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short course tx and riba question/ other posts too!
Hi All, any insight on this is greatly appreciated. I am geno 2, and cleared by week 4. I have been on 800 riba eventhough that is NOT weight based for me, i'd be up to 1000. Anyway, prior to starting tx, I asked to do weight based riba especially if I was going to do short course of tx. Doc said it wasn't necessary. Now, I talked to my NP today and he said well, I have talked to the doctor, and if you are going to do short course tx, then I think you should up your riba until the end to decrease odds of relapse. Does anyone know of any articles about short course of tx and riba dosing? I am a little bit afraid since the riba has been wreaking havoc with me the past few weeks, but I can definitely handle it if it increases chances of SVR. I don't know why this is throwing me for a loop. In a way, i'm kind of just mad because this is what I asked for from the beginning and NOW they are telling me it is a good idea. ARGHH.
As far as length of tx, here is my very unscientific decision. I will get my 12 week pcr, which I will not get the results of until about 14 weeks. At that point I figure I might as well finish out my current batch of meds, which would bring me to 16 weeks. I feel more comfortable with 16 than I do with 12 and I am optimistic that in my case, 24 is not necessary. I realize this may seem like crazy logic to some of you, but ummm I blame brain fog!
So, any ideas about whether upping the riba from now until the end makes sense?
Thanks so much for all of your support and insight!
As far as length of tx, here is my very unscientific decision. I will get my 12 week pcr, which I will not get the results of until about 14 weeks. At that point I figure I might as well finish out my current batch of meds, which would bring me to 16 weeks. I feel more comfortable with 16 than I do with 12 and I am optimistic that in my case, 24 is not necessary. I realize this may seem like crazy logic to some of you, but ummm I blame brain fog!
So, any ideas about whether upping the riba from now until the end makes sense?
Thanks so much for all of your support and insight!
If it was me I would call it a day at 16. As I recall you are youngish, had no bx and little kid(s). The no bx is the wild card here. Being young with other meds on the horizon, even if you don't get svr now, gives you options.
Well, asking me whether to up the riba is like asking NY Girl if if it's OK to up the ice cream :)
But seriously, weight-based riba intuitively makes more sense to me on a short course, but you might want to research out how the short-course study did it. For a brief overview:
http://www.medpagetoday.com/tbindex1.cfm?tbid=1240
Also, keep two other things in mind. First, non-detectible at week 4 was I believe by a very sensitive PCR that went down to at least 50 IU/ml. Make sure your PCR was at least that sensitive so you're not comparing Breyers to Hagen Daz. And second, I believe the 12-week short course study was for Peg Intron. If I remember correctly, the shorter-course studies for Pegasys were for 16 or 18 weeks, not 12.
Also, in spite of your early response, if it turns out that you were significantly underdosed with the riba for the first 12 weeks, a conservative approach might be to up the riba and go the full 24-week course. Same thing if you have moderate or significant liver damage.
Good luck. BTW all we geno 1's are very jealous you have these kinds of decisions :)
-- Jim
But seriously, weight-based riba intuitively makes more sense to me on a short course, but you might want to research out how the short-course study did it. For a brief overview:
http://www.medpagetoday.com/tbindex1.cfm?tbid=1240
Also, keep two other things in mind. First, non-detectible at week 4 was I believe by a very sensitive PCR that went down to at least 50 IU/ml. Make sure your PCR was at least that sensitive so you're not comparing Breyers to Hagen Daz. And second, I believe the 12-week short course study was for Peg Intron. If I remember correctly, the shorter-course studies for Pegasys were for 16 or 18 weeks, not 12.
Also, in spite of your early response, if it turns out that you were significantly underdosed with the riba for the first 12 weeks, a conservative approach might be to up the riba and go the full 24-week course. Same thing if you have moderate or significant liver damage.
Good luck. BTW all we geno 1's are very jealous you have these kinds of decisions :)
-- Jim
I'm not sure how I'd handle it - so I won't offer an opinion.
