Need some HELP

[sally123684]

Hey everyone,  I am going into shot 4 this friday and I remember reading that someone suggested that I get a PVC test done ast 4 weeks?  Can some one explain what this is and why I should have it.  My next dr visit is Nov 4 But dr said he couldn't tell if med's are owrking until 12 weeks.  Im confused!!!@!@!
Oh and FYI I was so nausead yesterday but today started taking med's with somehting on my stomach and its seeming to help.

[newleaf09]

Sally, ask for the 4 week PCR.  If the results are very good (some lucky people clear the virus by week 4 but a very large drop in VL is also good) it is incredibly encouraging and helps psychologically to keep you going.  Plus, if you are one who clears early and maybe runs into trouble later and needs to stop before the 48 weeks, its not so worrisome.  The 12 weeks bit comes from the very basic guidelines for HCV treatment published by the American Association for the Study of Liver Diseases.  

Terri - I wondered if I could do the shots but they took me into the exam room and the nurse handed me the injection pen and talked me through how to set the dose on the pen and had me give myself the first shot in front of her.  It goes into belly fat and the needle is very thin and sharp and really, you can barely feel it at all.  Be sure to take the ribivirin pills with something fatty, like peanut butter, nuts, butter cookies or a meal.  The fat helps the ribivirin stay in your system better so you can keep levels up until the next dose 12 or so hours later.  It will be fine.  It takes a month or 2 (that's how it was for me anyway) to start feeling bad and you just get used to it and keep plugging along until it's over.

[Bill1954]

Hi Terri—

Um… the doctor’s office will show you how to use do the injections; they’re pretty simple, and hurt less than pulling a hair out of your head… they’re that easy. The interferon just tucks under your skin a little, very much like insulin would.

None of enjoy being ill, but the idea behind all this is to rid ourselves of the virus once and for all, and be done with it all. If you feel a little crummy in the process, well, most of us have decided that it’s worth it… give it a try and see how it goes for you.

The best thing I can tell you is to continue reading and asking questions; this is a great group of people in here that have either done the treatment before, or are currently in the same shoes as you are now.   If you have any specific questions, please feel free to ask; someone will do their best to answer.

Good luck, and stay in touch—

Bill

[nygirl7]

A doctor who doesn't realize the importance of the 4 week PCR?  A doctor who has NOT kept on the latest research and is reading out of a very out of date text book to treat his patients.  Really.  Tell him nicely to read the Berg Study and Sanchez Tapias study and then see if he thinks 4 weeks aren't crucial?

and make sure it is a very SENSITIVE test.  Like it counts down to 50 NOT the older tests of 615 and 315 because they can easily give you a false impression on when you are undetectible or not and that can ruin your chance of success.

"Do you have any advice for me, i am very anxious about the needles and i don't like being sick... "

NOBODY I've ever read starting treatment liked to be sick and a ton like me were afraid of needles.  In a few weeks after you start giving yourself the shot you won't have that phobia anylonger believe me. It's not like you have to inject into a vein or something...I would point it at my thigh muscle and close my eyes and jab when I first started.....but after a while it's just no big deal.

While being sick is no fun but when you stop to remember WHY you are doing this and how important it is - you just suck it up and continue on.  

Really its all you can do!

[meakea]

Sally:

As JD and Bill said, be sure to ask your doc to do a PCR test at 4 weeks.  When I started treatment last September, my doc was only going to check my PCR at 12 weeks but I asked them to do a 4 week and they did.  I found out that I was undetectable at 4 weeks which is a very good thing for me.

When I ended treatment in August, my doc told me that he now orders a 4 week PCR for all of his patients.  

[terrilynn1977]

Hi Bill,
My name is Terri and i will be starting treatment in November. i am also genotype 1. Do you have any advice for me, i am very anxious about the needles and i don't like being sick... Thank God i'm not on any other meds but i'm concerned about what it will be like for the first while. Thanx for your input:)

[Bill1954]

Hi Sally,

I strongly agree with JD; you should insist on a PCR test at four weeks, this is an important test; particularly if you are genotype 1, which I believe you are.

This test can determine how fast you are responding virologicaly to the drugs; if you are responding slowly, corrective action might be taken to offer better chances of this working. The four week viral load test is relatively new; it wasn’t performed often 4 years ago, but newer research and treatment techniques require this now.

If your doctor won’t order this test, consider asking for a referral to another physician; the current one probably isn’t up on HCV management, I’m afraid.

All the best to you,

Bill

[jdwithhcv]

Do you mean PCR?  If so, this is a viral load test and it is very important to have a PCR at week 4 as it will indicate whether or not you are a rapid responder to the meds.  It is alarming that your doctor thinks it is not necessary until 12 weeks.  This tells me that your doctor is not knowledgable about the most recent protocols for HCV treatment.  

You should insist on a PCR at week 4.  Typically you would have blood drawn for a PCR just before you take shot 5.  I suggest that you look around for another doctor who has up to date information about this treatment.  HCV treatment is not an area in which many doctors are up to date, and it is imperative that you have a doctor who has expertise in this field.

Taking the ribavarin on an empty stomach is likely to make you nauseous.  Try to take it with food, and choose food that has a fair amount of fat as this will help your body absorb the meds.  I found that things like peanut butter, avocado, cheese or a yogurt smoothie (full fat) worked best.  

Good luck, and please post again to let us know that you got the week 4 PCR.  It is very important.

jd