Aa
2nd round HCV treatment
Okie-Dokie;
It took me 6 months to get this together, but I've finally got the 2nd round of Tx going again. Here is a brief overview of round 1:
51 year old Caucasian male
Genotype 1a
Grade 2, stage 3/4
254 lbs
Diabetes M. type 2
Dx with HCV 12/04
Treated with Pegasys/ Copegus total 56 weeks, from 2/05 through 3/06.
Slow viral response at 12 week assay, so increased riba from assigned 1200 mg/day to 1800 mg/day.
Became undetectable to <50 IU by week 20.
Relapsed within 30 days post Tx.
I started round 2 on 9/15/06 with Peg-Intron 0.50 mL/150 mcg/week, and ribavirin 2000 mg/day. For the first three injections, I've been drawing up the entire contents of the IFN vial, after reconstituting with 0.70 mL of the supplied diluent. This has given me an extrapolated dosage of 202 mcg Peg-Intron/week, based on a 0.68 mL injection. Although this IFN dosage isn't officially sanctioned by my new doctor, I have an appointment this Tuesday, and I'll disclose at that time. My three-week labs should be available for review by then, and hopefully will show some positive trends; if not, there's always dose reduction... :-).
Subjectively, I feel fine after three injections; no side effects have shown themselves yet, however this is still *way* early in the game. Last treatment, I was good until week 9 or 10 before this cr@p started creeping up on me, so I guess time will tell the story.
It's probably worth mentioning that I've made some changes regarding exercise and diet as well. As a diabetic, it's important that I maintain tight blood glucose control- particularly while on treatment. Over the last six months, I've managed to lose approx. 50 lbs; walking 8 miles daily in the hills here along with removing most processed foods as well as meats (salmon only now!) from my meals has been really helpful. More and more evidence is suggesting that obesity and insulin resistance are both negative prognostic indicators for SVR, so we'll see if this has any effect in the long run.
I don't expect to be posting very actively; however that just might change if these meds begin slowing me down. Until then, I'm trying to stay as active as possible. I think attitude is an effective tool for Sx; during my last treatment, I resigned myself to the fact that I'd get sick from these meds. This time, I'm going to keep going until I get Gumby-Legs and can't walk... In other words, if the side-effects knock the door off the hinges, I guess they're coming in; however, I'm not going to wait around for them.
My very best to all those folks that I recognize from days past, in addition to a whole lot of new ones as well. Keep plugging away at this stuff, and we'll eventually prevail--
Bill
It took me 6 months to get this together, but I've finally got the 2nd round of Tx going again. Here is a brief overview of round 1:
51 year old Caucasian male
Genotype 1a
Grade 2, stage 3/4
254 lbs
Diabetes M. type 2
Dx with HCV 12/04
Treated with Pegasys/ Copegus total 56 weeks, from 2/05 through 3/06.
Slow viral response at 12 week assay, so increased riba from assigned 1200 mg/day to 1800 mg/day.
Became undetectable to <50 IU by week 20.
Relapsed within 30 days post Tx.
I started round 2 on 9/15/06 with Peg-Intron 0.50 mL/150 mcg/week, and ribavirin 2000 mg/day. For the first three injections, I've been drawing up the entire contents of the IFN vial, after reconstituting with 0.70 mL of the supplied diluent. This has given me an extrapolated dosage of 202 mcg Peg-Intron/week, based on a 0.68 mL injection. Although this IFN dosage isn't officially sanctioned by my new doctor, I have an appointment this Tuesday, and I'll disclose at that time. My three-week labs should be available for review by then, and hopefully will show some positive trends; if not, there's always dose reduction... :-).
Subjectively, I feel fine after three injections; no side effects have shown themselves yet, however this is still *way* early in the game. Last treatment, I was good until week 9 or 10 before this cr@p started creeping up on me, so I guess time will tell the story.
It's probably worth mentioning that I've made some changes regarding exercise and diet as well. As a diabetic, it's important that I maintain tight blood glucose control- particularly while on treatment. Over the last six months, I've managed to lose approx. 50 lbs; walking 8 miles daily in the hills here along with removing most processed foods as well as meats (salmon only now!) from my meals has been really helpful. More and more evidence is suggesting that obesity and insulin resistance are both negative prognostic indicators for SVR, so we'll see if this has any effect in the long run.
