told to stop interferon

[jt57]

Had cbc today.  wbc 1.8
                        anc  .8
                        hgb  9.2
                        plt    40

My GP called my hep dr. and he said to stop the interferon and have cbc next week.  In my opinion, I think we should be discussing reduction in dosage, not stopping.  But I have had this sort of issue with my dr. in the past....

What do you guys think?

Jean

[geterdone]

Good Morning jt, hope the morning brings a brighter day.

Treatment is nerve racking to say the least because of the many unknowns. Sounds like you need to get both of them together and have them stop jerking you around. The stop and go on the procrit is causing all kinds of problems. It seems like it may had just gotten started and then was shut down and never made it to the line so it may take some time to restart the marrow train again. I started Procrit at week 5 of treatment and stayed on it to the end and then some with no additional damage. Demand that you stay on the procrit through the rest of treatment and this latest episode should prove that out and make the case for it and you. It sounds like you were starting to crest the wave here a little bit and then was left in mid air, not good. The good news is if everyone comes to an agreement and you stay on the procrit without interruption things will settle down and being that you are UND since week 4 is a big plus if a reduction is recommended for a week to allow the surf board to get in front of the curve again.

Stay Strong be Long and ride dem waves!!!

jasper

[jt57]

Thanks Jasper.  You make some really good points for me to think about.  I really don't want to stop treatment, but maybe on Monday, my doc and I can come up with a plan.  I just feel the NP telling me to stop was a knee jerk reaction to my platelet count.   Dose reduction should come before stopping completely.

My hgb had come up ..into the 11's, and I was told to skip a dose of procrit.  That was 2 wks ago.  I did skip one.  And here I am.  HGB back down, wbc lower again, and platelets lower.   I pray for higher platelets on Monday.  and worst case scenario, dose reduction.

[geterdone]

The thought behind my comment about following the NP advice and stopping the interferon was given the history of the platelets downward spiral with the consecutive dropping with in each blood test to date. It seems that the Procrit has not fully kicked in yet and takes 4 or more weeks to start working, as you know. In jt57’s case it seems that she is behind the 8 ball momentarily and is playing catch up because the interferon is steadily inhibiting the production of the platelets and is heading into the danger zone and is maybe why she was advised to skip a shot to allow the procrit to get in front of the curve. Yeah, they should have started the procrit earlier but it is not an exact science in how one will react with these meds at any given time but shows a pretty good road may of where she is heading.  


Getting another blood test on the day of your shot is a great idea, as numbers are at their highest on that day.  That is what I do as well. And the one day the counts were low is the day I did it 20 hours earlier.


Yes it is good to have the blood drawn just before the next shot and it does give you a very good indication of where your platelets are at as well as everything else. But if it is low say at 40 before the shot or at its highest peak, what is it after the shot? This is maybe where the NP or how ever is concerned in that it just may be below the 30 cut off point and even lower after the shot. I would venture to say it would be even lower given the downward spiral of the platelet counts in jt’s prior blood test so far.

I started at 251, down to 150 and stayed there awhile, then started dropping around week 4 to 120 for a couple of weeks, then it started down, 98, 92, 80, 79, 78, 66, 53.

now at 40.


Geter: I don't agree with jim at all on this one. I read Dr. D’s reply but it is not this person.
----------------
You may have misunderstood what I said. I agree with Dr. Dietrich's comments and I never said it's the same person; in fact I'm not exactly sure what you mean by that.

Jim, my meaning is that it’s all well and good in that circumstance but it is not jt57 and that’s all that was meant by it. But I do not agree with everyone pushing jt to continue with the interferon as we are not doctors and do not see what they may be seeing, if anything. Monday will come and she will see whoever and get another CBC and find that the platelets have started to come up because of the Procrit.


jasper  

[jt57]

Thanks Trin!   My red flag was when he did not even mention reduction.  Just stop.  

I'm willing to discuss reduction if I go any lower.  But not stopping.  Hopefully my platelets will be up on Monday!

Jean

[Trinity4]

jt,

I was told to dose reduce wks 6-7.  I complied because I was stupid and my doc was  going by the guidelines set forth in the medication insert for the peg.  Had I known then, what I know know I would have never done it.  Atlanta doc thinks that is what contributed to my not clearing by wk 12 and was very adamant that dose reduction was not necessary.  My platelets weren't quite as low as yours but they very low as well as my ANC.  I know you have to do what you have to do but it does sound like your doc has the same problem my local doc has which is cover his a-s-s in the event something happens beyond our control.  And had I listened again recently, I would have dose reduced reduced twice again, last week and the week before which I did not and whites are back to acceptable levels with the help of Neup.  Platelets, can't do much about that, but an aggressive hep doc will not make you skip doses completely, perhaps reduce to 90 mcg or 135 mcg but keep in mind you don't want to run the risk of a bleed so have to be monitored very very carefully.  Stick with it jt, don't let them jeopardize your chances of SVR.  Just my opinion, I've also been around the bush a few times with my doc.  I won this battle, he just doesn't know how I won it.  
Good Luck
Trin

[Marcia2202]

Great decision, I think.