TOPIC:

I'm a 55 yo male. USA
Type 1a
Hep C RNA PCN QN-Mayo 1860000 International_Units/mL

Albumin Level 4.1 g/dL
Alk Phos 68 International_Units/L
ALT 106 International_Units/L *HI*
AST 77 International_Units/L *HI*
Bili Total 0.7 mg/dL
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Comparison/Contrast .... USA/Thailand

USA
First diagnosed March 2013, likely had it 25+ years, maybe as long as 45+.
Had no insurance at the time, paid for an ultrasound to make sure there was no emergency and was "warehoused."
First clinic is in Washington State ....

Head back to work in North Dakota oil field .....
Finally decided to find a GP to refer me to a specialist on the third week of June this year .... got an appointment for third week of July.
Drove two hours to the appointment and discovered that the Dr. was gone that week and they hadn't been able to reach me by phone to cancel ... said they had tried four weeks earlier (Obviously didn't try very hard, and they sent an appointment confirmation letter in the mail 13 days before the scheduled appointment.)
Got a new appointment for August 19.

Irritated by the North Dakota Hospital, I called the specialist in Washington to see about an appointment there, talked to specialist's assistant, explained what I wanted to do with generics and needed a prescription. She said she'd talk to the specialist and get back to me.

She called back about 1/2 hour later and told me XXXXX said "No comment."
Me: "Well it doesn't sound like she's against the idea."
Specialist's assistant: "What do you mean?"
Me: "At least she didn't run from the room screaming in horror."
Specialist's assistant laughs.

August 19. Saw the Dr. in North Dakota, told him my idea, told him about Greg Jeffery's blog and Indian sofosbuvir, and asked if he'd write the prescription for generics. "No Sir." He said he would not write the prescription or oversee the treatment .... I could come back after I completed self-treatment and he'd do blood tests.

He ordered blood tests and said I'd get results in two weeks. Found my results online and deciphered as best I could. Type 1a, 1.86 million, no indication of cirrhosis.

Scheduled trip to Thailand for six weeks.

Went back to see Dr. on September 14. He had a pharmacist sit in on the visit but never explained why. He confirmed my understanding of the blood tests. I told him my exact plan and his attitude seemed to have softened. I asked him what tests I should have done in Thailand .... his answers were indirect. I asked about ultrasound and fibroscan .... he said a fibroscan would be a good idea. I asked about a biopsy .... he said a biopsy was the gold standard. I noticed he never actually told me to do anything specific, just gave general responses.

As I was getting ready to leave I asked him when I could come back. "Don't worry about it. You come back and see me whenever you need to ... I'll do your tests."

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Thailand

Flight from Seattle to Bangkok .... $804
Scheduled 6 weeks, discovered later that visas on arrival are only granted for 30 days .... bought a trip for 5 days to Singapore to break up the time and keep my stay under 30 days.

Arrived in Bangkok about 10:30am, September 18. Through immigration, baggage claim and customs by 11:15. Walk out of customs and see a kiosk for Vejthani hospital, one of three hospitals I had narrowed down to in my research .... I came with no appointment.

I walk over and tell the rep what I'm looking for and he gets on the phone. He needs a contact number so I head off to buy a sim card. On the way I change money, then get my sim and they activate my phone for me.

I walk back to the Vejthani kiosk and they get an appointment for 10am .... on a Saturday ... will pick me up at my hotel at 9:00am. It's still not noon yet.

I know I can't check into my hotel until 2:00pm, so I burn about an hour at the airport.

I take the train to Central and the SkyTrain to the nearest station and a taxi on to my hotel ... total 124 baht (about $3.75)

The phone rings a couple times while I'm on the train, but it's crowded and noisy and don't try to answer there. I find my hotel, and the hotel receptionist tells me that I have an appointment at the hospital and that the van will meet me at the lobby at 9:00am.

Tired .... sleep from about 4:00pm to about 4:30 am. Burn time online until 9:00.