I don't expect to be posting very actively; however that just might change if these meds begin slowing me down. Until then, I'm trying to stay as active as possible. I think attitude is an effective tool for Sx; during my last treatment, I resigned myself to the fact that I'd get sick from these meds. This time, I'm going to keep going until I get Gumby-Legs and can't walk... In other words, if the side-effects knock the door off the hinges, I guess they're coming in; however, I'm not going to wait around for them.
My very best to all those folks that I recognize from days past, in addition to a whole lot of new ones as well. Keep plugging away at this stuff, and we'll eventually prevail--
Bill
Glad to hear you are not experiencing sides yet. Keep us posted on how this round goes. I drank all my water yesterday but today I wanted a coke. First one since Thursday. I guess it must be that taste. I too need to clean up my habits. SOme are pretty good but there are areas that I am really laxed. ANyway do keep us posted on your progress. Have not seen you post in awhile.
Pat
Pat
WE have been looking for you!! Glad your back on track with tx, sorry your having to tx again!! Hang around, you've been missed!!
Hey Bill and Coldfeet! Looks like you both have a very positive spirit about you and the virus doesn't have a chance!!! What is the plan for you both this round? 72 weeks? My heart goes out to anyone that has to resign up for interferon! You both must be very strong people!! Good Luck to you both!!
I opted for the 72 wks peg/riba, gonna be a long trip,going to get 8wk PCR next fri. 4wk showed went from 4million 700thou to 54thou so hoping to clr at 8 wks.Thx for your support,we all need it.
Hi Bill,
Good to see you posting again and back on treatment.
If I remember correctly, even with all the riba you took last time, you had very little anemia and were still positive at 12 weeks? Are you planning anything different this time (like extending to 72 weeks) other than simply switching Pegs?
I flagged "Fishdoc" because I believe her consulting doctor suggested she may be riba-resistant or something like that given her lack of anemia. Certainly, there is enough data out there -- for me at least -- to suggest that ribavirin isn't absorbed by all of us in the same way, and that dosing riba by weight (as opposed to serum ribavirin levels) may not work for everyone.
I guess where I'm going is that you again mention "no side effects" like anemia. If you don't go anemic soon, it may suggest that you're not getting enough riba for your individual body chemistry.
Although there are obvious risk going above 2000mg/day, it's an approach you might want to discuss with your doctor. In the Sweedish high-dose riba study, I believe some took close to 4000 mg/day of riba, but of course they had the advantage of knowing serum riba levels. The best we have are viral response and anemia, certainly not as exact.
All the best.
-- Jim
Good to see you posting again and back on treatment.
If I remember correctly, even with all the riba you took last time, you had very little anemia and were still positive at 12 weeks? Are you planning anything different this time (like extending to 72 weeks) other than simply switching Pegs?
I flagged "Fishdoc" because I believe her consulting doctor suggested she may be riba-resistant or something like that given her lack of anemia. Certainly, there is enough data out there -- for me at least -- to suggest that ribavirin isn't absorbed by all of us in the same way, and that dosing riba by weight (as opposed to serum ribavirin levels) may not work for everyone.
I guess where I'm going is that you again mention "no side effects" like anemia. If you don't go anemic soon, it may suggest that you're not getting enough riba for your individual body chemistry.
Although there are obvious risk going above 2000mg/day, it's an approach you might want to discuss with your doctor. In the Sweedish high-dose riba study, I believe some took close to 4000 mg/day of riba, but of course they had the advantage of knowing serum riba levels. The best we have are viral response and anemia, certainly not as exact.
All the best.
-- Jim
You have a great attitude. I admire your strength and determination to fight this think no matter what it takes. I know your determination will help you get through the rough times, and I hope there's not that many for you. Good luck!
sure hope it works out for you...jim's comments on the 'fishdoc syndrome' may well be applicable- tho my hgb stayed within normal range until after i cleared @ week 12.....but i have been on procrit for 35 weeks now..i have always taken All the peg-intron that i could squeeze from the vial,seems o.k. in my very humble opinion.....weight loss sounds like a real good decision;i also lost 50 lbs before trx'ing..the walking will also do nothing but goodthings for ya...GOODLUCK & please keep posting
Welcome back to the Jumanji game! Hope your sx are not bad this time. Don't be a stranger, you have so much great info to give! I hope you don't get gumby legs and have to give up your busy life, but I do hope you keep posting when you can.
