Hello,

I’ve already ruled out structural causes with several exams. They seem to be anxiety related.

So, I should stop Propranolol?

That’s great news! I’m really happy for you! Thank you for your kind words. It means a lot to me and makes me calmer. Dr. Freeman is helping me more than my doctors!

I’ve just started treatment and my anxiety and PVCs went up and I’m taking propranol 50mg and clonazepan if I really need it.

I found interaction between Vikeira and Clonazepan but nothing on Ribavarin and Propranolol.

My PVCs (extrasystoles) are driving me crazy. They keep happening all the day long sometimes four per minute and stop and sometimes keep bothering all day long.

Did you experience any of these symptoms?

Dr. James, shoud I be concerned about interactions between both medications and Vikeira and Ribavarin?

I apologize for so many questions but I don’t feel my doctor share my concern about the treatment.

I guess it’s easy to dismiss an anxious patient that thinks that everything will happen and has all sorts of things going on, but it was thanks to my anxiety that I’ve discovered hep c after being discarded several times by doctors saying that my exams didn’t show anything besides a fat liver due to the ALT/AST ratio.

The worse thing for an anxious person if to be right about his anxiety because it makes you neurotic.

This is why I keep confirming everything twice or three times.

Thanks again

Thank you so much for your reply!

I just have two more questions and I’m gonna start treatment. It’s a relief to know we have other options is the treatment fails.

Can I take esomeprazol 20mg with Vikiera?

What side effects can I expect and what side effects should I keep my eyes on and go to a hospital if it happens while taking Ribavarin? I’ve read anemia is common but what else should I expect?

Thank you very much!

Got it! So, the trick is to lose the fat without losing the muscle.

The thing about carbs is so true. When I’m hungry I look for carbs and when I eat it, an hour later I’m hungry again and sometimes not hungry but craving carbs.

I don’t know how I let myself get into this situation, but the important thing is that I’m having a great opportunity to fix it, so that’s the good part.

It’s funny how we get used to carry two sacks of cement and not notice. I mean, it’s not comfortable, but it doesn’t feel like if I was carrying 50kg that it’s a short woman weight. That’s insane.

Thank you for all your help! You’re helping me a lot and I’m really grateful for that.

That chart is amazing! Thank you very much!

I’m worried about one thing and I was hoping you could help me once more.

My urine exam says that my bilirubin is ok but my Urobilinogen is hight. The max is 1 and mine is 4. Some places say this happens in hepatitis, other places says it happens on cirrhosis. Other sites says the exact oppostive happens in cirrhosis and the value would be lower. My urine bilirubin is normal except for the direct bilirubin and my urine bilirubin is negative. I mean, I think is negative because it’s listed as biliary pigment. Is it increased Urobilinogen a common find in chronic hepatitis c without cirrhosis?

I’ve used every single cirrhosis calculator I could find. Fib-4, Forns, Apri, AST/ART, NAFDL Score and others. All of them are negative, but I’ve read that this scores are useless in young patients younger than 36 and I’m currently 35. How reliable are these scores?

Also, I had chicken pox when I was little, should I vaccinate against herpes zoster before starting treatment?

I’m sorry for all these questions, but I’m anxious and I’m lost. The possibility of having corrhosis scares the hell out of me as I’m sure scares everybody so I’m trying to get some peace of mind using Google which is never a good thing, this is why this chart will be so helpful.

I promisse my next post will be a happy cured one.

Thanks once again.

But have you noticed that people that have “normal” ast/alt ratio before treatment <1 usually gets a higher ast and equal and lower alt after treatment?

If you take a look here at the forum, there’s plenty of people that got equal or >1 ratio during treatment and mantained this ratio after SVR.

So their general AST/ALT levels decreased but the ratio increased.

I thought it was interesting.

Any ideas what it means? Is it relevant?

Can you have a low ratio and have cirrhosis and a high ratio and not have cirrhosis? How good is the ALT/AST ratio for predicting that? Is it more reliable before treatment and unreliable after treatment?

Because if we take the ratio alone, that would mean that the treatment is making people cirrhotic and we know that’s not the case.

I know this is not important in the big picture and my questions are silly, but I’m curious why this happens.

No. I had the same exam and I’m trying to look everywhere for information. I know that doctors say it’s useless for detecting fibrosis, but my guess is that could show liver alterations and perhaps portal hypertension by alterations that are signs of cirrhosis, but I don’t think it could show cirrhosis stage 1 that most changes are not visible yet and it’s reversible.

Let me be clear that I have no idea what I’m talking about. It’s just a wild guess, but I couldn’t find anything for sure.

The only think I know for sure is that after 40 years with the virus and an MRI like that, you’re gonna be ok