New job and new treatment 6 days apart-am I nuts?

[ladybug52]

Part of me wants desperately to move forward, but I don't want to look like a total idiot when I start my new job. I have worked for this rehab company for 6 years, left for 3 and will be going back with them as rehab director. I'm thrilled to have been offered this opportunity and I do not want to mess up by appearing dazed or confused or unmotivated. Still, I have been waiting for Oct. 13 for many weeks because that is my projected start day. Please give me your honest opinions, I act impulsively and I am trying to approach this rationally. I am 53 with Stage 1 grade 2 genotype 2. (I had posted earlier that I was Stage 2 Grade 1 but got out the biopsy report and I was wrong-don't really know the difference) Thanks for any input.

[tonybuck]

You say that you are the thrilled about this opportunity. I think you will be fine and the job could possibly work to your benifit while on tx.. I somtimes think it would be easier if I was not working but the truth is my job helps me keep my mind off the sx., and gets my blood moving. Though I am not the employee I was prior to tx. I am managing by being able to take a time out when needed. Good luck !!!!.

[bobbyullc]

congratulations on your job,
no matter if your sides are severe,moderate or slight they will effect your performance. at grade 1 you definately do not have to treat now....maybe the new drugs will not be as great as hoped but that will be clearer in 1 or 2 years. at grade 1 you have the choice to wait 1 or 2 years and see. even if vx950 needs peg it is hoped it will raise the chance of svr and will definately reduce the time on tx and severity of sides. many here can not live knowing they have hep c, but, if you can, i feel you should consider waiting a year or two to see what is coming along.
please do not tx out of fear of what if's that most likely will never happen. as far as i know NO ONE HAS DIED AT STAGE 1.

my opinion alone ....I would never tx at stage 1.
i back that up as i was stage 2 and waited 9 years to tx and in that time the svr rate went from 10% to 50%. if i felt i could wait 9 years more i would. my dr said if this does not work i should wait for the new tx. i agree. i will not give up one more year of my life on a maybe.
bobby
ps. many geno 2's do not clear, many do.

[Pauly Boy]

Congrats on the new opportunity. I am a geno 2b, at week 21/24. I'm looking forward to finishing tx, so that I can return to a " normal" way of life. I have worked in rehab, many years ago and my concern for you would be the amount of time you will spend one on one with clients vs. time spent on management/ administrative type duties. As you know the one on one interaction is quite different than management duties, and can be further challenging considering the level of the clients. I waited till i could take time off of work if need be, I'm glad I did, I needed it. My worse sx is fatigue, downright exhaustion. I could sleep around the clock if I didn't make it otherwise. So at about week 5 I took some time off, I'm a builder and must be sharp at all times. The other sx I have noticed that has grown as time goes on is a fogginess of thought: I will not be able to remember words that I want use. It's frustrating. I also went thru a drop in my red blood cell count: hemoglobin, I took a drug called procrit which took care of the issue. On the positive note, the virus is undetected in all of my lab results.

I'm glad I did it, cause now it's almost over. Talk to your doc and others about the options and concerns for tx. New drugs will make tx easier in time. Others on this board can educate you better than I could regarding this. Good luck in your decision, whatever it may be, remember we'll always be here.  
                 Pauly

[lab-rat]

I was in complete denial at stage 1 / grade 2 and never wanted to treat.  I didn't think it would be worth the potential side effects for the odds of a cure.  The insurance companies helped me in my decision by not approving treatment.  I felt fine and thought I was fine.  However my GI is very aggressive and really began nagging me about beginning treatment.  I used many excuses to put it off...finally they offered me free drugs as long as I promised to comply (how could I refuse?).  As my last ditch effort to avoid 48 weeks of tx-hell, I took a shot at getting into the vertex study to pursue the remote possibility of shortened treatment time.  To get into the vx trial, I had to get a new biopsy - my previous biopsy was exactly 3 years old.  I was shocked to learn that the pathologist reported stage 3 with "evolving cirrhosis"...which actually excluded me from the study.  I thought the disease was slow and smoldering and I had plenty of time (I had already had it for 20+ yrs).  The study dr. disagreed with the reading and said I was more of a stage 2 than a stage 3 (without the cirrhosis) and I did finally make it into the study...(and am currently treating).  I just wanted to share this with you since I had a false sense of having plenty of time.  Apparently reading a biopsy is not all cut and dried - the study dr. explained to me that they can vary by as much as a stage and it doesn't necessarily indicate disease progression.  

Also, one of the things my GI told me was, at least give it a try.  If you get sick or it gets to be too much, then just quit.  That's pretty simple advice that many would not agree with, but that's what I would do if I were you (knowing what I know now). I'm still early into treatment, but so far its been a piece of cake and all the angst was for nothing.