Wishing you the best on tx this time!!
Wishing you the best on tx this time!!
TX is a game of second guessing, should ofs couldofs wills... I lost 58 lbs, same reason as yall, but I still have a bmi of 29, so i could have done better.... I think Bill is starting at 2000 mg of riba, so that is a hard hitting dose. wish he was on vertex too.........funny how if it was up to us, we'd fix it all if we could for our fellow heppers..
Whew Hoo Bill... glad to see your back & started again...
Good For You!!! I hope #2 will be the magical # for you too!
Buckle up that seat belt (the ride still gets bumpy)...You'll be in my thoughts & prays also.... !!!
;)
Good For You!!! I hope #2 will be the magical # for you too!
Buckle up that seat belt (the ride still gets bumpy)...You'll be in my thoughts & prays also.... !!!
;)
That was over a period of 4 years, not dieting. Fat people should never never never diet, best way in the world to gain weight!! That was just making healthier choices,, baked potato or curly fries... well duhh!! Last 20 lbs was on nutrisystem, trying to go low for this tx...haven't gained or lost in 7 months...
WHOO HOO!!! HI THERE...SOOOO good to see you!!
This ole fatty just gained 3 lbs out of nowhere...I'm not eating much at all lately, and really felt I had lost quite a bit over the last few weeks (even family said I had lost wheight) so I wheighed myself. HMPH! Yeah right.
This ole fatty just gained 3 lbs out of nowhere...I'm not eating much at all lately, and really felt I had lost quite a bit over the last few weeks (even family said I had lost wheight) so I wheighed myself. HMPH! Yeah right.
yup, some of us are just marvels of efficiency!!! Food gettin scarce...don'worry lil girl, we're gonna take care of you...300 calorie a day liquid diet...don worry lil girl, we'll save your @ss, I mean fat for you...I am just happy not to be gaining...especially with the thyroid issues... oh yeay, hyperthyroid, maybe i'll lose a ...don worry lil girl, we save your fat for you!!!
HAHAHA...this has been one of my best days so far on tx...who woulda thunk it!! All because of ya'll. Yup, I am sooooo one of those "cornfed girls" out here on the border of Nebraska, Iowa and So. Dakota...hahaha. Gee I sure missed bieng up and up online. This has been a great day 4 me...I went thru such a time this past few weeks, just couldn't hardly lift a finger to type and didn't have the brain capacity to think even if I could write! Luvs ya, Luvs ya, Luvs ya!!!
Hey there fellow native Sacramentan. Good to see you, it's been a while since I have seen you in a room anywhere. I started TX on 7/28 just took shot 10 of 48. Good to see you started again. I like the idea of hitting the virus hard and heavy at first and then backing off a little after being on TX for a while. Maybe it will work for you. will keep my finger crossed and even say a lil prayer.
Take care
Nicki
Take care
Nicki
I just got the calender out yesterday and I started on 2.10.2006, but went undetectible on 7.27.2006, so I am counting 36 weeks past that day....long roe ahead of us, hey?
Glad you got the plan lined out. I am duly impressed - walking 8 miles a day in the hills no less and changing your diet dramatically. Wow. I can tell you are determined that this will work this time.
2000 riba should sure do the trick. If it doesn't I wonder if any amount would.
Best to you - I will look for your posts.
kathy
2000 riba should sure do the trick. If it doesn't I wonder if any amount would.
Best to you - I will look for your posts.
kathy
I dont mean to take your hopes down or anything but to be honest part of your failure lies in your weight.Treating at that weight is huge factor in your treatment failing the first time.How do i know because i also treated at the same weight as you and failed.i did my research and found out the majority of overweight patients on treatment fail.Retreating now with nothing changing in your current physical condition will show no changes at the end of this treatment but loss of motivation.you must prepare your body for it.Exercise expand the veins,increase heart rate,increase protein to repair the livers damage from the virus,and remove the fat from the midsection so the pegasys can circulate.You will notice at that weight as i did the interferon almost seems non existent cause the weight is so high.its trapped in the fat.
I am preparing for my next treatment but not till i get my weight down.I am now at 210 from 250 and will retreat at 190.I would prefer to be at 180 but i dont think at my current weight loss i would hit that for quite a while.
