mandamus

[teirtat]

I am in prison and have numerous questions I am hoping someone can provide me with the answers to:

1. The forns index for determining fibrosis/cirrhosis is= 7.811  3.131 x In platelet + .781 x In GGT + 3.647 x In Age   .014 x cholesterol.  I comprehend the equations that have the plus and multiplication symbols, but I do not understand what the gap between 7.811 and 3.131 and In Age and .014 represents. Since I have to come up with "one" number what do the blanks represent?

2. Although my ALT and AST have never been "significantly" elevated, except during the few times I drank over the years, I still have developed significant fibrosis. My doctors keep on bringing up "Oh your liver enzymes are not very high" which, they are interpreting you are doing well. However, since it was determined in 2009 that I was stage 3 grade 3 (metavir scale), I don't hold a lot of faith in my liver enzymes. Moreover, I read in the AASLD's guidelines that some percentage of individuals who have normal ALT levels have sustained significant fibrosis. Anybody got anymore on that?

3. I also had hep B. It is resolved, however, I read somewhere that persons who have had hep B and get hep C that their disease progresses faster than otherwise. Any information on that?

4. My ferritin levels were, approx. a year ago 455. I know that 300 is the upper level of normal. My doctor was going to send me to a phlebotomist (spelled wrong maybe) but Bureau of Prison doctors in Central Headquarters shot it down. I have no idea if I have hemachromatosis (probably spelled wrong) but I don't think so. However, should it be treated and why?

5. I failed treatment with interferon and ribavirin. I also developed anemia and was close to going under 500 on my ANC. When the protease inhibitors came out I was put on Incivek, interferon and ribavirin. Although I was taking duel combination for 3 months before I started feeling bad; after my first shot of interferon it felt like I was hit by a bus. I concluded that I was having a drug to drug reaction between the effexor and interferon (EXTREME nausea). My doctor refused to listen to me and said "It's not the effexor" and I said, "it is the effexor". I discontinued the effexor. 95% of the nausea went away. However, I started getting seriously depressed. Rather than prescribing an antidepressant I could tolerate with interferon, they ended up discontinuing my meds. Needless to say I went off.

6.  Now, the last doctor I saw said that he believes that the treatment would kill me because in 3-4 weeks my platelet count dropped from 225,000 to107,000 and significant drop in my white blood cell count (I don't know the numbers). My opinion is that I need to see a specialist. I don't know if there isn't some way that the platelet count and white blood count can't be rectified while on treatment. Moreover, since my doctor is not a specialist and the bureau of prisons does not employ a specialist (neither a hepatologist nor infectious disease specialist) I want to see one but they don't want to approve it. I am seeking some input on this. It's not that I necessarily question my doctors here, but they have provided me false information in the past and I don't know. It's not like I can go out and see one on my own, but I am thinking about filing a "mandamus" with the federal court in Washington, DC and asking them to order the doctors in Central Headquarters of the BOP to direct that I am seen by a specialist. Anyone have any information on filing such a mandamus?

7. I know there is a super protein on the horizon that wipes out Ebola hepatitis, and all viruses. What else is coming out on the hep c and what kind of time frames are we looking at.

I actually have more questions but these are the most pressing ones.  Thanks!!!!

[Dee1956]

Keith I am really sorry to hear that the new drugs coming out will be for naive only.  I did not know.

[Dee1956]

Thank you for your post, I did not realize that the new drug would be for naive only.  That is huge information. So the medical person who told him that the prison might wait for new drugs was wrong to think it would be soon
I think this thread has been very helpful

[can-do-man]

Being that I was not able to offer much that was positive at the current time there is one thing I would suggest he could do. See if they will run the IL28b test on him. That seems to play and important factor with treatment. Knowing what his type is and how each type works with these new drugs that are in trials could give him a step up when retreating becomes possible... Doing some research on this and by following these trials would be time well spent.

http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/61702

[mzkity]

I just PM tiertat to make sure she paste/copies your post. I didn't see your post as bashing in anyway. I think it's the bottom line as far as his treatment in choices. I think all of you were so helpful to him. As it was in his original post, he was asking for advice on hep c. I think it got off course and might of got a little harsh. He's has good info now so maybe he can feel like he did what he could to get all his questions answered. Thanks to all!!    Kitty

[Idyllic]

I completely agree. It frustrates me and even sort of angers me the Hepatitis C does not have the infrastructure that HIV and Cancer seems to have. When I see all the programs, support, opportunity and/or awareness that is more readily available for those two conditions it is so disheartening that Hepatitis C is so different.

[rivll]

I completely agree with what you said about the drugs and the fact that he cannot treat before his release. That cannot happen, court case or not.
I appreciate how clearly you explained that because it is a dead end.

I am talking about looking back and considering the responsibility of the patient vs the responsibility of the practitioner...