Hepatitis C: The Post Interferon World has Five Scoops of Good News

Hep C:  The Post Interferon World is Five Scoops of Good News

  1.  Increased number of patients screened and identified
  2.  Increased options for those who failed previous therapies
  3.  Improved patient compliance
  4.  Possibilities of patient-guided treatment
  5.  Decreased need for liver transplantation
Donna Reed on Laundry day.  Now her modern day peers can get tested.

Donna Reed on Laundry day. Now her modern day peers can get tested.

  •   I quit writing my blog when I saw the first ad for Hepatitis C treatment on television. The representative people were not parrot heads or crack heads. They were typical ad people like Crestor or Nexium. These ads will bring people in for testing and treatment.  The early treatment decreases transplantation demands. But there is still a lot of Hepatitis C news, so I am back.

A friend of mine started round four of treatment three days ago and she is scared.  Because of Interferon and depression, she could not complete previous treatments. No pledge from me or her physician made a dent in her fear but time will show her. Her new protocol doesn’t call for Interferon, and she is on preventive anti-depression medication. The three drug cocktail for her is one of many not available six months ago, a bygone era.

I recall Fridays during treatment, Interferon injection days. Bathing and grooming started on Wednesdays. I could schedule most work meetings (via telephone) for Thursday and Friday. There is much compliance built around Interferon day. For me, there came the day I could not  work and Friday no longer mattered. Unfortunately leaving work isn’t always an available solution. I lost my career when I returned and I was still sick from drugs. Luckily I retired with benefits.  When I went through treatment # 2, I wasn’t working and could get all the rest required. In the post Interferon world of (mostly) no Interferon and ribavirin this may not be an issue, thus better patient compliance, and cure.

 

And now about patient-guided therapy and no you do not get to select from a menu. For those of you following genotyping using IL2b.  Researchers predict (I love that phrase) which treatments will work best in your body.  That will partially determine the treatment drugs for you, thus ruling out waste-of-time and money treatments.

Be sure to visit my friends at http://www.hepatitiscnews.com  They have great usable info and practical application.  They carry my blog too.

https://us-mg4.mail.yahoo.com/neo/launch?.rand=084ro4ia0h0pr#1

Kentaro Matsuura, Tsunamasa Watanabe, Yasuhito Tanaka

Disclosures

J Gastroenterol Hepatol. 2014;29(2):241-249. 

Hepatitis C Treatment: The Big Sleep In The Rabbit Hole

Going through treatment of Hepatitis C, I suspended reality. 

My world became a rabbit hole.  More like a depressed Bugs Bunny than Alice.

The first on-screen appearance of Bugs Bunny, ...
The first on-screen appearance of Bugs Bunny, from an unrestored version of the cartoon. (Photo credit: Wikipedia)

Only my husband Spanky, the psychiatrist and the research nurse could check on me.  But frequently I pulled the hole in on myself and stayed there.  It was kinda weird.   I felt safe from others but not my crazy mind.  I couldn’t close the rabbit hole fast enough to keep out my mind.   Sometimes I felt like I was watching the world through a window but  I couldn’t remember what happened that day.

Memories of coming out of a bar when the sun is still bright, eewww.

Twice stolen from Edvard Munch

Twice stolen from Edvard Munch

malavula.blogspot.com

I used to wonder if other study patients felt the same as me.  I would watch in the waiting room.  But they weren’t giving up their secrets.  Each traveling with his own rabbit hole.

Rabbit Hole Urban Dictionary
Alice in…Metaphor for the conceptual path which is thought to lead to the true nature of reality. Infinitesimally deep and complex, venturing too far down is probably not that great of an idea.
An allusion to Lewis Carroll’s Alice in Wonderland. To go “down the rabbithole” is to enter a period of chaos or confusion.
Or to take acid, Deb
…….
Then the study ended.  As drugs began to leach out of my body, I felt like I took a year-long nap.  Only I wasn’t asleep.  I was waking from a little tiny world.  Like a newly released guest of the penal system or someone from the space station, I heard about stuff while in my pseudo-sleep but hadn’t really grasped it.  Politics, friends, life skills, I had to catch up on it all. This is more difficult than you think, trying to get past all the celebrity crap. Who “gets” celebrity crap?  I don’t but somebody must or it wouldn’t be ubiquitous.
Sometimes I want to crawl back down the rabbit hole.  During those times, I hang out in our guest room, my home during treatment.  It’s comforting in a psychiatric kind of way.  It took months to feel free of that need,  about four half-lives*  When I can’t sleep I still go in there.  It is normal to lie awake all night in the rabbit hole.
 I’m thinking of painting the rabbit hole room lavender (I don’t like lavender) or getting a new bed (I like the existing bed).  Dismantle the tangible rabbit hole.
*A half-life, t1/2, is the time it takes to remove 1/2 of a drug from your system.  To approach 100% drug removal takes about six half-lives.

A biological half-life or elimination half-life is the time it takes for a substance (drug, radioactive nuclide, or other) to lose one-half of its pharmacologic, physiologic, or radiological activity. In a medical context, the half-life may also describe the time that it takes for the concentration in blood plasma of a substance to reach one-half of its steady-state value (the “plasma half-life”)

In The Waiting Room With The Losers: They Don’t Look Like Losers, Do We?

Tuesday Girl

When in a clinical trial for hepatitis C, there is no place to hide in the waiting room.  We are all there with our livers and our coolers full of injectable poisons.  You can tell what trial each person is in by the cooler they carry.  And watching the progress of a person, you can evaluate the side effect profile of the drugs.  Sort of. Do they bother combing hair? Coloring lips? Putting on lace up shoes?   Is that insider trading?  No, studies are blinded.  But we are not.  Clinicians would learn a lot observing us before we go on stage with the white coats.

I’m a Tuesday girl, I come on Tuesdays.  I recognize the Tuesday people.

You can clearly see the transplant candidates.  They look like Cecil without a smile.  A  yellow-green snot color with a gaunt face and an ascitic belly.  The post transplants look less yellow but more waxy, and kinda more dead.   High doses of steroids and immunosuppressives  will do that.  I look around thinking “These are not my people”  but they are.  If I look beyond the medical realities, they show up in a shirt and tie, uniform, sweat suit. But they don’t look like, I don’t know, losers.

I want so badly to change the TV to CNBC or CNN. But I am too short to change channels and everyone is staring at Good Day Houston.  I want to scream.  I breathe in and try to focus on questions I have and remember to request a copy of my lab work.  Don’t forget, don’t forget, don’t forget (Brain Fog).

I am sitting where I can’t see the TV, and listening to a book on my phone.  But then I watch everyone watch Good Day Houston and try to guess their faces.  Ugh, the only thing worse than a national daytime talk show is a local daytime talk show.  I remember Girl Talk with Virginia Graham out of Cincinnati when I was a kid home ill. I’ d never seen anyone so made up in my life.  And at 9 AM.  She had her hair combed into cotton candy, and four shades of lip color.  I don’t know about her feet.  She motioned for guests to join her at the coffee table.  Her jewelry jingled but her hair never moved. .  She was not my people.

Virginia Graham (the early 60s) way before The View…
Woah!  I Googled Girl Talk and got something completely different.