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Post - Tx Long Term Problems

It was requested that I re-post this. Are there others with this experience out there? ALL my doctors cannot seem to give me any answers!


micro2
06/26/2006
C23  . Hello All, I have not checked in here for months and this is just the topic I am intersted in. I am 2years post tx wchronic fatugue syndrome,fibromyalgia, neuropathy, extreme depression and mental fog. I am unable to work and collecting ssdi. I am still looking for that truck that hit me!!I treated for 19 months and did not kill the virus. I spend my time trying to make sense out of the person this tx left behind. Thanks, michael
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1130586 tn?1316266292
Welcome to MH !

I'd like to point out this thread is from 2006 ...

Maybe you would like to start a new thread or join one that is focused on the trial you are in ?

Cheers
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Avatar universal
I'm reading your words here and thought WOW! how does this person know exactly how I feel! I have been in treatment for 9 mts now,  I have 15 weeks left. I started reading all the messages of how other people are going through and  feel exactly what I go through. It is a very harsh tx. At first  maybe I just being a week person. loss of concentration,anxity, fituge, nausea, stiff neck, constant ache, loss of interest at times, shortness breath, ringing in ear, taking tome off of workbutto finish tx.On the good side, I pull myself through each day, stay positive, keep busy with projects etc. On good days I take advantage of it and Bad Days just rest. Getting toucher the futher I get into tx.  My tx is sponsorecd thru reasearch study the 1st 12 weeks I was on a study drug and standard care Interferon, ribavirin now just pegs and ribaviron,  and Procrit to keep my hemoglobin up. It is taken a toll on my body, Just wanted to see if there was a website to talk about this tx. and the side effects Thanks for listening.
Victoria
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Avatar universal
how can anyone argue with the fact that those who feel the need to express how they believe tx affected them physically and mentally, should not feel free to do so? They should by all means. Having said that, if others feel the need to balance a series of post tx comments and post tx issues by posting references to medical data that states it is not a high percentage of people suffering those symptoms, if they can back it up with medical articles, studies and related arguments, they should feel free to do so also, without anyone  accusing them of trivializing, minimizing and dismissing their personal suffering. As stated some time ago, support comes in many forms and trying to present as many facts relating to hcv and tx, so that we can make informed decissions is one way.
  By presenting relevant data and published articles, some of us are not saying, "so what if you are suffering?, it does not happen to too many folks, so is not that important to mention it" At least in my case, when I present a point that might be in opposition to one about ongoing issues, it is to alert those who might not have read or come accross what is out there on tx conditions, and perhaps balance the feeling that this is happening to the majority on tx. We might have the right to say that we believe it is happening to 90% of people, but that does not make it correct, and a reader could go away with a distorted conclusion. You should say what ever theories and guesses come to you, but please allow for opposing facts to be presented without you feeling dismissed.
I might not say it often, but I feel bad for those who are facing qol issues that might have derived from their desire to rid themselves of this infectious agent. How severe the impact is on qol, might be as individual as the perception of pain.
As much as I can, I will, (not contradict that anyone's belief that their post tx symptoms were caused by it because if that is what the person feels is true, I can't prove otherwise), but present articles and publications that might shed some light as to whether the belief that it happens in a large majority is possible and whether all the conditions attributed to tx are indeed only due to tx.
A balance bt information gathered from our drs and internet reputable sites appeals to me the most.
I don't agree that the medical community is not recognizing the effects of tx. By acknowledging them in the product information, and most of what is mentioned here has been listed, they might be alerting the consumer to the possibility that those conditions might not clear completely after tx.
During my search for specific conditions triggered by interferon(and you can search any condition's name + inf and get articles on long term outcome) I found the following one on thyroid problems. I admit I have been getting the feeling that blown thyroids are very common based on what I read here, but this is the kind of thing we have been debating recently, reality is a different matter. We might 'feel' that is happening everwhere, but reality says maybe not:
http://jcem.endojournals.org/cgi/content/full/89/8/3656
from the above:
"In addition to constitutional and treatment-related factors, the risk of developing thyroid dysfunction during IFN therapy is closely correlated with PREEXISTING thyroid antibodies. A metaanalysis of the literature by Koh et al. showed that about 50% of patients with positive thyroperoxidase antibodies (TPOAbs) before IFN treatment developed thyroid dysfunction in comparison with 5.4% in antibody-negative patients (37). The relative risk to develop thyroid dysfunction, mainly hypothyroidism, is 2- to 14-fold higher in patients with preexisting positive TPOAbs, compared with patients with negative antibodies (25, 64, 65)."
How many of us get antithyroid antibodies testing prior to tx? would it make a difference if we were positive for them? would we still tx?
I encourage people to get as many baseline tests as possible, in addition to read about side effects on boards, and do their own research on side effects and its prevalence.
here is another site found, it lists conditions and the percentage present on tx, I find it hard to believe that if 30% suffer a particular condition while on tx, that post tx 90% will suffer from it. I would have to assume that the same percentage or less would be left with the condition post tx.
http://www.hepatitis.va.gov/vahep?page=tp06-cs-01#t-1

