1 Down 23 To Go

Well, I've completed the first week of combo therapy as, with my wife's help, I injected the Intereron for the first time last Friday evening. Yes, I did get sides.......flu like body aches, loss of appetite, absolutely no energy. Had a bit of energy today, enough to do some mundane things around the house like pay bills and vacuum the carpet a tiny bit. Thankfully my lovely wife has been an angel this week, as always, she was there all week to pick up the pieces.
Well now that I'm feeling somewhat human again it's time here in another hour or so to give myself another weekly injection, getting ready for round two of this 24 round fight (thankfully my genotype, 3a only requires 24 weeks of treatment).
It turns out that I really could not have put this off any longer. I had reported in an earlier blog entry that my biopsy came back Grade 1. This was true but what my somewhat incommunicative Dr. didn't elaborate on was filled in by the nurse. As she explained and I've since confirmed by my own research is that Grade only refers to the amount of inflammation in the liver what is more important is Staging. Biopsies are staged in a 5 step point system, 0 to 4, 0 being a perfectly healthy liver and 4 being a liver suffering from cirrhosis with different Stages (1 to 3) of Fibrosis in between the two extremes. It turns out my biopsy came back Stage 3-4 which means its very fibrotic but not quite cirrhotic, but needless to say, it definitely has reached the stage where I would not want to put off conventional Combo Therapy (Interferon/Ribavirin) any longer. So I'm very glad we've got the ball rolling and with the support of my Lovely Lady I'm very determined to get through this, determined to keep my head up.

I Guess I'm Not Crazy.....

Well, turns out after consulting with my General Practitioner, the GI Doc is not going to insist I see a Psychiatrist :-) Rather, he agreed with my GP Doctor's assesment that any potential depression side effects from combo therapy could be managed by her. Thus, they are recommending a Rx of the antidepressant drug Lexapro to be begun two weeks prior to the commencement of combo therapy. I have taken it for several days now and don't really like the way it makes me feel, my biggest complaint being that, for me , it seems to cause insomnia.

My liver biopsy was performed quite well yesterday, virtually painless, unlike my last one four years ago which was a bit painful. Very pleased with that, now just waiting for the report from the pathologist in hopes that any liver damage caused by the virus continues to be minimal.

Good News and Some Frustration

Well, since my last posts I was seen by a local Gastroenterologist who ordered an Abdominal Ultrasound which I had performed this last Thursday and a Liver Biopsy which has been scheduled for Tues. September 04. The good news is that my lab work showed my viral genotype is type 3a. The reason this is good news is that the length of your treatment depends on what hepatitis C genotype you have. Genotype 1 generally is treated for 1 year and genotypes 2 and 3 generally are treated for 6 months. Also of significance is that studies have shown that treatment works for up to 50% of people with genotype 1 and up to 80% of people with genotype 2 or 3.

The frustration stems from being notified by my current Gastroenterologist that he won't put me on treatment until I am evaluated by a Psychiatrist for clinical depression, Clinical Depression is one of the main contraindicators for current Hepatis C Combination Therapy. This is due to the fact that when I discontinued my very short trial of interferon treatment around six years ago I mentioned the D word ("depression") as one of the reasons I wished to discontinue treatment at that time. Yes, I was a little down about not being able to work etc. and so decided to quit treatment and return to work, hoping to manage the virus with alternative methods (Chinese Herbal medicine etc). I know however, I don't have clinical depression and this is frustrating me because now that I have decided to undergo treatment I find myself anxious to get started. Oh well, for now it's hurry up and wait for the ultasound, biopsy results and the Psych referral.


As far as the labs which have come back already here is my current baseline;

AST is slightly elevated at 67
ALT is slightly elevated at 110
HDL Cholesterol is low at 37
And HCV Viral Count is at 5,790,000 (Genotype 3a)

Here's to the bells that still can ring.
Forget your perfect offering.
There is a crack in everything.
That's how the light gets in.
-Leonard Cohen

A New Direction

Well, my closing of this blog turns out to be a bit premature. Those of you who have been readers of this blog know that for the last couple of years I have been attempting to battle my chronic hepatitis c infection with alternative medicine, especially Chinese Herbal Medicine. I have recently come to a cross roads which has forced me to reevaluate my situation and chart a new course. Though for the most part I have been able to do what I want over the last couple of years things have continued progressing and I have continued to experience, off and on, some periods much worse than others, body aches, fatigue, lethargy, mild right upper quadrant abdomen pain and generalized "flu" like symptoms. The fact that for long stretches (months) of time I could just simply ignore these symptoms and go on, pushing myself to fulfill mundane responsiblies like my job etc. so that I could enjoy the wonderful year I have had, the highlight of which was marrying my Lady L. and enjoying a beautiful honeymoon and first year together, the fact remains, I too did also experience stretches of time where the symptoms where severe enough to limit my ability to work and take care of mundane affairs. I tend to be the eternal optimist and often found myself just pushing myself along, looking forward to the next beautiful day. Well, over the last couple of weeks I have again experienced a much more severe than usual bout of symptoms, similar too, but not quite as bad, as the first recorded in this Blog espisode of October 2005.

I am not sorry I gave Dr. Zhang's Chinese Medicine protocol a try, it definitely had some profound positive effects on my health and I am sure I am in better hepatic health today than I would have been otherwise. As mentioned it did allow me to enjoy an especially happy and rewarding period of my life. I have, however, now come to the point where I must admit this approach has not been enough, or at least, must now be augmented with more aggressive treatment methods. I am so certain of this that I actually approached my General Practioner this past week with a request for a referral to the Hepatologist I seen in June 2003 who at the time performed a liver biopsy (Grade 1, result) and offered me interferon treatment which, at the time, I declined for the option journaled here. At the time he said that was fine, he could agree to that and recommended a follow up biopsy in 2-3 years, time has a tendency to get away from one, and it has now been 4 years since this last biopsy. I am now awaiting the referral from my health insurance and will followup with this course of action. I am sure he will want to do a followup bisopsy and I am now determined to follow his subsequent recommendation, even if that is interferon treatment.

Like most guys, it's hard for me to admit to being afraid but I guess that's a large part of what I've been battling with. We all know courage is important and I am determined to muster the internal resolve to see this through but perhaps, the real key lies in the yogic Niyama (practices, observances) of Isvarapranidhana, which literally means in Sanskrit, "to lay all actions at the feet of God". Maybe self-surrender is the key, after all, as it is written, "For pure will, unassuaged of purpose, delivered from the lust of result, is every way perfect". After all, I know I have done everything in my personal power to combat this and now it's up to the Universal Will.

A Wider Lens

Since I have not had anything new to post recently in regards to Hepatitis C and it's treatment I have found myself posting here very infrequently, thus, have decided to begin a new blog which will be more eclectic in it's subject material. This will allow me to leave this blog as is, without diluting it's focus on Hep C, for those mainly interested in that subject matter.

The new blog can be found at, A Wider Lens

Great Little Essay

  I really enjoyed this post made by one of my favorite bloggers recently. He managed to distil more spiritual truth in one short essay than many books on Spirituality manage to accomplish in hundreds of pages. Kudos.