Get to the hospital, talk to the doctor, get an ultra sound and a fibrascan .... back to talk to the doctor .... results print-out at 11:35am. Pay a grand total of 7300 baht ... ($216.62 at the airport's bad exchange rate) wait 20 minutes for my ride back to the hotel. Doctor emails me scans of his report and a prescription with all his technical details at about 4:30pm.

So I'm in Thailand for about 30 hours and I've got everything I need.

Next, getting the drugs from Australia. I'll let you know how it goes.

More details: (Including typos, etc.)
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X-RAY REPORT


Ultrasound upper abdomen:
History of HCV

Normal liver size with normal parenchymal echo. Few cysts both lobes ,measuring up to 1.3 cm.
Small bright echoic spot at lateral segment of left lobe ,possible calcification.
The gallbladder is absence.
The CBD and intrahepatic ducts are not dilated.
The pancreas appears normal.
Normal both kidneys.
Enlarged spleen is seen ,measuring 1.4.8 cm . No space taking lesion.
Normal size abdominal aorta.

IMP: Few hepatic cysts, both lobes with possible small calcification at eft lobe.
Mild splenomegaly.
Post cholecystectomy.
Not remarkable otherwise.

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FibroScan

Observation Item Value Comment

Median stiffness (kPA) 6.2
IQR/Median (%) 16
Number of measurements 11

Comment

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Update:

Some back info, in case anybody wants to try the same thing.

I originally purchased tickets to be in Thailand for six weeks. I wanted to be here long enough to get my four week blood work done. (In the US my co-pay for one visit to the specialist plus blood work was almost $500.)

Problem ... A few days before leaving I discovered that Thailand is only granting 30 visas on arrival. Too late for pre-trip visa. Have to show a departure itinerary putting me inside that requirement.

No problem. I'll just book a short side trip.
Problem .... how could I know how my schedule with the doctor/hospital would work out?

Whatever, gotta do something .... I booked seven nights hotel in Bangkok and then a five day trip to Singapore .... leaving me 29 days left in Bangkok. That oughta work. Tiger air offered the flight for only $95. Well, not really .... Tiger air has gotchas .... ended up $133. Non-refundable. But still, that left me ready to land in Bangkok.

Got here, everything went too easy with the hospital. Need to book my hotel before I land in Singapore.
Ummm ..... Wow! Singapore hotels are even more expensive than I suspected!
Anyway, I still haven't booked because now I've got issues with the meds. May have to burn the ticket to Singapore and write a new plan.
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So, my doctor here in Bangkok chose to write me a prescription for Sofosbuvir/Ledipasvir .... told me Sofosbuvir/Daclatisvir wasn't recommended for 1a. I wasn't going to debate it with him, but it tells me where he's getting his information.

No problem, a couple days later I was given an email address for a contact to get Incepta's Twinvir for $1500.
Problem .... contact doesn't answer.

No problem, I can fly from Bangkok to Dhaka for $388rt. I'll get it straight from the source. And for only $1200.
Problem .... Visa on arrival costs $160 and there is no assurance they'll grant it when I get there. Really? Really!
Problem .... Incepta's marketing office, claiming to have their drugs in every drugstore in the country, isn't answering their emails.
Problem .... Lazz Pharma, claiming to be the largest, most trusted drug store in Bangladesh, with four branches, all open 24 hours a day, 7 days a week ..... isn't answering their email ... or their online order request form ... and I can't seem to get through on the phone either.

No problem .... Bangkok to Beijing is only $270rt. Back to Mesochem and APIs ....
Problem ... I'll have to go to the consulate/embassy in Bangkok to get a visa.
Problem ... I don't know if Rachel will sell me the meds when I get there.

Oh, and if I'm going the Mesochem route, I'd really rather use the Daclatasvir.
Hmmmm .....
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To be continued .....

