NOT UND yet but almost there

I'm encouraged.

Just got 4 month PCR results.

VL  90
Log 1.954

beginning VL  1,140,000
beginning log  6.057

total log drop week 16 is 4.103

i'm still slow but at least the numbers are still going down.

Last VL (14 week) was 510.

This week i do shot 19 and will get labs for week 18.

hopefully, if progress continues at this rate, I'll be UND (below 10 as that's the quantitation level at labcorp) somewhere between week 18 and 20.

gotta go to doctors now but will check in for everyone's feedback later.

thanks,

wyntre

[zazza]

Wyntre,

You know I am following your progress in beating this virus, being a slow responder myself. Keep at it, I am there cheering for you!

Have you read the Berg study about extending to 72 weeks yet? (I have a copy on my hard disc, if you write me at my lognameunderlineeuropeathotmaildotcom, I will send it to you.)

[Forseegood]

just wishing you all the best...youre a true fighter...

[jmjm530]

Your 1/2 log drop in two weeks is encouraging, but if you aren't non-detectible by  your week 18 test (week 20 at latest), I'd talk to your doctor about increasing the meds if your side effect profile permits. You really want to get non-detectible by week 24 in order to have a decent chance at SVR with extended (72 weeks) of treatment. BTW Labcorp has another test -- Hepatitis C Virus (HCV), NGI QuantaSure

[wyntre9]

thanks 4c.

Za, I will do that later.

Jim,

I thought a decrease from 510 to 90 was a 1 log drop.

isn't the rule something to the effect that every zero represents one log?

In other words, with beginning VL 1,140,000, a drop of 4 log would be 1,140, right?

And then 100 to 999 would be another log and 0-99 the last (of my original 6.057 log)



Can you explain this to me? (whenever you have a chance).

SLOOOOWLY, please.

wyn

[jmjm530]

WYN: In other words, with beginning VL 1,140,000, a drop of 4 log would be 1,140 right?
----------------
No, a 4 log drop would be 114, as per below...

Beginning Viral load (BVL) 1,140,000
1 log drop would be 114,000 (drop one zero from BVL
2 log drop would be 11,400 (drop two zero's from BVL
3 log drop would be 1,140 (drop three zeros from BVL
4 log drop would be 114 (drop 4 zeros from BVL
--------------------------------------
wYN: I thought a decrease from 510 to 90 was a 1 log drop.

A one log drop would be 51 (drop one zero). Since you were "90" is approx a 1/2 log drop which is OK for 2 weeks.

[zazza]

Wyn,

Google "scientific calculator", and you will come to a calculator online that lets you transform any viral load into log. Just enter the viral load number and then hit the log key.

So:
1,140,000 IU/ml = log 6.057 (your baseline viral load)
114,000 = log 5.057
11,400 = log 4.057
1,140 = log 3.057
114 = log 2.057
11.4 = log 1.057
1.14 = log 0.057

And:
510 IU/ml = log 2.708
90 IU/ml = log 1.954
which equals a 0.754 log drop.

[Proactive]

Hi za and all..za are you still planning on going for the 72 weeks? Had an appointment today with my hep docs np (monthly visit) and again asked about 72 weeks..If you remember our stats and response was quite similer..Basically I'm being told 54 weeks is enough (36 wks past), this from a very aggressive treater ( he's now weight base dosing Pegasys, like pegintron)
I think they are getting involved with a new weight based dose trial with the Pegasys. Actually they are beginning a few different trials. Hard for me or anyone to gauge ones treatment against anothers, as you might recall I'm also on high dose riba.

[wyntre9]

Thanks so much for the computational assistance!

boy am i dense.

But i was half right - coz the drop from 510 to 90 is almost .75, halfway between 1 and .5.

za, like that link but I DO wanna try to understand how it works.

Now (I think) i get it.

So from VL 90 I have to still have an almost 2 log drop to UND -

9 would be 1 log
-.9 would be the second log.

there's something about (trying to) understand the numbers that is strangely comforting.

wyn

[zazza]

Actually 10 IU/ml = log 1, so to get to UND with a test with the sensitivity of 10 IU/ml, you only need to drop one log from your current viral load 90 IU/ml (log 1.954).

If you were to use a test with the sensitivity of 2 IU/ml, which equals log 0.3, you need to drop 1.654 log from 90 IU/ml to get to UND.

Yes, I agree with you, understanding the numbers and facts oneself makes one feel more in control of what is happening, not so exposed. It makes us better able to make our own treatment decisions.

[jmjm530]

At this point, I think the more important point is not the log drops but getting to non-detectible ASAP with a very sensitive test like the one I referenced that has a sensitivity of 2 IU/ml. If you don't get there on your next test, you might ask your doc about increasing your peg and/or ribavirin. At some point, the rate of your log drops flattened out and you don't want that happening again. So, for now, think "undetectible", not log drop.

