Obesity

I am getting ready to start treatment next week.  I was wondering if being heavy because of weight lifting and not really over weight in the sense of being fat is still a negative.  I am wondering if I should just focus on slimming down for treatment reasons.  I am 30 years old 6'2 and 240lbs but most people that I tell this too find it hard to believe.  I am very broad and muscular and have been my whole life.  My liver is in great shape according to my doc and I most likely have only had the virus a couple years.  Just curious because if it is better to be lighter reguardless of my build than I will switch my workout to something that will slim me up.  I am very focused and can loose a lot of this muscle weight fast if I need too.  My doc kinda mentioned it as one of the factors in treatment but didn't really say that I needed to loose weight. Just wanting some opinions.

[OnAPrettyPoison]

More muscle mass isn't the same as being overweight.  You will probably be on the highest dose of riba, and would be at any weight over 165 lb.  I wouldn't worry about slimming down just yet, the drugs may do that for you all by themselves!  Lots of folks have difficulty retaining muscle mass on treatment because of the interferon.  I would want to be in the best physical shape I could going into treatment.  Just my two cents!

[jmjm530]

Being heavy is OK as long as your muscle/fat ration is good, as it appears to be. Just make sure you take enough ribavirin for your weight. I would imagine a geno 1 at 240 pounds should be on at least 1400 mg/day of ribavirn, but please check with other sources. Obsesity refers more to excess fat and is another animal.

[Stvski80085]

I was hoping that was the case.  Thanks for the posts.  I will have more to post as I start treatment.  Thanks to this forum I have pages of things I want answered by my doc and hav e an idea of what I would like to try if it doesn't seem to be working in the first few months.  The amount of good information here is priceless.  I wish all of you the best on your treament and look forward to posting with the rest of you.

[FlGuy]

One item that you should add to the list, if you haven't already, is the need for treatment with a liver that's in such great shape.  I hope you and the doc ponder that carefully.

[Stvski80085]

I know what your saying but the bottom line for me is I want to get rid of it.  I figure while my liver is in great shape, im young, and my shape is not going to get better with age so I am in the best shape I can be in to beat this s**t.  I really don't want to wait until it starts to do damage to do something about it.  My insurance is also good so I pay about 1000 dollars for a three month supply of both meds.  Perfect situation to try to beat this thing don't you think?

[jmjm530]

I agree with FL Guy. Generally, Hep C is a slow moving disease and newer, less toxic treatment will be presenting trial data all throughout 2007. Explore your options with your doctor before making a final decision. Hopefully, you're seeing a liver specialist (hepatologist). In general, they are more current on things Hep C.

[Stvski80085]

I am seeing a hep doc.  He has went over the options with me.  We both seem to agree that now is the best time.  I have other personal reasons for now verse later also but really he seemed to agree with trying to kick this thing now.  I trust him up till now so I am starting treatment next week.  I hear what your saying but I really think that now is good and I'm not gonna worry about what is going to be available down the road unless this doesn't work.  I have heard about a lot of situations were they say something better might be on the way but I don't sit well with "MIGHT".  I appeciate your view though and look forward to many more over the next 48 weeks.  Thanks again.

[FlGuy]

I'm glad you are making an informed decision.  Good luck in whatever you choose.

[dog_lover]

For those of you who remember me, I have been having some problems getting "the" treatment through my local VA hospital. They have been correct in their reserve but it appears they have finally succumbed to my charms.  I still have a couple of months to go before I start - September seventh - and still face a huge challenge, I have to lose some serious weight.  Ten years ago I was a ultra-marathoner, anything over fifty kilometers or thirty miles is an ultra. I ran everywhere; home from social engagements (My ex-wife drove while I ran home), to work and back, on weekends I would just get up, grab a few bucks and run all day long.  I have no idea what my body fat index was but I didn't have a lot to pinch. I could eat anything, a couple of pumpkin pies for dinner, half a turkey, a horse, you name it. As my back began to decline and become more painful I found my mileage decreasing as my weight increasing. I now have to rely on an indwelling morphine pump and pain tablets to control my back pain and it is still overwhelming.  Anyway friends, please wish me luck as I start this pretreatment-treatment to lose weight and then begin the journey that so many of you have shown so very much courage to take.
Peace
Dog_Lover

[Stvski80085]

I too have had a back fusion one year ago.  I know the pain you are talking about and although I haven't started treatment for hep c can't imagine anything worse.  It takes over your life just as this treatment does.  I too take pain meds 3 times a day but with the meds my life is some-what normal.  I am still able to workout but believe me I know when it's time for my next pill.  Like clock work.  The pain meds may actually halp with the sides but i can't verify that.  I try to think positive.  May I ask what the problem is with your back?  Just curious since i have been there.  If you have questions about surgery I have had two of them on my back so I may have some advice depending on your situation.  Good luck and God bless.

