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12773 tn?1328913186

Quest & Heptimax test

Well had my visit with Gastro, and he was not too concerned about HGB as long as I am getting the shots again.  He says after next lab if still dropping, he will intervene and get more, but says it may take a few wks for the up'd dose to show anything.    I asked for the Heptimax test,for my PCR,  but doc had no idea what I was talking about. the one he ordered goes down to 50.  So not sure if it was the one that JmJm tells us to get,  I even asked Quest when I was there if that was the Heptimax test..   she says I have no idea.    So.......  Then when I was leaving told me it only takes up to 48 hours to get results back on this test.  I thought it took up to 2 wks for that one ???
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Avatar universal
I like the "HCV RNA QL TMA" a lot. The test codes vary in different parts of the country but if written like I did between the quote lines, it shouldn't be a problem. Alternatively, you can look up the test on Quest site and get the test code for your particular lab. If you run into a snag, tell me where you are and I'll get you the code.

-- Jim
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96938 tn?1189799858
I'll probably give that a go.  I've got a stack of scripts now, for various things covering the 48 weeks (pcrs, lfts,  tsh, U/S, C/T etc).  He tried to slip in one for a colonoscopy, but I poo-poo 'ed that one .  I've 'adapted' some rx's in the past. This is the output from liveheads and tx doc's consult translated from the consult notes to a spreadsheet to the rx's, with some editorial license on my part already.  Last pcr was wk 16, on 22 now.  Think I have one dated in the vicinity of 22 or 24 (delayed tx start for med accumulation).  Thing is, I don't imagine extending or restarting after this 46.  Sort of casting my fate to the wind with this go 'round. Liverhead told me, with great certainty 'und by 4 - go 48, if not -72 and I'll be in the clear for good.  I'm holding him to it.  Otherwise, he may get voted off and meet the same soon-to-be fate as Sanjaya.  In the meantime,  I feel as stable as Heather.  I'm mixing metaphors here, but I don't feel as smart as a fifth grader these days.
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Avatar universal
Have you actually checked directly with your insurance company or are you going on the doctor's say so on what is and what isn't covered? Many have found they've gotten incorrect info from their doctors on these matters and all that is needed is an rx for any test. But assuming it turns out to be an issue, you might want to take this test instead since it's only one step and therefore might be as acceptable to your insurance company as the PCR. The test is Quest's
"HCV RNA QL TMA". Once you've been non-detectible down to 50, it's just as good as Heptimax and happens to be the test I've taken since treatment ended. Sensitivity is like Heptimax down to 5 IU/ml. But if all fails and you have to go out of pocket, I'd suggest you take the sensitive test now and not post treatment. Post treatment may be good for your curiosity, but what you want to know is your response while on the drugs. So if I had only one sensitive test in the bag, I'd def use it now.

All the best,

-- Jim
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Avatar universal
Oh that poor dog! Maybe you can convince him to take the dog to the vet.
I don't get it. He wasn't taking good care of your doberman, why would he want another dog. The dog may really need to see a vet badly. I hope you can convince him to take the poor dog to the doctor.
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96938 tn?1189799858
The heptimax is an insurance issue.  In some respects, they are very liberal, in others not so.  The doc and I have agreed though that he'll write one rx for heptimax (even if it's on my dime), which will be the 3-4 weeks post.  I know what you are saying about the increased surety of the more sensitive, I agree and  I'd prefer that.  As it stands, when tx ends I'll have 44 weeks of und measured less than 50, which is something that I'm ok with right now.
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12773 tn?1328913186
Yes they rule our lives for sure.    Actually believe it or not he has another dog, called me just last week and asked about giving asperan to dogs.. says he accidentally backed into her and she leg was hurt..   He still hasn't take it to the vet..   He is a mess..  

I spent over 3500 in vet bills last year.. LOL
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Avatar universal
I'm really surprised you still order only the real-time PCR. Not that it isn't a sensitive test but why not go with the best available, instead of second best? As you probably know, Heptimax is a two-part test that uses the exact same real-time PCR as you take as part I. Then if your negative on the PCR -- and only then -- do they run part II. Part II is a very sensitive quantitative test using TMA technology that goes down to 5 IU/ml. Unless your insurance doesn't cover it, can't see any reason not to use the most sensitive available. And there is at least one study that shows folks often carry low-level viremia (below 50) on treatment and therefore test negative at EOT with PCR but in actuality are positive by TMA. 100 per cent of this subgroup group will relapse. By using TMA technology throughout treatment, there will be no guessing game in that regard because you're using the most sensitive tests possible.
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Avatar universal
Yes, the test is "Heptimax". Obviously, the Quest technician you talked to didn't bother to look it up. You can see it here on Quest's website. Maybe print out and show both to doctor and Quest tech:  http://tinyurl.com/2mf73j  Just keep in mind that test code numbers vary by the region, but writing "Heptimax" on the req form or rx, is all the doctor needs to do. If you want to go further, call your local lab and get your local test code, or find it on the Quest site. Heptimax goes down to 5 IU/ml, not the 50 IU/ml your doctor ordered. But since he ordered a PCR to 50 IU/ml, as an alternative to Heptimax you could add Quest's HCV RNA QL TMA to the old blood sample if enough is still available.
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Avatar universal
38lbs for a doberman, ugh!  I hope he never gets another dog, poor dog.