-- Jim

[zazza]

High dose riba? Yes, that does sound interesting. Please refresh my memory of your stats.

I have an appointment with my doctor May 9th, and am going to ask for extension to 72 weeks then. I am planning to bring the Berg study mentioned above with me.

I don't believe in adding 36 weeks to UND. In the study Berg et al explains why adding 36 weeks is just a mathematical model - it has never been the object of a study. In fact Berg et al believe that the extension of the UND period must be calculated in a more exponential way for slow responders. I take that to mean that if you are UND 4 weeks after week 12, it is not enough to treat for 48+4 weeks. Maybe 48+(3x4) weeks = 60 weeks would be the correct number but since nobody has done a study of anything other than 72 weeks, 72 weeks is the only number that shows a relapse rate reduction of close to half.

Thank you for asking about me, that makes me happy. Keep me and everybody posted on your treatment.

[orphanedhawk]

Hey Birdie!
  When my viral load was <50 detected, I asked my heptologist if he thought increasing my dosage would help me kick the last HepC outta there. He said, he believes upping the riba helps to get the stragglers. So my riba was raised from 800 to 1000. He warned me about the possiblity of my rbc going down and my needing procrit. So far they've dropped but not that low. And I did come out und on a heptimax.   Good luck and go girl go!   OH
   BTW: No new birds, just some red spotted bugs, quess I'll talk to LB about that.
    

[Proactive]

My info stats: weight 170#'s (now at week 26, 177#'s)geno 1A ;2/2 bio
Beginning vl 2,450,000 vl-prescribed 120 ***@****/1200 riba
week 4 vl 52,000 iu continued same dosage
week 8 vl 1200 iu per qaunt test;vl 2000 iu per qual test(I have doubts on the accuracy of all these load tests). Doc increased riba to 1400
week 13 vl 256 iu per qual test (<10) riba increased again to 1600..
Week 17 1/2 Vl undectable per qual (<10) no testing between 13 and 17 1/2 weeks
Reccomended 54 weeks of treatment, and I've decided to go with the flow..an ivy league college medical center's opinion is good enough for me (vbg). Heck, they are actively treating more patients than are involved in many of these studies.I'm going with their experience-plus I'm sick of worrying about ;^)

[wyntre9]

thanks again.

now i REALLY understand!  (I think)

Jim,

I appreciate your suggestion about the heptimax <2 test.  If week 18-20 test shows UND by current test, i will then ask Dr. for the heptimax.

I will also be asking about the extension from 48 to 72 weeks, as zazza and proactive are checking out.

Zazza - the other reason i'm obsessing about these darn numbers is so i can try to grasp the concept.

It seems like the meds are kicking in.

According to the previous labs, while it took 3 months to reach a 2.3 log drop, it's only taken another month for an additional 1.753 drop.

That's almost double the rate of the previous 3 months.  (1.753 log per month as opposed to avg. .78 the first 12 weeks).

What are your current stats?

wyntre  

[wyntre9]

i was reasonable and fair.  i took a 5% price drop for the sake of a good solid deal with 20% down.  The quicker it's settlted, the quicker i start saving money.

i csn't wait!


It's both exhilerating and terrifying.

wyntre

[wyntre9]

thanks guys.

In light of the worsening sx, it's good to know that apparently the drugs ARE working.  SLowly, yes, but I'll take that over not at all.

Hawke -

ya sound good today.  glad about that.

Child,  how's nick?

All,

i sold my house (in less than a week) and will be moving july 1.  can you believe it?????

wyn

[wyntre9]

oh, thanks again!

ok - the <2 test IS labcorp!  I will ask Dr.

And i agree, UND is all that counts right now.  

(for all i know, i could be UND right now as the week 16 results were from almost 2 weeks ago.   I do next test this friday.  won't be able to ask for other test for that coz Dr. is away until May.)

wyntre

[Htownwife]

Good going, girl!! You're knocking them down alright!! You hang in there and keep on kicking them out till they're all gone!

AND sold your house! How cool is that??!!
You've got some real positive things going for you right now...congratulations!!

Maybe the move won't be too bad...just go slow and don't overdo it (like that's possible?) Do you have anyone to help you pack up, or are you hiring someone?

[wyntre9]

I'm a little in shock myself.  Put it up on friday, April 6, half dozen people saw it that weekend, had multiple offers tuesday, April 10, accepted offer friday, April 13 and the contract was fully executed yesterday.  Closing is on or before july 1.

guess this is meant to be.  i'm going to a tiny cottage i have up in the catskills.  it's very small and the flock is gonna drive me nuts there but it will all work out, somehow.

I gotta pack everything myself, but that's gonna be easy coz there's not enough space in the cottage for more than the pc, some instruments, some books, clothes and the birds.  Mostly I'm tossing and donating.

I'm gonna take it easy, finish TX, get my health back, and the money from the sale will keep me going for a couple of years.

It's a real step down in terms of space, but I'm ready for downsizing.  this disease has taught me a LOT about what's really important.

