emails between an Asian person & Dr.Misra-->可可转移

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Dr. Misra,



I've been reading a lot of information regarding what I need to do to

increase my immune system and to help my liver along. I'm not sure which is

the best route to take. Some mentioned stay away from protein because it

would put more weight on the liver, but increase more fruits and dark green

leafy vegetables and beta carotene. But then I also have heard, not to intake

so much dark green leafy vegetables, herbs, and beta cartone (because vitamin

a can be toxic to the liver). So I do not know which is the best route to go?

I do not want to do more harm than good to my liver.



Also, is it normal to have slight liver pain? Does that mean I am getting

worse?



Deena



Subj:    [HB] Re: Dr. MIsra (Deena)

Date:   12/4/2001 3:38:56 AM GMT

From:   [email protected] (Doc)

To: [email protected]

CC: [email protected]



Hi Deena,

I quite undersatnd your anxiety, esp because you

have an infection, no real symptoms, a list of

comlications and no curative treatment.

In order to  find out the extent of liver disease

by HBV, liver biopsy is the gold standard, it will

you if you have mild hepatitis, fibrosis or

cirrhosis. I think you should discuss this with

your doc and have it when ALT goes up. Ultrasound

is a rather poor test for the liver, it is used

mainly for follwo up reagrding development of

liver cancer.

If you have chronic hepatitis, then you have a

chance of spontaneously clearing  the virus ( 1%

per year), progression to fibrosis and cirrhosis

(25%) and increased risk of liver cancer (5%). If

you have minimal liver changes, then you are

compatible with normal life.

So you really need to know the stage and grade of

your liver disease to have more answers.

Modifications in lifestyle include briefly, no

alcohol or saturated fats, more proteins and

plenty of rest.

Regarding your docs view of IFN, maybe you should

ask him for some hard data, not just opinion.

Remember ignorance is bliss!



Dr Sharat C Misra MD,DM.FACG

















----- Original Message -----

From: [email protected]

To: [email protected]

Cc: [email protected]

Sent: Tuesday, December 04, 2001 8:37 AM

Subject: Dr. MIsra (Deena)





Dr. Misra,



If my alt does go up, is it necessary for a liver

biopsy? Would a ultrasound be sufficient?



You mentioned I can live a healthy long life with

some modification. What type of modification? Is

there a way I can control my own destiny? Would

diet and change of lifestyle help in my quest of

conquering this horrible disease? I am currently

reading up on the disease and still learning from

it. I'm known to be much of a pessimist so please

reconfirm any positive outlook in living a long

healthy life til my golden age.



Its so strange. If interferon does work on a

percentage of asian why would my doctor said dont

bother since its expensive and not effective on

us?



Deena



Subj: Re: [HB] Dr. Misra (Deena)

Date: 12/3/2001 5:28:07 AM Pacific Standard Time

From:    [email protected] (Doc)

To:    [email protected]

CC:    [email protected]



Dear Deena,

Read within:





> Dear Dr. Misra,

>

> You mentioned it is common for people like

myself to have normal ALT and high

> viral load. How long can I remain in this

situation before I see any problems?



25% of people in your situation will have some

symptoms( chr hep or cirrhosis) in 5 years but

this is only a statistical figure. You should keep

a tab on any new symptoms and  ALT levels every 6

months. When ALT goes up , you ssould have a liver

biopsy.





> Actually this question is for anyone who wants

to comment, I am so

> uncomfortable with this disease. I constantly

think this is the end of the

> world. Do you see people living a long and

healthy life til their golden age

> with this disease or do you find people having

problems and complication with

> this disease ?



Yes, you can live a healthy life for long with

some modifications. You should read about the

disease and its consequences and have realistic

expectations rather than fearing the worst.



> Dr. Misra, from speaking to my current

physician, he seems to have had

> experience with patients with hepatitis b. he

even mentioned putting those

> patients on lamuvidine. I do not know if their

situation is similar to my

> position or if worse.

> Hopefully those patients are more well informed

before deciding to go on

> lamuvidine.



It is a question of arming yoruself as well with

the knowledge about the illness and its treatment.

Lamivudine, is just one of the instruments and by

no means the best one.



> Do you know if interferon works on asian

patients? my doctor said if I decide

> to go on the medication, it would be preferable

for me to go on lamuvidine

> and not interferon since it does work on asian

people. Do you know how true

> that comment he made?



Yes, it does work wonderfully in Asians patients.

For  some American Docs, being of Asian lineage

may mean, like an excuse for not offering you a

particular kind of treatment. Not true, even if

you are precore mutant ( E antigen -ve) , you can

do well with IFN.



Dr Sharat C Misra MD,DM, FACG

























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