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Avatar universal

Sonic, immune sys

Hi Sonic, first chance i had to say thanks for visiting us here. i have a few questions i hope you will be kind enough to answer. i have noticed that my WBC has dropped over the last year from 7.0 to 5.0. i have not treated yet (my stats follow below). is there anyway to boost your WBC, immune system? it seems that with the constant on-going battle with HCV your body uses all its immune sys for that. this will leave your weakend immune sys open to other things. is this theory correct? perhaps why they are just starting to see a correlation between lymphoma, etc with HCV infected?
How do you feel about the reliability of the Fibosure,FibroSCAN tests.
Would you advise one of your patients to treat or wait with my stats.
THANKS again

STATS:
GT 1a, VL 8 million

0 fibrosis from "FIBROSURE", no biopsy but getting the fibroscan with dr afdhal in boston in Aug

bloodwork normal except the WBC trending down, lipids out of whack, glucose a little high.

cat scan of abdomen/pelvic & US normal except gallstones
25 Responses
Avatar universal
Hi copyman,
Not sure of the reference intervals of the WCC in you lab, but if they are similar to mine, a WCC is still normal.  First, It is common for the white cell count to fluctuate a bit over time. I wouldn't see a fall o from 7 to 5 as being a major problem.  Second, it is likely the WCC in the peripheral blood (as opposed to the lymphocytes infiltrating and attacking the infected hepatocytes in the liver) may not be that important; after all it is the viral antigens expressed on the liver cells that are attracting the activated white cells to the liver.  Third, while there is a relationship between HCV and lymphoma, thic is a rare occurrence.  It woulnd't be a motivating factor for me to want to treat HCV.  Fourth, I don't make a decision about treament or not of fibroscan results.  Unless you are elderly, have some MAJOR contraindication to therapy, I would suggest treatment for you.  You have at least a 45% chance of SVR and then would not have to live under the sword of Damacles wondering about cirrhosis / cancer etc even though they are unlikely.
Cheers,
SB
Avatar universal
Sorry, typo:
"but if they are similar to mine, a WCC is still normal"

Should read:
" but if they are similar to mine, a WCC of 5 is still normal"
Avatar universal
Like my doc, Sonic is quite bright and knowledgeable, but also like my doc is very pro-treatment, even in geno 1's with little or no liver damage. My take, as you know, is quite different, but I'm not as bright or as knowledgeable. That said,
I'm sure everyone understands that other doctors (as bright and knowledgeable) would not necessarily recommend treatment for a geno 1 with little or no liver damage and would adopt a watch n' wait approach. If you do decide to watch n' wait, Fibroscan can be a very useful tool.

All the best,

-- Jim
96938 tn?1189803458
On the other hand, your  doc may not recommend a 60 year old riding a scooter, downhill both ways, to the gym or competing in ramp-jumping with the local pre-teens.  Just remember, you're not getting older - you're getting faster.
Avatar universal
Another probing reply. Do you think my Scootermania is another post tx side effect?

Did I mention I also bought a skate board over the weekend?  But honestly, after about an hour's practice (and two falls w/full equiptment) I'm considering getting rid of the skate board on ebay.

Meanwhile, can't recommend the scooter enough as an aerobic workout, not to mention the fun factor. Sort of like running (similar muscle groups) with 90% less impact. Yesterday, my heart monitor registered 110-140 for a 45 minute skate. On the 'exertion' scale, I'd say less perceived exertion for the same heart rate than either cycling or rollerblading.

-- Jim
96938 tn?1189803458
Just funnin' your about the scooter.  I think it's a good idea.  We have skateboards around the house, I can't get the hang of them.  I think that ability and confidence  the skateboard requires the reckless abandon of youth.  As to the scooter being a sx of tx, you might have something there.  Perhaps catching up on the missed miles that tx consumed?  You were a runner....
Avatar universal
I'm quite bright and knowledgeable and I say "treat with full doses of all the treatment drugs you can get your hands on and watch and wait at the same time". That way you've got the best of both worlds - you're watching and waiting and treating all at the same exact time. How does that sound to you? It's groundbreaking stuff!
Mike
Avatar universal
Indeed, it is groundbreaking, and I'm surprised we haven't seen studies on this. Do you think we could throw kick boarding into the mix -- take max drugs, watch and wait and ecologically transport yourself around the hospital bed, all at the same time.

Be well,

-- Jim
Avatar universal
Sure we could and while were flying around the hospital why not throw a transfusion in just to keep things flowing? I think we should initiate a study. I'm confident many members would apply for the trial. I would and I'm SVR! I would  hate being left out of something like this and I bet I would come out of it SVR. Mike
179856 tn?1333550962
See that's the thing I don't understand - why would anybody want to wait until their liver was good and damaged before treating?  I wish I could have gotten info that I had this way before I was stage 3.''

