Forum Replies Created

Viewing 15 posts - 1,816 through 1,830 (of 1,968 total)
  • Author
    Posts
  • in reply to: MELD Score – Do You Need To Treat Now? #3491
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    I am happy for you Joy. MELD scoring is really only relevant for patients with cirrhosis.

    Your creatinine represents a balance between muscle breakdown (usually pretty constant and releases creatinine) and kidney function washing the creatinine out.

    Your creatinine is absolutely fine, and nothing to worry about.

    When kidneys start to fail creatinine rises. In round numbers a creatinine of:

    • 80 represents 100% renal function
    • 160 represents 50% renal function
    • 320 represents 25% renal function
    • 640 represent 12% renal function, and
    • 1280 means only 6% renal function

    People go pretty well with only 10% renal function, but need dialysis if their renal function falls below this level.

    There are many things that can increase muscle breakdown and thus the quantity of creatinine that needs to be excreted by the kidneys.

    Eating more meat due to a better appetite or doing more exercise (causing a small increase in muscle breakdown) are quite possibly the reason in you because your creatinine was unusually low to start with, so either you have kick ass kidneys that work much better than the average person, or your meat intake or base level muscle breakdown was lower than usual.

    If you want more detail that you could ever possibly need http://bestpractice.bmj.com/best-practice/monograph/935/diagnosis.html


    YMMV

    in reply to: MELD Score – Do You Need To Treat Now? #3483
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Is Prothrombin Time the same as INR?

    Yes, but no. Prothrombin Time is a measure of how long it takes blood to coagulate.

    https://en.wikipedia.org/wiki/Prothrombin_time

    The problem with prothrombin time is that different test methods get slightly different results.

    The INR (International Normalised Ratio) essentially just takes the Protrombin Time and divides it by a correction factor.

    A normal Prothrombin Time is around 12 seconds.

    A normal INR is 1

    If the Prothrombin time was 24 seconds, the INR would be ~2


    YMMV

    in reply to: Sof/Dac 84 or 90 Dosage? #3451
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hello Joy,

    This was my error. Before I knew more I knew less. Mesochem supplied in a standard quantity of 36 g (90 x 400 mg) so I made the incorrect assumption that it was 90 days treatment, rather than 84. To be totally compliant with the guidelines we now use 84 days.

    If it was me I would reserve the extra 6 to resume treatment in the (unlikely) event of recurrence. That will minimise any delay while further medication is shipped to you.

    Over treating for 6 days should not cause any harm, but given the recent Gecko data the 8 weeks works well for most people we are probably overtreating by quite a bit with the 84 day course.

    The trouble is we can only ever know we under treated….


    YMMV

    in reply to: tooth brushes & razors #3427
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    This is an extremely good point. My old understanding was that it could like for 4 days outside the body, however it has been shown the virus can remain viable for 6 weeks

    http://jid.oxfordjournals.org/content/early/2013/11/22/infdis.jit648.abstract

    There is further discussion about this here:

    https://blog.aids.gov/2014/01/scientists-discover-hepatitis-c-virus-can-remain-infectious-outside-of-the-body-for-up-to-6-weeks.html

    I have personally seen the parents of an HCV son acquire acute Hep C due to razor sharing so there is no doubt the virus can survive and infect from this source.

    Viral loads fall rapidly on treatment so after a couple of weeks there will be very little (or no) virus in your blood to coat either a razor of a toothbrush, so if you are contemplating frequent replacement of razors and toothbrushes there would be more benefit in doing this daily at the beginning of treatment than at the end.

    Here is what the CDC has to say about disinfection:

    http://www.cdc.gov/hicpac/Disinfection_Sterilization/3_2contaminatedDevices.html

    So soaking razors and toothbrushes in a 1:10 dilution (1 part bleach, 9 parts water) would be an acceptable alternative to replacement.


    YMMV

    in reply to: Interactions with Ayurvedic medicines? #3423
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    The DAAs work without assistance, and this was how they have been tested.