I agree about the small dogs at this point. Both our dogs are big and though I have always had big dogs and love big dogs, I envy people that have these little tiny dogs that they can take to the store with them. My one dog makes me feel so guilty if I have to leave her home alone just to run out to the supermarket. So I try to plan any of my outings while my mother or husband is here. It gets crazy sometimes. These dogs rule our lives, but I love them so much and would do anything to make them happy.



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12773 tn?1328913186
Well I am posting more today than I have really the past couple of weeks.  Can ya tell its shot day..  LOL  that is the day I feel the best.. but then the evil starts over..    

Yes giving up the baby was hard.  I didn't want to be around any of my friends, It was so depressing.. but after about 6  mos, I forced myself to take down the nursery and move on.    I am still waiting for what Plans God has for me..   Maybe it was meeting Mike and being a step mom.. who knows...  I still get upset sometimes watching silly stuff about babies.. but I am 47 now. no way do I want to think about starting a family.. Finally got the house to ourselves.. LOL    Its nice, I only had to start when they were teenagers.. LOL but that was pretty funny too..  

My ex and the dog.. yeah.. I wanted to choke him myself.  It was so sad, she was about 38 lbs I think when I took her to the vet.  But she recovered and gained weight, just not quite to what she was when I sent her to him.   When I moved in with Mike I did not want to take over his house with my dogs, so convinced my ex to take them both temporarily.   When we decided to keep the house and not sell it, I called to get them back, and he wanted to keep them, so I said well I will take Piper and you can have Cessna.. ( she listened to him better , even though she was my dog )  and then he thought he was gonna go to jail for driving w.o.l after 2 DUI, that I got her back.   and hadn't seen her for about 5 months, and she was bones....    But she had cancer, and Piper has Cancer and prognosis is guarded, she seems fine, and I watch for her to have any changes or more growths, but the time will come with her too.. and will just start over.    Trying to talk Mike into Mini Pins so we can take them with us, and travel, but he says you would give up a Big Dog for an ankle nipper ?     That is a good question...
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12773 tn?1328913186
Thanks.. yes losing Mom is never easy.    She had emphyzema, but refused to stop smoking.       My brother was all depressed over it, and some other health issues of his own.  He was on Paxil and was drinking,    so I am sure you know what that does.  Not a good combo..  Thats when he decided to shoot himself with a 30OT 6.. got his femorial artery on his right leg.    His whole stomach area is totally gone. all the fat and tissue and muscle is gone.  They grafted over it , and it looks like Jaws had him at some point.  

But he survived and gets around with a cane.  But they may have to remove that leg eventually, as he has a mass that is growing all around the artery they replaced, and its closing it smaller, leg is 3 times the size of his left one.  

Which he had a total knee replacement on, and body was rejecting during this time of Moms death, and they were talking about taking it off, that was part of his depression.     He lives out in Portland Oregon, and I am in florida.    At least I do still have my Dad.  I finally talked him into coming back from Mexico after Mom passed and getting a place near by.  That I worry about him traveling alone all the time.  So he did.  

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Avatar universal
That's tough, but I'm glad to hear that your father lives near you now. It helps to have a family member close by, or if no family, a person or people that is as close as family. Thats why friendships are so important. People do need people and no one really should be alone. Even just opening the phone book someone can find all sorts of support groups, religous groups etc.and if you're friendly,a person can have a bunch of new friends in a short time.

I think alot of times when someone goes through a tough time and gets hit with depression the worse thing they can do is isolate themselves. Though you do need time to grieve and sometimes even grieve alone, there comes a time you have to connect again to people. My cousin's boyfriend broke up with her. They were together for years. She was crushed. Then she lost her job,but really had no need to worry about money because my uncle is very wealthy. She didn't want help from them and had enough money saved to live off for a while, but I guess she was slipping into a deep depression and no one recognized this. She put a gun to her head and killed herself. I hadn't seen her in years and of course you feel terrible about not keeping in touch and all that, but even those around her didn't see any real sign.  I guess they thought she would be down for a while because of the break up and then she would snap out of it, but unfortuanately she didn't.

