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Avatar universal

Am I depressed?

I've been taking peginterferon and rebatol for 20 weeks.
What are the depression symptoms? I feel very weak, tired and no motivation
in doing nothing and have hard problems sleeping.

Am I depressed?

Am I depressed because I'm tired or am I tired because am depressed? In other words...Does it start from my brain or my body??
I'm so confused.

Can the meds I'm taking do that?
26 Responses
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Avatar universal
I SMOKED POT FOR ABOUT 15 YEARS...STRAIGHT. DAY AND NIGHT. IT WAS SOMETHING THAT I "THOUGHT" I ENJOYED. MAYBE IN THE BEGINNING IT WAS FUN BUT THEN IT TURNED INTO AN EXPENSIVE HABIT. WHEN I FOUND OUT I HAD HEP C, I WAS DEVASTATED. I JUST KNEW I WAS GONNA DIE AND SOON. AFTER THE TRAUMA I TRIED TO SMOKE POT AGAIN, AND PARANOIA CAME. I CAN NO LONGER SMOKE IT. WHEN I DID TRY TO SMOKE IT AGAIN ALL I COULD THINK OF WAS MY DISEASE AND HOW DEVASTATED I WAS. IT NO LONGER AGREED WITH ME. I LIKE THE WAY IT SMELLS, THAT'S ABOUT IT. EVERY ONE HAS AN OPINION AND PAST EXPERIENCES... THIS IS MINE.   HAVE A NICE DAY.
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Avatar universal
I support pot (medical or otherwise) for sx on tx as long as it is tolerated.Unfortunately, for me it isn't.

What we were talking about I believe is chronic use and whether or not it effects fibrosis progression. I think that's what the study Sandi referenced above is about, although not really up to rummaging through it now. Here's another study (or maybe the same) that I had marked.
http://www.natap.org/2005/HCV/062705_01.htm

I'm presenting this informational purposes only. No dog in this fight as I'm a non-pot smoker for other reasons and therefore have had no motivation to do any in-depth research. Maybe those that are chronic uses will pursue this more.

-- Jim
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Avatar universal
There is a seminar/symposium/meeting, whatever you wanna call it at the hospital where I work on Oct 20 on Hep C tx and liver transplant...a couple of doctors, infectious disease guy and a psyche doc, health dept nurse, transplant recipient, etc...perhaps I will ask them about this and other issues. Does anybody have any links on new treatments or studies that I can print and bring along? I could dig around this site but I don't have the energy...If anybody is in the upstate NY area and wants to go, here is the info:

http://www.benedictine.org/hospital/calendar.html

Cin
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Avatar universal
The only study I've seen, not sure if it's the only one people refer to around here; has two major flaws for you to consider.
One: Many test subjects also used other recreational drugs and/or drank alcohol. Two: The charting of fibrosis progression showed no difference from the % of error due to taking samples from different parts of the liver or from different pathologist reading the same samples. So take it for what it's worth. We are not talking about chronic use here, we are talking about occasional use for the relief of sx from these toxic drugs. I bet your pain meds are doing a hell of alot more damage.  Peace
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Avatar universal
Hi trouble maker. :)

I'm not really for Ritalin or even against Pot in all cases.

Regarding the ritalin, I was just answering someone's question which if I remember correctly was if ritalin is prescribed for hep c related depressive syndrome and the answer is "yes".

My shrink recommended it and similar drugs are recommended and talked about in a recent and very interesting web cast at Projects In Knowledge.  

And, yes, I decided not to take it for a number of reasons including the fact Ritalin is an appetite suppresant and I had already lost 20 pounds by that time -- although I didn't have any info that it was bad for your liver. My uneducated guess is that like a lot of drugs many of us take (including tylenol) ritalin in appropriate quantities is OK, otherwise it would not be so widely prescribed. Again, not recommending ritalin, just pointing out it's one more tool to get people through tx and they should discuss all of its potential side effects (including its addictive nature) with their doctor. Same thing for Provigil which is equally addictive and probably more widely prescribed for Hep C patients.