I will toss out a few thoughts though:
The studies that support the 12-16 wk tx cycles used weight based riba.
12 weeks with peg-intron. 16 weeks with pegasys.
Some say RIBA in the early stages is more important than later.
Consider what your course would be for a relapse? Are you talking another 16 weeks, 24 weeks, 48 weeks? Or hanging it up for a while?
What about stepping up the riba now, and seeing how it goes?
Does it really matter how much meds you have in the fridge? Should that be a weighty factor?
Good luck. This is a hard decision. I know.
I will toss out a few thoughts though:
The studies that support the 12-16 wk tx cycles used weight based riba.
12 weeks with peg-intron. 16 weeks with pegasys.
Some say RIBA in the early stages is more important than later.
Consider what your course would be for a relapse? Are you talking another 16 weeks, 24 weeks, 48 weeks? Or hanging it up for a while?
What about stepping up the riba now, and seeing how it goes?
Does it really matter how much meds you have in the fridge? Should that be a weighty factor?
Good luck. This is a hard decision. I know.
I don't understand why some of us are on 12 weeks, 24 weeks and in my case 48 weeks. What is the determining factor for length of treatment? As for the riba my doctor has me on 1200mg per day and weight is 195lbs. I didn't know it was weight based. I'm 54 and if I were much younger I would hold out for the next generation of medications which may be just around the corner. Stay away from any alcohol and learn as much as you can about it. Wishing you the best. Dale
Goofy said: sorry. cross posted with Jim.
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As long as you don't cross the line with the Gold Bond, we'll be OK :)
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As long as you don't cross the line with the Gold Bond, we'll be OK :)
I am 51, but geno 1b not 2. I am on 1200mg a day. At the begining of tx my weight was 135 and have lost 11 1/2 pounds so far. I am to go 48 weeks. I am told that my doctors office has a good success rate; but their belief is to hit it hard and then they can reduce from there.
dale_ray: I think that your geno type plays a part in determining treatment and length of time. If other factors play into this I am just not aware yet. My Hep doctor's statement to me was as soon as we find out your geno type we will determine treatment/dose/length of time.
Cajun
dale_ray: I think that your geno type plays a part in determining treatment and length of time. If other factors play into this I am just not aware yet. My Hep doctor's statement to me was as soon as we find out your geno type we will determine treatment/dose/length of time.
Cajun
Thanks for your insight. My brain capability is nil these days so I knew I could count on you to point out the obvious.
I guess my hesitation was in knowing that the riba was more important at the beginning then at the end of treatment, I am just not sure it is worth the sides. At the same time, it is for such a short amt. of time that i might as well give myself any edge I can get.
As far as relapse, I will be hanging up the towel for a while if that happens. I am 28, geno 2, no bx though. YIKES, I know that wasn't the best decision I have ever made, but once I decided I was going to treat, I just decided it didn't matter. I think i'll drop a few extra riba down the hatch over the rest of my tx and hope for the best!
About the different tx lengths etc., it primarily depends on genotype and point at which virus is cleared. Geno 2 typically treats for 24, but new reasearch shows that with an EVR (like mine by week 4) 12 weeks of tx is enough.
My personal reasoning aside from not wanting to poison my body any more than I need to is because I am antsy to have more babies! :)
I will do some reading about short course and make my final decision in a couple of weeks I suppose, in the meantime, I will up the riba a bit.
Thanks to all!
I guess my hesitation was in knowing that the riba was more important at the beginning then at the end of treatment, I am just not sure it is worth the sides. At the same time, it is for such a short amt. of time that i might as well give myself any edge I can get.
As far as relapse, I will be hanging up the towel for a while if that happens. I am 28, geno 2, no bx though. YIKES, I know that wasn't the best decision I have ever made, but once I decided I was going to treat, I just decided it didn't matter. I think i'll drop a few extra riba down the hatch over the rest of my tx and hope for the best!
