Aa
Instead of a PCR
Hi Dr Dietrich,
You mentioned to me to make sure I get a PCR at week 4 (I'm a 3A previous non-responder on mono-therapy in 1994; have just started tx). ALT 128/AST 78 low/moderate VL other bloods normal; Stage 2-3
My specialist tells me they will not do a PCR until end of treatment, and that there is no extended treatment anyway in New Zealand regardless of the case (I am looking into whether I can get a PCR privately)
I feel I'm in a precarious position and am looking into whether there is private tx that could hopefully carry on at the end of the 24 weeks if necessary. My nurse says she can tell from my other bloods as to what my VL is likely to be; while there is a relationship between them and VL:
a) Can she 'guess' how my VL is going from my ALT's
b) She says my chances of clearance are 50/50; for a SVR I think she may be being generous - your comments?
Many thanks
You mentioned to me to make sure I get a PCR at week 4 (I'm a 3A previous non-responder on mono-therapy in 1994; have just started tx). ALT 128/AST 78 low/moderate VL other bloods normal; Stage 2-3
My specialist tells me they will not do a PCR until end of treatment, and that there is no extended treatment anyway in New Zealand regardless of the case (I am looking into whether I can get a PCR privately)
I feel I'm in a precarious position and am looking into whether there is private tx that could hopefully carry on at the end of the 24 weeks if necessary. My nurse says she can tell from my other bloods as to what my VL is likely to be; while there is a relationship between them and VL:
a) Can she 'guess' how my VL is going from my ALT's
b) She says my chances of clearance are 50/50; for a SVR I think she may be being generous - your comments?
Many thanks
MEDICAL PROFESSIONAL
Lets sum this up succintly. As far as I am concerned, the only enemy here is the virus. We are all battling it and those of you on the medicine are in the thick of it. I have been there with you, took the medicine twice failed once and succeeded the second time. If you believe the enemy of my enemy is my friend then we are all friends in waging war on HCV. Lets stick together and win this one! DTD
Mike, my friend. I clearly believe you got the whole thing wrong from the beginning.
I don't think you realize that Dr. D. did NOT answer Kristina's FIRST post, because he was asked not to. He only answered the SECOND post. She asked him specifically TO INGNORE her first post and to only answer the second. So that's what he did. If you look at the dates of her posts and Dr. D's reply, you can see that he replied on the 17th, one day after her second post.
Marcia
I don't think you realize that Dr. D. did NOT answer Kristina's FIRST post, because he was asked not to. He only answered the SECOND post. She asked him specifically TO INGNORE her first post and to only answer the second. So that's what he did. If you look at the dates of her posts and Dr. D's reply, you can see that he replied on the 17th, one day after her second post.
Marcia
Okay, if I was wrong I was wrong and I apologize. I guess I've been letting my own problems with medical services prejudice me against the whole profession, which isn't fair. There are good people everywhere, and Dr. D. seems to be one of them. So, mea culpa, and I'll try to be more reasonable in the future. I certainly don't want to alienate all the good folks in this forum. I need them. And I guess I need the MDs, too, much as I hate to admit it .
Cheers to all, especially Dr. Dieterich.
Mike
Cheers to all, especially Dr. Dieterich.
Mike
Frankly, it was Dr. Dieterich's response to a question I posted to him that gave me the direction I needed to go in and advocate for myself to be able to get the rescue drugs I'm entitled to so that I don't end up on unnecessary dosage reductions. I think it took him no more than two lines to give me everything I needed in his short post and I'll be forever grateful. It was the capper on my own research and answered a very important question for me.
Dr. Dieterich has the gift, I've noticed, of being able to say much in few words. He gets right to the point. The first time I asked him a question, I was frustrated with the answer and asked the question differently. Then I got the answer I was looking for. For such a busy doctor he manages to spend quite a bit of time in here answering all kinds of posts. He's here on weekends answering posts.
I read Kristina's post and Dr. Dieterich's response and didn't realize myself that his answer was actually to her second post. In that regard, frankly, he answers her question quite well. She's getting a 4 week PCR and she states her current labs and his response is .. you're doing fine, keep a positive attitude! That's all that really needs to be said...that she's on the right track so far. Not everybody needs to post 700 words to say two sentences worth of content, Mike.
I'm one of those guinea pigs you refer to, Mike. And I'm good with that. I'm thinking my stint as a guinea pig is part of why I cleared by 6 weeks. And I'm thankful to the guinea pigs who went before me because I'm well on my way to looking like I'm going to have an SVR on those pills and drugs you disdain so much. I'm bloody thankful for them. I have a love/hate relationship with them and I'm bloody grateful for them. It's the only cure we've got and I'll tell you my kids are thankful for them. And the guinea pigs who keep on going may make it so that some day, treatment will be shorter, less difficult and more effective for those who come after us.
