Wait until summer (when school is out) to begin Hep C treatment?

[stravis]

I was diagnosed with Hep C six weeks after back surgery in 1993. After a few months of not feeling well then, I have been great ever since. I've been followed for the last 18 years, but have always ignored the doc's advice to get treatment since liver numbers have always been great, and I didn't want to go through all of the side effects of treatment.  I am also a 4 year breast cancer survivor and had to change oncologists last year because of a change in insurance. My new oncologist treats many liver cancer patients, and he has convinced me I really should pursue treatment.  I am finally listening and have been through all of the pre-tests (heart, eyes, bloodwork) and have been cleared for treatment.  I'm all set to begin in a couple of weeks, but now am reconsidering waiting until school is out in June (I teach 3rd grade in a small charter school, and it is my first year at this school).  Anyone out there have any thoughts about starting now or delaying treatment until June?

[curiouslady1]

If you go into treatment in April or May, you will still have a month or two of treatment to do come next school year.  Interferon and ribavirin are tough drugs and sometimes there are residuals after treatment.  

[stravis]

Thanks for the info! I am genotype 2, which I've been told if I had to get Hep C, it was the "best" kind to get...

[can-do-man]

"I'm just going by what the doc said.  He said that should be all I need with my genotype."

People seem to be assuming your genotype 1, sounds like from what your doctor said your either type 2 or type 3??? If so the new PI's are not for you as they are only for genotype 1.

[stravis]

I'm just going by what the doc said.  He said that should be all I need with my genotype.

[stravis]

Would you mind sharing our experience with me? I'm hearing lots of comments about the PI's and plan to ask my doc about whether or not that should be added to my regimen.  What kind of problems did you have with the peg & riba?

[mike716]

How can you be sure that you will only be doing 24 weeks of Tx? I mean, that depends on your reaction to the Tx, doesn't it?

[Mary4now]

eek, the peg and riba are what caused the problems in my case I was a geno type 1 and with the new PI's I was undetectable  after the 1st week.  from 8 million viral load

[leebambee]

That was just my experience so far. My  white blood count now at week 14 is 2.5. Normal is 4-10. I'm also on victrelis. My riba is 1000mg a day which seems kinda high. Everyone is so different...hoping for the best for you!

[stravis]

Thanks so much for your lengthy response. was told about this blog just this past weekend and have already learned so much! It has been especially helpful hearing from other teachers. I am only doing 24 weeks of Pegintron and Ribavirin.  I'm leaning towards starting in late April/early May, so I can get my 3rd graders through their first round of STAAR testing. I have a great support system.  I have not talked with doc about rescue drugs but will do so before I begin treatment.  Thanks so much for your input, and best wishes for your continued treatment.

[crossroadsec]

I agree that I'd ask for the PI. They're tough meds, but really increase your chances of SVR. I teach high school and taught part time after diagnosis. I started last July for a 48 week triple therapy. G4/S4, age 54.
I started in a new large urban district 2 weeks later. It was sooo hot starting in the summer months, and was pretty tough. I'm glad I stuck it out though. No one at work knows I'm treating so I have to work really hard. I do love my students and they are a daily inspiration to me. Literally, the reason I get out of bed some days.
I worried about my performance. Some days I don't have my old spark. But I can honestly say that my lesson plans and test scores are on target. That was a huge concern.
There are other teachers at all levels who are at about the same timeline as me. They too have had their struggles but are UND and going strong.
Do you have a support system? I moved in w/ my daughter after a transfusion.
You have to be willing to ask for help.
Do you have a plan with your Dr. for rescue drugs if your blood levels drop? It's good to talk about it before and let them know you will be working and can't take a lot of time off to sleep late.
How stubborn are you? Some days it's just that. Get on this forum and the group here will help you rally. The advice and information were vabluable. lol. Keeps you company when your up itching all night too.
There are so many other factors. I was -well I still am - pretty ignorant. I spend a huge amount of my mental energy on school related stuff. I had to have the insurance for the transplant hospital and didn't have a choice. If I had to do it over, I'd get through the 1st 12 weeks BEFORE summer. Heat is awful on this stuff.  If you're going 24 weeks, you'll be done and recouping when school is out. If the full 48, you'll have the summer to sleep.
I hope this helped. I'm glad you found the forum and wish you all the best as you make some tough choices.
Karen :)
  

[MagTX]

Hi and welcome to the Hep c forum.