On the pot -- pot doesn't agree with me anymore or otherwise I would have taken it (medical pot or otherwise) early on in tx for
nausea and appetite enhancement. That said, I did see some articles about pot and fibrosis progression that you seemed to pull up. Haven't had a chance to re-read them -- did you get anything out of the articles? I would think it's something to think about.

I agree there are other more natural ways -- some of which you listed -- to help with energy levels during tx. In the end, you gotta to what you gotta do to get through. We all are different and some things work better for us than others.

-- Jim
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96938 tn?1189799858
I hope to be where you are some day.  Congrats on the 'cure'.  In the years since tx how has the improvement to your liver been demonstrated, blood work, enzymes, subsequent biopsy, scan?  I'm curious to know, beyond PCR at 6mos. + what kinds of liver follow-ups you may have pursued in the past 3 yrs.
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Avatar universal

JIM, IS THIS THE ARTICLE YOU ARE LOOKING FOR on pot?

"Daily Smoking of Cannabis Is a Risk Factor for Fibrosis Progression in Persons with Chronic Hepatitis C".

http://www.hivandhepatitis.com/2004icr/39easl/documents/0426/042604_hcv_6.html
          
"This study discloses a strong link between daily cannabis consumption and fibrosis progression rate in patients with hepatitis C and supports our experimental data demonstrating the profibrogenic role of CB1 receptors. Daily cannabis smoking should be avoided in patients with chronic hepatitis C."

OR TRY THIS LINK...
http://hepcassoc.org/aasld2004.html#cannabis

the other thing i've heard of is that good adherence to tx leads to better treatment outcomes. i asume that drugs like pot and others as well as alcholol can cause folks to space out their treatment scheduals and perhaps forget doses...

http://www.hcvadvocate.org/hepatitis/hepC/hs-9.html

but, i still couldnt find the an article about pot and svr outcomes...  sorry!  hey if you ever find it can you pass it along to me too? thanks jim?

"AND NOW FOR SOMETHING COMPLETELY DIFFERENT..."
*RITILIN,RITILIN,RITILIN*

I still think the Ritalin is NOT worth the added HCC risk "because we already have a risk of getting liver cancer just from having the hep c".  Increasing the odds of getting liver cancer would be really stupid... like begging for cancer, "could I please have a better chance of getting some cancer in my liver, please dr??? all i want is just a little better chance of getting it than just this dumb old hep c.

heeheeheee...really though!:0)

Hepatitis C and Hepatocellular Carcinoma
http://www.hepnet.com/nih/bisceg.html

"Chronic hepatitis C can cause cirrhosis, liver failure, and liver cancer. Researchers estimate that at least 20 percent of patients with chronic hepatitis C develop cirrhosis, a process that takes at least 10 to 20 years. After 20 to 40 years, a smaller percentage of patients with chronic disease develop liver cancer"...

i wouldn't want to increase those odds just for a reason of being weak and tired...that's hardly a life or death issue requiring a posible "cancer" risk solution!!!....its not like fatigue will kill us if not treated...so i don't agree with your idea that we must do it to be able to stay on the tx to achieve svr...

you know most of us get that from the tx and from the hep c, and its a bummer for sure... but most seem to manage...and in 3 years of comming to this forum i have never heard of anyone seriously suggesting starting Ritalin for fatigue...what about the increase in heart attack risk?


***************************************************************
HOW ABOUT SOME HEALTHIER IDEAS OF HOW TO INCREASE OUR ENERGY???***************************************************************

don't forget that alot of that fatigue comes from low hemaglobin or rbc's... "Procrit" could be the clincher!! this would definately help them feel better and have more energy, as well as other benifits...with no risk of liver cancer.

is the person getting enough sleep and rest?...how about some ambian? there's nothing like getting extra sleep to begin feeling more energetic during the day.

are they fatigued from aches and pains?..."Tramadol", which is non adictive is really helpful in this...and my hepatologist says tylanol taken as directed is safe on the liver if compensated...i only take one if the tramadol dose'nt do the trick and it gets me through.

what about green tea or coffee??? they both increase energy and both have positive things written about them concerning liver health...

AND THEN THERE'S ALWAYS EXCERSIZE!!! YUCKY BUT WORKS!

