Hi All;

I haven’t been online much since end Jan and even now when I see a number of topics which are critical for me – I find it difficult to get my head around the content. So frustrating.

Since February I have been exposed to an unusually difficult situation, experiencing unmitigated distress & indecision – I don’t know how it will end. Im not asking for comment – just explaining to those who have so kindly tried contacting me – why I have been unavailable ie Cindi, Paul, Gaj, LondonGirl, Tina,Tim, Doc, Life and others …thank you.. I have simply not been able to talk to anyone. When I hear a kind voice it brings me undone – and I must keep working and attending to matters at hand.

When necessary, I have usually observed dietary considerations around insulin resistance, knowing its value to treatment success. Yet during the current stress I have too often indulged a sugar craving. Ive recently noticed symptoms not felt for some time – some may be DAAs side effects but most resemble pre-treatment symptoms & were I not still on treatment – I would suspect the virus has resurged. I now have concerns about later relapse. I complete my 24 week treatment in two weeks but would ideally like to sustain a better diet & take the meds for at least another month.

My specialist says no, that Im simply afraid. I think his view might be – that if the treatment was going to succeed, it would already have done so. I will concede the “afraid” part and may be hyper sensitive to these symptoms. or not. I do get it. Finishing treatment is like letting go of the dice in an all time crap shoot.

In 2010-2012 for two entire years waiting for treatment; I never touched salt, sugar, gluten, dairy – ate protein, complex carbs, good fats. After a coma, progressive ascites and varices, labelled palliative – my diet “relaxed”. However, after starting the treatment I should have sustained an optimal diet. For years, I too observed the cohort to which Price attributes such good nutritional advice. Though being so HCV advanced – it seems extending treatment is not recommended.

Cancer Surveillance:. I have previously had liver lesions, only one in Section 6 at 11mm (small), was finally monitored by a Surgeon as an HCC concern. I was keen to start treatment – mythology advocates that HCC is driven by the inflammation caused by HCV – therefore the sooner HCV is “cured” and inflammation reduced – the better one’s prognosis for current or recurrent HCC. It is a worry to find this position may be compromised by the very drugs (DAAs) – being used to achieve this outcome. Interestingly, when I started treatment my 11mm “lesion” had been stable for 3 months – however; in January, two months after starting treatment my scan found another area of interest, a small 7mm nodule laterally in segment 7.

Alpha FetoProtein AFP : I had started to relax when the first lesion seemed stable, particularly as my AFP also lowered. However one should be aware that AFP results frequently present both false negatives or positives. Much like the PSA results our gentlemen get for prostate surveillance – the most reliable indicator is a result which moves slowly and surely. Ad hoc variations are less reliable. However, particularly with collateral data; an AFP is still of value – and I will have an AFP done. I am also now due for next MRI but may wait a little longer – aside from the apprehension – I will fix timing around treatment cessation.

Hepatitis B: I have not yet got my head around Dr James’ account of the Hep B sero-conversion/antibody differentiation; however I may also need to have a Hep B panel done with my next bloods. I was diagnosed with chronic Hep B in approx 1972 and as far as I knew remained HBV positive for many years. In more recent years, I was told that I was no longer positive. Meanwhile I had been (1990s) diagnosed with HCV. In the light of Dr James’ post, Im not certain where I stand for HBV relapse – and I need to confirm my status.

Cerebral Aneurysm In passing – I also have a Cerebral Aneurysm – it is small and therefore not to be overly concerned about – except at routine MRI. Since the HCV complications – it is a little more risky. Getting to hospital for a ruptured aneurysm is not a best call with HCV low platelets between 50-70. Dr James explains in one of his posts the progression of bloods normalising with treatment, the platelets usually do so last – I was pleased to see that because I noticed mine were still low. Many people get small brain aneurysms as they age, and we would have less people unnecessarily worrying about them if todays technology wasn’t so readily finding them. A poor prognosis is usually indicated by family history.

Apart from work; Ive spent so much time in isolation – I finally decided it was time to make an effort to communicate with my forum peers. Sorry – I misplaced the “stop” button. Im just checking in really to stay in touch and appreciate the gift we have in this forum – the caring members and the information provided so generously by Dr James and other knowledgeable contributers.

Take Care Archer