[dog_lover]

Tried methadone, didn't think too much of it. Besides, it was invented by the Nazis. I used it for a while and wasn't too impressed. I went from methadone to oxycontin to mscontin (Time released morphine). I was a mess and even using oral morphine I had to use enough of it to make me totally worthless for anything else. The morphine pump does not work as well as the oral medication but the level of intoxication is night/day. The pump is not cheap, about seventeen-thousand to purchase and another fifteen-thousand to install.  On top of that is the refill expense of eleven-hundred dollars every three months.  I don't have private insurance any more so I'm praying that the VA will replace it when it dies.  Another problem is letting it run out of juice. A couple of years ago on my birthday I suddenly doubled over and started going out of both ends.  I felt like I had a hot poker jammed into my guts.  I have never felt this rotten.  Word for the wise.
Dog_Lover

[Kalio1]

Hi, welcome to the board! Looks like quite a few of us have the same back issues!
I can say that my back meds have SAVED ME on tx. Sounds like you and I are on the same pain med regimen. I dont know how people make it thru tx without them. I switched mine to a more liver friendly Vicoprophen (from advice here) and they have worked out fine, still control the back issues but also help with the side effects big time. One little blessing there, I haven't had to try to hasse pain meds from the doc for Hep C which I hear can be difficult for some people. Mine are from the pain management doc and I have been on them since the surgery in 03.

[dog_lover]

I had a fusion done at L5-S1 over twenty years ago. That remedy was fine for a number of years until the formation of scar tissue overcame any benefits from the fusion. My pain is at times is almost too much to bear.  I use morphine which is automatically injected onto my spinal space every few minutes. On top of that I take oxycodone every few hours.  What do you use?  I have found as a general rule that most other means of pain mitigation, such as tens, acupuncture and other means are ineffectual for me. I am now totally disabled and unable to work any more, retired at fifty-two. Now I get to go on interferon.  I hope I can find the courage somewhere to do this, that's one of the reasons I spend time on this site, so many courageous people here have made this trip and I am going to pick their brains until they are sick of me - if they are not already.  Hope this helps buddy.
Dog_Lover

[Stvski80085]

I was hoping that was the case.  I am on methadone still but it has only been a year and they think in time I should get even better.  I know tha tit's strong stuff but believe me with what i  have been on and the dose they have me on is enough to get by.  I am also a big guy and I think that plays into my ungodly tolerence for pain meds.  They really don't effect me like they do most people.  I am glad I ahve them for this treatment though.  I had a feeling I would need them.  

Personal advice on the back is to avoid surgery at all costs.  Don't think it did much for me and after two of them I wish I would ahve just medicated and moved on with my life.  There is no doctor that can say for sure that it will fix the problem.  If you can get by with meds then do that.  you are much better off.  I still have my flare ups but the meds do a damn good job.
Take care.

[Stvski80085]

ask the doc about methadone.  I take it three times a day.  I have been on oxycodone for a long time before surgery and I must say that methadone is much more effective.  My doc said it is better for pain involving nerves and the back and I must say he is right.  another positive to that medicine is you don't get that jittery feeling or any real side effects if you run out or miss a dose.  I felt much more addicted to oxycodone than the methadone i am on now.  Just a suggestion.  I would give it some serious thought because my doc said you should not be on ocycodone for long periods of time like over a year any way.  I hope this helps.

[Kalio1]

I have heard the same thing, if your pain is nerve related Methadone can really help.
I use vicoprophen regularly, 3xday and skelazin and clonipin as needed, I need it less and less.
I don't get side effects from pain meds, no light headed, no cognitive problems, no "high" feeling, it seems to "go to the pain" in me. I have always feared being dependant on the meds so I tolerate (up to a point) some pain, but I know I have to keep it under control because if I dont it goes out of control and then it is very hard to get back in control.

Stvski I agree, surgery is a **** shoot, tht is why I am afraid of the fusion. I did let them do the first surgery because I could not walk unassisted and the disc pieces were jabbing the nerve. Some good came of it, and some permanent feeling was lost and some ability to move my foot, lift my foot, etc.

[dog_lover]

I thank GOD we live in a time when we have both dental anesthesia and enlightened pain practitioners. I have had severe back pain for twenty years; from my early thirties into my early fifties and it's been a battle getting relief. I finally found an Internist who backed my up and gave me adequate anesthesia.  From her I found another who was equally up with the times who referred me to a Pain Management Clinic. For years I met ass***es who wouldn't treat because I have a " ... very serious drug problem."  Time after time, jerk after jerk ER after ER same BS. Now that's all changed.  I HATE pontificating doctors!  Phew, that felt pretty good.
Cheers

[Kalio1]

Man me too! The ER people are the WORST. They act like you are making up some BS story. It is ridiculous how many people they would rather see suffer than to help them with meds that are INTENDED for that purpose. Anyone dealing with chronic pain would benefit tremendously from finding a good pain clinic. I found one too and they are the best. They are well aware that pain meds managed properly serve to improve our QOL so we can even HAVE a life!
Those pompous jerk docs and nurses better hope they never have to face that kind of pain and deal with someone like themselves!
What I would give to be THEIR doctor when they are doubled over in pain. I'd insinuate they had a drug problem and watch them squirm!

ahhh that feels better!

