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116701 tn?1210259164

Follow the bouncing platelets and ANC's

Just a note. Saw the doctor yesterday and my platelets had risen to 67k on their own. No one seems to know why they are bouncing. My ANC has shot from 1352 to 5200. again no one seems to know. I had gained 3 pounds so that is my first upward movement on weight. Doc said his success rate for treating people was running in the 50% range but the national average with Pegasys/Copegus was 41% when used on us 1A's. Feel like a warm steaming pile of mashed potatos but only eleven more weeks left after tomorrow. You guys (non-gender related) hang tough for you have a weakling in me. Best to the best. Dale
44 Responses
Avatar universal
That is very encouraging to hear you doing so well.  These bodies we live in are so quirky.  It's nice to hear yours quirky in the right direction.  Best to you!

132578 tn?1189755837
Hang in there Dale , sorry you feel so bad ( I just assume that a hot pile of mashed potatos is bad , maybe not , actually it sounds pretty good right now. Do you like the way I am speaking parenthetically and highlighting with non-parenthetic text?)

Actually Dale , I noticed a few minutes ago that I was feeling pretty good myself and of course my next thought was wondering if I forgot to take my Riba. Shame that its come to that.

Talk to you later.
Avatar universal
Great to hear there's some improvement.  I know what you mean about the frustration when no one can answer why numbers are bouncing around.  Good to hear your nearing the end of the tunnel.  Hoping upturn is the beginning of a pattern to carry you through to the end of tx.
Avatar universal
Can't talk to platelets, but ANC bounces around a lot due to any number of factors including infections, recovery from infections, etc. My ANC was 320 one week and over 1000 a couple of weeks later with no Neupogen intervention. Couple of weeks later it was down to around 600 then up, then down, follow the bouncing ANC :) Because of this, my personal opinion is that doctors are too hair trigger with Neupogen when if they re-tested in a week or so, it might just go back up on it's own. My med team doesn't get concerned until ANC hits (and stays) around 200-300. From what they tell me, they rarely use Neupogen in their practice and they treat tons of patients with HCV.

-- Jim
Avatar universal
Said:  wondering if I forgot to take my Riba.

You know the riba hardly bothers me physically at all anymore ... after a while you do seem to acclimate to it.  Of course that doesn't count with the hemoglobin but...with all the effects they do seem to come and go but once your body gets over the initial shock period...it seems to get somewhat better.

I certainly hope that is what is happening for you!
Avatar universal
Probably should add to those new here that the usual protocol that hear/read about is to intervene with Neupogen (or reduce peg dose) when ANC hits 1000, 750 or 500, depending on the doctor, with 750 seeming to be the most popular number. If I followed this protocol I would have been on Neupogen --- probably needlessly -- for much of treatment. Newer studies I've read suggest infections from low ANC are different (not as significant) for those treating for HCV as for the rest of the population. I do not have the studies handy so you can ask, but you may not receive :)

-- Jim
85135 tn?1227289772
Glad to see your numbers going up. Maybe you can strive to feel like a warm baked spud, not mashed.
Avatar universal
100019 tn?1335919717
Not exactly sure what the ANC is supposed to represent, but if it has to do with blood cells, etc ...

You mentioned you have a sore throat.  I wonder if you have an allergy infection dripping into your throat and the ANC rose because your bodies trying to fight off that infection?

Keep in mind those famous words from Dr. McCoy....I'm a sales rep, not a doctor.

Glad to hear your feeling like mashed potatoes instead of noodle soup.   :)

You're going to make it!!     Valorie
Avatar universal
Hi, how are you doing?  I read your thread yesterday and feel for you.  What a dilema.  Are you still leaning towards treating longer?  (In case you don't remmeber me, we talked weeks ago when my hubby (the one who drank heavily) was just getting ready to start treatment.  My whole family went to the doctor about it blah, blah blah.....If you do remember,  he hasn't touched a drop.  yesssss and I start treatment Monday.

Anyway, I wanted to ask you all.  What exactly is ANC.  I can't find anything in my or my husband's labs that use that abbreviation and I can't find any three digit #'s, because ANC would be a 750, 1000 or whatever, right?

Thanks, Char
Avatar universal
Good dale! I know how this has been working on your anxiety. Now that ya got some mashed taters on the platelet, add alittle gravey now and I'll hand ya me platelet for a  helpin .
Avatar universal
For what it's worth, if you haven't picked this info up already:

ANC is the Absolute Neutrophils in your blood and represents the level at which your immune system is prepared to fight infections.  A high WBC usually means that the immune system is fighting some sort of infection.  Both are usually lowered by IFN.

