EXACT triple therapy testing schedule - please help
I am trying to find out exactly when week 4 (etc) testing is done. For example, if I start triple incivek treatment on July 18, what is considered week 4 testing date? Need to coordinate start date with test result dates and insurance company authorizations.
Here's what my nurse told me to do. I did weekly labs at first.
Take a calendar. July 18th is a Wednesday, the following Tuesday put a circle on it with a one in the middle. That is week one. Continue doing this so the next Tuesday makes week 2, then 3. On week 4 I put a double circle, to do my monthly labs.
August 14 would be your 4 week lab.
She also had me put a triangle on shot days. So, you'd put one on the 18th and each Wednesday after.
It seems so simple but once you being treatment, little things like this and having a weekly pill box, really helps you to keep track.
P.S. keep drinking the coffee. That and vitamin D have been proven to help reach SVR.
I was told by my case manager that 4 weeks meant 4 full weeks of meds after starting treatment. Therefore, she said, to get 4 full weeks in, the lab had to be drawn on the morning of the 5th injection day. Otherwise you will be short a couple of doses of meds when you have your labs drawn (if you draw them on the 14th.
Now, it obviously seems like nit picking as to whether it is Aug. 14th or Aug. 15th, but, if your 4 week test comes back <43 but Detectable or <25 but Detectable, you may wish you had done the test after taking the full 28 days of meds. You don't want to do the test after doing only 27 days of meds plus only 1 (of the 3) doses on the 28th day. You want to have the lab drawn after a full 28 days of meds.
Remember, the 4 week lab determines if you can continue treatment and it also determines how long you will treat. If you come back <43 but Det. or <25 but Det., you will treat for 48 weeks instead of the 24 weeks. So, in my opinion, it is worth it to give yourself the full 28 days of treatment before having the lab tests done.
Since I was one of the people who came back <43 but Detectable at week 4, I was very glad I had the test after 4 full wees of meds. If I had had it drawn the day before I would never have known if I may have been UND at exactly 28 days, the full 4 weeks. I am doing 48 weeks.
OH ... I know you have a great and competent team. I think for you it may not have mattered. You were on SOC. But for those of us on Incivek, I think it does matter.
It is true that Wed. through Tue. is a full 7 days, but it is a full 7 days only after taking the last dose on Tuesday (which for Inc. would be around 10pm or 11pm. .
It is true that July 18th through August 14th adds up to 28 days. However, to get the full 28 days of meds, one either has to have the lab drawn at midnight, after taking the 84th dose of Inc. or one has to have it drawn the next am but before the 5th injection.
Maybe a couple of doses short would not matter, but if one is Detectable, it may matter.
I thought after I wrote this that to be a full week would be from the same time, i.e. doing the shot at 10 pm Wednesday and doing labs at 10 p.m the following Tuesday, which of course, is not what we do.
And you're right, I didn't do the triple whammy. Adding an extra day is probably better than going one short when it comes to viral loads.
My doctor told me basically what Pooh said.
My 24 weeks fell exactly on Thursday 28 June but my viral load was taken on Friday 29 June the morning before shot 25. I am not sure if quite that level of specificity is indicated in the Incivek literature but my doctor was involved in the trials so I have to think the idea had to come from some where. I know the guy wasn't this picky when I was on SOC.
Like OH said, my dr wants labs done before shot should they choose to adjust dose prior to next shot. My 4 week test included viral load test and was done 3 weeks 5 days, not 4 weeks. Luckily I was undetectable. If I had not then I would have been very upset after reading this and other threads.
Only way around this is to do 2 labs on week 4. If shot day is Friday and labs on following Wed, then do all 4 week labs except vl on wed and go back Fri for vl test. Yes, you can get picky and argue all you want about 10 o'clock in evening but is several hours really going to make a difference. Just get close as you can to be safe. You can always scream unfair and demand retest minute results are in. You just might get stuck paying the $700 for the extra vl test your insurance won't cover.
I would like to know how many people got tested in 26 days like me and were fine and how many did the 28. Is it dr. protocol or insurance? I know this, 24 is a lot easier than 48. I respect the 48s, I did that first tx.
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