Aa
fishdics consults-interesting
OK, everyone in the area of Albuquerque, Dr. Arora is the real mccoy. I put 11 years of labwork into a spreadsheet, my list of questions, and this is the skinny. Just to update those that don't remember, baseline 2,890,000 12 week was 38,700. His resident said "thats close enough", and I was thinking HUH UH< I have read the literature... Dr. came in with two students, and said. You failed to achieve a 2 log drop. If you continue the current course, you have a 5% or less chance of SVR. However, it may be that you are not a true nonresponder, because your hemoglobin has remained virtually unchanged, which tells me you are one of less than 5% of patients that hypermetabolize ribavarin. ( he has conducted 17 clinical trials with ribavarin) Essentially, you are on monotherapy. Options: increase ribavarin, 6 weeks at 1400, then up to 1600 for another 6 weeks, redo the PCR. If you are undetectible at the 12 week, you have a 65% chance of SVR. If you fail to hit undetectible, then stop the treatment. If I am undetecitible, my 48 weeks starts today. If I stop, and start again in 6 months, you start out with the same odds as this time (I wondered about that). He also said that he has a VX-950 trial coming up for....... nonresponders. You have to have failed to achieve a 2 log drop, and failed to hit undetectible at 24 weeks. Starts in 6 months or a year. So trip was well worth it. Cops came and hauled the crazy uncle off while I was gone, man, I'm a making progress. Thanks for all your well wishes, I could feel the vibes...
Dyce: how are you going mate?Have you had your PCR yet? On my first 2 weeks of tx i was an insomniac. but now i sleep about 10-12 hours a night. i was worried it was the antidepressant but the doc said it was the interferon. i have weird dreams tho. nightmarish.
Forseegood: Heres a story for you that i know you will appreciate. (Everyone else close their eyes) My HB and neutrophils and energy dropped, so the naturopath gave me some herbs and my last blood test showed my HB within normal range and neutrophils nearly there. Yay. the dr said riba dose gets dropped by 13 week mark normally (if needed) so she was happy with the results. so am i. i cant wait until I tell the naturopath. My ALTs are still peachy too
Forseegood: Heres a story for you that i know you will appreciate. (Everyone else close their eyes) My HB and neutrophils and energy dropped, so the naturopath gave me some herbs and my last blood test showed my HB within normal range and neutrophils nearly there. Yay. the dr said riba dose gets dropped by 13 week mark normally (if needed) so she was happy with the results. so am i. i cant wait until I tell the naturopath. My ALTs are still peachy too
I'M NOT SURE WHAT HAPPENDED TO MY POST BUT I WAS HOPING I COULD ASK YOU A COUPLE OF QUESTIONS ABOUT YOUR SOCIAL SECURITY AND THE TRIALS YOU MAY OR MAY NOT HAVE OBTAINING YOUR BENEFITS. ASKING FOLKS ABOUT THESE KINDS OF THINGS CAN BE A LITTLE INTRUSIVE SO I'LL UNDERSTAMD YOUR RELUCTANCE.
MANY THANKS
DOG_LOVER
MANY THANKS
DOG_LOVER
Hey, was just asking about you in another post....here you are! I have been out of town, played catch-up w/everyone else but was missing you.
Memorial day weekend pool party......everyone will be here, hope you can make it, ought to interesting!
Have a good one,
Fisheress
Memorial day weekend pool party......everyone will be here, hope you can make it, ought to interesting!
Have a good one,
Fisheress
Great Gonopodiums!! Glad to hear you found a doctor you can work with. Here are a couple of papers you
In addition to their famous (infamous) study you reference, an older paper from the same Sweedes (wish I could find it ) show a relationship between plasma riba levels and anemia, which is I believe is the concept Fishdoc's doc is using.
