How much water should combo patients be drinking per day?

[mremeet]

Hi, I'm going to be starting combo treatment in less than two weeks and have a question. I've been researching and communicating with people who are in treatment, or who have already been through it (sometimes multiple times). I've heard over and over again that you should drink a LOT of water every day. Most combo vest have told me to drink at least a gallon a day, as it will really do a lot to lessen your sides. They even seem to say it ike this: "Getting ready for treatment? Better learn how to drink a lot of water REAL soon." And say it in a way like "Ohhhh you'll be sorry if you don't...you'll learn alright!" I also asked my RN about this and she confirmed that you should drink a lot of water and that it does significantly lessen sides. But, of course I've never been through this, so what do I know? Not much, so I'm hoping those with actual, extensive experience can tell me once and for all if this is a wive's tale, or it really is a good idea. Thanks in advance for any and all responses.

[jmjm530]

180 mg Pegasys is standard dose for all weights. Why the 135? I still think you should trot the WBC studies to your doctor. Just because extra drugs don't hurt SVR, doesn't mean you should take them unless necessary.

[sfbaygirl]

I don't know why 135mg was what the drug co said I should take. After coming here and asking why I had to squirt out 45mg, I called the dr. He said take 180 if you can handle it. So I have been since day 1. I agree with you about taking extra drugs, I don't want to take the neulasta and will check my labs, but want to wait until the numbers are 200-300, if this is okay.

My hgb went up and has stayed up, perhaps my WBC will too. I can only hope and try that shark oil.

[Bill1954]

Thanks for your response, Debbe;

Yeah, I suppose they've got to ask regarding reinfection; I was going to ask as well, but didn't know how to delicately present the question. It's an ugly situation he's dealing with.

I would certainly think the test sensitivity was sufficient; although there are quantitative tests available to <5 IU, and I believe a qualtitative assay that reads to <2 IU, <50 IU is frequently used to establish research parameters, etc. At any rate, he somehow slipped through the cracks. As Jim mentioned above, some doctors believe that multiple Tx might "train" the immune response; my new doctor seems to subscribe to this theory himself. Hopefully Greg's T cells agree as well...

I

[jmjm530]

There was a study suggesting  certain per cent of EOT PCR positives were also TMA negative. 100% of his subgroup relapsed. Not sure how sensitive either of the tests used were.

I'm not saying that's the case with your husband, but it would definitely make sense to get a more sensitive test this time around -- something that goes down to 5 IU/ml. Quest labs has a couple of tests like that. One is "Heptimax" which is quantitative. The other is their HCV RNA Qualitative TMA, which is a qualitative. All the best with his new treatment.

-- Jim

[Better_Angels]

Greg's PCRs were sensitive "less than 50". He was undetectable all through both treatments. As I mentioned in my last post he was EVR at 18 days his first round and EVR again at 10 days this time around.

There wasn't much conjecture about anything, there was just plain shock. Especially on my part. The first question put to Greg was "could you have reinfected yourself"? I think Greg almost fell over. How? Toothbrush? Shaving? Clippers? No, actually we were wondering if you were infected "again" not reinfected? Ah, you bet. Ran right out and put a needle in my arm because the hell I just lived through wasn't hell enough. Still, they tested his genotype to be sure, but he was the same as the first time, so "relapse" it is.

He did have histological liver improvement. both treatments have taken him from a 3/4 to a "mostly 2 with a little 3". So all was not lost.

We are going to ask for a super or hyper sensitive PCR at 6 months. Since his viral load was so low when he relapsed (3,000) there is some speculation on my part that he had just relapsed. Shortly before his 12 month PCR he complained that he felt like he was "sick again". I ignored that because obviously he was SVR. I just kind of blew it off. I feel bad about that now because he never complains about anything. While I know VL can fluctuate dramatically from day to day, it's the only thing that makes sense to me.

I tease Greg and tell him he's "special". He always did do things his own way, never fit into any mold.

Bill, I don't know why your doc isn't a fan of Infergen. We're not either, but we aren't fans of any of these treatments. Just felt like our options were limited. It's tough, the sides were over the top and he isn't even remotely the same man he was. If he doesn't clear it this time, he's going to do maintenance and wait for something better drugs to hit the market.  

Thank you both for your kind hearted concern and empathy. I hope you and yours are as well as can be expected.

Take care,
Debbe

[jmjm530]

I have no idea what the protocol is to go off Neuesta. I just know my doc waits until ANC 200-300 to prescribe it. Hopefully your doctor will order frequent CBCs until things stabalize and both of you can come to a mutual understanding. Lots of different approaches regarding ANC in the Hep C medical community. As far as fooling around with the sharks, just don't bend over :)

-- Jim