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168732 tn?1311712079

Caught pneumonia,, Doc may delay next shot...

Wow, one thing to another!  Maybe Jim or some other kind folks have some comments on this scenario:

In my 5th week of Peg,Intron,Riba combo and UND at week 2. Have had a bad cough for 2 weeks and today the x-ray showed small area in left lung that suggests pneumonia. Almost put me in hospital for I.V. for a day, but then blood work showed WBC 4.7 and Neuts 36, so they put me on the 5 day Levaquin 750 oral regiment and could go home. BUT, when they called my hep doc., he said I may have to "delay the next shot on Tues". They want to watch CBC and WBC closely to let the antibiotics be effective.

I understand that with my immunity lower the pneumonia is very serious, but what is the consequence of delaying the interferon?  If they have me wait a few days, does that have much effect on treatment success?  Shucks, this was not what I needed to face right now.
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142526 tn?1397090672
Bug,  see there I go, I had to re read  the shrimp thing a second time and now I see what you were saying,  my stupid brain! lol  No really, sometimes it's a little difficult for me to catch every last bit of American humour, it tends to fly straight over my head, hee hee.  Hubby and the kids find me amusing at times since I'm not completly fluent in the language and didn't grow up hearing that type of humour in the house, combine that with hcv on the brain and I could keep you laughing all day long! :)
Wonderful place for your grandaughter to have spent her first night, sounded like she was there for observation and routine care. :)

Chcnme,  my uniforms still hang in my closet even though hcv has destroyed my career and almost my life too. However, we shouldn't give up all hope that one day we may still be able to return to our specialized careers.  Some of us do or can get better cognitively, post tx.  I never asked my hep doc why he chose pegintron alpha 2b, but I made him quite aware of the cognitive issues before starting.  So, knowing that pegintron has a smaller molecule that crosses the blood barrier, I'm wondering if it will clear the brain and help "lift this cloud".  Which Peg will you be using in the trial?  

Hopefully my uniforms will still fit.  :) :) :)

Chat with y'all later,
Maggie

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Avatar universal
Wow - I just read your story.  What a story.  And you did NICU?  OH MY!:)  I worked long-term peds back in ... gosh I guess it was in the mid 80s  (very sad job - terminal children, mostly).  But it also had its miracles, and some of the kids I came to love I can still see their faces. I went off the job for the same reasons you described.  Was don at the time, but over about a two years period I began feeling like my brain wasn't working right anymore - like a cloud had moved in and wasn't going to leave.  I didn't know I had Hep C. I thought it was depression, thought I might get better.  I was then diagnosed Hep C shortly thereafter.  Cry?  oh my gosh.  My uniforms hung in my closet for at least 6 years, like there would come the day I would put them back on and go back. I guess I finally accepted I wasn't ever going back. When I moved a few years ago, I boxed them up and took them to Salvation Army. I tried one on -- just one more time.  It fit.  hmmm.... I bet that thing wouldn't fit now - lmao!

And lol - YES magtx iodine deficiencies are indeed a thing of the past in the U.S. because of things like iodized salt, drinking water, fortification, lmao - my family thought I had lost my mind when I was looking for the salt.  Here I was - a relatively smart person, reaching for the Mortons salt, even askin them to validate my insanity on the prominence issue, saying "well... don't you think it MIGHT help?? I mean.... grandma had a goiter and HERS was from iodine deficiency - I might have one  - I DID cut all my salt out - so I'm gonna start eating some- NOW!"  (I think my Hep C caused worse than cognitive deficiencies.)

