Continuation of below post about anemia

[prettydamscared]

Apparently low hemoglobin can be caused by various factors?  One would be low iron/ferritin levels and another would be anemia brought on by the ribavirin and/or possibly peg?  So, is it safe to say that there are two basic causes for anemia during treatment.  If one does have low iron/ferritin levels then taking iron pills would be beneficial for such a person?  If anemia is brought about by the usual combo treatment, then iron pills would be contraindicated?

I am completely guessing here and have not ever seen her labs.  She, at this point, does not actually have copies of her labs which I know would probably help.

Am I on the right tract here?  If anyone can shed any light on this, we'd both very much appreciate it.

I'd like to add that she does seem to have an extremely "busy" and high profile study doctor who hasn't fully answered these questions for her.  In my very humble opinion, she has gotten some odd and questionable responses to specific questions.  So, in cases like this where one feels they don't quite know what to make of their doc's responses or lack thereof, we come to this trusted source (knowing that none of us are doctors, of course)  If anyone can help shed some light on this, we'd both very much appreciate it.

Thank you in advance from the Bobbsey twins

[jmjm530]

On re-reading, I see my last post was not addressing what you seemed to be referring to. But yes, I often wondered if I "quizzed" my doctor in the middle of an exam as to my gentotype, stage, treatment history, etc, how good he would score. Never had the guts to do so and plus it probably saved me from being unnerved if/when he had to shuffle like real fast through his notes to find out. LOL.

[couldn't think of a nickname]

Yes, I was referring to how you asked your doctor questions. They do see a lot of patients, and are only human, so you leave less to chance by being more thorough like that IMHO.
Not trying to say its ok for a doc to be lax, but it is a way to cut down on misunderstandings.

[jmjm530]

It's reality, especially these days with 20 minutes or so per patient. If anyone has got to know your patient history COLD it's YOU. Nothing wrong in "prepping" your doctor each time in order to get beyond your knowledge base and what he has to offer.

[jmjm530]

If I had to choose between following what you describe as a "high-profile study doctor -- or advice given here -- especially on a pre-tx hgb issue --  I'd follow your study doctors advice. Ideally, however, you would independetly research out both, possibly getting a second consult with another hepatologist or hemotologist.

You say the doctor is "busy" and so was mine. Sometimes I found it useful to go back to my doctor with the same question, sort of organizing my history ahead of the visit and then summarizing it for him as I asked my question. It's unfortunate that they don't sit down and study your charts prior to your visit, but I'm sure a decent percent of them just rifle through it when they walk in the door. Mistakes can be made this way.

Good luck.

-- Jim

[jmjm530]

To clarify what I meant by the above, I might ask a typical question like this:

"Given the fact that I'm a 58 year old geno 1b with stage 3 damage and cleared at week six, do you think I should treat longer than 48 weeks or do you think that is enough".

In other words, I'm making sure he's aware of pertinent stats that relate to the question as opposed to assuming he knows my stats by heart or even is going to look them up. I always asked all my important questions this way.

[couldn't think of a nickname]

A very smart way of handling the situation. Something we should all keep in mind.

[jmjm530]

It's really taking a risk reading something in a discussion group like this and then taking action without doing some more independent research be it studies, articles, or consulting with your doctor or an outside consult. Especially if the advice is against what your doctor is telling you. I never did on anything important. In part, what groups like this are good for are to find out what everyone else is thinking and doing and using that as STARTING POINT, not an end point.

Never actually sat down with pencil and paper, but IMO about 50% of what you read here and in other groups is factually wrong. Now mind you, that also means that 50% is factually correct, which really is very good IF you take the time to separate the wheat from the chaff. If you don't, you're gambling more than you really should.

[couldn't think of a nickname]

A very smart way of handling the situation. Something we should all keep in mind.

[GrandOak]

As I understand it, various forms of chemo-therapies can produce chemically induced anemia.  For HCV, it is the Ribavirin which reduces the RBC/Hgb (anemia), while the IFN can reduce the WBC/ANC (neutropenia).

I've learned the lesson on Riba induced anemia the hard way, and am still battling that one to keep from becoming severely anemic by playing with Procrit dosages and frequency of injections.