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Avatar universal

Argument with Dr..

Good morning.. I have been slacking around here, but have been sooo busy..Having wood floors put in two rooms in my house.. Damn, what royal pain!!
Yesterday, I went to my GI center.. Did all the baseline bloodwork done, went over expected approach, preventional use of meds to stay on tx, and all lab work.. They will be doing blood, first 2 weeks, then 2 weeks after that, then every month following.. Only doing pcr, at 12, and 24 weeks.. I had to fight for pegysus.. Told me that I was crazy, that sx's are the same, percentages are the same, and that the leaders in treating hep c, won't even touch pegysus.. Supposedly, Dr. Schiff from the Liver Institute in Miami, won't even touch pegysus..She told me that if it what I want, she would order it, but it is not her first choice..
Has anyone else come across this with their DR.??
I also lucked out, and she gave me three month supply of Effexor samples for free..She wanted to do a phycological evaluation on me, before tx.. I told her fine, but I would have to talk it over with the voices in my head!! LOL..
Looks like I'll be starting here in the next two or three weeks.. She told me, to use Benadryl, and Tylenol PM, and Zyrtec for sides.. Gauranteed to do evrything possible to get me through.. Wanted to make sure I was ready for it, and feet where firmly planted.. How could I say no to such a beautiful woman??
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Avatar universal
Good luck man! I just went to my doctor, I did the same thing and asked for Peg. He said no problem, neve batted and eyelash.  He said all studies show about the same and "I have no allegence to any drug company, they both work" He also went to the first meetings and continues to stay involved with the "Ideal" study. We talked in some length about it.

So Snook, Just repeating what I was told. But I find it hard to believe that a doctor would be so one sided. It doesn't seem as though the facts would make a doctor feel and think that way? You, I and a lot of people here know as almost as much (or more) about the studies as some of these doctors. And we certainly have the first hand info from tx patients. I hate to say it, but it sounds money related to me. Just my opinion. Tear 'em up Snook!!!

Lou/Unico
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Avatar universal
hey buddy sure sounds like your doc is ok to a point
with all the info out there Re.pegysis she may be using or recommending the other for purely financial reasons we have heard where some docs get a per patient $$$$ for each new person they start on a particular regimen. It may not be the case with you but....
Glad you weathered the temper tantrum from Charlir OK .I tell ya it was scary as hell knowing some of my new family was in his way Hope all of you FLA folks are OK and getting back to the same O same o. Best wishes for Y'all
I'm off in a few to take the Grandkiddies to the park so gramps can have an excuse to ride on the slide Yahooo My 14th childhood(at Least)
Talk at you all later and have a great lowSx day  Peace
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Avatar universal
Here are some web sit's you should print and take to your Dr.

<a href="http://www.hcvadvocate.org/news/newsRev/NewsRev-16.html#1">PEGASYS
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Avatar universal
Here are some web site's you should print and take to your Dr.

<a href="http://www.hcvadvocate.org/news/newsRev/NewsRev-16.html#1">PEGASYS
Helpful - 0
Avatar universal
Here are some web site's you should print and take to your Dr.