About the different tx lengths etc., it primarily depends on genotype and point at which virus is cleared. Geno 2 typically treats for 24, but new reasearch shows that with an EVR (like mine by week 4) 12 weeks of tx is enough.
My personal reasoning aside from not wanting to poison my body any more than I need to is because I am antsy to have more babies! :)
I will do some reading about short course and make my final decision in a couple of weeks I suppose, in the meantime, I will up the riba a bit.
Thanks to all!
You're right I remember he couldn't determine my treatment until he geno typed me. I am 1a. I was down on VL from 1.5m to 827 at 12 weeks and he said to just continue with Peg, riba and nupogen as is until I see him in May. Lot of blood work in between but he was pretty confident about it. Thanks for the feedback or at least the brain fog clearing. Best to ya! Dale
you said... because I am antsy to have more babies! :)
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Not sure what ants have to do with it, but if riba makes a person want to have more babies. "YIKES" Im tossing all mine out NOW. Jim free riba here.
Good luck to you, your chances for SVR our great, whatever you decide to do.
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Not sure what ants have to do with it, but if riba makes a person want to have more babies. "YIKES" Im tossing all mine out NOW. Jim free riba here.
Good luck to you, your chances for SVR our great, whatever you decide to do.
ha! thanks for the laugh. I think most people on here would be throwing that stuff into the ocean :)
Thanks for your support. That article that jim posted made me feel better about the whole thing actually. Going to keep looking for more info!
Thanks for your support. That article that jim posted made me feel better about the whole thing actually. Going to keep looking for more info!
That's right, studies suggest a positive correlation between serum ribavirin levels and baby production :) Meet me under the bridge at midnight and you can exchange all your riba for some moth balls.
Sorry it has taken me so long to respond back from the other day. I posted before I left work that day and when I picked up oldest son from school he was not walking too well. Strained his groin and pinched legimate that goes down his leg, in basketball and then when my youngest gets home he is sick with sinus, headache etc. Needless to say I have been busy in and out of doctors office.
Strator:
I do get alot more tired these days with the drops. I do go this Tuesday, to see Hemotologist. I have noticed that before my counts drop I get really blurred vision, so bad that I get dizzy (like vertigo), then from what I have noticed the counts drop next and on that day I go home and straight to bed for about a 15 hour snooze and only get up to take meds; I am just too tired to get up. After, about the second day my body seems to re-adapt itself and I can function again but, not at top speed. I get so frustrated when I cannot read things and have to back off; but, part of sx on tx.
Beamish:
Yes, we do need assistance sometimes with the rescue drugs. I am very hard headed and thick skin; sometimes not a good trait. The Ativan (Lorazepam) work wonderfully. The hubby and kids are soooooooooooo Thankful for these little pills.LOL The hubby has also warned the kids that it takes 2 hours before it really sets into my system; so stay clear for a while until it does its thing. LOL LOL
Nygirl:
Yes, the (lorazepam) is in the Valium/Xanax family and when it gets into my system I tend to get a little more relaxed and sometimes want to go to bed. On the Paxil, I cannot take that particular brand of AD. I get every side effect it has and to the point that I have no function ie motor skills. Back then they took me off and put me on Prozac and that one I could take. Do not know if I will give myself the shot for blood counts or if I will go into primary doctors office to get it. I will find out on this Tuesday. On my eyes I have been told by three doctors so far that it is not permanent and not to go through too much expense on this until after tx.
You know, I would like to put your boss in a crate and address it to many, many destinations before he gets to that final destination (where ever that might be) and put No return address. Can you imagine (picture this) all the tumbling around and security checks and somemore flipping around in and out of air craft, more inspections and no return address. LOL That jerk would deserve every inspection point.
Well I do shot #10 tomorrow night.