    My advice to patients is to stop taking things like Milk Thistle, tumeric, etc because:

    1. They are not required to achieve the desired results
    2. It is possible they may make treatment results worse

    YMMV

    in reply to: Liver Clinics and Generic Rebels #3411
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hello again

    I have received my medicine today. 400mg Sofosbuvir and 90mg Ledipasvir (separate bottles). I am arranging next week to take a weeks’ leave from work and will start my medicine today week. I am very nervous about side effects but I know I need to take the medicine to get rid of this awful virus. Reading your posts has certainly helped.

    Wish me luck!

    Lynne


    YMMV

    in reply to: REDEMPTION-2 and 3 Timelines #3355
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi Felix, Thank you for the encouragement. Are you from the USA too? Are you getting treatment?


    YMMV

    in reply to: My twinvir story #3326
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc


    YMMV

    in reply to: Liver Clinics and Generic Rebels #3313
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Your right Vicki, doesn’t’;t really matter now how I got it…also I apologise for the typo (bloody) instead of blood. I did do my homework because the whole thing has totally “done my head in”….however since I found this forum and spoke to Dr Freeman I feel like there is now a light at the end of the tunnel. I cannot imagine how those with very bad livers etc. must feel. And yes, thank goodness for modern medicine!


    YMMV

    in reply to: Liver Clinics and Generic Rebels #3290
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hello again I made an appointment with a Specialist here in Bendigo just to arrange for Fibroscan etc. I am Genotype 1b with 3.13 million viral load. The Doctor at the Royal Melbourne was happy with my Fibroscan and also with the ultrasound….it appears that at present I have a fatty liver (which many people have anyway) but otherwise no obvious hardening/cirrhosis etc. I am aware just how “lucky” I was to be diagnosed through a bloody test which showed up liver function wasn’t so good. I am not seeing the Specialist here again because he tried to more or less say that because my first husband was an IV drug user that is where I caught the Hep C (even though I told him I didn’t use drugs and never had). Anyway I have a supportive GP and will be starting the med soon I hope (still waiting for delivery). I will contact the Hep C Clinic here in Bendigo to let the Hep C nurse know what I am doing. It will be interesting to see what sort of reaction I get.

    Will post again once the meds arrive.

    Lynne


    YMMV

    in reply to: HCV treatment Centres in WA? #3261
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Dr Richard Sallie is a gastroenterologist who has been involved with Hep C since it’s discovery and assists patients with generics.

    Dr RICHARD SALLIE MBBS MD PhD FRACP FACG
    Suite 35, 95 Monash Avenue
    Nedlands,
    Western Australia
    Telephone: 089-389-7101
    Facsimile: 089-389-7103


    YMMV

    in reply to: Travel & Vaccinations #3260
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home~handbook10part4~handbook10-4-5#4-5-6

    Booster doses

    Booster doses of hepatitis B vaccine (after completion of a primary course by using recommended schedule) are not recommended for immunocompetent persons. This applies to children and adults, including healthcare workers and dentists. This is because there is good evidence that a completed primary course of hepatitis B vaccination provides long-lasting protection. Even though vaccine-induced antibody levels may decline with time and may become undetectable, immune memory persists and is thought to result in a protective immune response on re-exposure. However, booster doses are recommended for persons who are immunocompromised, in particular those with either HIV infection or renal failure. The time for boosting in such persons should be decided by regular monitoring of anti-HBs levels at 6- to 12-monthly intervals.


    YMMV

    in reply to: Incepta’s Twinvir #3240
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    I am in Dhaka. Has anyone done business with Parvis from Incepta ? Please answer asap


    YMMV

    in reply to: Liver Clinics and Generic Rebels #3197
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hello Vicki I live in Bendigo Victoria and am facing an 18 month wait at the Base Hospital before I even get to the Liver Clinic. I have purchased generic drugs from China through the Buyers Club and expect delivery within the next two weeks. I am very nervous but also excited to take the meds and to see the end of this virus. I was diagnosed in February this year…. no idea where, when or how I contracted it. I have struggled every day with the fear of living with this virus but acknowledge that there are many many people a lot worse off than me. My GP is supportive of me taking the generic meds.

    I will post on here once I receive the meds and start my journey.

    All the best


    YMMV

    in reply to: daclatasvir is on the way #3165
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Mesochem Daclatasvir is Dac 2HCl and yes they just write Daclatasvir on the packet.


    YMMV

Viewing 15 posts - 1,816 through 1,830 (of 1,968 total)