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Hi Dr James and anyone else who is knowledgeable!

Its over a year since I cleared gen 3a - still clear- yet I had a gastroscopy today - I was told there wasnt much change since the last gastroscopy which was 2 years ago(before treatment commenced).
platelets still low but WBCs up to more reasonable levels -- all other parameters seem normal...
However I my consultant gave me prescription for indoral 80mgs daily by time release tablet-- previously (2 years ago i was prescribed indoral 40mg daily--
thats quite a change in dosage - so am i left in confusion as to why its been increased - I did tell her that I stopped taking the indoral when i completed treatment( something i omitted before )
so my question(s) is /are do the betablockers facilitate any healing in relation to varices?(might they shrink and go with the ingestion of betablockers long term??) why the increased dosage ? (to make up for the all the time i didnt take them??) does all this mean that there is still Portal Hypertension ?? will it ever improve or is it just an irreversible symptom of the damage that hep c had on my liver -- my fibroscan results didnt indicate any inflammation they were almost in normal ranges after treatment!!
Thanks for your imput-- I guess I am spinning on a bit of anxiety around all this and am looking for some clarity!! Other than that I feel so so much better on all levels ,more energy etc less fatigue /
Thanks from Bob in ireland

Hi Bob,

So you can find more than you ever wanted to know about portal hypertension here: www.ncbi.nlm.nih.gov/pmc/articles/PMC3309905/

The reason we use a very old NSBB (Non Selective Beta Blocker) is complex but is explained in this article. Other things have been tried, but nothing else seems proven to be better.

If you neglected to mention to your doctor you had stopped taking the Inderal 40 they probably had a look and went, hmm, not much change, Bob's on the lower dose and not complaining, so let's give him more!

Yes, you should take them and yes they do help. Consider blowing up a balloon. You know how it's hard to do at the start and then gets easier? Your portal veins are like that. It's hard to get them to blow up, but the more they blow up the easier it is to blow them up. If you can shrink them down a bit that actually makes them stronger and more resistant to being blown up.

Technically that is called Laplace's law and here are a couple of explanations: www.tiem.utk.edu/~gross/bioed/webmodules/tensionblood.htm

medicineconspectus.blogspot.com.au/2013/...sion-radius-and.html

We do expect some improvement over time, but on the bright news front, if you ain't dead already then you'll probably live long enough to succumb to something else!

Life is a terminal disease, and sexually transmitted at that. None of us get out alive but chances are it won't be your liver that marks the final chapter.

Aha moment !! Thanks James so very much for shedding some clarity on this situation-- will resume taking indoral as from today
Hope all well

from Bob