A Date With Peg and Riba

[Fighting-this-Together]

Hello all! I hope that today finds each of you feeling well, and on your way to SVR.

In 6 days my Husband will be starting TX. Everything got here this last Fri. and is ready to go. All the ins. stuff got worked out. His first shot will be done at the GI office.
I would like to be prepared with all the things that have helped each of you get through the sx that may surface.  I know this has probably been posted a million times. I would also like to compile a list of questions for the Dr. concerning Tx.
Should a CBC or PCR be done prior to the day of the first shot? Last PCR  was done Feb. 19 not sure if a CBC was done then also.
Thank you in advance.

[capn hardass]

my kid deleted your incoming e-mail.please feel free to e-mail me again and ill be glad to respond

[Fighting-this-Together]

I missed your post. It is jmjm530 and I-horns fault. I forgive them though ;p

Thank you for the good wishes, and glad I made you laugh. He is on his own when it comes to the Riba. He is anxious as it is. More than likely he will start with the shot, as that as when he has a few days off. The PA never called back (sigh).

[Fighting-this-Together]

Honey11, I so have to giggle! We discussed today how Hep c could be fatal. That means lock up ALL firearms and throw away the key LOL.
He is afraid of brain fog. He has nightmares about letting all 3 dogs out at one time( lets just say they are not friends). I told him no worries! I will leave you a check list. I may possibly have to get combo locks and not give him the combos ;)

harda$$ I have seen so many say that Ice Cream has been vital. You keep up the good work on UND and I will force him to eat ice cream, because lots here say it is yummy ;) It is just not something we have here all the time, so I want to make sure it is available.

[l-horn]

Technically I would continue the riba for 5 days after my last shot since I started the riba 2 days before my first shot.  I don't think starting riba a few days before the first shot OR not continuing the last few days after the last shot
makes any difference, when it gets right down to it.  I've read here that the riba stays in you for up to 30 days post tx AND takes a few days to build up.

I started the riba before my shot. Do as you like, or as your doc said.

There are always people who disagree. I'm just saying that's what I did as per my doc. He said start the riba as soon as it arrived.

[jmjm530]

Normal protocol is to takethefirst ibavirin dose the morning of the first shot. However, your doctor is going to draw blood that day, you might want to wait until after he draws blood before taking the ribavirin. If it were me, I'd request another viral load test the day of your visit (before the shot)as well as a CBC which I assume he will do anyway. I'd also bring up the fact that you'd like a sensitive week 4 viral load test -- something like Quest Diagnostic's "Heptimax" that goes down to 5 IU/ml.  This blood for this test is best drawn the day before your fifth shot. You also want CBC's on a regular basis during the first 12 weeks. I had mine weekly but I also became anemic pretty soon.

As to I-Horn's suggestion of taking the ribavirin a week in advance of the shot, one of our members, FlGuy, did so as part of a planned strategy. This is not standard procedure by any means but personally I think it has great merit and would do it myself if I hypothetically had to treat again. That said, best to follow your doctor's directions, not to mention that pre-dosing ribavirin would screw up your blood tests at the doctors if he plans on taking them the day of your first injection.

-- Jim

[Fighting-this-Together]

Thank you for your quick reply. I think sticking with the original plan is a good idea. I thought the Riba works only with the Peg.

[welderman]

also keep him drinking plenty of water. I keep a bottle of water with me where ever I go. I don't know how much you should drink some say half your body weight in ounces. I just keep plenty going.

[Myown]

I wish your husband the best!
Side effects are different for everyone so try not to worry too much ahead of time.

[Fighting-this-Together]

Thank you. You were posting as I was. Hopefully FlGuy will come in and explain his strategy ;)
As far as the Quest Heptimax we have to go through Lab Corp does that matter?
He has an Appt with our PCP tomorrow morning maybe we could have her order the blood work.

Now I am confused LOL

[Fighting-this-Together]

You guys are quick this morning :) He drinks about a gallon a day already hopefully he will keep it up.

[nygirl7]

Well...the guys have already given you the best stuff but I just wanted to chime in and say GOOD LUCK!

And remember - if he starts to yell at you in a few weeks for ABSOLUTELY NOTHING...........it's the meds (Riba).  I don't know if you have kids or not but I am SO GLAD I told my kids and my parents about the riba rage BEFORE I started or they would have killed me off for sure!  It's crazy stuff...so just remember it's NOT YOU - it's the meds!

That might help you save your marriage!  ;)

On a serious note...good luck to both of you!