OH! By the way did you watch LOST last night. Oh my, it was so good.
cajun
Strator:
I do get alot more tired these days with the drops. I do go this Tuesday, to see Hemotologist. I have noticed that before my counts drop I get really blurred vision, so bad that I get dizzy (like vertigo), then from what I have noticed the counts drop next and on that day I go home and straight to bed for about a 15 hour snooze and only get up to take meds; I am just too tired to get up. After, about the second day my body seems to re-adapt itself and I can function again but, not at top speed. I get so frustrated when I cannot read things and have to back off; but, part of sx on tx.
Beamish:
Yes, we do need assistance sometimes with the rescue drugs. I am very hard headed and thick skin; sometimes not a good trait. The Ativan (Lorazepam) work wonderfully. The hubby and kids are soooooooooooo Thankful for these little pills.LOL The hubby has also warned the kids that it takes 2 hours before it really sets into my system; so stay clear for a while until it does its thing. LOL LOL
Nygirl:
Yes, the (lorazepam) is in the Valium/Xanax family and when it gets into my system I tend to get a little more relaxed and sometimes want to go to bed. On the Paxil, I cannot take that particular brand of AD. I get every side effect it has and to the point that I have no function ie motor skills. Back then they took me off and put me on Prozac and that one I could take. Do not know if I will give myself the shot for blood counts or if I will go into primary doctors office to get it. I will find out on this Tuesday. On my eyes I have been told by three doctors so far that it is not permanent and not to go through too much expense on this until after tx.
You know, I would like to put your boss in a crate and address it to many, many destinations before he gets to that final destination (where ever that might be) and put No return address. Can you imagine (picture this) all the tumbling around and security checks and somemore flipping around in and out of air craft, more inspections and no return address. LOL That jerk would deserve every inspection point.
Well I do shot #10 tomorrow night.
OH! By the way did you watch LOST last night. Oh my, it was so good.
cajun
10 blocks!that would be a dream come true to walk. Walking was my mental check out and recover plan for a lot of years and you take that away and its like a screen door on a submarine............dive , dive, dive. Everyone on here picking at me and being playful is a God send. They have so many hidden meanings to most comments it makes me think and rethink which is like exercise. You sound great though and please keep telling us how you are doing post TX. That is the biggest concern I have. I hope you paint a masterpiece tomorrow and if its got a monkey in it I'll figure it was me. Ha! Have a great evening and thanks for all your support through these days. Dale
im sure your going my some Italian study. I bet your eyes lit up just reading "free riba" you'll say and try anything to con someone out of their riba.
BTW you can keep your durn moths, i don't need them, im married. but wait a minute maybe we would make a trade there?
BTW you can keep your durn moths, i don't need them, im married. but wait a minute maybe we would make a trade there?
you know what i would do is up the riba for the short amount of time you have left just to give it a good ole kick because you are wanting more babies and the least amount of tx you have put in your system is going to be better for your unborn baby ...so what im saying is push real good towards the end so you dont have to go back ...let this be the only round of cell changing med you will ever have to take... how long will you wait after your off meds before trying for another one.... im so glad you have a short tx..i know what its like to want more babies i have 5 myself.
God Bless
God Bless
Hi tx buddy,
Here's my thoughts, as we both started together on tx and are the same geno type. First, how are you feeling?
I know you have small children and it must be hard to take care of them and your self when your not feeling good.
If I was in your place and doing ok, I would do the 24 weeks because I fear relapse more then any thing else. Many drs. have different opinions and the way I see it, who's right? I don't know the answer to this and I don't think anyone can be certain they have the right answer.
This is just my thoughts on this matter my friend.
Beagle
Here's my thoughts, as we both started together on tx and are the same geno type. First, how are you feeling?
I know you have small children and it must be hard to take care of them and your self when your not feeling good.
If I was in your place and doing ok, I would do the 24 weeks because I fear relapse more then any thing else. Many drs. have different opinions and the way I see it, who's right? I don't know the answer to this and I don't think anyone can be certain they have the right answer.