Platelets represent the bodies clotting ability.  Low platelets means you at a higher risk for blood loss, especially if it is internal. Fog is kicking in here, so I'm not sure if IFN, Riba, or both affect this one.

Hgb is the Hemoglobin measurement which when combined with RBC indicates your blood's ability to carry food and oxygen throughout your body.  One reason why fatigue, and I suppose brain fog, is related to these readings being low.  These are generally affected by Riba.
96938 tn?1189799858
Dilemma!.  I've got a dilemma for you.  Spouse A is spread out on the couch, hgb-impaired, on traditional combo tx 12 of 24 done, 12 of 24 to go. Spouse B walks into the house with a fist full of VX-950.  That would be a dilemma in my house.  Great thing Spouse A has been und since week 4.
116701 tn?1210259164
ANC (absolute nuetrophil count). It's one of three parts of the white blood cell. From what I am told it is a big part of the bodies immune system that helps fight infections. It's probably lumped under white blood cell count on your labs and if it is okay they don't flag it to the right column. Assuming your lab sheets are like mine. I've confused myself so no telling what I have done to you. Dale
116701 tn?1210259164
Spouse B keeps his mouth shut and slowly passes spouse A in treatment race. Then when the news reports Vertex causes male dingulackus you admit what you have done and file legal charges against Vertex. Or test them on her first. Spread out on the couch - sounds like the Sunday new paper to me. Have a good one. Dale
Avatar universal
It'e good to hear your doing better.  How are your other sxs?  Beagle
131817 tn?1209529311
Just got back from the hemo for my neulasta shot. He said he had gotten an emerg. call from the lab about my WBC. He told me that it is very easy to get an infection or pnemonia with these low counts.

While I would LOVE to not take these shots, I would rather be safe than sorry. Unless we can walk around in a bubble we are susceptible to so many germs. (I heard cell phones are the worst!) I think taking Neupogen or neulasta at 500 or up to 1000 is a way we can protect ourselves from becoming even sicker.

My husband and I were just down with a bug. I had it first and thought it was sx from tx. He was really sick with the same symtoms as me, so I figured he must have caught it from me. Luckily, I didn't get sicker. I have lots of people running in and out of here. I have told them all not to come over if they are ill.

I think saying that neupogen is given too often could be true, but I think I would rather side with caution.

The hemo told me that it is not true that we don't get those infections as often with the low white counts.
100019 tn?1335919717
Hi Char,  yes I do remember you. I've often wondered how your husband was doing.  I'm so glad to hear he's been able to refrain from drinking during TX.  How is he feeling?  Has he been able to handle the side effects?

So your starting next week?  I can't imagine two people on tx together.  You'll do fine, tho.

At the moment when I finish tx I'll have two weeks left and I think I'll go ahead and take those just for an extra cushion.  AS far as extending there really isn't any data that suggests it gives you more of an opportunity for SVR.

How did your daughter take it when you told her?  I'm sure it was shocking at first, is she okay now?  Or at least doing better?

Avatar universal
SF: The hemo told me that it is not true that we don't get those infections as often with the low white counts.

Of course go with your doctor. They are treating and responsible for your welfare, and when the sh*t hits the fan, they are the ones you will hve to turn go. BUST I will now try and dig up that study I mentioned cause I think your hemo is wrong on the above
statment :)
Avatar universal
Sh*ttt....I meant "but" not "bust"....I guess that shows where my mind is today. LOL.
Avatar universal
I'll see if I can pull up the study cited but here is what I was talking about.

A small exerpt:

"The authors concluded that neutrophil count “is not correlated with infection rate in recipients of interferon-based therapy for hepatitis C,” and suggested that patients who develop neutropenia during hepatitis C treatment may not require interferon dose reduction or adjunct therapy with G-CSF."

Full article here. BTW "G-CSF" is Neupogen.

131817 tn?1209529311
Well at least I made you go dig up the study ;)  The hemo did say that, cuz I asked him. I was under the same assumption as you are, they we were not as suseptable to the infections.
Avatar universal
Here's the abstract: http://tinyurl.com/ropmb
You can probably buy the full copy if so motivated, or maybe some more searching might find it posted somewhere.

Another snippet: "Reduction in interferon dose and/or dosing with granulocyte colony-stimulating factor in those with neutropenia is not supported by this analysis."
Avatar universal
Nothing against your hemo -- and maybe he has some valid reasons -- but I'm often ASTONISHED at how little many of the non-Hep C medical specialists know about this disease -- be it my eye doctor, dermatologist, etc. One thought the treatment was around six weeks (didn't even know about riba) and another asked if I had to take the injections for life. Absolutely amazing. You really gotta become your own advocate.
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