There have been a lot of good points brought up already and few good options have been described.

It appears from your original post that you're not a geno type 1 and your doc is prescribing SOC for 24wks for this reason.

I think curiouslady1 brought up an interesting idea about the benign treatments which do not include the interferon and therefore don't cause the debilitating side effects that can make working while on tx extremely difficult.
There are many here in the interferon free trials and curiouslady has posted a lot of good links to information about these trials and has a journal posted.

I hope you're getting some helpful info in making your decision.

[curiouslady1]

I would start right away for different reasons.  You are likely already used to your classroom.  No surprises.  It is downhill from here.  You can use those extra months to recover from the treatment or extend treatment if necessary.  You will want to be ready to go back at the end of August.  Since you do not have seniority, I don't know that it would be a good idea to take much time off at a new teaching post.  

It is also not clear why your doctor is averse to your waiting a few more years for more benign treatments or even a year or two so that you have developed some seniority.  (is he trying to make a link here between liver cancer and Hep c and breast cancer for you ?) Not clear what the condition of your liver is at this point, what genotype you are, how old you are, when you were infected etc.  Good teaching posts are hard to find nowadays.  

[stravis]

Thanks so much!  So, do you work outside the home? If not, do you think you could have kept working?  Do you mind me asking what the current issues are that you are now experiencing? Good luck!

[mykids247]

currently I am treating with SOC geno 2 and the first 15 weeks were OK, now going into week 17 having some issues, I think probably with my blood will find out tomorrow, but having said that depending on what type of treatment you are doing........if its triple I have no business comenting but if its soc I say start now then when your body is just about ready to wave the white flag it will be almost over, with any luck and PRAYERS, Lots of prayers. Good luck wish you well. :)

[micheall]

Timing and preparation is important.Ask your dr a lot of questions about side affects and the drugs he or she will prescribe.With Incivek you need to eat 20 grams of fatty food 30 minutes before taking Incivek.I would wait till vacation to start to get use to the side affects the 1st few weeks.Read a lot of these posts to get more info.Best of luck.

[belle19]

if you do the triple therapy with a PI summer can be hard with the itchy skin and the heat.  things to consider.  good luck.  belle

[Tekelcat]

I don't think there is any way of predicting the anemia associated with Ribavirin. Mine hit in bad 3 weeks into tx. Similarly, there's not much way to predict the other sx. Some sail through. Some get really sick immediately, others not until later.

[Advocate1955]

Would you want to consider asking your doc to add one of the PIs? It would increase your chances of clearing Hep C a lot.
Advocate1955

[can-do-man]

If one is only going to be on peg and riba then i would start right away for the reasons noted.......... I take it your not a genotype 1?

Of course this is just my opinion from my prior treatments and how many others seem to fare.

[stravis]

Thanks so much for the input so far! My doctor has only ordered Pegintron and Ribavirin. Would that change anyone's input? The point that leebambee made above seems to make sense about counts not dropping for 3 months or so, so that would be more like to hit in early summer...  Any more thoughts about that?

[can-do-man]

If your going to being using one of the new PI's the timing might be more important...... It seems with Incivek it hits you hard from the very start so waiting might be a good ideal..... With Victrelis it seems to be more of a drag later on in treatment so starting now might be the best that way school will be out when it becomes the worst........ Of course everyone is different, wishing you the best.

[working dog]

i would make a plan for anything and everything you can think of that could happen....you might feel ok...there are teachers here that keep teaching....i would think it would be tough in most cases....as tx moves through different phases....tx's not the same all the time....bad days and good days....some days more mental and some more physical....i would talk with your doctor about this like when to bring in rescue drugs to make tx easier or even possible .....stay on the forum and ask questions...i think do tx summer and fall if you can wait...go back to work in jan next year if you can...good luck...billy

[marty59]

I was not able to work while taking the incivek. It was actually 3-4 weeks after the incivek that I felt well enough to consider work.

[EyesofBlue55]

Being an employee of a school system also,This is why I am waiting.Everyone is different as far as sides but better to be prepared with a plan before you proceed.How many weeks do you have in the summer?How many weeks are you gonna treat?Do you have a disability policy and/or sick days you can use??? Careful planning is  a must...cindy