Off, On, Off, On, maybe off again

[hcvJames]

Maybe I'm a light switch. Was off treatment due to WBC/ANC thing .. scheduled for a full month off, cut to two weeks .. Took shot on 02/15 ... told to stop 02/17 .. made enough noise to get an appointment on the 24th, was being shot down until I asked about the VL test results. They impressed him enough to change his mind and schedule a CBC on 03/01. 03/01 the blood levels had rebounded. Given go ahead to continue treatment. Took my last shot that night. 03/02 discovered there was a problem with the script. It's a replay of last month only with less time. Today MAYBE it's fixed LATE this afternoon. Roche says up to 48 hours to fill it, call Fri to schedule delivery. Except Sat delivery is 12 - 15$ extra, specified in advance. Roche doesn't do Peg and CoPeg on Mon's. So it'll be touch and go as whether it gets here on time. Of course I'll call Roche every 15 minutes Thur and Fri asking "are we there yet, are we there yet" Maybe get lucky.

Meanwhile four appointments have been ordered. Two likely need to be canceled.  No, they won't catch it, I'll have to ask, because, as it happened before, if I show up they will freak out. It's a mess.

Ignore this paragraph :) just working it out .. Blood draws on the 15th, 17th, and 22nd. The appoints for the 17 prolly should be canceled, or the blood draw should, the doctor part moved to accompany the draw on the 22nd. The 15th should prolly be moved to the 22nd also.

Given the above, on the 15th it will have been two shots since a two week hiatus. Here are the tests:

ALT, AST, URIC ACID, TSH

Question: Are any of these going to be affected by the interruption ?
Are any of these particularly time sensitive? I mean couldn't they be moved back a week without a big problem?

Lab Tests Online for the first two simply says " To detect liver damage and/or to help diagnose liver disease"
Well they kinda know that already eh? Having had a biopsy and all.
There must be more to it ?

Uric Acid, don't have joint pains, used to have a certain type of kidney stone, that after too many years found out could be avoided by drinking more water than I was. I've mention this when they ask what medical conditions have you had in the past. Otherwise don't know why they would want to test it now, I'm not complaining of either.

TSH : The intern said one side was slightly swollen, guess that's the reason for that. Not sure I want to know what it might portend.

Once again Thank you everyone.
All the best.

[eureka254]

It's standard protocol to check liver functions (AST,ALT, AlkPhos) during treatment, even though, as epi pointed out, it does fluctuate.  My understanding is that they are usually monitored because there is a small percentage of patients (mostly those with cirrhosis) who can have adverse reaction and increased liver dysfunction to treatment, and and AST & ALTs in the hundreds can indicate that when it happens, hence the regular testing... a safety measure, if you will.

[rcfarm2013]

You are doing the best thing that you can, in that you are a vocal advocate for your healthcare.  Far too many people sit quietly by and defer everything to their doctors, never questioning anything the healthcare workers might say or do.  When I worked as a retail pharmacist, I'd often go to counsel people on a new med. and the first question I always asked was, "What do you know about this medication?"  "Oh, nothing.  My doctor just told me to take it.", was the answer so, so many, many times.  It was quite frightening.  If I could tell people with chronic illnesses one thing, it would be to "Question, question, question!!!!!"  

[epiphiny]

My ALT and AST (LFTs) were regularily checked during treatment, it's standard operating procedure.  It is also quite common for them to go up (or down) during treatment.

LFTs are a measure of activity in your liver - this can be caused by many things - the virus for one, also other medications can affect them, having a cold or a stomach bug can affect them, even the treatment meds themselves can affect them.  Most people with HCV will have raised LFTs which is often the first clue to having Hepatitis.

Don't be too concerned unless they are crazy out of range, like in the hundreds.

Also, I don't think you should worry too much about having to be a day late with your meds, you can't do anything about it now.  It's not ideal but it's what you have to work with.  You can pull it back 24 hours at a time to get it where you want it.

I know this is hard going for you but you're doing really well, hang in there.

Epi :)

[hcvJames]

yap. Not feeling good about the treaters in this treatment. Sigh. Tried but couldn't save it this time either. Med's won't make it in until the day after my next scheduled shot. Guess the thing to do is take whenever it arrives and walk it back six to twelve hours a week until it gets back where I want it.

Any comments on the AST ALT tests at this point? Why would they be done during treatment? They have to be an indicator of something. What I've read it just says if you have liver disease or not. And if you have Hep C (with cirrhosis?) they should stay within normal range. Doesn't clearly say what it means if they move out range.

Thanks

[jusjames]

poor you , you are up and down more times than a ****** panties!, sounds like they botched your tx

[nygirl7]

I think with all the disruptions what you need is a PCR to see if you are still UND or what - I don't get why they didn't just give you neupogen and let you continue.......what a pain!

[eureka254]

I'm of the mind that it's less like being a light switch and more like handing the remote control to your life and body to your health providers!  

Hats off to your perseverence... and boy, that's a blood a lot of days in a row!  I don't imagine that a couple of days on those particular blood tests should make a significant difference unless you're having symptoms, but it's always a good idea to check with the doc -- maybe s/he'll tell you to do them all in one fell swoop.

Good luck on getting the meds on time!  ~eureka

[Trish77]

TSH is a thyroid test.  I'm assuming it means that you have a swollen thyroid gland.  It's a good thing they're testing that.  If your thyroid is out of whack, which can happen due to the interferon, then they'll put you on meds to regulate it.  

On all the rest...good luck with it all.  This catches me at a betwixt and between moment and that's all the comment I've got in me right now.  Take care and hang in there.

Trish