[Kalio1]

I was in the same boat but I chose not to get the pump put in, I had had it up to here with surgeons and hospitals and I was in denial too I think. I used a combo of meds and a good dose of suffering instead. I hear you, it is hard to lose when you have these back issues, mine were severe, required surgery and still had constant leg/hip foot pain,still need the fusion, have residual neuropathy and numbness. At first I was pretty much immobilized, the PT didn't work, you know the drill.
Eventually I devised my OWN style of PT. I did Pilates, leaving out ANY of the movements that my back couldn't handle, Piates was designed by a person with back injuries so it is a good fit but some of the movements I couldnt take. I also did work with small, really small weights, (started with 3 lbs. and worked up to NO MORE than 1o max the doc said) for upper body and used leg weights while walking for lower. I started not being able to go very far, for fear I wouldnt make it back LOL
and worked up. It DID work, the exercise slowly started improving the pain, I started to build muscle and lose fat. I was very careful to not do too many movements that later would seize me up, again I am sure you know what I mean. So, push but not TOO hard, push a little at a time, keep it there 3 to 5 days then push a little harder. I also tried to cut out the red meat and other no no foods. I did what worked for me designed by me and today I can say I have "pain free" days with just the vicoprophen for control. I do need those, but am able to cut out the mid day dose often now. I was told I would NEVER walk normally without limping again, that the pain would not improve, the nerve damage was permanent and so was the numb foot and leg. and there was no remedy other than the full fusion they want me to do. I refused to believe them! I have regained some from the numbness and unless I really overdo, I do not have a limp now.
If you were an ultra marathoner you can devise your own plan, one your body can hack. I am convinced that building up the muscles contributed to my improvement, walking was probably the biggest plus. The doctors were astonished and told me it happened due to my attitude and determination and pure stubborness. Again, it is by no means perfect but given I was so compromised the improvement is remarkable. You have the perfect background to assist you. I think the hardest part was forcing myself thru it in the beginning but it got easier pretty fast.
I also got a recumbant bicycle because you sit on it like a chair and the angle did not put any pressure on my back like a regular bike does. I am trying to lose now too, my doc says I am not overweigt but I found a chart on the net that says I am so I want to drop to ideal by that chart so I should take 20 off I think. SO far I have lost 7.
Good luck, congrats on getting a start date for tx! Good luck working on the weight, you can do it! MY matra, when every step hurt was "there is no gain without pain" which was my old swim coaches' mantra while I worked out for the Olympics as a kid.
He was right, there IS no gain without pain!
Power to you! It was very emmpowering to overcome it to some degree when al were telling me "it can't be done"

[cuteus]

speaking of jerks, well, maybe she isn't but many drs, if they do not see a severe condition in x rays, MRIs or scans, they will not Rx analgesics. So, for folks that do not have an obvious condition... they are out of luck. Like degenaritive arthritis, which does not really show physically, but you can feel it, if they don't see it, is not there.  If you get a condition, a herniated disc for example, and if it does not show big time as influencing your leg and foot, the dr tells you is not that bad. If you tell him that there are issues with urinary and fecal incontinence, the neurologist states he does not think is the herniation./ How can they be so sure?? We see here people with a tad drop in HGB and feeling ill big time, and then those with a big drop and stating they feel ok. It is so individual, how can they be so sure that a small herniation is not already influencing big time? Just like they can't say that mild liver damage is not making some folks quite ill. Individuals react so differently to the same stimuli, that drs should KNOW this already and believe the patients for once, not the medical literature! Pain can be like the wind, you can't see it, but you can feel it! I think I will use that the next time I ask for pain meds!

[dog_lover]

My physician and I have a near ten year relationship. I have always been honest with her and she with me. For the past fourteen years I have had a female Internist.  I think - for the most part - that women make better primary care physicians. They are more compassionate, patient, empathetic, understanding and kind. She is all of these things.  I try to take in a box of Mrs See's chocolates every other visit just to let her know how much I appreciate her.  Pain shows itself in other ways besides just your vocalizations. Your blood pressure soars, you may perspire more, you guard - either consciencely or unconsciously the painful area and in the case of back problems there may be visible spasm that you cannot see.  You can fake some of these symptoms, straining like you are trying to pass a basketball will take your BP way up and you can "act" like your in pain but this only works once or twice in the ER and would never work long-term with the same doctor. ER physicians are very suspicious of folks coming in and asking for pain meds, abusers don't have any special look about them and range from children to senior citizens. It's best to get them from your own physician.  If they won't, get another doctor - permanently. If you like your doctor and they won't ask to be referred to a pain clinic.  Hope this helps.
Dog_Lover

[md1johnson]

I've been taking methadone for a while now for my back and fibromyalgia. I feel and also my Dr's that if there is any thing out there that does not have tylenol or aspirin in it helps my liver. And with methadone being time released that's even better. As for treatment of my liver I can only offer my experience. The rebatol pills I took along with my shots caused me took have pulmonary hypertension. Which doesn't happen to a lot of people but if you read the information on these pills you will see that Respiratory problems are listed. My Liver Dr works close with my pain management dr.