But that's my take on the whole thing - I would have tried to force the issue if I was a 0-1 before my liver was already so decompensated.
Avatar universal
You should be an expert by now at the waiting part - you've certainly been doing it long enough. I would have hoped they'd have ten new treatment drugs after all this time. Mike
86075 tn?1238118691
yeah, I know, and maybe it's caused resentment, I don't know, but oddly enough, I'm now ready to do something...hope all is well with you and yours...and that youre taking advantage of the good weather to ride your bike...it's a Harley isn't it?
Avatar universal
It wasn't resentment that prompted my response. It was the realization that waiting can be a very long and unfortunately sometimes unrewarding process. I recall trying to get viramadine - the ribavirin pro-drug back in 2003. Have you heard anything about that drug lately? Well, it didn't pan out like expected. I hope for better with the PIs and/or polymerase inhibitors.
I have a Harley and a custom bike. The custom is sitting in my garage and the Harley is getting super brakes put on it before I ride it.

Mike
92903 tn?1309908311
...waiting can be a very long and unfortunately sometimes unrewarding process.

And so can treating. Sometimes we pick our poisons, and sometimes they're chosen for us.

Take care and enjoy the weather (assumng it's as nice there).
86075 tn?1238118691
NYgirl, think my doc's a little bit in the Jim category, I don't really know, but in MY case he is...he says he likes to tailor treatment decisions, and maybe most docs don't...I have thought of going downtown and getting, yet, another physician's advice...but about 6 months ago, when I finally decided to treat, my doc said "wait and see what these new drugs turn out like....youre labs are great, very low viral load, low alt's and asts, etc....and everything he's tested for apart from that is good...plus he knows I have relatively little liver damage...he said if this equasion with me was different, where my labs were off or something, or something else more drastic....he'd be telling me let's go with what we got..but he just thinks I'm not going to be very much more damaged if I wait for the new drug data and then get into a trial, he says my immune system or whatever has put up a good fight agaisnt the disease...to be honest, he doesn't like soc, I guess Sonic said as much in another post, most doc's don't probably, but they don't like liver damage even more, and it's the only thing we've got "right now"....

Just in MY case, my doc wants me to wait a little bit, if things don't go as well as expected with trial data, etc, he'll put me on SOC...I often wonder if I should just see another doc...
Avatar universal
I am the kind of person who would rather do something and be disappointed than do nothing with the same outcome. I like to be engaged in my fight but that's not how all of us feel - obviously.
The weather here is gorgeous.
Mike
92903 tn?1309908311
I see you point - but at the risk of mixing metaphors  - I like to choose my battles. I might play tennis agains Billie Jean King, we she on a comeback mission, but I ain't climbing in the ring with George Foreman. Like his burger machine though.

It's a complex issue with personal factors and infinite risk/reward variations.
Avatar universal
wow! talk about a thread getting hijacked, LOL.
Thanks sonic for the response. so you do not think that my body fighting the high viral load will cause my wbc to drop?
Is there anything that can raise the WBC beside the extreme of nupergen(sp?) shots?  i'm not so much concerned with the WBC count being low for damage to the liver but more for getting sick more with colds, etc. seems like this past winter i got sick more then i ever have and just so happens my WBC trended down. God bless
86075 tn?1238118691
hey sorry for the hijacking Copyman!...at least for my part, these threads are so short nowadays, I think it's pretty reasonable that a person youre flagging will see it, hope youre well...

Mike Simon: youre right, we're all different, funny that I was finally ready to treat after my fibroscan a few months before, like I said, and now my doc wants me to wait for this new thing...but if my labs, condition, were any worse, I would of treated long ago, believe me...

We all have different dispositions about things...and no, I know you don't resent me for it, but I have run into people that have, who told me that talking about my story will discourage people from treating right away....I just don't believe I can have that much power, we all have different circumstances we're looking at, and of course I don't mean to do that...

I'm just beginning to think more and more of tailoring processes to individuals when it comes to healthcare...there have been some interesting discussions on this lately...to me, blanket recommendations don't always apply...I'm glad youre riding your motor cycles, love them, just haven't been on one in a long time...I can actually drive a smaller one, preferably with an electric ignition, ha ha!
Avatar universal
I really never had a choice. I didn't even know I had HCV until a major esophageal bleed - varices. Then I got my liver and the HCV was back and I didn't think I could afford the watch and wait approach. So it was simple for me - treat and treat and treat one more time. So Goofy, would you call that choosing my battles or just trying to stay alive a little bit longer? Mike
86075 tn?1238118691
course, in your case, I am very glad you did what you did...and are still here helping people to boot...have a great weekend...
Avatar universal
Thanks and you have a great weekend too. Get out and enjoy the weather and stop all that waiting and watching for a few days. Mike
86075 tn?1238118691
hi, I know what you mean, not that I matter so much here, but in terms of my own situation, I maybe convey that I'm much more worried that I am...

I was actually kind of heartened by my last testings, and I'm not *that* freaked about this disease anymore, nor have I been for a while...I kinda use this board more for a chat board, a blog if you will...cause I've made friends and I'm interested in people and how they are faring, even if I can help just a little bit...I try...

I guess once you start treatment, it's a whole new ballgame here, and people need it much more for obvious reasons...but I'm enjoying my life pretty much, and trying to do what I can to help in other areas, this kid I take care of, animals, political causes a bit...If I don't try to help, etc I tend to be a very self-absorbed, self-centered person, to be honest...so that's why I do many of these things, to help, and also for my own selfishness...as it turns out...be well...
Avatar universal
I still love you, you selfish, self-centered, self-absorbed brat,.....you ONLY took a teenager into your house because it had a destructive home.
Prost my friend....I wish I knew more people like you.

Ina
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