If you look, you can find enough information to make a good guess as to how many suffer from particular situation post tx. Of course, new conditions might be harder to research and compare.
Let's feel free to speak about our post tx issues, whether present or absent, but allow for medical literature to contradict some of the speculation we are engaging in. We can accept it or dismiss it, after reading.


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Avatar universal
You guys 'said it all' on this thread.  All of the issues around what to say or not to say, and how to deal with post-tx problems, how to conduct one's self on the forum, what people need to hear about from us, etc. are all summed up wisely and honestly in your responses.  

I have to believe that this forum is a 'mini cross-section' of the general HCV and tx population out there, and that the issues we hear about on this forum represent a 'typical' slice of what the general HCV population experiences.  Since most people come to the forum BEFORE beginning tx, there is no chance of 'skewed' or biased commentaries, or of having a population consisting chiefly of those who develop tx problems....because, when coming here, nobody really knows WHAT their experience will turn out to be.

If doctors are finding a big group of people to treat, who almost NEVER develop any post-tx problems, then I would LOVE to know who the heck these people are!!!!!  Because, this board is open, democratic, and probably utilized by the same cross-section of HCV patients as those that the doctors see.  Where in the world are they finding all these wonderfully cured, problem-free, happy-go-luck tx'ers?  Because, maybe we should all have gone to those doctors!!!!  OOPS, I forgot, I did go to one of those doctors.
I sure would love to personally interview all the patients who have done the tx!  Might just get a little different perspective than that held by the doctors.  Just my guess!

Anyway, thanks for making very clear what we are trying to accomplish, and why it is the right way to go.  I truly think that the 'fear mongers' are in the OTHER camp, in that they seem to truly FEAR honest commentaries, and anything that might contradict what they probably 'wish' to be true.  The people who wish to 'censor' personal commentary often come armed with nothing more than quotes like: "a bunch of doctors say...." etc.  Very little in the way of scientific studies, hard researched numbers, etc.

I personally enjoy hearing everyones' experiences, and realizing that there are a multitude of differing patient reactions, sx, pre-tx problems, post-tx problems, and attitudes about therapy.
What we do not need to hear is people saying 'don't talk about THAT, you are in the minority....your experiences are not true.....you are making people nervous...'etc, etc.

This is a FORUM, and what it asks for is PERSONAL insights, and experiences.  

Thanks for your clarity, and strength of opinion!!!!

DoubleDose
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Avatar universal
by all means, let's be concerned with what afflict us personally since we are the ones that have to live with it. but no man  is an island and what might not be of interest to one, it might be to another.
make things available for all to read  and let them assess what is important to their situation, and skip readings  that lacks relevance in your status quo.
allow for those with a Mother Theresa complex to express their concern for the other  group without making them feel that they are not worthy enough to do so.
I guess we will continue expressing what we feel is important, and hope that no one will jump at us because they are taking the post personally or it is of no consequence to them how things started. but things don't get posted here by others  because we have  considered them  relevant, sometimes it is not about me only.
as mad as we can get at each others postings, things are at least, civil, for now.
be well
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Avatar universal
First, to Beamish and anyone else who took me at face value about the priapic problem:  It was a bad attempt at levity, a false alarm, a silly joke.  Sorry!  

Rev, you just said it all, and I  am tempted to let you speak for me.  But Cuteus has asked for clarification about why we would even bother to relay our subjective impressions about the after-effects of treatment, so here go some thoughts on that subject.

Why?  Well, to create awareness within the medical community, to alert clinicians to potential problems so that they can provide better followup.  Simply that.