CHOCOLATE.... gives me energy and has been shown to have alot of antioxident benifts in the cocoa flavanoids...helps skinny folks gain weight too if eaten in large quanities <;0) heeheehee...

see doesn't that sound better? have a cup of coffee with a chocolet bar...yummmmmm! that's what i do every morning to wake my butt up and getter going!!!

(there is a new "health" chocolet bar sold only on the internet called "COCOA VIA" at www.cocoavia.com, that boasts making the chocolate in the very best way to researve the healthful cocoa flavanoids, it also has soybean extract and great healthy vitamins as well... like e and c and folic acid, calcium, b6 and b12....healthy, yummy and will open your eyes and git ya movin!!!...)

i eat the "chocolate blueberry crunch bar", they also have cherry and other flavors, only 80 cals and 2gms fat... with real blueberries in each one...i have one for breakfast with meds and coffee... we're suppose to have a bit of fat with our meds anyway...it helps the meds metabilize to the system correctly...

*coffee may have benefits against liver cancer...
http://www.hepatitisneighborhood.com/content/in_the_news/archive_2488.aspx

Green tea protects livers...
http://www.news-medical.net/?id=7841

Green Tea Ingredient Might Block Fatty Liver: Study...
http://www.hepatitisneighborhood.com/content/in_the_news/archive_2263.aspx

but, if a person's dead set on receiving their energy from a pill... than ask the dr about safer meds than ritalin because of its liver cancer risks.  i bet there must be some prescription out there that has similar effects as the ritalin on energy but without the added liver cancer reports...

my Prozac gives me energy...it's an AD plus gives me extra energy...and also has helped me not to have any depression in the two years i've been on tx... not too bad i say...but weight loss effects make it a bad choice for thin folks suffering from lack of appetite on tx...prozack will make that worse...

some other AD'S spoken of giving energy are bupropion [Wellbutrin], reboxetine [edronax] or moclobemide [aurorix]? Paroxetine...but i have NO idea if they are safe for the liver...  a trusted hepatologist could give some ideas on that to the patient with depression needing extra energy...

All i know is that an increased risk of liver cancer for hep c patients is not a good idea at all...esp. for a reason such as a need for more energy...this is hardly a life or death issue...worse thing that happens if we say no to ritalin is we're exhausted and have associated problems due to that...but it is all temparary and none fatal...

this person also should start getting used to this "exhaustion" effect from the TX and learn to adjust to it...we need much more rest and avoid alot of difficult physical challenges...we are sick!!! and it's okay to rest and just be sick...and getting rid of hep c is our main priority...not even our jobs are more important than our lives...we must do what we must do to get rid of this killer hep c......it's hard to do if ones been a "DOER or WORKAHOLIC" for thier whole life...its hard to settle down and expect way less from ourselfs and simplify life and expectations...also when we are sick we must have lots of rest and "getting free of c" takes all priority in our lives because THAT is a life and death issue for us, our friends, and family.

hey Jim, just curious why you said that "YOU" decided against the ritalin???

YOUR TROUBLE MAKER PAL,
SANDI <;0)~

hey, all trouble making aside, how are you feeling Jim? any better at all?  i sure hope so. i haven't been able to get on the computer that often do to the shut down probs...but, i'm praying your feelin better Jimbo...

