hemotologist and hepatologist - does one need both?

[libzo1]

My mother died in my arms.  One of the last profound statements she was able to summon to me was to NOT give up.   She nursed me through my first treatment in 2007 and after.  While I was regaining my health, hers was deteriorating.  Circumstances allowed me to repay her love and support when I became her caretaker and was there when she needed me to be.  I am so blessed.  I was able to inhale her last breath.  I am beginning triple therapy Sept. 13th, the second anniversary of her passing and I feel her all around me.  Destinys circles that open and close bring us closer to fulfilling our personhood and purpose.  She held me as I cried like a baby when the dreaded relapse became an omen.  

I am just saying that everything looks up to me at this point in time.  My main concern is anemia because of my difficulty in the past.  How does one get a hemotologist just to sheperd one through this issue?

Thanx for allowing me to purge my soul.  I feel better.  I hope I didn't make you good people feel worse but hug your Moms!    Libzo

[working dog]

i guess i have to wonder if you have any help at home....triple tx can be tough...i can't wait to stop the incivek...like others have said i think you really should educate yourself about rescue drugs...i tell everyone if you can get blood work every week do it!!! keep a close eye on everything...the drugs are reeking havoc with my system...they may or may not with yours...did you start an ad?? i''m glad i did...drugs like procrit you really need to understand...i would start asking questions on the forum and be prepared...i'm on week 10 now and was my best on weeks 7 and 8...i'm not trying to scare you just trying to help..good luck...billy

[spectda]

It sounds like there was a lot of love between you and your mother and you seem to have a very good attitude about her passing.

A good hepatologist is capable of monitoring your blood and prescribing rescue drugs if needed. In my Victrelis trial my hepatologist handled everything. It seems to me that more often (not always) a hematologist is used with a gastroenterologist who may not be as experienced in handling HCV tx.

The important thing regardless of whether you use a hematologist or not is that you have an agreement before starting tx about what will happen if blood levels drop to a point where you need intervention.

I would want to know if the doctor will use rescue drugs, dose reduction and at what levels they will intervene. Trying to figure this stuff out in the middle of tx when you may not feel very good and suddenly you need to have additional drugs prescribed and approved is not the time to have to deal with it. Poorly timed dose reductions can negatively influence your success.

"Some" hematologists are  not experienced in handling HCV tx and the guidelines for intervention are very different then they are for cancer patients for instance. also if you use a hematologist I would want one that has a good working relationship with the main treating doctor.

Good luck with tx,
-Dave

[jjsmomma11]

Hi again, I forgot to add that your brief story about your mom touched me, then inclined me to join the group. You are truly blessed, your mom will stay close to you, and make sure you maintain and succeed through this upcoming round of treatment.  With protective angels, blessings. Jules

[jjsmomma11]

Hello,
I also will start the triple regimen at end of Sept 2011, withTelapravir, Riba, Peginterferon. I had taken the dbl treatment for 5 months until Dec. 2010, when I also suffered  with severe leukopenia, anemia, very low hgb. So finally, I found a new GI/Hep doc and one thats seems to be more intuitive/focused on obtaining/maintaining my optimal pre-treatment good health. Don't need a hematologist, I am fortunate I have no other health issues besides HepC. My present  hep doc has made it a priority to make sure my ferrous level (iron) is normal and that I have an iron reserve accumulated in my liver prior to beginning the triple meds. I have been taking iron tabs twice a day for about 3 weeks now and will continue to do so throughout my future treatment. He also has made the rescue drugs (blood builders) like procrit and neupogin available to me during my treatment, just in case I become anemic during this attempt.  Although I know it won't be easy with the three meds, I am far more optimistic with the addition of Telapravir.  Goodluck and blessings to you. Jules  

[belle19]

without a doubt your mom is with you.  i wish you the best of luck with your tx this time.  i pray that you'll clear it and get on with a great life.  so sorry for your loss.  i lost mine 12 years ago yet she was the 1st person i wanted to call when i found out i had hep c last november.  even after all those years.  miss her everyday.  best wishes for you.  belle

[shanro]

Wow!!! How amazing that you're starting tx on her anniversary... I truly believe that your mother will be there with you during your tx... hugs!!!

[can-do-man]

First, sorry about your loss. a mother can be ones best friend.

If one has a good hepatologist that is up to date on these new meds then that is all that should be needed....... Make sure you both agree on using rescue drugs if needed and at what point, dose reduction should be the last choice......... Wishing you the very best.

[OC]

i don't have an answer to your question, but i wish you the best!

peace