Hep C Discussion Forum

mindovermatter · Veteran Member

RE: Experiencing neutropenia: feeling upset

Groupergetter · Guru

mallani wrote:
Hi MoM,
Your platelets are in the normal range. Re the Riba. For Geno 3, Interferon and Ribavirin are equally important. Both play a part in the development of the anaemia we like to see. The degree of haemolysis relates directly to erythrocyte Riba concentration- this causes a decrease in red cell numbers, and the red cells increase in size. Usually, a drop in Hb of >3 is considered desirable, but all this is old data. You're Undetectable, which is all that matters, so carry on . Cheers.

Malcolm, gimme that fish you're holdin, I'll fillet him for you in a heartbeat aww Thanks for sharing the knowledge in a way common folk (me :) can grasp. I gave your "understanding RAV's" post to a friend, he was very thankful. That could be a sticky in itself. Appreciate you. Glad you found your cure and a new lease on life.

Tig · Admin

Hey Malcolm,

Wow! That was quite the explanation mate! I'm so glad that you're a member on our Team. As always, your knowledge and willingness to share it is beyond impressive. So grateful for what you do here! (Just thought you needed to know) smile (Nice fish!)

Tig

@MoM, it's all looking good brother!

mallani · Guru

Hi MoM,

Your platelets are in the normal range. Re the Riba. For Geno 3, Interferon and Ribavirin are equally important. Both play a part in the development of the anaemia we like to see. The degree of haemolysis relates directly to erythrocyte Riba concentration- this causes a decrease in red cell numbers, and the red cells increase in size. Usually, a drop in Hb of >3 is considered desirable, but all this is old data. You're Undetectable, which is all that matters, so carry on . Cheers.

mindovermatter · Veteran Member

Hi Malcolm and Gracie,

I would not reduce my Interferon dosage as of now. As I have said earlier, I am not experiencing any serious side effects as of now. I am feeling good to be honest.

Thanks Gracie for sharing your experience, you are a trooper.

Malcolm, do you mean Ribavarin has not been as effective as it should be? Could you please explain?

My platelets are 209.

-- Edited by mindovermatter on Wednesday 26th of March 2014 05:41:41 AM

mallani · Guru

Hi MoM,

As others have said, your Neutrophil levels are just a bit down, as expected. What are your platelets? In any case, I'd want to stay on the full dose of Interferon. Your Hb and MCV suggest that Riba is not having a big effect on your red cells, so I would definitely refuse an Interferon dose reduction. Cheers.

Gracie · Guru

1.5 is borderline low. As mentioned mine is .57. I had to reduce when it went down to .5 as if it went below that, they would take me off the treatment for an entire week and didn't want to chance it. At 1.5, I'd stay the full dose and see how your next work up is. It's not really that low. But, as always, it's your decision, and if unsure, definitely ask your doctor to get advice. And stay away from sick people!

mindovermatter · Veteran Member

Thanks Tig, I would stick to the full dose as of now biggrin

Tig · Admin

Hi MoM,

Thanks for posting your results. While there are some obvious low values, they aren't so low that I would recommend a dose reduction. You've got additional room to drop before things get problematic in my opinion. The signs I see indicate an effective response to treatment and your unfortunate discomfort is part of that fortunate reward. Hang in there! Good luck...

Tig

mindovermatter · Veteran Member

Hi Tig,

My hepa is in a different city and I consulted him by email. I had posted my CBC report and he advised ' You have the option of reducing your interferon dosage by 0.25'.

Physically, I am feeling just fine.

I have read many people on this forum being advised against reducing interferon dosage unless they are down with very severe neutropenia.

I remember Zlikster telling me that interferon dosage reduction should be avoided unless one does not have any other option.

Personally, I would not want to reduce my dosage because I am feeling good physically.

However, I just wanted to know what you guys have to say about his advice.

Please find my CBC report which was taken at the end of week 12.

-- Edited by mindovermatter on Tuesday 25th of March 2014 06:20:46 AM

Tig · Admin

Hi Mom.

While I don't know the entire story behind your doctor's consideration to reduce your Peg Interferon, Perhaps you could post your lab test results here so we could provide a better informed opinion. I would want to know exactly why and request some facts to back up the decision. There are many things you can do to combat the negative effects of Interferon, but the simple fact remains, it's a tough road and is wrought with bumps and ruts. If you can tolerate the negatives, and it's okay with your doctor to continue at full dose, it's what I would do. It's so vitally important to keep your doses at the highest level possible, especially with GT3. They are your swords in battle, keep them as sharp as you can. Good luck my friend, we're here for you!