sandi

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Avatar universal
You open your eyes, stir up and feel achy and in pain, bingo! you then feel depressed. It is a natural reaction to an ongoing state of being. Is it clinical depression? The mini mental I had to take monthly during tx did not think so. There are specific questions that will signal the provider that we are entering a danger zone. What we feel is a natural progression to the tx and sometimes to the chronic infection itself.
Before dx, I felt mildly depressed, I was achy and fatigued and just felt plain "not right". I thought it was all in my head. HCV dx was a blessing in that respect. It validated my suspicions. Mild damage aside, I wanted that feeling gone, as well as HCV. Why wait until I felt worse or my liver took a nose dive?
Remember how we felt when we had a cold, the flu or a fever? The body slows us down while we heal. We feel yucky. But is short lived. So we get over feeling bad. Most of us go on a very long tx journey. We have to live with this feeling for what seems forever. It is going to be demoralizing. If our providers do not find a good effective pain med for us to get relief, the bad feeling will remain with us for the duration of tx. I was able to take Vicoprofen(hydrocodone+ibuprofen) and that was a med that allowed me to continue working and going to the Y weekly. And then the Procrit was added also.
I still felt mentally exhausted, and the apathy was overwhelming, but the mentioned meds took a lot of the edge off. You must INSIST on effective medications to have a shot at some normalcy. The hydrocodone had the added benefit of keeping my intestinal cramps under control as well as the runny nose and cough. It had a multipurpose for me, just one med.
That is why they are treating depressed individuals with chronic pain with pain killers and antidepressants, because it is a vicious cycle.
Pain=depression=more sensitivity and intolerance to pain.
The apathy can be such, that we don't even want to make the effort to try and feel better, we don't even care if we do feel better. Scary feeling, apathy is.
I chose not to add any ADs because of their own sides, and stuck to the pain med(worry about dependance later), which also aided in keeping me calm.
This site mentions the articles related to health and happiness, you can check the magazines and books out at the library.
http://www.time.com/time/2005/happiness/
remember the dr Robin Williams portrayed in the movie "Patch" Adams? It was a true story.
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Avatar universal
Some interesting points you bring up but it still comes down to risk and reward, like many of the drugs we take. If ritalin or Provigil, or whatever, will get us through tx, then some risk is justified because our best chance of not getting liver cancer is SVR.

My shrink recommended ritalin to me early in tx and I chose to pass for a number of reasons. But speaking of studies, a number were recently posted about the detrimental effects of smoking marijuna and liver  -- specifically adversly affecting treatment outcome. I tried to search the archives but some of the links do not work.


-- Jim
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Avatar universal
AAAHHH yes the 'white crosses' I had forgotten all about those things! so many years ago...so little brain matter left...but I remember those! funny what you remember isn't it?

And the joint smoking...I enjoy it a great deal and it's one of the things I have a hard time giving up...I don't drink, don't do much of anything else either so it is one of the few pleasures I allow myself...However, from what I hear, it causes liver damage but if I don't have much damage then what the f***? How can it cause damage and I've been a chronic smoker for at least 30 years...and have very little damage? hmmmm...quite the conundrum...

Thanks for puttin the scare on me about my liver...I think I'll go smoke a joint and calm down...

Cin
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Avatar universal
Smoke a joint and calm down.  We're all depressed for one thing or another @ one time or another.  I find smokin' a joint and takin' a long walk seems to help that helpless feeling.

I was infected via transfusion in '67.  Altho I was dx w/dif types of hep c, no one thought it was important.  I didn't even know I had hep c until 2 wks after my liver failed and I ended up in icu.   There's tons of people like me.

Now as to the wisdom of waiting until you have real problems and irreversible damage, that's just crazy!  

My acc't told me today of a client who had localized tumors in her liver and had 80% removed and expects to have her liver 75-80% regrown by the time she leaves the hospital in 2 wks.

And I have another friend who didn't tx, transplanted and the new liver is now a stage 3 in less than 8 mos.

Now 4 yrs ago they told me I would be dead in mos if not sooner.  I tx'd 24wks-72 shots peg intron,-3 shots a wk- pen, 5 ribas a day.

So 3 yrs ago I was 'cured' and now I have 3 yrs of growing a better liver    instead of being dead or waiting to get even sicker.

I would rather be growing a new liver instead of watching the diseased liver fail.
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Avatar universal
Taking Ritalin with hep c may not be the safest suggestion...it is addictive and it is a speed so it has heart attack problems associated with it...and so can the hep c treatment...

but the real reason i think it shouldn't be used with liver patients is because, it has been shown in mice, to cause hepatoblastomas, (liver tumors and liver cancer) ...and many folks/drs may not know this...

but, i'd be real careful about the ritalin because it's been linked to liver cancer in mice...mice have always been the closeset animal "double" before going to human trials, because alot of their biology is similar to ours...anyway, please read this and bring to the dr if any of you are ever concidering ritalin with hepatitus c or liver damage...cause that would put you at an even greater risk of getting liver cancer with ritalin...hep c is one of the main reasons folks get liver cancer in america!!! and that's without ritalin in the mixture!


