new poster/treatment recipient has WBC concerns

[wMich]

Hello all, new poster/treatment recipient here. I am 53 y.o. male, contracted HCV (genotype 1a) in late 80's, diagnosed in 3/05. 1,140,000 viral load, stage 2 grade 2 liver. Last week's test results revealed undetectable above 650. (Yes!) I start week 13 of 180 Pegasus and 1200 Copegus tonight. Side effects for me have been slightly less debilitating than for most people I hear about and talk to.

I do have questions about WBC counts as my latest count was 1.85. I've read some about this issue here and elsewhere and the consensus seems to be to consider WBC boosting meds if the count dips to 1.5. I've been told to accept a Pegasys reduction only as a "last resort" since reduction can affect my chances of attaining SVR. What do you know about this? Are there non-drug ways to raise my WBC counts? Exercise? Diet? Stress reduction? Thanks in advance.  - Lee

[friole]

Neutrophils are one of several types of white blood cells.  So the Neutrophil percent tells you what percent of all the whites are neutrophils - the main infection fighters. The absolute neutrophil is expressed in a # (on my labs it is K/UL).  a reading of 1.1 is the same as 1100 - in fact, I found 2 ANC calculators on the net, and one uses the decimal and one does not.
friole

[cougareyes]

What value is your neut # expressed in, that could be your anc. If not the simple calcuation is your wbc x %neut. My wbc is 2.5(k/cmm) x my %neut which is 37(%) = 925. So my anc is 925. Most docs aren't concerned until 500, some even lower.  Peace

[Pirategold]

I'm confused about calculating ANC.  On my CBC I have Neu # and Neu %.  How is that used to calcuate ANC?

Pirate

[GoofyDad]

I too am noticing problems with my moons. They seem to be getting larger, whiter, and softer, all at the same time. And the left one has developed (gasp) a big red zitm, just at the base. Sometimes I think daily exposure to sunlight might help, but I'm not sure this would be the most prudent course of action, given my 47 years and carrying 10-15 extra pounds.

[cuteus]

I remember your name from before or someone similar, You have posted before, right?  My memory did not fail me on this one? It was a while back...
how are you?

[friole]

I have not seen any nutritional information on bringing up the white blood counts. I am afraid, if it is interferon related you would not be able to do enough through vitamins or diet to make a big difference.

My WBC is 1.6 and the and is .5 (500)and I am going to start on Neupogen on Monday.  ANC is caluclated this way.

wbc x bands (%) x segments (%).

Here is a cool little calculator.  My problem is that most of my lab work does not show the segments and bands, so I can't calculate it myself.  
http://www.freekinetics.com/anc_calc.htm

friole

[EarthMan]

Mitch,
I'm going on 3 years SVR now and others are correct. The Total ANC's are used to determine need for implementing additional measures such as Neupogen. The dosing instructions for both PEG's state to reduce @ 750 Total ANC's. But as mentioned above some Docs allow to fall much lower.

What works for some people is 100% Wheat Grass Juice. You can find it at any good Juicing Shop or Reputable Health Food Store. If you take the Capsules, make sure they are 80% Standardized to 100% Wheat Grass Juice Powder. Worked for many I know and even worked for me. Kept me from having to resort to the Neupogen. You may want to consider it.

I don't know if others have any experience with Wheat Grass Juice or not. It doesn't work for everyone but has helped many of us so called old timers.
EarthMan

[PasoPerson]

All I can say is THANK GOD for our sense of humor.  It gets us through the toughest times.  And Sambone, you are too funny.  Thank you for my early morning **HUGE SMILE**.

[EarthMan]

Friole,
There are many new people around these days and not aware of the benefit of certain herbs that actually work. Even when its PEG-IFN induced. Go to the following URL and post a Question about Wheat Grass Juice. Any of the oldtimers there will be able to respond and confirm the benefits.

http://forums.delphiforums.com/hepatitiscen/start

EarthMan

[Sambone Martian Ambassador To the moon]

hello all,
I am actually having trouble with my fingernails and toenails.
THE MOON ON MY RIGHT INDEX FINGER HAS ACTUALLY LIKE DIED!!!!
Thats okay though it started growing back imediately. The doc says it is from the combination of type II diabetes and liver damage. I thought my whole finger was probably going to fall off.
its hard enough to type with all my fingers so missing one would be a nightmare.
  hello to evryone else. I was recalled to mars and you just can't get a good e-mail conection there, they have returned me to the moon now so I can get back online.  
               sambone

[nanniegea]

Hi Everyone,
   Hope you all are doing ok. I wanted to know if there was anyone out there who has noticed the moons on your fingernails changing color at all? I have always had nice white moons but right before I started tx this past Jan. I noticed they were turning red and the moons were disappearing but now that I am on the last month of tx they are returning to normal. I have cirhosis and I was having horrible symptoms of bloating and pain in the abdomen. I wonder if the cirrhosis had anything to do with it or do you think it was the hep-c or maybe even a combination....Any ideas anyone???

[jmjm530]

ANC (absolute neutrophils) is the number to be concerned about.

Some docs prescribe Neupogen when ANC drops below 750 but some allow it to drop as low as 200-300.  

Two weeks ago my ANC was in the low 400's and today it's 1050,  without Neupogen. Point being ANC can go up and down for a number of reasons, apparently even including having a cold.

From what I've observed here and at other discussion groups  is that in general docs are too late on the draw with Procrit (for anemia) and too fast on the draw with Neupogen (for Neuponia.) Go figure.

Congratulations on your 12 week PCR. GREAT news!!!
I'm assuming your next PCR will be at 24 weeks -- in any event, ask your doc to order one of the very sensitive ones -- that goes down to at least 50 IU/ml.  Better yet, you could order a test like Heptimax from Quest labs that goes down to around 5 IU/ml.

-- Jim

[cuteus]

HELLO! welcome to MHI, the best site on hep c online support. No bias here.
I believe the number they look at is the absolute neutrophils and if below 500, they might start you on neupogen. It is good to hear from people that are not having horrible sides, it gives the newbiew a balanced picture of tx.
be well