Jim observed that it is the results of double-blind trials, and not random impressions or anecdotes, which create medical "facts," and that it is these medical facts which eventually dictate protocol.  I couldn't agree more.  But without an atmosphere of urgency, those trials would never exist in the first place.  Most frequently the motivating "urgency" is financial, as we all know.  But there have been instances when patient activism has called attention to problems within the patient population, and that has served as incentive to research and improved health care delivery.  Where there's smoke, there's fire.  And besides, there are already reporting systems in place that need to be better utilized.  The FDA maintains a storehouse of data on all the drugs it has approved, so isn't it our job as concerned patients to make sure that our experiences with those drugs are reported as hard data & entered into a national data base?

If I have a personal agenda, it's based on having been allowed to slip through the cracks more than a few times.  In 1990, in fact, I woke up one morning in my fifth month of interferon and nearly slipped into coma.  The next few hours were truly hair raising, as I struggled to maintain consciousness and keep myself breathing.  I had been without thyroid function for some time--that become obvious in retrospect.  But my hepatologist--a heavy hitter in the field--did not test thyroid levels and had resolutely ignored my glaring physical symptoms.   There were already a few published reports out there pointing to the connection between interferon use and the development of Hasimoto's, but interferon was still basically being used experimentally on hepatitis patient--I started tx one month after approval-- and current safeguards were not yet in place.  

My experience caused a change in protocol in that practice:  from that point on they began testing thyroid levels.  And word went out on the MD grapevine.

This time around I developed neuropathy around month 6 of tx.  A year and a half later someone bothered to test for B12, and it was found that I was completely deficient.  If only someone had bothered to run a simple test while I was on tx!   And to make matters worse, the same thing happened to two other treating patients in that particular practice.  Someone clearly was not paying attention to this data on a small scale.  And what about the larger scale?   All I am saying is how can we contribute to filling in that larger picture, if doing so can eliminate any one instance of unnecessary suffering?



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Avatar universal
overtime, the board changes its mood and the ones that can't relate to the present mood, will stay away and become reluctant to post their concerns. When the board did not foster post tx issues to be discussed, people felt alienated and retreated to lurking instead, then when it becomes saturated with conversations of post tx problems, those who can't relate are faced with the same feelings of alienation, and some might stay away for good, and others will lurk until the mood changes again.
from time to time, some of those who can't relate to lingering post tx issues will visit and remind the board that we all don't face ongoing conditions due to tx, that there is light at the end of tx for many if not most. I remember one woman who came back to let us know how well she was doing post tx, and how much stronger she was than the guys in her unit(she was in construction and in her 50's), her post left me in awe, and I wanted to be like her post tx! I wish I would have saved her post, but I did save this one:
"deb3
(06-Jun-04) . Hi
Its been a long time since I've been here- I finished a years treatment- peg-intron and riba- in Dec 2002, 1b and still clear!
I had every side effect listed--except the good one-weight loss! I was in my 2nd, 3rd and 4th semester of lawschool then-I know this now because I'm still there, hardly any memory of it though. The side effects were brutal, my thick waist legnth hair nearly all fell out or broke off, I cried through my classes, wept with fatigue and depression, had numerous experiences where I'd realize I had know idea where I was or how I got there--more crying then. And I don't even want to think about the excruitating headaches.
But NOW, my hair is back, thicker and shinier than ever, my skin is great, and I have strength and energy I haven't had for at least 15 yrs (I'm 52.) For so many years I had terrible joint pains, depression, unexplained fevers and fatigue and constant headaches. (I guess the docs have begun to realize that HepC DOES have symptoms or related problems before advanced liver disease sets in--the immune system is so overtaxed by dealing with the dragon)My memory is back and better than ever.
It is so worth it to have put up with the tx!!! Don't give up--fight to get procrit if you have to, go with the mood 'swings' and beg forgiveness later. Just do whatever to get through it--anti-depressants, painkillers, ritalin, sleeping pills, muscle relaxers. Don't let your dr, like mine, tell you that you just have to 'put up with the sides or quit the tx'--make them help you or find someone who will.
Stay with the forum for support
Debra "
and this one

I was a 1B, did 48 wks tx, starting VL was 596,000; VL at 12 wks was 370 and undetectable at 24 wks. Still clear at 1 year post.

