Hep C Discussion Forum

Ruby Red · Senior Member

RE: On my way to Club Zero

Phoenix17 · Senior Member

Ruby - Mexico sounds good to me right now, as it will be a high of 37 today, Sigh,,,,,, At least it's not snowing. Not yet anyway. I just don't like driving in it.

Thanks Tig! Good to know that these medications will clear fast. Yay!

Tig · Admin

Good news is all around us! The final countdown... How sweet it is!!

Once you're done the drugs don't take long to clear your system. The new DAA's go in a week or so. Those on Ribavirin have the longest wait, 6 months! Fortunate that we're seeing less of it.

You both keep doing the great job you have done so far. The Epclusa Station is just around the bend! EOTVille is a great stop on your way to SVR!

Ruby Red · Senior Member

Phoenix lol I also have 2 December Bday's. My oldest grandson turns 18 tomorrow, (that's a huge WOW for me) we celebrated tonite and my youngest son just before Christmas. :)

Ya the nausea ugh! It's ok though it's really nothing compared to previous treatment.

Back to positive talk ....the trips...haven't decided on which one and certainly wouldn't go until early spring. I haven't been to Germany in the spring so I naturally sway in that direction but of course Mexico would be so much cheaper and warmer lol...lots to consider. Lots of things to factor in making this decision.

The best for last.....YES, we are down to the wire WOOHOO!!!!

Phoenix17 · Senior Member

Less than a week Ruby! Wow, you are way ahead of me! I still have most of my Christmas shopping to do. disbelief Although I do have 2 Dec birthdays done. Sorry to hear about your nausea. I am sure it will stop EOT. Have a great time on your trips. You deserve it!

Sydhanrahan · Guru

Hi Ruby Red,

i have fallen off my Hepc friends perch a bit and the first post I saw on my return was yours. How fantastic to know that your latest result was indiagnosed. Sounds like you well and truly got it this time. Also so great to hear you have a heap more energy and so much positivity oozing from every pore.

you go girl! Germany here you come.

Hugs,

Syd

Ruby Red · Senior Member

Yesterday I also started my last and final week smile Next week EOT blood work. All is well and I mean well! For some reason the past couple of weeks had been a tad rough with the waves of nausea but other than that I feel good!! During the past 11 weeks there were times when I had to ignore any side effects and just focus on the prize. I live alone so yes there were times...enough on that.

I have longer periods of time where I can go go go but then I just have to stop, unlike before lol when it took alot out me just to get ready to go out. This was an issue prior to treat also. I have had people tell me that I look good like I have a glow...that makes an ole gal feel good lol

I have all my Christmas shopping done and wrapped, that's how much energy I've had recently smile Just knowing the dragon has been slain and no longer resides in my body is such a relief!! (Of course I'm expecting the same results as I've had at 4 and 8 weeks..UND

I am deciding on a trip, to visit friends, one in Germany or my friend in Mexico, we'll see how that turns out. I just know 2017 will be a great year!! (It's already looking GREAT...SVR here I come

Ruby

Ruby Red · Senior Member

Thank you all for sharing in my happiness!

Canuck, right from the beginning I wouldn't allow myself to have one iota of a thought that Epclusa wouldn't be "the one"! My faith keeps me hopeful all the while being grateful for positive results...even before I saw them :) I've been mentally determined to be a member of Club Zero lol Love the art work, it gave me a giggle....thanks for that :)

And you are correct, not only am I a very lucky gal, I am so blessed!!

Next Stop EOT

wendyo · Guru

WOO HOO you go girl!

Canuck · Guru

Lovely Ruby!!

"NOT" or "UND", same thing ... it adds up (in my preferred terminology) to being a great big fat ZERO (TWICE now for you!). Very significant, at 4 weeks and 8 weeks.

I know the prior disappointment will never be forgotten, but epclusa is a whole dif. kettle of fish. I think in your heart you already knew this stuff was going to work for you. You are a lucky gal.

You can keep looking forward to celebrating every ZERO you will get from now on.

In celebration, I have gone all artsy - I have drawn a portrait of you, with the glee of big shining ZEROs in your eyes! You got your ticket to Club Zero alright. Us Canucks are jes killin' it eh! C.

