doctor and patient conversation

doctor and patient conversation
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  • Hello Doctor, I am here for my yearly checkup.
  • Hello, My name is Dr. Logue. After doing an exam on you, I will go over the results of your blood work. It will tell me the status of your health conditions and treatments available.
  • James, I have your blood work results. It shows that your Hepatitis C has progressed into cirrhosis of the liver. Some of the risk factors you have are your IV drug use ,excessive alcohol consumption, and non- compliance with taking care your medications.
  • Wait, How did this happen? I don't understand how I got this? My war buddy said there is going to be a cure. Either a liver transplant or medication. Can I get either one of these to fix me?
  • Well James, Unfortunately you are unable to have both of these treatments. To qualify for a liver transplant, there are many things you would have to do. The first is to stop drinking as well stop your IV drug use.
  • I am devastated. Why can't I get the medication? I don't understand
  • According to a report called A Prospective Multi-center Study Of Eligibility For Antiviral Therapy among 4.084 U.S. Veterans with Chronic Hepatitis C Virus infection there is a list of qualifications that make a veteran eligible for Ribaviron or Interferon treatment. James, almost 70% of veterans that have hepatitis C don't qualify as candidates for this medical treatment. There are very strict criteria that you have to meet in order to qualify. The factors that disqualify you include your advanced liver disease,  mental health issues, substance abuse issues. age of greater than 50 as well as amount of sexual parters greater than 50. This study did not compare prognosis for individuals infected compared to those that are not infected with hepatits C. (No relative or attributable risk) Instead it looked at individuals that had Hepatitis C broke them into groups that did and did not have treatment. 
  • What can you do then? Is there anything you can do to help me? How am I going to be able to take care of myself?
  • James, there is a ton of new treatment that is being researched right now. I know you do not qualify for interfreron alfa and ribavirin therapy. There is such limited funding right now and you do not meet the qualifications. However, there is other research studies out there and we will find some way to try and help you. One option is to enroll you in some research and or give you supportive care for your signs and symptoms. Although we cannot cure you, we can try to slow the progression of your disease and make you comfortable. . 
  • Thank you for your help Dr. Logue. I appreciate you and your team helping me and discussing options with me. 
  • You're welcome James. I know this is hard news. However, my team and I will help you in anyway we can. 
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