Hi klhilde,

If you are going down the Bangladesh route I heard that Beximco Pharma are also doing a generic Harvoni. Contact is Badrul. Email is:
This email address is being protected from spambots. You need JavaScript enabled to view it.

But - as you are now in Bangkok anyway (I think), why not just fly down to Tasmania and let the good Dr Freeman sort you out. Seems a helluva lot easier to me than either Beijing or Dhaka.

Good luck,
dointime

Yes, I had thought earlier of going that route rather than taking the trip to Singapore. I was originally planning to get the meds from Dr. Freeman. At the time I was finding flights to Perth at about $320 ... going east gets much more expensive. I figured I'd decide after I got here. In any case, I didn't want to have drugs shipped to me here in Bangkok, to a hotel address ..... just asking for trouble.

Then it started looking like it would take at least a week to ten days to get through the *wire money/import/test/capsulize/deliver* process ... and I've still got it in my head to get a four week blood test before I return home. I suppose I don't really need that.

In any case, I need to know exactly how long it will take before I go hunting airfares.

You can't expect such certainty about timing with this arrangement. I know I would much prefer ordering and taking delivery from anywhere in Australia vs the rest of Asia, especially as for the moment at least, FixHepC have an established, well tested pipeline. So I would go to say, Perth and arrange delivery to there.

Once racjel from mesochem received my bank transfer it took 3 days to arrive china to australia. And 2 more days to go through customs to dr freeman. Gotta love fedex. Em

Well well, look what I finally found ..... it's not a great price, but I just booked a flight Bangkok - Melbourne rt for a little under $700US ... and I can reschedule the return with no penalty .... and I get to fly on a Dreamliner!

Quick update ..... been in Tasmania for ten days.

Came unannounced and with no warning to Dr. Freeman and staff.
WILL HAVE MY MEDS SOMETIME NEXT WEEK! Likely Wednesday but Friday at latest.

Dr. Freeman and his staff have been beyond generous with their help.
People in the USA might well consider a trip here for the simplest, clearest method to acquire treatment.

I've met Greg and he's just as genuine and sincere and helpful in person as he seems online.

Chester says "Hi" ... and is the only known person on the planet whose side effect to Rib has been a broken arm ...
("Side effect" is humour ... broken arm is real.)

If you really need Twinvir I will give you. You can take Twinvir with or without any prescriptions. I will arrange everything for you for your convenience. I will provide you Twinvir from Incepta. Incepta is the first generic manufacturer of Harvoni.

Hi Klhilde

I'm hoping your api's came in the latest batch this week? When it comes to commitment and dedication you win the trophy. If you need to extend and wish to have a look about, we have 4 spare bedrooms in Orange NSW. Maybe not as antiquated as Hobart but spectacular countryside and rivers. So happy for you. Em

Clarification now antiquated is positive people meaning old world charm, I love Hobart, the history is so well preserved and the people are amazing. Em

Hope Chester is ok ?

Hi LondonGirl,
Chester is managing fairly well. Her main problem is the inability to drive and her discomfort with the idea of a right hand driver (me) driving for her with no international driver's license (no insurance.) (Hitting a wallaby on my first trip probably didn't help ... ) This should be better when they change her cast in a few days and she gets her fingers out of the cast. Otherwise there's not much slowing her down.

Emilio, Thanks for the kind words and generous offer, and I'd enjoy seeing that part of the country, but at this point I think I need to stay put until I get my meds in my hands. And for a few more days Chester might need occasional help with her sheep and other various chores. (She was going out to the sheep when she slipped and broke her arm.)

As for Tassie and Hobart .... I understand exactly what you mean. It's a nice place with great scenery and the people are great and I'm sure Americans would enjoy visiting here, but there is definitely a time warp in some ways. It's part of the appeal for most visitors, I'm sure.

O

klhilde wrote: Hi LondonGirl,
(Hitting a wallaby on my first trip probably didn't help ... )

!!