<a href="http://www.hcvadvocate.org/news/newsRev/NewsRev-16.html#1">PEGASYS
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Avatar universal
Hey, glad to hear everything is rolling along.
I see Schiff it 2 weeks (been waiting 6 and 1/2 months for this appt).  No Peg huh?  I'll see first hand and let you know.
Effexor doesn't come in generic so that was good you got samples.
I just got my Rx filled for Effexor too but haven't taken it yet.
I'm not looking forward to sides of the AD's. My Rheumatologist prescribed it for my pain and sleep.  Unfortunately, they make me uppity (is that a word)? so I'm holding off as long as I can.
So No Peg from Schiff - Now I need a round of ammo to go to see him with.  I'm curious as to why it isn't your Doc's first choice? What were her reasons?  Isn't there documentation stating that Peg has less severe sides?
Thanks Snook
Enigma
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Avatar universal
Thanks   :-)
Just what I was looking for
Enigma
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Avatar universal
I'm glad you are able to get the treatment you want. Some of these doctors have mis-placed loyalties.
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Avatar universal
My dr also was ready to go with PEG and I said Noooo,,,I prefer pegasus and he said his patients were on Peg and there was no difference.  I had somewhat of an argument but told him,,,,If I'm doing this for a year,,,I want least sides as possible and it would make me feel better so he laughed about it but I did get Pegasus..
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Avatar universal
Hey, thanks for the support and info.. What she told me is that she only Rx pegysus when patient has history of renal problems. I argued, that I wanted it because it was processed through the liver, and I have liver damage, so I want to hit it as hard as possible..
She said that all her patients see the same sx's, that it has nothing to do with the different med.. I was suprised myself, cause I have done alot of research on the meds, and feel alot more comfortable with the pegysus. She told me all studies that state which one is better, or has made any claim, was sponsered by the pharmacutical company promoting its own drug. She is participating in the IDEAL study, and claims that at the last conference, the best SVR% was coming from Peg 2b full dose with 1200mg of Riba.. Almost 70% for geno 1's..
Yeah, the Effexors where a godsend.. Even with my insurance, my prescriptions are like $40-$50.. So the couple months free are great.. She told me not to worry, that if they have samples, I will always get them..
I heard a unusual story about a patient of hers also.. Many people are amazed at my VL, of only 5460.. She told me that she has a guy, that VL came back at only 97.. Yep, 97.. They did the biopsy, and he had severe fibrosis, and was thought to have had the virus for 28 years..
I am eager to see what my labs come back with.. She is running all tests, including thyriod.. My meds should be here in two weeks, then its time for war!! I know what to expect this round, and feel more comfortable with Dr and entire situation. I just want to do this, put it behind me, and start my family..
Best wishes to all.. Snook
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Avatar universal
I go to a University Hospital and they let me choose Peg or Pegasys.I talk to lots and lots of people on treatment,because I have nothing better to do and Pegasys has less severe sides.Those who have tried both say do Pegasys.
I had my 12 week pcr drawn today,so waiting to see if I continue to 48.
Michael
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Avatar universal
hey.. I posted about this awhile ago.. I had to argue and beg to get Pegasys,,I printed out documentation and took to him, he finally agreed to let me have my way..   His office generally uses PegIntron from Scherring..   It has been suggested by soem that perhaps kickbacks are involved, his office says that Scherring has been more willing to give pts meds free when they can't afford them or get dropped from a study but want to continue.  Even thoug your doc agreed, I'd take printed documentation to her just to back up your position..  
Why the tylenol PM and benadryl?  is that what they recommend for sleep??  if so that sux!!  Benadryl make me feel very depressed.. and  the couple times I tried tylenol pm made me so groggy the next day it was like I was walkng on the moon..
I used to use Valerian root to relax me so I could sleep a little, but it interferes with clotting, so since that's an issue for me now, I can't use it.. I do use 0.25 xanax now and then to take the edge off so I can sleep occassionally. because I have had SERIOUS insomnia for YEARS...
  I know I will PROBABLY get blasted for this but...here goes...
  there are herbs which will help you sleep without ingesting them.. <<<it doesn't work for everyone, just like the same drugs don't work the same way for everyone>>>> but worth a try:
lavendar : either the flowers tucked into a pillow, or the essential oils mixed with water in a spray bottle and sprayed on the sheets,,or in a diffuser in the room.. or a pure incense
ALSO:  SANDALWOOD.. it has sedative properties.. I have a pure powdeered incense that I burn, and it actually gets rid of migraines. it has a very soft light scent../ it can also be sprayed on linens using essential ois in water..
maybe, in SOME cases, using some aromatherapy would be of benefit to some, for some things.. rather than having to take more drugs which in turn have more side effects of their own..
There's alot available online on herbs and aromatherapy..  Just thought it was worth a mention!
Anyway.. my pegasys is sitting in the fridge, just waiting for me to be able to start..hopefully in 3 weeks or so..
   OK.. I have to go lie down..just popped on here for a minute..have had a really bad night..feel like ****.. and I'm not even on Tx yet!!! LOL...  ya'll have a fab day!!!
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Avatar universal
"She told me all studies that state which one is better, or has made any claim, was sponsered by the pharmacutical company promoting its own drug. She is participating in the IDEAL study..."  last i heard the ideal study was sponsored by a drug company...scherring....her statements do not hold water, do they?
She didn't know Snook then...but she does now...best to you in your  new battle.
interesting note on vl and damage, you would think the more there are the worse off your liver is, but hcv holds no logic...
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Avatar universal
KC,,,Good Luck on your PCR and let us know!!

Snook,,,Wishing you the best for you new tx,,,No Sides and just gliding,,,,
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Avatar universal
I've had to see several different doctors and P.A.'s before, during, and after tx., and the first question I always ask is if they are invested in drug companies. Most of them laugh and say no. The ones that get flustered or snotty, I don't see again. If a doctor is vested in a company there is a lot of evidence to show that they prescribe drugs from them, even if there are cheaper, more effective drugs on the market. Joni
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Avatar universal
She told me that the tylenol PM, was for shot nights. And to take them an hour before shot. And that Benadryl would take away some of the flu like symptons.. The Zyrtec, is an antihistamine, and she stated that that helps with itching, and some flu like symptoms.. She also brought up the theory about tylenol damaging the liver, and said that the reason we do this tx, is to save the liver. By what ever means necessary!! If you have a headache, take tylenol, if you have fever, take tylenol. I really like her.
I know what your saying about natural herbs to promote sleep.. Calmomile Tea, works great. Valerian is liver toxic, so avoid that. I like Melatonin.. Start with 1mg, and if it works, than continue.. Anytime I have a rough time getting to sleep, one pill usually does the trick..Looks like we'll be starting around the same time.Wish you the best..


Oh boy, I know alittle something about Dr's prescribing what they are paid to!! Whether there is a better or cheaper drug. I have posted many arguments about this on the forum.That is why, everyones input and research is so important!! So we can fight for the better meds, and let the Dr's know that we are on top of things.