My doc had explained that 1's start with a 50% chance of SVR; if a 2-log drop or more at 12 wks, then chances increased to 60%. Undetectable at 24 wks, chances increased to 70%. Still undetectable at end of tx, chances increase to 80%. And darn near 100% if clear 6-month post. My doc only does the end of tx PCR and 6-month PCR (many dr's do a 3-month post PCR) so I talked her into waiting til 1-month post rather than testing right at end of tx just to give me a better feeling that I would stay clear. I'm not sure where she got the figures from but I liked the idea of increasing my chances as my tx progressed.
Good luck to you and may you have a Happy Thanksgiving.
Lynne"

what if the collection of post tx data actually confirmed that the percentage of issues was actually low rather than more as we are implying? it could go both ways.
Most of the post tx issues are mentioned in the insert literature as possible side effects of tx, it might not say that they might linger post tx, but I think we can safely infer that  it could happen, and weigh in  that information while deciding on tx. It is not like the medical community does not think it can't possibly happen. If it can happen while on tx, it can remain after tx for some. What are we trying to find out, the percentage of actual cases? would that make a big difference? Those that want to treat will do so whether the effects  happen to 10% or 80%, even if their liver damage is mild. They will go for the meds regardless. I read the inserts many times, the list of possibles scare the heck out of me, but people like the posters above alerted me to the fact that it doesn't always happen. Bless them for also dropping by, to add another view to the tx picture.

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86075 tn?1238115091
hey, don't know nothin about no priapic whatever, ha ha! Or at least I used to! Hey, always enjoy reading you, you have a kind of Jack Kerouac style as you go through treatment, well, at least to me! hope you feel better soon, be well!!!!
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Avatar universal
Let's have a moment of silence, please.   Other people's litigious behavior, whether actual or potential,  is of no interest to me, nor is it my responsibility.  The last thing I want to do here is offer up my painful past history as fodder for further argument.  Support forum, anyone?
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Avatar universal
"But Cuteus has asked for clarification about why we would even bother to relay our subjective impressions about the after-effects of treatment, so here go some thoughts"

that is not what I typed or inferred. I was wondering what difference would it make whether it is a small or a large percentage suffering a particular issue, if someone wants to treat regardless, but I am glad you posted your why, because I was wondering that also, reasons why folks post these issues, because there seem to be several, from wanting sympathy to urge the medical community to rush more effective, gentler treatments.

But once we have accomplished this, the drug companies and drs are informing the world that there is long term severe effects happening to a large sect of the population(this is hypothetical) and neuropathy can be rampant(again hypothesis) what then? are we looking for them to just inform all their patients so that they can be well informed when making a tx decission, are we wanting them to warn of severe conditions and spur research on tx for these conditions, or a cure(even though things like neuropathy don't seem to have a cure regardless of the cause)? If I am a Dr and give my pt the product information, and tell them that some might experience these post tx, what else do we want them to do? What might happen is the same thing as with Vioxx, lawyers will jump at the sight of lawsuits for tx induced conditions, drug companies pay millions in settlement, pull the drug off the market because it is not worth more lawsuits and hep c infected will have a harder time at choosing tx, unless they are at ESLD. Why couldn't the manufacturer of Vioxx just add the possibility of cardiac events to their inserts and allow for consumers to decide whether they would risk it? because they did not want to create new sources of litigation in newly affected patients. Does anyone not see this happening to hep c drugs, should the manufacturer ever step up and say "our drugs are causing your myalgia or neuropathy'? Why isn't it enough that they acknowledge it in the inserts?
Does anyone really think that lawsuits will not sprout left and right, thus jeopardizing the freedom to chose hep c tx? I can see this easily happening in this country.
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Avatar universal
I am a boogerman and the devil's own advocate!!~good thots from All;i want to know about everyones 'condition' durin & afterTRX...cuteus helpesd me feel good about my present need for pain meds-i don't believe i could have managed longterm trx w/out 'helper meds"...my body is doin some strange things in this my 35 week of Peg/Riba-i greatly appreciate findin confirmation...simpatico helps..we are isolated or feel such,w/ this virus-sharing  'war' storys and comparing 'battle' scars really helps Me to deal w/ trx issues...That said,everyone's med decisions,health issues and reactions are personal-just glad that they aren't private..........My joint pain seemed to subside 1st month  of trx-Now it's back w/ a vengance..!!! but hey,i am killing virus.......
Now,Califia-i gotta good inkling what priapism is& what part of my anatomy would be affected,but please post me All the bads news,or a link if yu must..THANKS
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Avatar universal
I think that all we really need to do on the forum is to honestly relate our experiences of being on tx and life after tx.  We all have somewhat different stories to tell and outcomes unfolding.  But, I really do NOT like anyone telling me, or anyone else, that they should not tell the truth because it might 'frighten' someone, or make a 'newbie' too nervous to do treatment.  
We all try to give an honest, and objective account of our experience, and point of view.  I think THAT is plenty sufficient.  The FACT IS that many people do seem do experience problems after tx that they did NOT have before tx.  That is not so 'frightening', or surprising to most people who have read anything at all about interferon, how it works, and what it can do.  I really dislike being contradicted when it comes to relating my own personal experience, and describing what my post-tx problems involve.  It would be the same as me saying that those who do not suffer post-tx problems must be imagining things, or are not bright enough to understand that they do have problems.  But I do not think that we are trying to say that.  I do believe that many people do the tx and do not experience lasting after-effects.  I have no problem with that information.  What I do NOT want to hear is that I must be mistaken about my own personal experience, or that I should 'keep quiet' because I might be the 'boogie man'.

