We got some more information about the request for a new liver biopsy from Dr. Carl Berg. Here’s what Cindy sent us last week:
“Carl is hopeful she’s not going to need a liver transplant based on her normal coagulation studies, platelets, Liver Function Tests and CT scan. However, her liver biopsy is worrisome, based both on pathology and the gradient numbers (note from Cindy: “gradient numbers” reflect pressures inside the liver. Anya’s are high). He doesn’t fully believe the gradient numbers and wants her to undergo a repeat transjugular liver bx with wedge pressure measurements at inova.”
Basically, three of the four tests (coagulation studies & platelets, LFTs, CT Scan) came back mostly normal. One test (liver biopsy), did not.
When Anya had her first liver biopsy at Duke almost two months ago, they were supposed to go through the big vein in her neck (transjugular), but they couldn’t do it due to one reason or another, so they ended up either going through her pelvic area or her abdomen. We’re not really sure which one, since there were three different noticeable entry points on her. Anyways, the liver biopsy test showed irregular “gradient numbers”, which were of concern to Dr. Berg.
Dr. Berg asked us to come back down to Duke to see him on April 16th. He ordered a CT Scan to get some more clues. The CT Scan came back mostly normal. Here were the findings:
- No significant morphologic findings of cirrhosis and no definite suspicious liver lesions seen.
- No findings of portal hypertension.
- Prior bilateral lung transplantation with groundglass opacities and areas of bronchiectasis partially visualized at the lung bases.
The only thing of concern in the CT Scan was:
There is a questionable 3 mm subtle focus of hyperenhancement within the inferior liver (series 5, image 32) seen on the arterial phase images only.
Ultimately, based on all of the clues, Dr. Berg doesn’t fully believe the first liver biopsy, but it doesn’t mean that the test results are not accurate, which is why he ordered another one.
Dr. Berg made a call to Fairfax iNova and scheduled an appointment with their liver team for us. Our appointment is next week. We’re hopeful that they will schedule the liver biopsy shortly after the appointment. And we’re also hopeful that they gradient numbers will be better than the first one.
On a better note, Anya seems to be feeling much better now than she has in the past several months. She’s even been able to gain a little bit of weight. I think the pulmonary rehab (3 days a week) has really helped her get stronger and feel better. She still has a little bit of a cough that she can’t seem to get rid of, but it hasn’t gotten any worse, which is a good thing.
Anya told me that she walked a little over 1300 ft in 6 minutes at pulmonary rehab last week and only on 4 liters of oxygen. At Duke, two months ago, she walked a little over 1100 ft in 6 minutes with 8 liters of oxygen, so it’s definitely an improvement. Unfortunately, her pulmonary rehab stint ends next week. I’m not sure if it’s an insurance thing or a Fairfax hospital thing, but the 9-week program ends, and apparently, it cannot be renewed.
With that said, Anya’s gonna try to keep the rehab going at home. We’re working on getting a treadmill now. Luckily, my parents have one sitting at their house that we can borrow. I might even put our chubby dog, Remy, on it. 🙂