results after 4 weeks of tx

[nency]

My VL after 4 weeks 2000, dropped from 252000. Is it good respnse? Is it undetectable?!
Thank you for your feedback.
Nency

[jmjm530]

nency: I am worried, because I work in a hospital, so I can't continue with my wbc numbers, even physically I think I can manage it.
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I'm not sure this is correct. Earlier, I posted a study showing no relationship to low WBC/ANC (induced by Hep C treatment) and an increased suseptibility to infection -- plus I dont think yours are that low anyway, considering your on SOC.

BTW I have no recollection of that Shitake Mushroom post, but what I do recommend is, as before, you pick a doctor to listen to, and my suggestion is to listen to Dr. D. based on credentials.

Also, if it appears that your doctor will force you off tx because of what he thinks are low WBC's, then you might consider either changing doctors, or changing his opinion in advance of that possibility.

I'm getting the opinion that you're letting one "nay" (from your doc) overide a "ya" (from doctor D.) and you should sort out in your mind why that is happening.

-- Jim

[nency]

Hello Alagirl, I am glad to hear from you! Thank you for your post. You right, I am worried, because I work in a hospital, so I can't continue with my wbc numbers, even physically I think I can manage it.
As I posted, I did a full dose, so, next week labs will be interesting. I found Jims posts from 2006, about shitake mushrooms increasing natural killer cells and lymphocytes - I started eating them and cranberry juice. Will see....
Thank you for your feedback, glad to hear from you. How is your tx going? By the way ginger trips by solaray helps me with nausea and mineral water with few drops of lemon, I hope will work for you too...
With the best regards
Nency

[alagirl]

May be I am doing something wrong, may be you guys not eating some food that decrease drugs effect? Recently, I have red, better not to ear grapefruit.
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nausea is such a huge issue with me that I've been eating whatever I think I can keep down, or at times of not being hungry at all, whatever might tempt my stomach to feel like eating.  I've tried to stay high fat with some things to absorb the riba, but when I have craved fruit or oranges, I have eaten them.  If I wanted avacados, I've eaten those.

I suppose that theoretically, there are people who could argue that foods that increase the absorption rate of iron (such as vitaman C) might not be as good of an idea, dependent upon where your body is with all of those rates.

Also Nency, I don't quite get, I don't think, why you are wanting neupogen?  You can read back and I've even posted a thread asking about this myself but there is at least one study suggesting it isn't that helpful in low wbc related to this tx.  Also though, the low wbc related to this tx is COMMON.  I would venture to say that most of us either have it or or have had it.  My wbc count went down to your level, and finally as of the past week or so it is coming up a little but certainly, it didn't cause me sife effects I felt were bothersome.  I'd go ahead and get the recommended vaccines to guard against flu, pneumonia and the like, certainly.

Your RED blood cell lines are typically what cause the most probs on this tx.  Reduced hgb and hct.  But your hgb is at 12, which is wonderful!  And certainly, if your doc doesn't want to start neupogen yet, one would think that he would try that before pulling you from the meds.  At less than an UND at 4 weeks, I hate to see you reduce, patricularly your pegasus.

I guess my main question is, WHY are you so concerned about the wbc?  Is it because your doc is concerned or because you are concerned, and if you are worried, what precisely are your fears about this?

[jmjm530]

Both great doctors and both in NYC.

http://directory.mssm.edu/faculty/facultyInfo.php?id=21794&deptid=18

http://www.cornellphysicians.com/imjacobson/

[angelo212]

I see you talking about a Doctor D who is suppose to be a great Doctor and he is in New York. Can you give me his address and number? Thanks

[jmjm530]

No headaches. You're a real trooper and just want what is best for you and don't want to see you yanked off treatment unless necessary of course.  Dr. D. is very experienced, but you have to go with your heart on this one.