We all need to just 'tell it like it is' for each of us.  The good, the bad, and the ugly.  How else will we find out the real truth about HCV, tx, and everything else related.  No muzzles please!

Thanks for respecting all of our points of view.  And, by the way, we will ALL help the 'newbies' make their way through tx.
That is why many of us stay on the forum after clearing!

I fully agree with many who have posted on this thread, and just as strongly disagree with some others.  That is how 'opinion' works.

DoubleDose
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Avatar universal
I appreciate your clarification.  Frankly, I haven't been here continuously and know nothing about the dogfight to which you refer--was merely reading what you wrote and excised a part that I thought fairly represented the whole of what you were saying.
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Avatar universal
I am not going to go round and round on this anymore, as far as it has been established by the medical community post tx issues are in fact "rare" or "uncommon" and no evidence presented by you or anyone else disproves that at this point other than antecdotal experience, dotors view it as a rare occurance. A group of people's experiences on the internet does not a fact make. Doctors need facts. No data, no facts. No facts, no answers, no answers, no help for the sufferer. You think they are rampant, I think they are rare. Leave it at that.
The rarity of a situation is irrelevant to the sufferer, it doesnt lessen your suffering, it only makes you feel as if others are discounting your problems, that is not what I am saying. Judging by the number of people who check in here on a regular basis to say how great they feel,clearly many go on post tx without these issues. If we go by antecdotal evidence for negative post tx issues, we should balance that with antecdotal evidence of positive post tx experience of those who stop by to say how GOOD they feel and how grand life is post tx and there have been lots of them. What about  ALL the people that feel good that do not ever come back, their experience has to be accounted for also in the equation. If you are having problems post tx, you are more likely to come to a place like this to find answers so it skews the view.
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Avatar universal
Speaking of post tx issues, what is going on with your stomach problems - as I recall you stopped the proton pump drugs and went with lifestyle changes.  I developed some pretty nasty stomach problems on tx and they are continuing 5 weeks post tx.  I really dont like the proton pump drugs.  How are you doing without them?
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Avatar universal
That is soo true that to the person suffering the conditions it really doesnt matter when they started, but it does matter when trying to figure out what role tx plays in it. Preexisting conditions and having had Hep C or long periods do factor into the equation. It is noted in the meds. literature that the tx can cause existing conditions to flare or increase but it is not noted that you can suffer from long term issues due to the tx. To me, that is the issue, that patients need to be warned and made aware if they can end up with long term issues if it is true they are due to tx when making their decision and evaluating the risks. With  no studies to go by, it hasn't been established by the med. community that they are related to tx so the patient can be fully and properly informed before hand.
Clearly studies need to be done so that can be established or refuted.
I think it is a problems with MANY drugs approved by the FDA. Vioxx is a good case in point. These Hep C drugs have been around quite awhile now so it seems to me these studies should have been done by now as they have large pools of patients that txed to learn from.
I hope you get some relief soon, sorry you are going thru this.
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Avatar universal
AMEN to Jim's post.  

Me, I'm the neuropathy kid with constantly buzzing, throbbing, tingling feet and hands.  I'm also very prone to severe spasms in those parts, many of which like to occur in the middle of the night, casuing me to do my little St. Vitus dance routine.  A little annoying, especially for the two other creatures I share a bed with.  (Me, I'm resigned to it and hope it will abate at some indefinite point in the future.)   Anyway, let's just say I'm in a chronic pain state, but I'll take it any day over fun with dermatology.

