Hello and thank you for submitting your question.

Your question is a very good one and I will work on providing you with some good information and recommendations regarding what is going on.


Regarding your blood test. It is certainly possible that a mildly decrease in the RBC account is within acceptable limits. I would really have to see the absolute numbers in order to make real comments. Also regarding your platelets this is something that I would also like to evaluate based on previewing your report.

What I would recommend is that you attach a copy of the report and send it to me via e-mail at the following address: YYYY@YYYY to my attention.

When I review the results I will be able to give you a more firm recommendation regarding appropriate follow up. I appreciate your question and hope you find my response to be helpful and informative. I wait your reply.

Sincerely,

Dr. Galamaga

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Hello and thanks for the followup.

I apologize for taking a long time to reply to you. I did not realize that you have hepatitis C. This is important information to know when considering what to do about these blood tests.

Regarding your blood counts, your hemoglobin is normal - no sign of anemia. You have a slightly diminished total white blood cell count which presents no danger to you at all. Your platelets are low but not in a range that would provide an elevated risk of spontaneous bleeding. The reason the platelets are low is likely from the liver disease you have going on. This chronic level of disease causes the lifespan of your platelets to be shorter than usual which is why the count is diminished. Treating the liver disease would result in improvement of the platelets.

If you have HepC Interferon is the only widely accepted treatment which potentially offers a curative outcome. I recommend you proceed with therapy if your gastroenterologist recommends it. There are simply no other therapies available that have been proven to be effective. Using interferon will not guarantee a cure but it will give you a chance to cure this viral disease.

I am not sure the question you have about your mouth. You indicated that someone recommended steroids for your mouth. Can you please give me some detailed history about your mouth and what has been tried for the issue you have going on there?

Thanks again for the query. I hope we can get to a point where we provide you an adequate and helpful recommendation for working on optimizing your health.

Sincerely,

Dr. Galamaga

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Hello and thank you for your follow-up question.

I also thank you for providing background information regarding your medical history and professional status. I completely respect where you are coming from regarding this situation and I want to provide you with helpful information.

Regarding the steroid rents, this will not provide any negative effects on your liver. It does not cause liver damage. If the steroid rinse controls the Lichen planus, I recommend you continue using that as directed by your physician.

Regarding the hepatitis C, honestly there is no good therapy for this other than the Interferon which is available. There are new formulations of interferon which might be more tolerable for you and you will need to discuss this with your symptoms is severe depression which can really hamper your ability to complete therapy and function on a daily basis. This is especially challenging for someone such as yourself who is extremely high functioning.

I am sorry, I have no other alternative to offer regarding treatment of the hepatitis C. I encourage you to reconsider fulfilling a full treatment regimen and discuss this with your primary care doctor and the liver expert.

Again I hope this is been a helpful experience for you. I am certainly available for you if you have any additional questions. If you would like I could also refer this to one of our specialists in the field of gastroenterology.

Regards.

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