And Cuteus, that was my statement to her exactly. "Isn't Scherring paying for IDEAL", and she just sort of said yes, and avoided the question. She stated that her choice is based on experience from patients, and research done by Dr. Schiff.I told her that my choice, was also based on first hand accounts from patients on tx, and patients that have taken both.She told my wife, "I don't want to burst his bubble".I wish you all the best, and SVR to us all!!
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Avatar universal
Well, I cl'ed in peg 2b provided free from Schering.  W/o their generous program, many-myself incl-would be dead.  That's right dead-as in the 'light and spiit has left the building.'

I'm another one w/the liver failure, near death white lights. icu, and then correctly dx w/hep c.  Never had a clue.

I'm also one w/o any health insurance or gov't aid so I could not afford to MD shop or make demands-a very humbling experience.

I had few sx's and never took AD's.  I kept my blood values in the low normal range b/took nothing else.  I used tylonal and generic (costco) benedryl.  And I smoke medical marijuanna-legal pot-hep c is a 'qualifying' disease.

Everyone has to fine tune their own treatment plan.  I took a very 'holistic' approach, using MD's only for blood work and monitering every few mo's after I cl'ed in 18d's.

I used food as medicine-not just nurishment-and walked and meditated(prayed).  I also had a good partner who willingly picked up the slack and kept me on track.  Just as he does today.

Living w/ESLD is more work than most hep c'ers will ever have to undertake.  That's why I don't understand people who just wait for severe damage before they tx.  You don't want that severe liver damage.  That damage will stay w/you forever, causing you problems forever.

Just my thoughts
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Avatar universal
Effexor...nice name but how does it work? Ihavebeen on thisdrug for close to 3years some was prior tx. Statically there is no difference between it and placebos.Dont believe me wll do your homework. It along with several leading ADs with held placebo results from the FDA until recently. Withdrawl can be distressing and slow. I've repeated info re ssris and other ADs but no-one wants to know. The evidence is there but most people dont seem to want to hear. Oh it's ok pegasay v Pegintron but take alook around the net for good quality research about the effacacy of Prozac Seroxat Effexor and all their friends. Start with Dr Breggin and the class actions against Seroxat.
Did you also hear about the $10000 cheques arriving ,unsolicited from Schering toencourage GPs to prescribe their products? Give you the source if you want but you will have to push me.
Sam Hall
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Avatar universal
Lordy, Sam, no!  That was not an attack--it was high praise.   My old man's a drummer, you see,  so at my house that kind of punctuation is the highest compliment.   Looks like our messages crossed on the last thread.
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Avatar universal
Sorry,just me being a bit touchy i s'pose.
SH
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Avatar universal
My doc (GI) put me on Pegasys as he felt the sides were less. He stated that both types seemed to be equally efective but initial experience with patients seemed to favor Pegasys for minimal sx.

I also got almost the exact advice on use of tylenol PM and benadryl from my doc. I haven't really used the tylenol too much as I'm nervous about it's effect on the liver but the benadryl seems to help.

I sometimes get a mild hives type reaction after the shot and a half a benadryl has prevented this as well as letting me get a good night's sleep on shot night.

Silvermoon - that's too bad the benadryl makes you depressed. Its been helpful to me and I didn't think it would have an adverse effect on other folks. Goes to show how important it is not to assume anything.
Peace
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Avatar universal
Ah, you're a gent.  Don't worry about it.   Just  keep those stories coming...
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Avatar universal
This is the final paragrphs of a meta -anlysis provided for the FDA re-the most frequently prescribed ADs. If you want the rest look for "The Emporers New Drugs".

To summarize, the data submitted to the FDA reveal a small but significant difference between antidepressant drug and inert placebo. This difference may be a true pharmacological effect, or it may be an artifact associated with the breaking of blind by clinical trial patients and the psychiatrists who are rating the severity of their conditions. Further research is needed to determine which of these is the case.

In any case, the difference is relatively small (about 2 points on the HAM-D), and its clinical significance is dubious. Research is therefore needed to assess the additivity of antidepressant drug and placebo effects. If there is a powerful antidepressant effect, then it is being masked by a nonadditive placebo effect, in which case current clinical trial methodology may be inappropriate for evaluating these medications, and alternate methodology need to be developed. Conversely, if the drug effect is as small as it appears when drug/placebo differences are estimated, then there may be little justification for the clinical use of these medications. The problem, then, would be to find an alternative, as the clinical response to both drug and placebo is substantial. Placebo treatment has the advantage of eliciting fewer side effects. However, the deception that is inherent in clinical administration of placebos inhibits their use. Thus, the development of nondeceptive methods of eliciting the placebo effect would be of great importance.
SH
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Avatar universal
One quick comment. Almost ALL industries are involved in some type of rebate programs with vendors. The medical industry in no exception. Trucking, travel, food, just about all of them. This is the way of accounting. My regular doctor and I are very good friends. The stories he has told me about drug companies and their efforts to get doctors, hospitals and HMOs to go their way is mind boggling. But the reality is it is no different or worse in the application to other industries. Because it deals directly with sick people makes it morally incorrect more disgusting But
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