All the best,

-- Jim

[nency]

I guess, I am the problem here, you right, I have to decide who will be tx me. I just inject full dose, and hopping for the best! I am sorry, if I gave you a lot of headache. You are being so nice to me, and thank you for all recommendations. God bless you.
Nency

[jmjm530]

If I'm assimilating this correctly, what is happening is that Dr. D. recommended you to remain on full-dose but your afraid that if you do, and your WBCs fall more, then your doctor will take you off all meds?

If so, then you really have to decide what you want, and who you want to treat you. Personally, if I thought my doc would take me off my meds without real cause, then I would switch docs right away and not wait until that scenario happened. You might therefore switch to Dr. D. as your treatment doctor. Second best might be to ask Dr. D. for a referral -- or have him convince your doctor that it's not necessary to stop the Peg given your drop in WBC and ANC.

But your current course -- consulting with Dr. D. but being scared that your doctor will drop meds if you follow Dr. D's advice -- sounds like a potential rx for failure.

-- JIm

[nency]

Dear JIM, Answering all your questions! YES! I was on full dose up until now and-did not change yet! My Hb was12 and remains 12! That's right I saw Dr. D, but still nervous that Tx at the risk to be stopped, unless wbc rebound.
Thank you once again that you care, and I always waiting for your opinion
Nency

[jmjm530]

OK. I see you were on full dose prior to the blood test. Probably all the more reason not to reduce since your're still detectible. ASsuming, of course, your doctor is on board. My point I guess was that I thought you were now consulting with Dr. D? Maybe I have it confused. But if you are, then I would run ALL dose issues by him.

[jmjm530]

I thought you said that Dr. D. in NYC told you not to reduce your Peg? Also, still unclear if you have been on full dose peg and riba up until now, and therefore what is reflected in the 4-week test? Do you know what your hemoglobin was prior to treatment and what it is now? As to WBC -- if you are consulting with Dr. D, -- why not follow his lead regarding that as well. I doubt if he'd either prescribe Neupogen or dose reduce, unless your ANC dropped below 300 and if I remember correctly, it's not even close. At some point you have to decide which of your doctors to follow. Personally, if Dr. #1 is a gastro and Dr. #2 (Dr. D.) is one of the country's leading hepatologists -- I would go with door number two :)

-- Jim

[nency]

As Jim asked, Here is my medical history am 30y.o, 100lbs, no other medical problem, EXEPT 1b , VL 252000 before TX, still on 1000 riba, test with VL 2000 was done before fifth injection(pegasys180), BUT today is my next injection that as per my doc I still should decrease my Pegasus dose. MY WBC 1.0 ANC-610, my doc still does not want neupogen! Instead, giving me lower dose, I still probably will inject in 2 hours 180, but! If wbc dropped to the point when my doc will tell me to stop TX, I do not know how to proceed.
Thank you JIM and all who is responding for everything...
Nency

[jmjm530]

Since you understandably have a lot of questions re treatment, you might want to take the time to fill out your profile and include your stats such as age, sex, race, height/weight, genotype, amount of liver damage per biopsy, what drugs you're taking, doses of peg and riba , side effects so far, pre-treatment hemoglobin andhemoglobin now,  first time treating or not, etc.

But in general, assuming your're a geno 1, it's a good response, but like stated you really are looking to be UND. Not sure if you reduced Peg or riba from previous posts because I do remember your doc suggested you should. Your best chance at UND is on full dose meds, including weight-based ribavirin. So, if you reduced doses, ask your doc if its safe for you to go back on full dose. Also, if it were me, I'd ask for weekly viral load tests at this point until UND. You want onethat goes down to at least 10 or 5 IU/ml.

-- Jim

[nency]

One thought in my head,-so many with VL millions getting undetectable in 4 weeks, but I am with my freaking 252000 still positive in 4 weeks, May be I am doing something wrong, may be you guys not eating some food that decrease drugs effect? Recently, I have red, better not to ear grapefruit.
I do not know what I am doing wrong? Any advice will help..

[nency]

What are you guys think my chances are?

[desrt]

It's more than a 2 log drop but not undetectable.  I'd call it a good reponse but see if you can get another test done between now and your 12 week to get a better idea of when you do go undetectable.