And frankly, Mike... you just may be the beneficiary of doctors like Dr. Dieterich and others who do the research and the trials and of us guinea pigs. If you ever get around to doing treatment.....you will indirectly have Dr. Dieterich to thank as his past and ongoing research as much as anyone's is part of the treatment process we have today which is better than what was before and what is to come will be better yet.
There are enough lousy doctors out there without you unfairly attacking one of the really good ones.
MD-lovers....now that's just bloody idiotic, Mike. If you look past your own ego, and you've noticed anything at all about our forum, we're as hard on the medical profession as anyone, always advocating for getting copies of tests and advising people to educate themselves, helping where we can to support people in that and helping people advocate for themselves. Nowhere in the forum will you catch an attitude of "put up and shut up" when it comes to the medical profession.
That was just way off-base, Mike. Kind of surprised at you.
Trish
Dr. Dieterich has the gift, I've noticed, of being able to say much in few words. He gets right to the point. The first time I asked him a question, I was frustrated with the answer and asked the question differently. Then I got the answer I was looking for. For such a busy doctor he manages to spend quite a bit of time in here answering all kinds of posts. He's here on weekends answering posts.
I read Kristina's post and Dr. Dieterich's response and didn't realize myself that his answer was actually to her second post. In that regard, frankly, he answers her question quite well. She's getting a 4 week PCR and she states her current labs and his response is .. you're doing fine, keep a positive attitude! That's all that really needs to be said...that she's on the right track so far. Not everybody needs to post 700 words to say two sentences worth of content, Mike.
I'm one of those guinea pigs you refer to, Mike. And I'm good with that. I'm thinking my stint as a guinea pig is part of why I cleared by 6 weeks. And I'm thankful to the guinea pigs who went before me because I'm well on my way to looking like I'm going to have an SVR on those pills and drugs you disdain so much. I'm bloody thankful for them. I have a love/hate relationship with them and I'm bloody grateful for them. It's the only cure we've got and I'll tell you my kids are thankful for them. And the guinea pigs who keep on going may make it so that some day, treatment will be shorter, less difficult and more effective for those who come after us.
And frankly, Mike... you just may be the beneficiary of doctors like Dr. Dieterich and others who do the research and the trials and of us guinea pigs. If you ever get around to doing treatment.....you will indirectly have Dr. Dieterich to thank as his past and ongoing research as much as anyone's is part of the treatment process we have today which is better than what was before and what is to come will be better yet.
There are enough lousy doctors out there without you unfairly attacking one of the really good ones.
MD-lovers....now that's just bloody idiotic, Mike. If you look past your own ego, and you've noticed anything at all about our forum, we're as hard on the medical profession as anyone, always advocating for getting copies of tests and advising people to educate themselves, helping where we can to support people in that and helping people advocate for themselves. Nowhere in the forum will you catch an attitude of "put up and shut up" when it comes to the medical profession.
That was just way off-base, Mike. Kind of surprised at you.
Trish
I agree with Jim - you are seriously off base here. I am one of Dr Dieterich's patients and I can say first hand that he is a wonderful caring doctor. We should all be grateful that he is willing to take the time to participate in this forum. You should think twice and learn the facts before you post such a rediculous statement.
I found Dr. Dieterich's answer fine. He did not answer her first post, as Kristina asked him to ignore it.
He answered the second post. He says no to her question, if she should have her bloods done again, before 4 weeks. He comments to her stated blood values, that she is doing just fine. And then he wishes her good luck.
Makes perfect sense to me.
Marcia
He answered the second post. He says no to her question, if she should have her bloods done again, before 4 weeks. He comments to her stated blood values, that she is doing just fine. And then he wishes her good luck.
Makes perfect sense to me.
Marcia
You're way off base.
Kristina is in New Zealand and states the limitations of testing/treatment there. Given those limitations, the Dr. is trying to be positive and supportive. Remember, he is not her treating doctor, and these forums have limitations/restrictions for advice, especially from a medical doctor.
If you looked at other professional forums you would know that and you would also know that Dr. Dieterich's answers are probably the best of the lot given the limitations of the format.
Maybe time to concentrate on your own treatment, such as getting that biopsy you keep putting off, instead of attacking Dr. Dieterich who is a tremendous asset to this forum. If you want more detailed answers, probably best to make an appointment with a good hepatologist in person.
-- Jim
Kristina is in New Zealand and states the limitations of testing/treatment there. Given those limitations, the Dr. is trying to be positive and supportive. Remember, he is not her treating doctor, and these forums have limitations/restrictions for advice, especially from a medical doctor.
If you looked at other professional forums you would know that and you would also know that Dr. Dieterich's answers are probably the best of the lot given the limitations of the format.
Maybe time to concentrate on your own treatment, such as getting that biopsy you keep putting off, instead of attacking Dr. Dieterich who is a tremendous asset to this forum. If you want more detailed answers, probably best to make an appointment with a good hepatologist in person.