And Bug, you are the funniest thing to me!  Hey (here we go lol  hahahaha - you have a thermometer in your back pocket, and I have salt packets in mine :)

You all have a great nite!  Gotta go feed the crew.
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146021 tn?1237204887
You are so funny! Those turtle necks look really good on you by the way. Being born without a neck (head just rests on shoulders) I can't seem to pull the turtleneck look off too well.
Mag: NICU awesome! My granddaughter spent the first night of her life there, she was born 2 weeks early at 4lbs 9oz. Mom just quit producing amniotic fluid. BTW chcnme is pulling your leg about my advice to her. She said she is eating shrimp for the iodine and I said 'Beats a handful of table salt!' She's a fuuny girl!
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142526 tn?1397090672
Hi ladies always good to hear from you.

Bug, thanks for respomding to my question, is appreciated. :)
Buttinski's are helpfull considerate type of people like you very much seem to be. :)
Yes,  am a profesional BSN, spent years as a team leader overseeing the NICU (liscencd in the state of CT and TX) Haven't worked a day since 2004.  I noticed myself slowly deteriorate "cognatively" over the past sevral years, it became so bad that I just couldn't continue doing required things like decission making, rationalizing and just making simple connections mentally.  I felt there just wasn't a place for me anymore in a work enviroment that requires "quick thinking".  My hep doc and I have attributed this brain issue to having HCV, I cried all the way home after he said the hcv is most likly living in the (my) brain tissue.  Dealing with the horrible mental fatigue has been my worst HCV related issue.
  
I admire you being able to continue working even on tx.  Stay well and take care.

Chcnme,  you still cracked me up with the iodized salt box.... I pictured you eating salt in between posts here, and making the face again from the salty taste, hee hee. Shrimp have a high iodine content, but don't OD yourself on that (unless you love shrimp like me), there's plenty of foods you probably eat everyday that are fortified with iodized salt.  If I'm correct I believe iodine defficiences have been practically non existant in the US for many years since they have started fortifying foods, try not to worry yourself :)  ....
Take care, you sound prepared for your tx "journey".
Mag
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Avatar universal
Must disagree with advice to lay on affected lung. Laying on the good lung will facilitate drainage of the lung with the pneumona
This is known as postual drainage.
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Avatar universal
Hi magtx, thanks for asking. I think (I hope) "it was just my 'magination, once again... running away with me" :)  I didn't go to my primary over it since he had just done a TSH in Oct (normal) and since Duke probably did one, too, at my Nov appoint. I just chalked it up to my imagination and finally put the box of Morton's iodized salt back in the cabinet after OD'ing on it (just kidding). Bug told me to eat shrimp and wear turtle necks :)

Re tx, I'm waiting on the phone call (I guess for enrollment, don't really know - have just been told to wait for a call.)  It's nerve racking waiting and not knowing, but I guess that's the way this stuff goes.  It's not a blinded study (from what I can tell on-line) and so I feel better about that part.  Doc said I should be on treatment by mid Feb, probably. ("Probably" is like the words "may, might, could". hmmmm... :) Hopefully things will get rollin' soon because I'm ready to get some kind of a show on some kind of a road!  See ya soon.  Have a great day.
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Avatar universal
I have heard of a person treating who developed "interstitial pneumonia" which was attributed to interferon.  Apparently this form of pneumonia is often associated with undeveloped (such as babies) or immuno-suppressed folks such as HIV/AIDS patients.  While it is not common in HCV sufferers, when RBC and WBC values drop the chances increase for many types of infections.

In this case the poor fellow, although he had cleared the virus was possibly facing permanent lung damage.  His feeling was that better monitoring and a swift intervention (such as rescue drugs) might have prevented or minimised the damage.  As it developed he had to quit treatment and may not be able to treat again in addition to his lung damage.  