[jmjm530]

LabCorp is also very good. I think they have an even more sensitive test you might ask for at week 4, but this one might be better pre-treatment since it has a higher upper limit:
http://www.labcorp.com/datasets/labcorp/html/chapter/mono/id005500.htm

I flagged FLGuy, but like I said, pre-dosing with ribavirin is not the normal thing.

-- Jim

[NYCMark]

LabCorp has a similar test called QuantaSure that is sensitive down to 10 IU/mL.

Mark

[Fighting-this-Together]

Thank you all for the good luck and advice.

nygirl7 I will try to remember that :) It will definately be hard. He is not the yell at me kinda guy. So it will definately be interesting to say the least. I am more the "hot head" around here. Oh man, and to think if I had to take Riba.

jmjm530 Thanks, and hope FlGuy will give us his opinion.

NYMark thanks for the exact name of the test.

I am working on getting my ducks in a row, and praying for an easy Journey.

PCR and CBC
Water
Ice Cream
Pizza
Benedryl
TylenolPM
Tylenol

[l-horn]

If you don't, your first shot is basically mono-therapy. It takes a while for Riba to build up. I think I would have cleared at 4 weeks had I taken the Riba a week prior to my first shot. I started it as soon as I got ( per doctor ) and got my first shot 2 days after I started the riba.

Take the riba now. Trust me. You want your shots to be as potent as possible.

[Fighting-this-Together]

Thank you for giving an explaination. It does seem to make sense. We will see how he is feeling . Maybe he can start it tomorrow morning  after he sees the NP.
His PCR done Feb 19 had a low VL 712,000, but he is a 1a. So maybe it would make sense to get that built up in the system.

Don't most people continue to take the Riba after their last shot anyways?

[Kalio1]

I started riba with the shots, not before. You don't want to take antivirals without the Interferon and risk mutations is what I was told. I'd do it like your doctor said to.

[jmjm530]

Please, this is where the internet can get people into trouble. There is only one person I know here who has pre-dosed ribavirin and that is FlGuy, and I assume he did that with the knowledge of his treating doctor. That last part is very important, HIS TREATMENT DOCTOR WAS ONBOARD. I urge you not to pre-dose ribavirin without running it by your treatment doctor. By now, probably not too many people reading this thread, but I guarantee that if you start a new thread with the title, "Should I pre-dose Ribavirin a week before Treatment" NO ONE will tell you to do so without consulting your doctor first. At least I hope no one will.

-- Jim

[Fighting-this-Together]

Just wanted you to know that I would make him call the GI first. Guess I didn't make that clear.

[jmjm530]

You know, pre-dosing ribavirin is an intriguing idea, but these drugs are just too powerful to go solo. If you GI is onboard, that's another story. I'll be surprised if he says "yes", but I've been surprised many a times before here. Do let us know what the GI says, and all the best luck with your husband's treatment.

-- Jim

[l-horn]

I'd be willing to bet hundreds if not thousands of people have started riba a few days before their first interferon shot. Show me a link where it says definitively that it is not recommended or even moreso, dangerous, as you're making it out to be. For weeks or months, mabye. But for a few days. No frickin' way.

Ribiviron is used in monotherapy for other illnesses. Sars and RSV in infants. You're playing it like Ribiviron by itself is some kind of killer. You're giving the wrong impression.

[jmjm530]

She said "six days" before. All I'm saying is that it's not SOP and it should be run by the treating doctor for approval and monitoring if necessary. The links I have say ribavirin should be started the day of treatment with SOC.

[jmjm530]

Looking back over the thread, I'd like to apologize for my wording in "C18" above. I certainly could have expressed myself in a better mannered way,  but it's been one of those days. I thought we had a pretty good relationship in the past and hopefully we can agree to civily disagree on this one, and pick up where we used to be. To clarify a little, I don't think it's a "dangerous" approach, in fact I find it an intriguing approach. Just think for a number of reasons it should be medically cleared. Nuff said on that.

Be well,

-- Jim

[l-horn]

Yeah we're cool. It just kinda struck me the wrong way and I LOST in, man.

I'd also like to say that 'pre-loading' is generally a term used when taking a drug with an initial high dose to get the blood levels up quickly ( usually by IV ), then going to a lower, usually oral, dose to maintain that level.

Technically, taking riba before starting interferon isn't 'pre-loading'.

All is well. Congrats on your 1 year SVR. Man, I'd be having a big FAT cocktail were that me. I did shot 33 today. Whoooo-hooooo !!!