Latest CBC

[gauf]

Yikes, Things are going a little south here. Any thoughts from the lab gurus?


WBC 0.72 4.0-11.0 k/uL             L
  Repeated and verified. This result has been called to RH at OP by J. NAU
on 06.18.2008 at 16:26, and has been read back (Dr Bauman's office).
RBC 3.19 4.5-6.0 M/uL                L
Hemoglobin 10.1 13.5-17.5 g/dL   L
Hematocrit 32.9 40-52 %             L
MCV 103.1 80-100 fL                  H
MCH 31.7 27-34 pG  
MCHC 30.7 32-36 g/dL                L
RDW-CV 18.5 11.7-15.0 %           H
Platelet Count 43 150-400 k/uL      L
MPV 10.9 7.3-11.1 fL  
Neut% 40.0 40-70 %  
Abs Neut 0.29 1.8-7.7 K/uL             L
Lymph% 39.0 22-44 %  
Abs Lymph 0.28 1.0-4.0 k/uL          L
Mono% 12.0 0-7.0 % H
Abs Mono 0.09 0-0.8 K/uL  
Eosin% 2.0 0-4 %  
Abs Eosin 0.01 0-0.4 K/uL  
Baso% 1.0 0-1 %  
Abs Baso 0.01 0-0.2 K/uL  
Realym% 6.0  -  %  
Red Cell Morph Anisocytosis  -      
  Present
Slight
Polychromasia



"...Houston, this is 13, there is a lot of condensation on these switches....what's the story on the likelihood of some of these shorting out?"
"... This is Houston, we'll just have to take that one at a time Jack."
" ...roger that Houston, ..... this is like driving a toaster through a carwash......"

[medicmommy]

Dang, with those #'s I'll bet you feel like poo!  What week are you in?!? Hang in there sweetie....((((((((((((((((((((HUGZ))))))))))))))                             ~Melinda

[orleans]

Hey, Peg's in the fridge, Riba -n- Alinia's on the shelf, not looking forward to this but ya gotta do what blah blah etc. etc. ??what kind of lactoferrin you deside on?? jerry ps. are both lactoferrin and oxymatrine considered GRAS?

[gauf]

YOU? Betting on something off the SOC beaten path? Wonders never cease my friend. (grin)

[jmjm530]

Gauf: That's right Jim, we need you to put a square peg into a round hole"
-------------
Not as difficult as it sounds. Just reduce the size of the "Peg" until it fits into the hole, as you appear to be doing. BTW I just went long on a pharmaceutical sector fund based on your treatment war chest :)

Be well,

-- Jim

[gauf]

Yah, I am going to the standard dose of peg. 1 a week now. I hate to do it as I feel about the same on a single vs a double dose. I am happy that my platelets are holding. I started procrit so should stay ok on that. Hopefully by reducing the peg and increasing the oxymatrine (from 800 mg to 1200mg) and melatonin from 3 mg to 6 mg, may help the WBC. Now that I have cut back on the peg, started taking Lactoferrin 1 pill twice daily. Hope to give my immune system a boost for the transition.

"13 this is Houston, Jim we have kind of an unusual procedure for you"
" Copy that Houston...an unusual procedure?"
" That's right Jim, we need you to put a square peg into a round hole"
" kay"

[HectorSF]

Assuming you had your HCV RNA test done at the same lab so we are comparing apples with apples...I would guess that the reason your VL went up at week 8 was because you cut back on the peg at week 6.  (I understand you had to as your platelet count was getting too low (24k!)). Remember that your VL's response to treatment is mostly dependent on the action on the the peg. The Ribaviron's main action is to keep the virus from coming back. So given more time the peg should get rid of the remaining virus. So be sure to be compliant with your med dosing as you don't want to have the virus bouce back. Worst case, you are having a partitial response and need more peg to wipe out the remaining virus. Let's hope a new drug that raises platelet count comes to market soon. Many of us with cirrhosis and low platelet counts are caught in the middle when we try to treat we need enough interferon to kill the virus but without having to stop treatment because our platelet count gets too low because of the interferon.

It is great that you have dropped more than 2 log. Now let hope your VL become undetectable by week 12.

Best of luck.
Keep us informed.
Hector

[scoop49]

good luck in your fight
my cbc's are very similar to yours- 38 plate.3.05 red,10.6 hglb,32 crit,and nutro .5
im taking 300 nuprogen once a week and 1200 peg/inton plus 1000 ribivirin.

can you take a minute to explain when procrit is needed-i know it's for anemia-but don't know which results would indicate taking it.
my vl at start was 250k dropping to 55k in one month and now at week 8 is up slightly (60 or 70? not sure) so it's definitly getting sketchy- do vloads vary? or im i kind of sol with the increase.

later
scoop49

[CockSparrow]

Your Platelets have gone from 51 to 43 so that’s too bad
Your Hgb has actually gone up slightly
The only thing that is a worry is your Whites. They are copping a hiding.