Add this to the association between higher blood riba levels and SVR and you can see where he's going. But once again in the world of Hep C, everything is not always so clear cut. This recent study for example seems to contradict those theories although my hunch is that the difference in riba levels (higher in Sweedish study) may be the reason. Fish, you might want to show this to your doc and get his opinion and please post it if you do.
http://www.hivandhepatitis.com/hep_c/news/2006/033106_b.html
--------------------
BTW, I believe the word in the exerpted article is "saturable" not "storable" as written. "Saturable" actually means the opposite of the way I've sometimes seen it referred to here. When something is saturable, for example riba -- it means that less is absorbed the more you take at any one time -- not that more is absorbed. Actually, it doesn't really mean less is absorbed, but just that it isn't absorbed in a linear fashion -- in other words less of a percentage is absorbed. That's why for example, if you take let's say 3000 mg/day of Riba, you whould get more riba into your system if you dose three times a day as opposed to one. Keep in mind that the saturable concept may not be applicable to the normal doses that we use per normal protocols and I was told by my hep (before this paper I should add) that dose timing didn't matter -- and to some extent he's still right at normal doses within certain limits.
In any event, the saturable concept is somewhat mute the way the Sweeds dose, because they use a special blood test (HPLC) that monitors plasma riba. That gives them the exact number they need -- but again, the study above challenges that assumption and would love to see what Fishdoc's doctor says about it since he appears to be a Sweede at heart :)
But all said, and going back to Bill's example, and Fishdoc's current situation -- it appears to me that if her doctors want to see a drop in hgb this time. That's why I suggest she ask her doc for weekly monitoring of hgb levels -- because if they don't drop the way her doctors hope, then the whole thing in my opnion becomes academic. Bill, I also wonder if that was your problem as well -- not enough of a hgb response, maybe not enough riba in spite of higher than normal dose. Just speculation, of course, based on what Fishdoc's doctor says and some of the Sweedish studies which show that dosing sometimes has to go as high as 3,600 mg/day in certain individuals in order to get the plasma levels they need.
Hopefully, the whole riba issue will become academic as newer drugs in trial either replace riba or make its impact less important, because as we all know it is one NASTY drug.
-- Jim
Add this to the association between higher blood riba levels and SVR and you can see where he's going. But once again in the world of Hep C, everything is not always so clear cut. This recent study for example seems to contradict those theories although my hunch is that the difference in riba levels (higher in Sweedish study) may be the reason. Fish, you might want to show this to your doc and get his opinion and please post it if you do.
http://www.hivandhepatitis.com/hep_c/news/2006/033106_b.html
--------------------
BTW, I believe the word in the exerpted article is "saturable" not "storable" as written. "Saturable" actually means the opposite of the way I've sometimes seen it referred to here. When something is saturable, for example riba -- it means that less is absorbed the more you take at any one time -- not that more is absorbed. Actually, it doesn't really mean less is absorbed, but just that it isn't absorbed in a linear fashion -- in other words less of a percentage is absorbed. That's why for example, if you take let's say 3000 mg/day of Riba, you whould get more riba into your system if you dose three times a day as opposed to one. Keep in mind that the saturable concept may not be applicable to the normal doses that we use per normal protocols and I was told by my hep (before this paper I should add) that dose timing didn't matter -- and to some extent he's still right at normal doses within certain limits.
In any event, the saturable concept is somewhat mute the way the Sweeds dose, because they use a special blood test (HPLC) that monitors plasma riba. That gives them the exact number they need -- but again, the study above challenges that assumption and would love to see what Fishdoc's doctor says about it since he appears to be a Sweede at heart :)
But all said, and going back to Bill's example, and Fishdoc's current situation -- it appears to me that if her doctors want to see a drop in hgb this time. That's why I suggest she ask her doc for weekly monitoring of hgb levels -- because if they don't drop the way her doctors hope, then the whole thing in my opnion becomes academic. Bill, I also wonder if that was your problem as well -- not enough of a hgb response, maybe not enough riba in spite of higher than normal dose. Just speculation, of course, based on what Fishdoc's doctor says and some of the Sweedish studies which show that dosing sometimes has to go as high as 3,600 mg/day in certain individuals in order to get the plasma levels they need.
Hopefully, the whole riba issue will become academic as newer drugs in trial either replace riba or make its impact less important, because as we all know it is one NASTY drug.
-- Jim
I specifically asked if I should take it more often, and he said no.... but I'm a gonna..... reminds me of the "day" when I partied. I could drink/party most men twice my size under the table, back then I thought that was cool, now it's not so cool....
You are reading content posted in the Hepatitis C Community
Learn about this treatable virus.
Getting tested for this viral infection.
3 key steps to getting on treatment.
4 steps to getting on therapy.
What you need to know about Hep C drugs.
How the drugs might affect you.
These tips may up your chances of a cure.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
