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    How to detect hepatitis and is it advisable to take panel test? Will my son get neck pain after sleeping on high pillow?

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Posted on Tue, 21 Jan 2014 in Medicines and Side Effects
Question: Dear Doctor: My husband pass away last month due to liver cancer with 7 weeks. Its was a horrible nightmare. Please let our family know the best way to detect Hepatisis A, B, and C. so each of us can be safe and sound? Is it advisable to do blood work for Hep. panel every year or in six months time? I myself have enlarged goiter on my right neck for 5 years, the size has been stable and Dr. advised me to see them yearly for regular check up. My blood work is normal for TSH and therefore never been put on medication. Please advise the best way to prevent the goiter to grow bigger which will eventually prevent me from swallowing and breathing like a regular person ? My son aged 19 likes to sleep on high pillow and I am afraid he will get neck or back bone pain eventually, please advise me with some medical knowledge so that I can explain to him in a more professional manner. Its seems he never trust me in this issue and I have no clue how to tell him. My heart hurts when I see him sleeping in this position. Thanks a lot for answering me and Merry Christmas to u all. Regards
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Answered by Dr. Jorge Brenes-Salazar 41 minutes later
Brief Answer: Answers below Detailed Answer: Dear XXXXXXX Merry Xmas. Sorry about your loss. Let me address each one of your individual questions: 1) Hepatitis: the best screening method would be a one time serology for Hep A, Hep B surface antigen and antibody and Hep C antibody. There is no vaccine for Hep C, so if the Hep A and B Ab are negative, vaccination is recommended. Unless you engage in very risky sexual behavior or intravenous drug use, regular screening for Hep B is not indicated after vaccination. 2) Goiter: the best thing is to keep monitoring your TSH, and maintain a normal iodine intake, not too much, for example, it is contained in higher concentrations in seafood 3) Pillow: indeed, a poor posture at sleep can contribute to degenerative disease of the spine and chronic neck pain; ask him to experiment with other smaller pillows, or no pillows, and keep a log of his sleep satisfaction that way. Hope this helps, wish you the best, Dr Brenes-Salazar MD Mayo Clinic MN
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Jorge Brenes-Salazar 2 days later
Hi Dr. Brenes, Thanks for your prompt reply. The following are some follow up questions: I myself have acquired antibody of Hepatitis B since I married to my deceased husband for over 30 years. Do I need to have extra boost up for injection, or are those antibody for life ? It there a chance that my daughter and son, 24 and 19 will inherit Hepatitis B from the Dad since both the 2 brothers of the dad has bad liver too. Maybe their grandfather have a bad DNA regarding this I suppose. Only the boys in the family are more likely to have this bad thing. Can I ask what is anti-hav*hav means? The result for this is "positive" so what does it mean? Do I need to do anything for my son? Is it advisable to do a Hep Panel every year since Hep B and C has no sign of telling you if u are infected or not? If we use condom for sexual course, is there a chance of infecting Hep B and C too? Thanks for your concern. Regards Anne Lam Hui
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Answered by Dr. Jorge Brenes-Salazar 1 hour later
Brief Answer: See below Detailed Answer: Dear XXXXXXX Thanks for the concise follow up questions 1) If you have Hep B antibodies, those are for life. 2) Hep B can only be transmitted by the mother in utero through the placenta or labor. If you did not have Hep B during pregnancy, there is no way they would have contracted it as babies 3) Anti HAV Ab means positive for Hep A antibodies, meaning that the person is immune for life against Hep A 4) Again, unless you engage in new risky behavior after last check up, such as blood transfusions in a third world country, IV drug use, new sexual partners without protection, then there is no need for yearly screening. Condoms dramatically decrease the chances of acquiring Hep B and C Wish you the very best, Dr Brenes-Salazar MD Mayo Clinic MN
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Jorge Brenes-Salazar 11 hours later
Hi Dr Brenes It is advisable to have paracentesis done when patient weight 216 lbs which the body weight is only 170 lbs. And how often can this be done to release the body fluid in the abdomen ? Is there anything related with internal bleeding in this issue? Since protein found in meat and bean can both increase growth of cancer cell and normal good cell, is it advisable to decrease intake of protein food to inhibit cancer cell to grow any faster before doing and Chemotherapy? If a cancer person involve in vigorous exercise twice a week and over 2 hrs each time, which type of cell will grow faster ? Cancer cell or normal good cell ? Or they grow both at the same speed together. And if the cancer person is eating meat, especially beef in huge amount, which makes the body more acidic will the cancer cell even grow faster. Since cancer cell will like to multiply a lot in an acidic atmosphere rather than alkaline environment. Can a stage IV liver cancer patient can prolong his life after a liver transplant ? If he is luck to have a chance ? How about if there is multi mass inside both liver ? 3 on right side and 2 on the left liver ? Can huge dose of Vitiman C inject through IV prolong the life of cancer people and at the same time release some of their pain ? Since if they put continuous morphine to avoid pain for cancer patient, they will go unconscious until they die ? Thanks a lot for answering me all these questions. Regards XXXX
doctor
Answered by Dr. Jorge Brenes-Salazar 21 hours later
Brief Answer: See below Detailed Answer: XXXXXXX Thanks for the queries. 1) Paracentesis should be done only when ascites cannot be controlled with diuretics and salt restrictions. Usually, up to 5 L can be removed; there are many risks with the procedure, including infection and renal failure 2) Actually a normal protein diet is advisable to keep the body well nourished prior to chemo 3) Usually exercise will not interfere with the metabolism of the cancer, so regular physical activity is still advisable. A normal consumption of red meat, such as 2 servings per week, is advisable 4) A Stage 4 liver cancer patient is not a candidate for transplant 5) Vitamin C will neither prolong life or help with pain. Indeed, at some point the narcotics may hasten death, but it is a death with less discomfort and pain, including air hunger from increased ascites and difficulty breathing. Wish you the best, Happy New Year
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Jorge Brenes-Salazar

Cardiologist

Practicing since :2007

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