-- Jim
Thanks for your post Mike - I probably have to stop bothering poor Dr D (I never saw his reply when I sent the 2nd post). I don't blame him for the comments - he probably shouldn't have to get into intense discussion with brain fogged people who answer their own questions a few days later :-).
We all have our challenges eh - it's either our Dr's, our partners, our kids, our finances, our disease. My cousin always says to just put "peace love and joy" towards those who aren't helping us. Sometimes that's a bit hard so I put peace love and joy around myself and hibernate - always come back out stronger..... well, mostly come back stronger.
Regards :-)
We all have our challenges eh - it's either our Dr's, our partners, our kids, our finances, our disease. My cousin always says to just put "peace love and joy" towards those who aren't helping us. Sometimes that's a bit hard so I put peace love and joy around myself and hibernate - always come back out stronger..... well, mostly come back stronger.
Regards :-)
MEDICAL PROFESSIONAL
No it sounds like you are doing just fine. Keep a positive attitude! DTD
Hi Dr Dietrich,
Ignore my above posts - I'm contacting a private specialist to get a PCR at 4 weeks. After week one my ALT's have stablised back to just above normal; Neutraphils .87 (From 2.7) WBC 140 (from 188)all else normal.
Unfortunately she won't have my bloods done again until week 4, but I see from an earlier post that you said that you don't worry too much about the neutraphils if everything else is okay. Should I try to get bloods done earlier through my GP?
Thanks for being here for us; my anxiety is lessening.
Ignore my above posts - I'm contacting a private specialist to get a PCR at 4 weeks. After week one my ALT's have stablised back to just above normal; Neutraphils .87 (From 2.7) WBC 140 (from 188)all else normal.
Unfortunately she won't have my bloods done again until week 4, but I see from an earlier post that you said that you don't worry too much about the neutraphils if everything else is okay. Should I try to get bloods done earlier through my GP?
Thanks for being here for us; my anxiety is lessening.
Good answers from both of you, bravo!
"If you believe the enemy of my enemy is my friend then we are all friends in waging war on HCV. Lets stick together and win this one!"
Pretty much says it all.
"If you believe the enemy of my enemy is my friend then we are all friends in waging war on HCV. Lets stick together and win this one!"
Pretty much says it all.
I have no apologies to make regarding my previous post here. Dr. D's reply was what was off base, in my opinon. I'll repeat what I said: If he doesn't have the time to read, think about, and answer coherently peoples' questions, he should step aside and make room for someone who does. Inviting questions and then not answering them is insulting and counter-productive, to say the least.
As to Jim's post, I've never read such self-righteous malarky. You apparently have no knowledge of my biopsy results or other tests, Jim, and know nothing at all about the many hepatologists I have seen, so your remarks are as off base as Dr. D's non-reply to Kris.
It's a shame, though, that we should be scrapping like this, and I see that I'll have to make an effort to be careful in future and not offend all the MD-lovers' sensibilities. How's this for a start: "Thank you, Dr. D., and all the other marvellous, brilliant, philanthropic pill-pushers around the world for exploiting the heck out of all the Ph.D.s who invent the medicines you tout and the patients who serve as your guinea pigs. Salaam and may the force be with you!"
Okay now, everyone?
M.
As to Jim's post, I've never read such self-righteous malarky. You apparently have no knowledge of my biopsy results or other tests, Jim, and know nothing at all about the many hepatologists I have seen, so your remarks are as off base as Dr. D's non-reply to Kris.
It's a shame, though, that we should be scrapping like this, and I see that I'll have to make an effort to be careful in future and not offend all the MD-lovers' sensibilities. How's this for a start: "Thank you, Dr. D., and all the other marvellous, brilliant, philanthropic pill-pushers around the world for exploiting the heck out of all the Ph.D.s who invent the medicines you tout and the patients who serve as your guinea pigs. Salaam and may the force be with you!"
Okay now, everyone?
M.
Hey, Doctor Dieterich, how about answering this poor sick girl's questions? What's this "it sounds like you are doing just fine. Keep a positive attitude" jazz? Are you a priest or what?
Kriss, he isn't even gonna read your second post, much less answer it. He never sends second posts. As long as you're tx-ing, he's happy. Don't worry, be happy. Get it?
Man oh man, but I am tired of MDs. Especially the self-righteous ones who pretend to want to help but then don't. That's all we sick people need... more hot air. We don't have enough troubles already with incompetent hepatologists, drugs that don't work, and the knowledge that our lives depend on a medical profession that is letting us down.
Enough!!!
M.
Kriss, he isn't even gonna read your second post, much less answer it. He never sends second posts. As long as you're tx-ing, he's happy. Don't worry, be happy. Get it?
Man oh man, but I am tired of MDs. Especially the self-righteous ones who pretend to want to help but then don't. That's all we sick people need... more hot air. We don't have enough troubles already with incompetent hepatologists, drugs that don't work, and the knowledge that our lives depend on a medical profession that is letting us down.
Enough!!!
M.
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