Low platelets, doc says reduce inf

[aquarius64]

i just got my labs and saw my GI today. my NP wanted to stop tx but i said no. she consulted with doc and they agreed to reduce my iterferon from 180mcg to 90mcg per week. i just did my shot #12 (1/2 dose) tonite and i was UND at week 4. i am getting 40k of procrit every 3 weeks, so far had 2 shots of that. does cutting back sound like a good idea? here are my labs from 2 weeks ago and yesterday:
HGB was 11.2--now 10.7 (it's been lower, i'm on procrit q 3wks)
HCT was 32.6--now 31.4
ANC was 1.7--now  2.3
PLATELETS were 84-now 59
just wondered what you might suggest. i don't want to have to stop. i've come this far, just want to be sure i get the best out of this whole tx ordeal. i go see my hema on thurs(i think, i can't remember much anymore). i am feeling more nausea a day after shots for 2 days and i am definitely fatigued. i am now starting to lose a bit of hair too. i haven't had a thyroid test since week 4. should i ask for another? i have only lost about 4-5 lbs. thanks for any imput and i hope you all are well. i don't get online much these days cuz i let my 3 and 4 yr olds use my pc to keep them occupied since i have no energy. thanks and i'll check back in the morning.

[aquarius64]

hey there, thanks for your imput once again. i hope you all have a nice easter weekend!

[dperry10]

Hang in there..  You have come this far, and it really would be a shame to stop now, but if the sx get to you and you decide to stop, it is your decision.  

But something my doctor said to me last appointment, when I was feeling like I could not handle the sx much longer, that I was thinking since geno 1a, that my changes are low anyway... then he says, if you were not having any side effects, I would be concerned that you were not responding.   With the levels dropping like they are, means the meds are working hard in there, and your chance for SVR is greater, just wait till we get the PCR you will see.  

Then it came back undetectable.

[Cindy10]

Also his dropped about 30,000 when he first started tx (so that is normal),
his float around between 30,000 - 45,000 now.

[sallyo]

I know we shouldn't compare labs and advise each other.  Every bodys body is different and their may be other blood clotting factors which your doctor might be taking in to considertations other than platlets.There is act (ACTUAL CLOTTING TIME) Pt and ptt.
  In my case the platlets were and remained in the 40's.  Howerver the other clotting factors were adequate and I continued for months on the full dose of interferon.  Also I think you will find that platlet numbers although low will swing around a bit.
  If you decide to stay with this doctor and he is willing to continue on the lower dose interferon, I say try it.  After all the goal is to get rid of the virus NOT the patient.  Relax I say and give your body the help it needs.

[orphanedhawk]

My first GI wanted me to stop tx but not until my platelets had hit 33. Even he wouldn't have worried at 59. I've changed docs and this one will let me go down to 25.  I tried to find out if there were any supplements that increase platelets. Vitamin K is a possiblity. I take super K by lifeextension. The other thing that will raise them on the CBC is to exercise ( fast walking is fine) prior to your lab. Good Luck.

[Cindy10]

Hubby on same week as you and his platelets are 34,000. Doc said he wont do anything until they get to 25,000. Some doc react to quick. Have another conversation with him and see if he will let you go a little lower first before reducing meds. Good luck!

[aquarius64]

thanks for the imput and i do miss the boards bug. i manage to get on and read, but my hubby has taken over my study while we are building him an office in the basement now that he's working from home(yippie). as far as tx goes, i thought it was a bit conservative myself. i have my next months meds already so they have full dose in them, so maybe i'll see what happens over the next week with the labs. is dropping 30 platelets in 2 weeks alot? the reason i was doing the procrit every 3 weeks at first was cuz i had really weird sx from it, or at least i thought i did, and i ended up in the ER with chest pains and felt very dizzy and bizarre. the second shot wasnt so bad. no noticeable sx. i feel ok hovering in the 10-11 range, fatigued, but i can deal with it. also, i noticed that the rest of my labs got way out of whack once i started the procrit, labs got high that never were and things got low or lower. maybe it's just the inf.  i think it was dperry's doc with the concern of procrit's black box.it seems that going into this second 1/2 of tx is going to be more difficult. i asked my GI for something for my anger/anxiety/sharp temper and she wrote a script for zoloft 25 mg.per day(i think) i wanted something more like zanax or something. what do ya think? i only want to take something if i need it, not every day, if i can help it. i am getting sick of meds and needle sticks as i'm sure you all are. hope everyone has a nice easter weekend! thanks again!

[GoofyDad]

Here's the poop. Many docs are (dare I say inexperienced?, nay cautious would be kinder) and worry about platelets in the range you describe. I think that's waht the insert tells them - you could look it up. The more agressive hepatologists disregard that and worry when platelets get down around 30. 25 seems like an absolute bottom - at some point internal bleeding and brain hemorrage if I recal becomes a real risk. I treated with platelets in the 40's mostly, they would cycle up and down - 40ish was my personal low end.

I'd think about getting a rapid consult with another doctor, doing a google search for low platelets hcv treatment threshold, and generally tring to get a more agressive ptotocol going on. Dose reducing at 59 seems awfully conservative.

Good luck!    

[ladybug52]

Re; the zanax, I'd say whatever works for you. See what meds are processed by the kidneys more than the liver. I take clonazapam for sleep, it's milder than ambien, and a lot of people take that for anxiety. Tell your dr you'd like a mild sedative for bad days and see how he responds. A lot of dr's prescribe  the a/d's because they really do help anxiety. Good luck, this tx is rough and having small children 24/7 is exhausting also.
Bug

[capn hardass]

50 yr old male on third treatment with infergen.virus was iced in only a few weeks.have a long way to go on the medicine.pot makes me feel better,but then it always did.ha.infergen is worse than other two treatments combined.i can only work bout three days a week/sure appreciate va-s help

[aquarius64]

thanks and i will see if i can sway my GI's approach!

[Myown]

Hey Aquarius!
Good to see ya! Sorry to hear you're not feeling well. I agree with you that you have come this far, no way would I want to quit.

Maybe as Goofy mentioned and get another opinion.

Hope you feel better soon.

[capn hardass]

im a 50 yr old male.am a two time nonresponder.third treatment am on infergen. infergen iced the virus in only a few weeks. still have to stay on treatment for about six more months.infergen is rougher than the other two treatments combined.total exhaustion.im only able to work about three days a week.results for infergen have climbed to 43%.looks pretty promising..

[ladybug52]

Just wanted to say I was glad to see your post. I was just saying we heard from chcnme and compulsive now where's aquarius?
Platelets are the most concern and also why procrit every three weeks? I mean it's not 3x a week, but once every three weeks? I'd think you would need more with that Hgb level. Was your hemo the one worried about the black box warning or was that dperry? I haven't had any problems with platelets, hence I'm ignorant of issues that are not all about me. I know Mike, Jim, OH, Goof, Nygirl, all know of these things, and hopefully you will get some real answers in the morning.
Take care,
Bug