But in asking questions about her to my other cousins and aunt, I found that she isolated herself, mainly due to never really hanging out with anyone but her boyfriend and not having other friends. That 'one friend' could have helped if she had one. I think sometimes people think if they don't have alot of friends that it is too late to try to build good relationships at this point. That is a thriving fallacy as far as I am concerned. Some of my best friendships are the ones that I have developed over the last 5 years or so.

So anyhow I hope your brother gets well and I hope he stays connected with people. Have a nice weekend. I can't believe it's shot night already. The weeks are flying by.

See ya later!

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179856 tn?1333547362
I had the TMA to <5 and it took just the same week that my PCR took.

My regular doctor doesn't order them but Dr. J. did.  Now I'm going after my regular doctor to order them for me - no sense to have a high sensitivity and be falsely lead to thinking UND is correct without really having better proof.
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12773 tn?1328913186
Yes it is shot nite again. #14 for me.  . I have to go do my monthly shopping already tomorrow at the Base commissary.  Just hope I can make it thru, without feeling like I am gonna pass out.   Just gonna take longer, as I have to go slower.. LOL     I was married for 20 years,  we just grew apart.   we still speak from time to time..  Mostly about the dogs.. our only connection anymore.    But 7 years ago, I met Mike online and we have been together since.  So I do have someone close besides my dad, plus my adopted step daughter has been there to help me when I need it.   So thats been nice. And a few long time good friends.    Its hard to believe how many have passed at such an early age.   I always thought it would be me first, after going thru treatment 14 years ago and it came back ??    Just hope its works this time.  

Debby,

When I asked gastro about the Heptimax test, they had no clue.  I told him I wanted the most sensitive test with the lowest levels.  and tried to explain to him why it really DID matter about the 4 wk PCR ( which he refused to do ).. gave him some printed info on it and told him he could keep it... he thanked me and said he will pass the info on.    

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96938 tn?1189799858
I don't get too nuts about waiting for lab results, especially pcr's and lft's.  It's part of my 'less stress' theory of tx.  My job is to take the meds, stay upright when I should, lay down when I need and make it from one dose to the next.  The only exception to this is bi-weekly cbc's and I get instant results because the hemo has a cbc machine right in the room where they draw the blood.  Some things I can control, some things I can't.
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Avatar universal
adopted a son, who after 22 months, the mother decided she wanted him back. that almost killed me. but I am a survivor. I will get thru this too
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Well if you got through that, you can get through anything. That would have put me down for the count.

Your dog was skin and bones when you got him back from your ex? Thats awful. Glad you got him back.

You think your post was too long....I probably hold the record for long posts. ha!  I type the same as I talk...tooo much.  I like to talk to people so I can't help it.

see ya later.
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96938 tn?1189799858
I've found that insurance, and following their rules, is one of those necessary evils in the world of tx.  I would be scared to jeopardize that part, as well.  We've put off any energetic trips til tx is over, especially the theme parks.  There will be time later.  Starting in just a few weeks we'll have access to beach weekends again.  Although I'm not a sun worshiper I find that early mornings and later evenings walking and sitting on the beach are beyond theraputic on tx.
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Avatar universal
shot 14, ya getting there. Glad to hear you have people around you and its nice to hear that though you aren't with your ex, you still have a healthy relationship. Dog people usually always remain friends. If a person doesn't like dogs, I can't understand that. I am nutso for my dogs. I had one but now my mother is living with us and her dog is here, so I count that one as mine too.