               "Ritalin and Liver cancer"
http://www.preventcancer.com/patients/med_avoid/ritalin.htm

..."Adult mice were fed Ritalin over a two-year period at dosages close to those prescribed to children. The mice developed a statistically significant incidence of liver abnormalities and tumors, including highly aggressive rare cancers known as hepatoblastomas (liver tumors)...

These findings are particularly disturbing as the tests were conducted on adult, rather than young mice which would be expected to be much more sensitive to carcinogenic effects. The National Toxicology Program concluded that Ritalin is a "possible human carcinogen," and recommended the need for further research...." try above link to read more on this.

hope this was somewhat helpful...i pray mauka that you will be feeling well again soon...believe it or not you will get used to functioning on this stuff...i would try the antideppresants way before the speed. i use prozack and i think it helps me with depression and energy level...and for me it has a double positive...it helps with loosing weight...i would try a different AD if you can't afford to loose more weight...but there are many out there to try...trazadone an AD also helps with sleep...

my prayers are with you,

sandi

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Avatar universal
I was in the minority of those people who had a full-blown acute stage of the disease.

In 1969, my skin and eyes became jaundice, my urine turned brown, I had fever and my liver enzymes were through the roof. The diagnosis then was first acute hepatitis and then when I couldn't clear it, the dx became chronic persistennt hepatitis.

I had my first biopsy around 1970 and I think it was stage 0 or 1 because I remember they said I had no damage. Later the dx was changed to "non-a, non-b" hepaitits and finally, to hepatitis c when tests became available. I had several acute relapses in my early twenties and then it seemed to go away.

Since there was no such thing as "hepatitis c" in those days I continued to live a normal and active life, working, playing competive sports, even winning endurance races. I basically pushed the whole hepatitis thing completely out of my mind and just figured I had some sort of liver damage but since there wasn't anything I could do about it (no dx of hep c, no treatment then) why even think about it. And I didn't. My liver enzymes remained mildly elevated the whole time except when I went on a very low-fat diet (Pritkin). During those periods they "normalized" but studies show that enzymes in the "normal" range aren't necessarily normal. For example, right now my ALT is 16 on tx. It never got that low even on the low fat diet.

I only decided to treat when I was told three years ago I was a stage 3/4 after being dx with hep c.  My understanding then was that I was between stage 3 and 4 but in fact what that means is that I was stage 3 out of 4 stages. Even then it took me 3 years to begin tx although over a year was wasted because of a bad reaction to some herbs and/or the hep b vaccine.

After I started tx I had my biopsy re-evaluated and staged at 2-3 out of 4 stages. Had I known that I was a stage 2-3 out of  when I started (as opposed to thinking I was between stage 3 and 4) I probably would not have started treatment 32 weeks ago and would now be in a watch and wait mode.


-- Jim
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Avatar universal
Hi, everyone, just thought I'd jump in this conversation, I don't think I'm depressed but I'm so tired that everything I do I go to sleep afterward, go grocery shopping, fall asleep, go get gas, come home fall asleep. I've never seen anything like it and I thought it was just me, I actually had to get my niece to come sweep, vacuum, and mop my house. I take Procrit every wk now and never would have thought I would be so tired. Plus last time I posted I ended up with flu and sinus infection and it just seems like I got weaker. I thought maybe it had something to do with the kidney disease, but I hear alot of you saying the same way I'm feeling so I guess I'm on track, This will be wk 8 of 12, still no sides, other than weak. Anyway everyone take care. Linda
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Avatar universal
Mauka, I had to go back and read your thread from about 2 weeks ago to refresh my memory.  You were on week 20 and had had no blood work and no PCR done.  You lived in New Orleans and are now looking for someplace in Baton Rouge to get your labs drawn, right?  I would say you have a lot of reasons for depression outside of your tx. It seems that your life has been thrown into - I don't know - but it has got to be hard.

I think the first thing you must do is find somewhere to get some labs -- even if you have to go to the emergency room and tell them you are anemic - surely they will draw bloodwork there for the CBC.  Then you can at least see where your hemoglobin stands.  From what you are saying, I think you are anemic but depression has certainly got to factor in there.

Please see if you can find some medical care and stay in close touch here.
Kathy
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Avatar universal
"Sometimes I wonder though, if it makes some of the dryness problems worse."