HT, i'm also licensed there (as i am in 5 other states) so if i was DESPERATE enough for money i could sub or take a position once i'm done with meds.

but somehow i don't think that's gonna happen.  it's like i'm getting a clean slate, a life do-over moment, and that includes the way i earn a living.

Weird,isn't it?

wyntre

ps - elaine, i read about nick's progress on the other side.  i sure hope everything works out for you two.

[chcnme]

I cannot keep up -- I miss notes a lot and then feel awful for missing them!   And I have barely read what is going on here ... or , put this way - I don't understand this log drop stuff enough to know what yours is doing.  (I don't think Jim could be slow enough on his explanation for me - lol.)   I hope whatever is going on with your viral load it is good news!  You just hang in there.   You sound good (spirits up, at least). OK  Bye - I just wanted to drop off quick and say hang in there.  I always have you in my best thoughts!  

[wyntre9]

thanks chcnme.

i know what you mean about trying to keep up, especially with two sides of the board.  I mostly post here, now, as it's too confusing to try and do both.

yes, i am in good spirits - physically i feel like cr*ap but maybe i'm getting used to that and compensating in other areas.

The log drop and VL is encouraging, at least to ME!

I think I'm gonna be UND next lab, if I'm not already.

And if I'm not, I'll deal with that, too.

Good to hear from you and I appreciate the good thoughts.

wyntre

[ladybug52]

Of course you are und even as we speak. You were that close, and it was an old test, so, need I say more?
One word--UND!
I hope you got a good price for your house. I worry when a house sells quickly that the seller didn't ask enough. My daughterand her husband found an incredible house for an incredible price one weekend. By the following Monday, there was a contract and 3 back-ups for the house! Then they knew they had missed a great deal!
Hugs and congratulations on the numbers going in the right direction!
Bug

[jmjm530]

The "<2" test is not "Heptimax", it's a LabCorp test (see previous post). I recommended that test since your doctor apparently uses LabCorp. I see no reason to wait until non-detectible on the less sensitive test, I'd just have the doctor order the sensitive LabCorp test next time. Alternatively, he could order "Heptimax", but the LabCorp test is just as good and even more sensitive.

I do understand what you're doing regarding log drop, but at this point I'm not sure you can compare what is going on now with before. You only have six weeks to get non-detectible and should soon pull all reasonable stops. Undetectible is the only "log drop" you're looking for now.

My stats: Previous 1B. SVR. No detectible virus for one year. Normal liver enzymes. Pre-tx fibrosis, probably around stage 3. Closer to stage 2 now by mid-treatment Fibroscan. Hard to tell if the difference is related to treatment or the different testing modalities. Treated at age 58.

-- Jim

[Htownwife]

That sounds wonderful and exciting (and terrifying, but what big change isn't?)
A small cabin in the Catskills sounds perfect for getting your health and life back together.
And you don't NEED much space right now. If you do, go outside! You've got the Catskills!!
And spring is here so you're going to have the best weather you could ask for! I'll be thinking of you this summer when Houston is over 100 degrees with 100% humidity!!

Somehow I don't believe you'll have to go back to teaching or subbing. If you have the drive and courage to do all this on treatment, you'll find another way to support yourself.
I'm excited and happy for you!!

[AMERIBOI2003]

Great news for you!!!!  Am so happy for you!!!  Keeping a close eye on you, my friend, and in my prayers to Heavenly Father to watch over you!!!

Yours in Christ,
Rick

[madbrad]

Great news....Be relentless.......

[rosebud57]

the disease has taught me about what is important.
---------------------------------------------------------------------------
i can agree with that. as happy that i am that i am graduating fact is if something happened i may never work, could lose all possessions in any manner of ways, what is important is the people who we care for spouse children family friends. etc.  & our connection with god. not necessarily in that order.

I find since i have been in school i have spent much of my time at home in a relatively small space. gotta guess here  11x15 room. bed, books, computer desk, small t.v.  during tx.  all my time in this small space, for most of the time didn't even want to leave it.  but have about 1740 living space..

[wyntre9]

Thanks, rick.

i keep asking about your puppy but i guess you haven't seen my posts.  everything gets buried around here!

so much to say, so much to do, so much going on!

wyn

[Pdilly]

Oh how wonderful it sounds.   Donating....don't forget to log everything as it is a huge tax deductioin.  We have been wanting to move to the mountains of southern Colorado.  It will have to wait a couple years.  I wonder what the birds will think..  I still thing of your parrot post.

[wyntre9]

The birds aren't happy but i told them i'm downsizing and they're gonna haveta downsize too.

And there's gonna be RULES.  They don't won't like that either.

the worse part of the move is gonna be driving a couple of hours with 6 parrots and a dog in a Kia.  Man, is that stressful!

thanks for checking in.  I'm optimistic about everything, from tx, to UND, to new beginnings.

what's up with you?

wyn