This is just my thoughts on this matter my friend.
Beagle
I'm having a bad case of the grouchy-grumps and major irritability lately. My ability to tolerate minor annoyances is just not there. Which in turn, makes me want to hide from everyone. I don't see how anybody can stand me at the moment!
Susan400
Susan400
I know what you mean, we all have days like that. Maybe there is something the Dr. can give you if it's that bad. I think someone posted they were given something to help but don't remember what or who it was.
beagle
beagle
Thanks for your input and support! Yes, goldyn, the clock is ticking and i'm itching for more to love! I have to wait 6 months after tx to start trying for more kiddos. It is definitely doable. :) They are truly a blessing for sure! Exhausting as anything, and sometimes frustrating (my daughter is 2) but completely magical and amazing!
Beagle- Thank you for your input! The relapse rate is identical (according to some studies) independent of tx length if clear at 4 weeks. It's hard to poison myself any longer than necessary! I guess we will see what time brings.
In fact, I just did jab 10 tonight. Tx is kicking my butt this week, so the thought of only 6 more seems quite right at this point! I am going to up the riba starting in a couple of days and see how that goes.
Hoping to kick it in to the end. I do realize how extremely fortunate I am to be responding well and have these options. Somtimes I feel bad posting here because I know I have it so good. Please know that I keep each and every one of you in my thoughts and prayers and will always continue to pray for your SVR!
Beagle- Thank you for your input! The relapse rate is identical (according to some studies) independent of tx length if clear at 4 weeks. It's hard to poison myself any longer than necessary! I guess we will see what time brings.
In fact, I just did jab 10 tonight. Tx is kicking my butt this week, so the thought of only 6 more seems quite right at this point! I am going to up the riba starting in a couple of days and see how that goes.
Hoping to kick it in to the end. I do realize how extremely fortunate I am to be responding well and have these options. Somtimes I feel bad posting here because I know I have it so good. Please know that I keep each and every one of you in my thoughts and prayers and will always continue to pray for your SVR!
Sorry tx is kicking your but this week, if having a hard week too.
Don't feel bad about posting how well your doing, it's what we all need to hear and it gives hope to all.
How much riba will you be taking? I do #10 Sunday, I'm right with ya.
Beagle
Don't feel bad about posting how well your doing, it's what we all need to hear and it gives hope to all.
How much riba will you be taking? I do #10 Sunday, I'm right with ya.
Beagle
I got brainwashed early (before tx) and I like our dear friend JIM take extra right now - I would be at only 800 weight based but ASKED to do the manufacturer recommended 1000 to get the extra bit of everything I can
I only want to do this once you know? On tx night I have to admit I even pop and extra one. Sick yeah...that's me but since I am trying to cut down on the ice cream a bit now...I think I'll substitute the Riba ;-)
It's a pain having the sx but...I would do anything to help my chances of SVR since I am a 1A and 1B.
I only want to do this once you know? On tx night I have to admit I even pop and extra one. Sick yeah...that's me but since I am trying to cut down on the ice cream a bit now...I think I'll substitute the Riba ;-)
It's a pain having the sx but...I would do anything to help my chances of SVR since I am a 1A and 1B.
Lexapro Susan. My doctor finally made me start taking it at 12 weeks and man it cut the edge right off of me most of the time. It was so bad I couldn't stand the sound of a tv set on or my dog starring at me licking his chops. Now is a much better place. Glad my doctor saw something and reacted to it. I hope you can get ride of the thing because I know how uncomfortable it can make you in your own skin. I hope this stuff holds up for me. Best wishes, Dale
a mommy; the relapse rate was not identical in the short tx group v the full course group, it was very close, though. There still were some RVR that relapsed, even if it was a very small group. You have a lot of other positive factors on your side. Being a mommy is definetely one big plus.
good luck
good luck
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