Still learning.  What does this mean?  

Pirategold
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Avatar universal
You said that you contracted Hep C in 1969 so you have had it for 37 years.  How did  you know you contracted it in 1969?  Has your ALT been elevated the entire time?  And now that you are treating and suffering sx, were you motivated because of the Stage/Grade or were you suffering before treatment with symptoms?  Just trying to get a handle on what I have to possibly look forward to as time passes.  6/04 BX was Stage 1, Grade 2,1B.

Thanks for sharing.

Pirategold.
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Avatar universal
I USED TO TAKE RITLAN AND IT IS ADDICTIVE AND IT IS SPEED. REMEMBER THE WHITE CROSSES THAT "SOME" USED TO BUY AND SELL IN HIGH SCHOOL. WELL, THAT'S THEM. USUALLY RITLAN IS PRESCRIBED WITH ANOTHER DRUG TO WORK TOGETHER, FOR ME IT WAS RITLAN AND INDEROL AND THEN SOMETHING AT NITE TO SLOW IT ALL DOWN. RITLAN IS USUALLY PRESCRIBED FOR ADHD BUT MAYBE IT USED FOR OTHER THINGS AS WELL. AS SOON AS STRATTERA (THE NEW DRUG FOR ADHD) CAME OUT IN JANUARY OF 2003, I STARTED TAKING THAT. IT IS NON ADDICTIVE AND JUST 1 PILL A DAY WILL DO IT. JUST THOUGHT I WOULD COMMENT. GOOD LUCK TO YOU IN ALL.
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Avatar universal
I'll look into both. Thanks, adoubter
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Avatar universal
Yes, I would say I am pretty depressed too.  But, as Jim says, it kinda comes and goes in intensity.  If it doesnt "go" much, maybe treatment for it is in order.
I have been taking benadry(Tylenol PM) from day 1 to help me sleep.Doc has no problem with it.  Sometimes I wonder though, if it makes some of the dryness problems worse.
Hang in there!!!
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Avatar universal
Ritalin is sometimes used alone or in conjunction with an SSRI for interferon-related fatigue/depression. I never tried it but I believe it's addictive. There was an interesting web cast on Projects In Knowledge recently on treating inteferon-related depression. If you can find it, very worthwhile.
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Avatar universal
HEY. DO YOU KNOW OF ANYONE USING RITALIN FOR THE VERY LOW ENERGY SD'S? I WAS THINKING OF ASKING MY GP FOR SOME AS I SIT ON THE COUCH ALL DAY LONG. I AM NOT REALLY DEPRESSED BUT FOR THE LETHARGY.ALSO I READ THAT PAXIL WORKS REAL WELL ON TX.

GOOD NEWS. AS I MENTIONED MY INSURANCE WILL NOT COVER"INJECTABLES"AND THE SHOT ARE $419 A WEEK.WELL,I GOT WORD ABOUT COMMITMENT TO CARE ON THIS SITE AND THEY JUST INFORMED MY DOC I WAS BEING COVERED IN FULL. THANKS WEB SITE,THANKS SCHERING PLOUGH. THANK YOU! THANK YOU! THANK YOU!

BOBBY
PS MAYBE I SHOULD TRY THE RUNNING MASCARA THING. I COULD USE MY WIFES.
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92903 tn?1309904711
I have ambien. But I prefer 2 benadryls when I expect a difficult nite. Ambien's faster acting and less groggifying.
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Avatar universal
"Pardon my thread". No its not a Bing and Bob Road movie:}

Just started tx last friday and already w/ the muscle aches and pains. This seems like an inflamation issue to me as I've had a touch/bout of this before some years ago, { first time I experienced HCV symtoms was servere inflammation} but it kinda faded into the back ground and has just resurfaced w/ tx drugs!

Big Q! {q's} Does anyone here use Naproxen? I guess if a yes, then its Ok w/peg and riba?
How about valium? Please say yes ha ha!

Tylenol is not a anti inflammatory so thats out for this, { it does relieve a darn thing for me anyway, a waste of $$} and aspirin is the best, but I was told NOT to use it!

Another issue is getting to sleep at bedtime and staying asleep. Anything of use that works?

Adoubter
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