[ladybug52]

Thank you all for your honest answers. Of course I got 4 different answers but they were all heartfelt. my options are 1) treat and I'll probably be o.k.
2) wait for better drugs in the future
3) treat, take time off if I can if I'm too sick to work or wait
   for better drugs

[ladybug52]

Sorry I cut myself off by pushing the wrong key
4) Wait and maybe this insidious disease will progress and I'll get sicker and older before I start tx.

The neatest thing is hearing congratulations from you all. I was only trying to explain that my job will be demanding but thanks for the congrats.  
PaulyBoy you hit the nail on the head re: work. I have the patience of a saint with sick old people (not my family)but how will I deal with constantly giving and the lifting involved in rehab? Plus end of month billing to medicare requires some brain cells firing and I just don't know if I can handle it.
I have called my doctor three times asking if I can come in for my appt Friday and not start treatment that day or should I reschedule.  I don't know if the time they allow for training visits are longer or shorter than others.  They don't understand my question once it gets past the receptionist and I only get messages back to call again.
Final answer, I'll show up at the doctors and bring my meds and hope she'll talk me out of starting now!

[FlGuy]

You could also wait 6-8 weeks or so to see how the job demands affect you without the cloud of tx.  The first several weeks were a whirl of odd feelings and mild confusion.  Probably not a condition you want to start a new position with, especially if you want to be impressive to those around you.  Also need to consider if the time/events around holidays and year-end business activities will pose more of a problem if you are not in top notch condition.  Good luck in whatever you decide, hcv will be there waiting for you.

[NYgirl]

Since I started treatment I only missed 3 days when my hemo dropped suddently and drastically.  Otherwise it's not been easy all the time but I've come in.

I did get a promotion somehow in all of it and start a new job (at the same company) so it is possible.

I personally wouldn''t want to have to do what you are but...you can't guarantee you will even get any hard sides at all so if it would cause you to lose the job to put it off I'd go. What do you have to lose if you'd lose the job anyway right?

Take it one day at a time and time your shot on Friday night so that most of the effects will be done by Monday and you will have all weekend to rest up if you need it.

Good luck - you sure are BRAVE and that is a good thing it will help a lot with treatment!

[jmjm530]

Whatever you decide,have a plan "B". Treatment affects everyone differently. Some can work just fine, some have to cut back some, some can't work at all.

As far as when you start treatment, that should be up to you and not the nurse. Remember, they work for you regardless of how they might act.

All the best.


-- Jim

[Kalio1]

If it was me in your situation, I would start the new job and give it six months at least before I attempted treating. That way you can have a good feel for the situation at work and not jeopardize your new job.
You are in a good position to wait and there is no rush to treatment necessary. I dont know how long you have to work at the new job before FLMA or other benefits kick in but I would wait until then just in case treatment isn't always easy for you and you need sick time off.
I know once you decide to treat it is hard to wait but the job sounds like something you think will really be a good move so I would do all I could not to compromise that.
Good luck with your decision and your new job!

[slowsouthernstyle]

ladybug you should listen to miss kalio she is a very smart beauty.slow

[jmjm530]

If you do decide to wait six months, make sure you look into how the phase II Vertex trials are doing at that time. SVR data will be coming in from the various arms (segments) all through 2007. Should things look promising, you might decide to put off treatment even longer, or perhaps enter one of their stage 3 trials if available for your genotype.

[ladybug52]

Thanks so much for the input. I'll probably have my labs checked (they have always been normal) have the dr. check the alpha fetal protein as she suggested (or that might be the name of the test for pregnant mothers)get vaccinated for A and B, (she says if the B vac is older than 10 years revaccinate) and then decide based on my labs.  Thanks everyone.

NYgirl:Thanks again for the encouragement, taking it one day at a time!

[Kalio1]

I was told there is a way they can tell if your previous vaccinations are still working. Maybe your doctor can check that out before having you do a whole second series?
Good luck with not drinking, NYGirl tells how she looked at pictures of a damaged liver compared to a healthy one and that did the trick for her. Maybe hse has the pics somewhere!

[Drarig]

You sound like you are in a position where you can put tx off for a little bit.  If you can, then maybe you could try your new job for awhile then start tx. I personally regretted waiting (3 years) because I didn't think I would be healthy enough to raise my 3 kids & work my two jobs.  (Plus I haven't told anyone about my hcv).  But somehow I'm plugging thru it all.  I just regret waiting because I would have been done a long time ago & less damage would have been done to my liver.  Everyone has to do what works for them, though.  Good luck in whatever you decide.