Tx appointment

Today was my husbands tx appointment.  We learned how to inject, which was more than we expected since there are several steps to getting the injection ready (not hard, just a few steps to remember)
I was relieved that the doctor ordered another blood test to have a starting base for VL.
His last VL was 248,000.... fairly low according to the nurse.  
After reading many posts about when people are doing their shots we decided Friday nights would be best giving him at least the weekend to recover if needed.  Tx start this Friday.
So far we are told he will have blood tests weekly.  After 4 weeks of treatment he will have a VL test.
We were a little confused as the nurse said his genotype 1b is the hardest to cure (yet most people have type 1) and that his VL was low and that there is usually a better response with a lower VL (but she also said it has nothing to do with the outcome)  a little confusing.
Greg told me tonight he's getting anxiety about starting the treatment and the reality of everything is hitting him now.   Can someone really go UND in 4 weeks?  Janet

[Pinksmything]

Oh, the one thing I forgot to metion/ask is I asked for a copy of the blood work and they gave us a copy. I see the part where it says Genotype 1b.  I don't see the part where it says VL.
would that be listed under something else?  Janet

[jmjm530]

Sure. Especially someone with such a low pre-treatment viral load. And your husband does have a better chance of SVR (cure) with a low-pretreatment viral load. Of course, the acid test will be his viral response.

Your medical team seems very receptive and communicative. You might ask in advance what viral load test they will use for week 4. You want a very sensitive one, like "Heptimax" from Quest Diagnostics or LabCorp's Hepatitis C (HCV) QuantaSure.'  Also, if he injects Friday evening, a good day to have blood drawn for the week 4 test would be on the Thursday before his fifth injection, of sometime during the day on Friday, but before the injection.

It's also very good that they will be doing weekly blood tests. Among them most probably will be a blood count to check among other things his hemoglobin level. Problems with anemia (low hemoglobin) are very common on treatment, so they more you monitor and communicate with your doctor about this, the better. Some of us need the helper drug Procrit (epo) if  hemoglobin drops too fast or gets below a certain number.

Your husband's lucky to have you in his corner,.

All the best,

-- Jim

[desrt]

If it's today's bloodwork you won't see the viral load for three to ten days - the labs that do that test aren't in every town. When you do get ha result, it'll probably be listed as something like'PCR quant.

[Cindy10]

It is possible, in fact alot of people here went UND at 4 weeks. Keep the faith. You both have a long road ahead but you will get through this and it might not be as bad as you might think.
I wish you the best of luck!

[Pinksmything]

Gregs doctor and the nurse are very informative and spent a lot of time with us.  The nurse also told his if Greg was a non responder he's very open to supporting/guiding us through alternative options, etc and that he would never give up on Greg.  The intersting this we were told is that the Doctor almost 'Never' reduces the dosage he originally perscribes. (not sure why? but will ask later, Im curious)
Thank you for your support... means so much to me.  Janet

[orphanedhawk]

I see you are in Fresno. I know the liver clinic from CPMC goes there or Modesto. You may want to get a second opinion on treatment options from one of their heptologists. They are researchers and treat aggressively.
   Take the time to be as informed as possible.

[nygirl7]

To make things easy as possible without making a mistake I'd take the old sage advice I got from Jim before I started with my shot - ALWAYS take out the instructions and follow along step by step.  

Otherwise the phone rings and you look up and forget a step...a kid comes in with a question...there's a knock on the door....and bingo, you've totally forgotten.

Of course after a while you could do this in your sleep (really) but at first it was a life saver (especially after I botched up a shot exactly because the phone rang and a kid came in at the same time).

It's a great thing to have a doctor that doesn't believe in dose reduction - you sound like you have a really great staff there that is on top of the game.  If there is a dose reduction you give the virus a chance to go 'aha! there's an opening I'm going back in' and bang...they can start replicating all over again.  Best to keep them locked up tight with the ribavirin while the Interferon goes in and beats them on the head until they are dead!  (Trying to make it as "english" as possible for ya!)

It sounds like you are really asking all of the right questions and believe me in a few months...you'll know more than you ever imagined.  That's a good thing because as things come up having the answer in advance can REALLY save the day.  For example when my hemoglobin dropped extremely drastically in just over a week my doctor was all confused but because I read all the warning signs in here...when he tried to send me for a chest xray and an ENT doc I said uh...you think it might be the anemia causing me these a.b.c.d. problems? and he was like oh DOH!!!!  That saved me days and days of not getting on the Epogen which i desperately needed.

Geno1 isn't a fun time but beating it can be done.  I was both Geno1A and Geno1B I had them both luckily for me...and they are outta here now...after 72 weeks I am SVR and it was ALL worth it!!! (PS I started with a low VL at 568k...I am VERY glad I had the 4 week test and the 12 week test because I had a count of 400 that would NOT budge...just be careful to get the sensitive test so you can make sure they are indeed gone.  Had I not known that my numbers did not change from between 4 and 12 it would have drastically perhaps hurt my chance at SVR but because I knew...I made it).  SOMETIMES - a few of us with the lower viral load have had a hard time getting rid of the final few for some unknown reason...........just something to keep in mind and the reason to make sure you are getting the right test.

BEST of luck!!!!!!!!!!!

Your H is a very lucky man!  Watch those hemo numbers and drink water!   :)