As mentioned.... pneumonia is nothing to mess with particularly when one is challenged by treatment.

best wishes,
willy
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146021 tn?1237204887
Gazebo:Glad you've kept a sense of humor, although I disagree with Bobby. I think the virus definitely clears if you die. But we just don't consider that a viable form of tx. How's your back?
Mag: Chcnme should answer questions directed to her but I'm a buttinsky. I think she decided it was not that prominent and is including more iodine in her diet. Mag are you a nurse or allied health professional?
Janice
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168732 tn?1311712079
I'm with you bobby, dying is more of a bummer than clearing I've heard.  But still wondering how many days delaying the shot effects the tx.  G.
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Avatar universal
i had several shots late due to shipping trouble and cleared. if you were und at 2 weeks you are in very good shape. you will not clear if you die from pneumonia. relax you are doing great. get well and then finish.
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142526 tn?1397090672
Hi there, don't no if you gave us an update on the potentialy enlarged thyroid gland (prominence) that you discovered.  If you posted anything then I missed it, so, any news on that?  Hope it turned out to be nothing and that all thyroid hormones are WNL.  Guess you'll be starting in the trail soon and I understand your worries about not needing additional issues to have to deal with along with tx sx issues.

Good luck with your tx this time around :)
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Avatar universal
aw - so sorry to hear that :(  What a bummer!  But it does happen sometimes with Hep C treatment.  Pneumonia is nothing to fool around with when it comes to Hep C treatment, either. It can wind you up in a heap of trouble - quick, so try not to worry too much about a reduction if that happens because your lungs are truly what's the most important thing right now. They're going to be important when you resume Hep C tx, too.  I've met a few on treatment who had some really tough times with recurring pneumonia.  Rest for now.  Just rest really really good and take it easy.  Get over this hump and then go from there.  Hope you feel better soon.
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Avatar universal
Sorry about all that's going on. Sounds like you have to go with what your doctor determines is your best/safest course. Hopefully, the delay, if any, will not affect your non-detectible status.

My only other suggestion is that if you're not seeing a hepatologist (liver specialist), now might be the time to get a quick second opinion. We often read here that GP's and Gastro's stop or delay treatment prematurely while more agressive liver specialists keep patients under full dose under the same circumstances. For example, my hepatologist rarely uses Neupogen or stops treatment due to low WBC or ANC based on more recent studies showing that the infection rate of interferon induced low WBC (neuoponia sp?) is not different from those with normal WBC. How this plays out with pneumonia is beyond my knowledge base.

The important thing I would think is that given your pneumonia you have to follow your doctor's instructions -- be it your current doctor or another doctor you bring in.

Hope it all works out,

-- Jim
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148588 tn?1465778809
I have no idea if Neupogen/Neulasta is appropriate in a case like this, but I know that I wouldn't want to delay my shot on week 5 by more than a day or so, especially since Peg-Intron has a shorter half life than Pegasys. Your counts don't seem that far off - neutrophils slightly below norm and WBC at the low end of norm - but your doc is the doc. I'm just a guy who turns a wrench.
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142526 tn?1397090672
Hi and wow your scenerio sounds all too familiar to me. Levaquinn is a very powerful antibiotic, your prescribing doc probably picked a good oral med for you, it's a broad spectrum meaning that it will cover many different types of bacteria.  However the IV antibiotic may  have been the better choice since it goes directly into the blood stream and begins working faster and in most cases better too.  Sounds like you may have caught it early enough and that this will be all you need.  The next chest x-ray comparrison will show how well your immune system and antibiotic are fighting to clear this up and whether you doc will feel comfortable having you continue tx, after you've stopped for the week.

I can't answer the question on whether stopping tx for one week and then restarting will affect the outcome. There are plenty of others that can help with their knowledge on that.

I really wouldn't mess around with pnuemonia especially while on tx.  In case you have to stop tx completly based on that next chest x-ray, just count your blessings that it was caught early enough so that you have a good, fast and easy recovery.
Putting even 5 weeks into this is still considered a considerable amount of time and effort (in my book) but getting into this situation lets say weeks or even months later would be devasting if stopping tx from this complication.

Keep up the water intake and when laying down lay on the AFFECTED side (left side) this will aid in in a better recovery.

Take care and let us know how your doing.
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Avatar universal
I'm so sorry you have got pneumonia now. I hope the others can make some good suggestions.
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