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Avatar universal
Just a quick response to your "if it is true" qualification as to the veracity of reports about post-tx conditions.  (Our posts crossed.)  You know, in the medical community, good practitioners rely to a great degree on anecdotal information, and that information is already there in abundance.  For example, the head of Neurology for Northern California Kaiser agrees with me that my neuropathy is interferon induced.  He also reports that the literature shows this happening to a hapless 1% of interferon consumers.  Does he take that low figure as gospel truth?  No, he does not.  It is his strong impression from clinical practice--not from reading the existing medical literature--that this figure should be much higher.  As he lamented to me, the reporting mechanism are just not in place.  Current documentation is piecemeal, to say the least.
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Avatar universal
Kalio: That is soo true that to the person suffering the conditions it really doesnt matter when they started, but it does matter when trying to figure out what role tx plays in it.
---------------------
Maybe I wasn't clear enough but of course it matters when trying to figure out the role treatment plays and that was my point, at least in any practical sense to the patient.

If treatment flares or bring's out an underlying condition that persists after treatment, possibly permanently, then what is the difference from the patient's point of view? If you're making a technical argument OK, but I see no difference between the two when it comes to someone factoring in the possiblity of long term side effects into risk/reward equation for a treat or not to treat equation.

Having said that, many report persistent side effects that were NOT pre-existing. So what is your response here? The literature doesn't say this. C'mon. I think Rev put it very well in another thread:

"I've yet to "meet" a person that doesn't have problems post-treatment, directly due to the combination of peginterferon and ribavirin. Long term studies on the subject are scarce, if any exist at all. We don't need them to know these things are happening with our bodies/minds post-treatment. The validation comes from the people on these forums. Remember the words "believe the children"?"

Now how we factor all this into a treat or not to treat decision is an entirely different matter and two people can agree on the same data regarding side effects and legitimately come to different conclusions. But to say that persistent post-treatment side effects are "rare" as you have in the past, just doesn't seem to fit in with the many experiences documented here.

-- Jim
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Avatar universal
That's Zantac, not Xanax above, although maybe I should have taken both :)
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86075 tn?1238115091
very nicely worded post, I'm just hoping that youre skin problems will be significantly better soon, I know youre thumpingly bored with them by now, but I'm confident that they will be better in, let's hope, the not too distant future...
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Avatar universal
Prior to Tx I only had mild fatigue. Funny.. my primary doc admits that I am not the same person that I was prior to Tx. I am...truly changed. I am not necessarily a worse person (other than physical)...I am a different person..and thats who I am trying to live with. thanks, Michael
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Avatar universal
One more thing:  And so what only 1 in 3000 male geno 1's become confined to their homes with interferon-induced priapism?  I mean, who better to bring that story to than US?
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Avatar universal
To take out of context part of what I said and quote it is a bit misleading. Without proper studies we can ONLY go by antedotal evidence and we need more than that to get doctors to address the issues and to warn patients and help them post tx. To establish a medical "truth" you have to have more than antecdotal evidence as I am sure you know. My doc also agrees it does happen but so what, that doesnt help one of the people suffering! I am NOT saying patients complaints aren't real (as taking just " if it is true" insinuates out of what I said) at all, but doctors often IGNORE patients when there is only antecdotal evidence and no medical factual basis ie medical "truths" to back up their complaints. As we see from those going thru it, doctors often tell patients either their complaints are not related to tx or tell them it is in their head or caused by unknown reasons because there is nothing being done to collect data. Without studies we do not know for a fact if tx is the cause or having hep c is the cause or oxygen deprivation during tx is the cause or some other mechanism of tx is the cause or what it is caused by, even though it seems obvious it is caused by something having to do with tx, many doctors want established facts before they will address it and treat it and make that connection. This is why so many patients are under or improperly treated or ignored for these problems in my opinion.

People need a bad guy in this dogfight and I am sick of being painted as someone who doesn't believe the complaints are true in this forum. If you want to blame someone blame the doctors and researchers. Same goes for the "supplements are beneficial" argument, maybe they are, we need clinical facts to back that up, the sooner the better because if it can be established they work, it will give people options.
It needs to be studied before we know for A MEDICAL FACT that tx is the cause and I can't personally do anything about the fact nothing is being done.
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Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.