you ever want clarification.)

Why would it's title be damask? because it's smokin'