Tig

PS: Glad to hear that you're feeling better and in higher spirits! Keep your chin up!!

mindovermatter · Veteran Member

Gracie, Lisa, Jill, Scruffy, Tig,

Thank you all for your inputs. I know where to be when I am feeling low smile

To tell you the truth I have been lucky. Of the 12 weeks of treatments I only had one bad week. Other weeks have been good aww .

And honestly physically, I am feeling good. It is just the damn CBC which put me in a bad mood...lol!

I consulted my hepa yesterday and he suggested lowering the interferon dosage. Please advise if I should go ahead with this suggestion or should I stick with the full dosage.

-- Edited by mindovermatter on Tuesday 25th of March 2014 05:11:29 AM

-- Edited by mindovermatter on Tuesday 25th of March 2014 05:11:44 AM

Gracie · Guru

My ANC (neutrafils) have tanked since week 4. Last week .57 but it's been as low as .5. I have gone to work and out to shows, shopping etc and havent caught anything. I just take precautions like hand sanitizer, use the automatic door openers I open with my elbows when they are available, and stay well back from sick people. It's a good sign actually, that the treatment is working. You are doing it M.O.M!

... I'm with you on the 12 week wait... I had mine done last Friday.... Pretty intense....

Loopy Lisa · Guru

Hiya,

I recommend a big hug from someone, a comedy and remember we are all here when you have any worries.Try not to worry too much although I know its hard, you are doing really well and there is an end in sight. I think the interferon makes people more emotional although people blame it on the Riba. You are half way through, it probably seems an eternity, but this time next year it will be all over with.

Hugs!

Cinnamon Girl · Guru

Hi MoverM, I agree with what the others have said, it`s quite normal for your neutrophil count to drop when on treatment with interferon and many of our members have dropped quite a lot lower than where you are now. As Tig said, your doctor can prescribe injections of Neupogen which will stimulate the bone marrow to produce more white blood cells and that will get your neutrophil count back up.

Don`t be upset, this is all part of going through treatment, and I expect your emotions are all over the place at the moment! Your doctor is monitoring your blood levels and will take appropriate action when he thinks it`s necessary.

Most people miss a dose at some point during tx so don`t feel bad about it, just make sure you keep track of it in future. One missed dose of ribavirin isn`t going to affect your chances of success, so don`t worry. You`re bound to be feeling anxious waiting to get the results of your 12 week viral load test back, but try to relax and go with the flow!

Best of luck, keep us updated! smile

Scruffy · Guru

Hi mindover

My red count have been anemic since week 7. My white count just started going down the last month or so (7 weeks left). I get two shots each week for the blood counts. Doc's says my marrow is getting tired from the long tx. I don't think the missed dose matters that much just keep an eye out for those slip ups. Ribaviran and the wait for your vl results is IMO whats making you feel upset.

Keep that chin up!!!

Tig · Admin

Hi MoM,

Try to relax. I know a change in any of your labs can be concerning, but trust me, your results aren't unusual at this stage in treatment. Your low neutrophils are likely due to the Interferon. This drop is expected and your doctors have a number of ways to address it if they feel it's necessary. My white count dropped significantly as have many others while on treatment. My doctor started me on Neupogen for much of my treatment. Your risk with neutropenia and low white counts is infection. You can catch any cold or flu bug that blows by. So be cautious when you're around others and avoid those environments.

Missing a single dose of Riba is nothing to worry about. It's something you want to avoid, but missing a single dose happens to many people. Do your best to set alarms or whatever you can do to help remind you of those administration times. Riba and Interferon are long acting medications, so your blood levels will remain adequate. Just do your best to avoid any missed doses in the future. So take a deep breath and understand that things will be okay! Good luck!

Tig

mindovermatter · Veteran Member

Dear All,

I am done with 12 weeks of peg interferon ribavarin treatment. I have now started experiencing neutropenia (150) Range 200 to 700). My monocyte % is also rising over the weeks it is now at 11%.

I am upset. I know that many people experience low neutrophil counts during treatment. But I do not know why I feel upset.

Probably because, I missed one dose of Ribavarin yesterday. And secondly, I have given blood for my 12 week PCR. I was UND at 4 weeks.

I am a little scared to be honest.

Experienced member please advise

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