I have cirrosis and have been working out 4 months now and have lost 40 pounds.Working out mon,wed,fri with weights and 10 minutes of cardio at end of weight training.If i have the energy i do cardio for 30 minutes on tues and thurs.Low impact since my joints hurt me alot from being overweight for so many years.I eat 4 small meals a day.
I eat 4 egg whites and one whole egg in morning with ketchep mixed with 1/3 cup oatmeal.
Then to gym.
After gym banana 1 teaspoon peanut butter,and chicken or oatmeal again.and yes it tastes horrible,but i want to succed at treatment this time.
supper my wife makes roast beef,more chicken,or steak.
For my last meal i eat yogurt 1 more teaspoon peanut butter and almonds or pecans,or my fav snack grape tomatoes.
I have one junk day a week on sundays i eat ice cream,cookies whatever i want to relieve my cravings then back on track from mon to sat dedicated.
I am keeping a photo journel of my changes i will post it once my goals are achieved once a month i take front and side photos of myself.I have noticed since i have been working out i have required my sleep for my liver to repair and keep with the virus.i try for 10 hours a night.
anyways if you decide to go for it now good luck.But i suggest taking 30 pounds or more of fat away first.Then you can be confident things have changed this time for success.
I am preparing for my next treatment but not till i get my weight down.I am now at 210 from 250 and will retreat at 190.I would prefer to be at 180 but i dont think at my current weight loss i would hit that for quite a while.
I have cirrosis and have been working out 4 months now and have lost 40 pounds.Working out mon,wed,fri with weights and 10 minutes of cardio at end of weight training.If i have the energy i do cardio for 30 minutes on tues and thurs.Low impact since my joints hurt me alot from being overweight for so many years.I eat 4 small meals a day.
I eat 4 egg whites and one whole egg in morning with ketchep mixed with 1/3 cup oatmeal.
Then to gym.
After gym banana 1 teaspoon peanut butter,and chicken or oatmeal again.and yes it tastes horrible,but i want to succed at treatment this time.
supper my wife makes roast beef,more chicken,or steak.
For my last meal i eat yogurt 1 more teaspoon peanut butter and almonds or pecans,or my fav snack grape tomatoes.
I have one junk day a week on sundays i eat ice cream,cookies whatever i want to relieve my cravings then back on track from mon to sat dedicated.
I am keeping a photo journel of my changes i will post it once my goals are achieved once a month i take front and side photos of myself.I have noticed since i have been working out i have required my sleep for my liver to repair and keep with the virus.i try for 10 hours a night.
anyways if you decide to go for it now good luck.But i suggest taking 30 pounds or more of fat away first.Then you can be confident things have changed this time for success.
just noticed my bad you mentioned you have already lost 50 pounds you are right on track.awsome i see success in your future with this treatment.
Welcome aboard! Glad you could join us for the ride LOL
I did the same thing as you using the whole vial on shot day. I also did an additional shot mid week for the first month, sort of my own brand of induction therapy. I wasn't as brave as you with the Riba (plus I couldn't get my hands on enough to do 2000/day or I would have!)I did 1600 for the first 6 months and that kicked my arse. I was UND by week 4 so it was worth it. I lowered the Riba to 1200 after that. Still UND so far. Hope you have minimal or NO sides! I guess if we don't see you that will be a sign of good news!
I have been so pleased because my platelets went up to `137 and I was told they might not ever go up again so I take that as a very good sign!
I was reading today about how using two interferons can really bring histologic improvement ( a la MKAndrew) and I am going to try to get my doc to give me two when I finish tx if he will go fo r it. Seems to work for many.
I did the same thing as you using the whole vial on shot day. I also did an additional shot mid week for the first month, sort of my own brand of induction therapy. I wasn't as brave as you with the Riba (plus I couldn't get my hands on enough to do 2000/day or I would have!)I did 1600 for the first 6 months and that kicked my arse. I was UND by week 4 so it was worth it. I lowered the Riba to 1200 after that. Still UND so far. Hope you have minimal or NO sides! I guess if we don't see you that will be a sign of good news!
I have been so pleased because my platelets went up to `137 and I was told they might not ever go up again so I take that as a very good sign!
I was reading today about how using two interferons can really bring histologic improvement ( a la MKAndrew) and I am going to try to get my doc to give me two when I finish tx if he will go fo r it. Seems to work for many.
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