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12773 tn?1328913186
Well I have to get used to going to functions while on treatment.  We have seasons tickets to the Bucs and Arena Football, Storm.     I went last saturday nite to the Storm game and did ok.. Luckily were able to park just across the street, so it was a breeze, except for the stairs going in.  I had to stop 2 times before I got to the top.. as long as flat walking, I can go further.. LOL  Just have to take rest stops...    It will be the Buc games I will have a hard time with.    In the sun and we park about 2 miles away and walk to the stadium, just so not to get caught up in departure traffic.      So that will be a problem I think.  I have been trying to get  a little bit of sun out by my pool, but with the pool screen you have to be out there a long time to get any sun, especially this time of year.   But its beautiful here too, just the water not warm enough to swim in.  No heater.. LOL    and as far as the job thing and insurance, I will just go back and if I can't handle it, then I may have to see what to do at that point.   the stress at my job is almost unbearable..    and Riba Rage and customer service issues sometimes are not a good combo.  I am in sales, but we are so micromanaged that we also have to cover a queue of customer service/ sales calls, and if you deal with the public, you know what I mean..    I was biting tongue there quite a bit towards the end.., and disputing everything my boss would implement. LOL  Which is not like me. I am the top producer and normally a positive person.    
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12773 tn?1328913186
Yes my dogs are my life.. my kids.. I never had any kids, in the 20 years married.  
Had 2 tubal pregnancies & 1 miscarriage, and had to receive blood after hemorage.    Hense the HepC...  1984..    Of course was 93 before I found out., and only because of other issues.. Gall Bladder, pain still from time to time in same area..   after its been removed.  now they say that is anxiety..  , and other health issues over the years, like gout and reflux, diabetes, and now I find out that most of these issues since have been because of either the treatment 14 years ago, or the disease itself.  Really sux..    
I even went thru invitro twice and adopted a son, who after 22 months, the mother decided she wanted him back.     that almost killed me.   but I am a survivor.  I will get thru this too..     But the dogs, yes were my rocks, when I split up with my ex.    It was hard to put the oldest down in January, but I still have her daughter , who is 12.   so as you can see they are my kids.. LOL, we may have to make that decision again soon with Mikes dog.   But its his call.  I say its time now, but not mine to say..      Piper would be so lost without both of her buds.. but she will make it too..   I did separate the 2 of them about 1.5 years, when I first separated from ex.  But then I met Mike and Piper had Oreo.. then I got Cessna ( mamma ) back from my ex.. she was skin and bones.    I was sooooo mad at him, I almost call the authorites,.. its a wonder no one else had, if they had seen how she was soooo skinny..  but she was funny. only eat when you eat.. so I guess he was drinking instead of eating.. LOL   He still drinks everyday..    But 15 is really old for dobies..  ooops.. sorry.. I guess I forgot I was not typing an email.. didn't mean to go on and on.  I got on the phone, and came back to this not realizing how long it already was.. LOL
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12773 tn?1328913186
I just hope I get the results back in time to get my refill ordered, as only have 3 left, and doing one tonight.. but If you say a week,, then I should have it back by next thursday, and that will be ok.      Also plan on going back to work the week after next , depending on how I feel that is, but really cannot afford the decrease in pay to 50 % at that point, so kinda forced into going back.     I was offered something under the table, but kinda scared to do anything like that, cannot think about losing my job or insurance if they find out.    I am gonna go back and work for 9 days, then take my vacation, unless something happens and I am not able to go.    We have a time share in Orlando, and live just outside of Tampa, so not a far trip.  Hoping I can handle Cypress Gardens or Disney, but if not, always got the garden tub in the room.  Which is where I spend my evenings.. LOL   but no more sipping wine...  That was about the only time I would drink.     we go every other year to Orlando, and go other places the years in between.   I was born in NYC, but have lived in FL since I was 5.   Palm Beach was where we moved to and lived till I was 15.    I loved it there, but too expensive for me !!!!    But I love the ocean compared to the gulf ..

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Avatar universal
sorry to hear about your mother. I don't even want to think about that day, though I do at times and it is so upsetting.

I hope your brother is doing well considering. Thats ashame.

I hope you feel better tommorrow. Stress definitely can make you feel like that.So a good nights rest should help.

see ya tommorrow.
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12773 tn?1328913186
I totally understood what you said. and can relate as well.  You would be surprised how many of my friends have died in the last 10 years, really sad.  I also lost my mom in the last 5, and almost my brother,,, he tried to kill himself, but he did survive.. he is just handicapped now.  

Well I am going to go to sleep.. really tired after this afternoon, and was having pains in my chest by the time I got home.. it passed after about 15 mins.. hurt when I would take a breath.. on my left side of my chest.. kinda scared me, but think it was just stress.
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Avatar universal
Glad you weren't involved in the accident. That had to be scary for sure. Thats sad that someone died. Having the cops show up at your door to give you the bad news is a nightmare. I know that first hand unfortunately.

It's strange sometimes because we all were faced with our mortality when we received the news of having hep, right away we figure we will be first to die out of everyone we know, but yet since I have been dx, I know of several 'healthy people' (young too) that have died. They didn't have the stress and worry of hep hanging over their head, probably thought they'd live forever and here we all on forum out lived them. Its just strange when we think about it and really helps bring things into perspective to try to enjoy each day as if you are well (if possible) because someone who is healthy can be gone before you and they weren't obsessing or  about dying, yet they did. I'm sure I made no sense to anyone but myself.  And no I don't smoke pot for sx. ha!

Take care
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