Your are going to have to start thinking about cutting back on the IFN otherwise you will have no whites left.

All the Best
CS

[Tallahassee]

Well, when I studied about Oxymatrine excessively, I read that in Asia they use it during chemo therapies for Leucocytopenia (sp-?) -- meaning, that it will stimulate your Leucocytes (sp-?) or WBCs production.  BTW, it is also used in Asia for patients with tachycardia – and since my heart rate was 100 + (Toprol was prescribed at this time), I thought that a reduced heart rate  will make  a nice “side effect” for me.

I heard an anecdotal story in this forum that Oxymatrine may stimulate platelets production -- I was hoping for it - this is the only reason I started taking it even my Dr. was a little skeptical.

Basically, I used myself as a guinea pig and derived the following conclusions:
1) Oxymatrine did not stimulate my platelets production.
2) Oxymatrine increased my WBCs production -- I was able to reduce my Neupogen shots from 3 x week to about every 4-5 days.

All the best to you, gauf!!

Most importantly, do as frequent as possible all your blood work -- so you don't miss critical points.  ... and do your WBCs & RBCs prior to your interferon shots.

[HectorSF]

I tend to watch platelet counts…
Platelet 43k is not too bad. Especially with cirrhosis. Excellent!!! Of course it depends who’s looking at it. Some docs will start to worry. I was down in the 20s. 26 at last CBC at week 12. I hovered around the low 30s most of the time. Heck I’m probably in the 30s now after stopping treatment 4-5 weeks ago! Love my enlarged spleen. (not!)
Hopefully your platelets count will stabilize. Easing off of the interferon will always bring ‘em up.

Can’t wait till the new med comes out that can raise platelets. It should be within the next year if all goes well. I won’t be able to retreat until I have some platelets left after the interferon spanks ‘em down.

Keep up the good work!
Hang on to your reds, whites, and blues (platelets)!
Hector

[gauf]

Oxymatrine helps to increase WBC count
-------------------------------------
I didn't know that. Where can I get that info? Thanks.

[Tallahassee]

Your Neupogen definitely needs to be increased.

I was on 3 times of Neupogen per week (300 mgx3).

Also, Oxymatrine helps to increase WBC count.

The only thing that concerns me is your platelets count.  My platelets lingered at the 30,000 and below for the whole 2nd year of treatment (~22-24 mcg of daily Infergen, just like Magnum).
I supplemented myself with vit. K --- don't really know if it made any difference.  The only thing I know, that the platelets have tendency to aggregate and sometimes it is difficult for a technician to count (and re-count it).  If you repeat the test (even on the same day), the results could be significantly higher (high enough to allow the Dr. to maintain the dose of the meds).

But maybe you are already UND -- and a reduction to a regular dose is appropriate??


All the best!!!

[meki]

LMAO!

Well heck - you're too cool.

[gauf]

Shucks ladies, I am all a fluster....

[meki]

Gauf ---- Love ya hon... Super hugs and hang on to your seatbelt --- this is gonna be one wild ride.

Meki

[Marcia2202]

I admire your courage and tenacity. My prayers are with you.

Marcia

[Trish77]

sorry Gauf .. that was directed to lab gurus of which I am not one.  Just an opinion.

Good luck with this.

[Trish77]

Yeah, I looked at your ANC and lymphocyte numbers and got a wee bit concerned.  You're already on neupogen. I'd feel better if your ANC and associated white counts came up.  That's just me.  If they're bouncing around, fine .. if they're not coming up or don't have much upward bounce, that's something else.  Be careful out there while you're driving that toaster through that carwash .. wear your protective gear.

[gauf]

I start the procrit tonight. I have been on one shot a week of nuepogen. They may increase that to twice a week. I will take a Peg shot on Friday, which is a day 5 mark, and then perhaps go to every 7 days now. I rebumped the riba from 1400 back up to 1600 this week, but will now begin to taper down to 1200 over the next 2 weeks. I do not want burn up prior to reentry.

[jmjm530]

Better get on the Procrit (epo) horn with your doc now and/or quickly evaluate your riba dosing or Houston may cancel the space flight. Same with your Peg as ANC is starting to plummet. Testing CBC twice a week at this point would seem reasonable. Remember, if you can't stay on treatment, all the drugs in the world aren't going to help you. You must therefore work with your doc and find a reasonable compromise. ANC tends to bounce around a lot and you may be lucky. Hgb on the other hand, tends to keep going down and there can be a 2-6 week delay between riba changes -- or Procrit intervention -- so be very careful and try and get ahead of that curve.

-- Jim

[FlGuy]

No so surprising with the riba (think you have since reduced to 1000/1200?) and the frequent Peg (still every 4 days/).  Do you and the doc have a plan to address the hgb and neutrophils?  Established intervention poits?  What about 4 week pcr?  At some point you'll need to back off the Peg and I think you plan was to pump it up til undetectable?  Time to find out if you are.  You don't want to burn up in re-entry, heat shields can get tangled and frayed.