Aa
another bloodwork question
Is once a month frequent enough for cbcs while on tx? I thought it was going to be every 2 weeks, but the nurse says every 4.
Aren't you already undetectable? It doesn't make sense to me to increase your riba if you are already clear. It will just make you feel worse and you'll still be at the same place, UD.
I was under the impression that most people had tests every 1-2 weeks, I'm glad 4 weeks is standard.
My doctor has never given anyone more than the 1200 riba/day, but I asked about it and he did some research. Now he wants me to call him next week and said he may agree to up me to 1400 (because of my obesity). My hemoglobin actually went up 0.1 to 13.4 between my 1-week and 4-week tests, so I would like to try more riba I think.
I don't know enough about the neutrophils and platelet counts, etc. to know what to look for exactly. They are all in range except for the eosinophils (which are low now) - but all them are decreasing except for neutrophils which went from 3394 to 4967. They went up?
Is that backwards? Weird.
My doctor has never given anyone more than the 1200 riba/day, but I asked about it and he did some research. Now he wants me to call him next week and said he may agree to up me to 1400 (because of my obesity). My hemoglobin actually went up 0.1 to 13.4 between my 1-week and 4-week tests, so I would like to try more riba I think.
I don't know enough about the neutrophils and platelet counts, etc. to know what to look for exactly. They are all in range except for the eosinophils (which are low now) - but all them are decreasing except for neutrophils which went from 3394 to 4967. They went up?
Is that backwards? Weird.
The National Institute of Health recommends:
Measure blood counts and aminotransferase levels at weeks 1, 2, and 4 and at 4- to 8-week intervals thereafter.
Their site is at http://digestive.niddk.nih.gov/ddiseases/pubs/chronichepc/#c
Most patients on a typical TX regimen get by well with that plan, since the big crashes tend to show up early and then moderate. If you are going outside the typical by increasing the riba (as copyman says), you may need more frequent monitoring with CBC's. From personal experience, I can tell you that strong responders to IFN (like you as a URVR) tend towards worse neutrophil and platelet counts and may require more frequent monitoring. If you have any doubts, such as feeling much worse at some point, being ghostly white, or developing infections, don't hesitate to call for a CBC more frequently than the 4 weeks.
I was a URVR too, had 2 week visit scheduled until week 12, then was supposed to move to 4 week visits between weeks 12 and 28, then 6 week visits between 28 and 40, 8 weeks between 40 and 48. The more frequent visits were also scheduled because I added a 3rd trial drug at week 4. I NEVER made it to the 4 week visits because platelets stayed crashed and they had to monitor me more closely for dose reductions, adding neulasta for neutrophils and procrit for hgb. When you go outside of the standard regimen extra CBC's are built in to monitor the effects of the rescue meds and dose reductions.
Measure blood counts and aminotransferase levels at weeks 1, 2, and 4 and at 4- to 8-week intervals thereafter.
Their site is at http://digestive.niddk.nih.gov/ddiseases/pubs/chronichepc/#c
Most patients on a typical TX regimen get by well with that plan, since the big crashes tend to show up early and then moderate. If you are going outside the typical by increasing the riba (as copyman says), you may need more frequent monitoring with CBC's. From personal experience, I can tell you that strong responders to IFN (like you as a URVR) tend towards worse neutrophil and platelet counts and may require more frequent monitoring. If you have any doubts, such as feeling much worse at some point, being ghostly white, or developing infections, don't hesitate to call for a CBC more frequently than the 4 weeks.
I was a URVR too, had 2 week visit scheduled until week 12, then was supposed to move to 4 week visits between weeks 12 and 28, then 6 week visits between 28 and 40, 8 weeks between 40 and 48. The more frequent visits were also scheduled because I added a 3rd trial drug at week 4. I NEVER made it to the 4 week visits because platelets stayed crashed and they had to monitor me more closely for dose reductions, adding neulasta for neutrophils and procrit for hgb. When you go outside of the standard regimen extra CBC's are built in to monitor the effects of the rescue meds and dose reductions.
am on week 32. my last blood work was week 24, next will be 36 and then once again at 48.....so I guess it just depends.
if you are upping the Riba then I would do bloodwork weekly or at least every two weeks for the first few months. Just in case the extra Riba brings on anemia.
Sounds like you have an aggressive doctor increasing the Riba doing tx. You are lucky to have a doctor like that. Most doctors stick to the SOC protocol instead of treating each patient individually. Tweeking the Meds early on could increase chances of SVR dramactically. The idea being to hit this virus hard early to clear it as soon as possible (hopefully by 4 weeks) or be clear by 12 weeks to have the best chance of SVR.
Sounds like you have an aggressive doctor increasing the Riba doing tx. You are lucky to have a doctor like that. Most doctors stick to the SOC protocol instead of treating each patient individually. Tweeking the Meds early on could increase chances of SVR dramactically. The idea being to hit this virus hard early to clear it as soon as possible (hopefully by 4 weeks) or be clear by 12 weeks to have the best chance of SVR.
My gastro did CBCs and CMPs once a week for the first six weeks and then once a month for the rest of tx. I guess he wanted to know early on if I was going to have any strong reactions to the meds.
Okay - that is good to know. My bloodwork was good except for my rising liver enzymes. So now, upping the riba to 1400 next week. Next cbc at 8 weeks, and next pcr at 12 weeks. More waiting I guess ha-ha.
Thanks YuK :)
Thanks YuK :)
Once a month should be fine if your labs are not to erratic. I get my labs monthly unless something is dropping too far from the normal range. Like right now my hb is having a tough time getting higher than 8.6 and I'm on procrit so I go every 2 to 3 wks. But in the past when it was almost 10 and my ANC was over 600 I only went once a month.
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