"0 0"

U

Phoenix17 · Senior Member

Yay Ruby! Awesome news! Almost EOT!!!

Tig · Admin

Hey RR,

WOOT! That's fantastic, congratulations! There's nothing quite like seeing your own tests come back undetected or not detected (same thing) for the first time. Kind of makes you feel, powerful! It's a feeling like no other smile

Good to know your Dragon has left the building... Keep up the good fight!! SVR is in sight!

Ruby Red · Senior Member

Hey Everyone

My 8 week VL results...reporting NOT DETECTED!!!!!

I know everyone posts "undetected" but my written report states "not detected" so that's why I report it that way. I know it means the same but that's what my eyes see and that's I share hahahahaha

This second report is important to me because in my previous treatment I received a good report after 4 months, then at six months there it was doing it's dirty deed with numbers even higher than when I started treatment.

Needless to say I am very happy!!!

I can't wait for the day when all of us sitting in the Epclusa corner and everyone else on different treatment report those three sweet letters ...SVR

I am feeling so blessed!!

RR

JimmyK · Guru

Like watching a race to the Wreath.

wink

Phoenix17 · Senior Member

Three weeks to go!!!

I am sure you will still be UN! Post when you do.

Ruby Red · Senior Member

Hi Canuck

Was hoping to get my 8 week VL results today as it only took one week at my 4 week test but no luck . Tomorrow is another day and I'm hoping it will be in. I certainly will post when I know

Week ten started today!

RR

Canuck · Guru

Hey Ruby,

Won't long now!!!! ... I can't wait to see you post your VL soon. biggrin

Phoenix/Shadowfax/Ruby and me!, and all,

It's good, but also kind of sad state of affairs that we end up learning so much about blood draws from our end of the stick eh? Be dif. if it was our job or something!

It was good thinking/advice, all round (mostly borne out of unfortunate practiced experience tho). Yes, we have tried my hands Phoenix, but not much, one look and feel will tell them (as I know) there is rarely ever any promise there, almost a "no go" zone, nothing there, drat. My best "one" that has not disappeared over the years, is the unfortunate "your it" - a single decent vein I own in the antecubital space, that might cooperate, if you hit it the first time. When we are desperate and have exhausted the usually useless tries in the other antecubitals, we morph downward to forearms/hands as last resorts, they never seem to find any in my hands, let alone deliver from them, and (for me) with "misses" I found digging misses more sensitive in my hands than my arms.

One note - don't be fooled when they use a butterfly - inquire as to the gauge they have chosen for you, the large bore ARE often used even if they just happen to be in the butterfly format! "Butterfly" does not necessarily equate to smaller gauge.

Everyone is correct here, large gauge can be required, for good reason(s).

Shadow, Nice you provided a good article.

Who else, is soon to announce their next SVR12/24's??!! My most fav. topic. biggrin

Ruby Red · Senior Member

Hi Shadowfax

Believe me I don't mind them using a larger gauge needle but they also have to know how to use it disbelief daaa you'd think they would, that is their job lol Plus if the lab technician decides to use the butterfly it actually is more uncomfortable because it does take longer to extract the blood.

They do take a lot of vials but once the needle is in it makes no difference to me. Every time is an experience LOL

Thank you for the link, it totally makes sense!!

Shadowfax · Guru

Regarding a butterfly needle. It is an easier way to have blood taken but after research and speaking to the vampires that take my blood, It absolutely is a reason that blood samples can be hemolyzed and rendered useless like a number of my samples were. If they can take the blood fast and with a larger gauge needle, there is less chance of that and getting good samples.

My rule of thumb now is that if they want one or two tubes, they can use that but since 7-9 is usually the number, lets get it right the first time.

http://clinchem.aaccjnls.org/content/46/2/306

SF

-- Edited by Shadowfax on Tuesday 15th of November 2016 05:20:27 PM

Phoenix17 · Senior Member

Have you guys tried getting blood drawn from the tops of your hands? With me it's so much easier that way. Less stress for the lab tech that is doing it and less pain for me. I just tell them to do it that way and they don't even bother trying on my arms. I had to learn the hard way before a tech got smart and suggested the hands. So much better!

Canuck · Guru

Ya, I figured you prolly knew all the tricks already, but, just in case. Us, with either bad, rolly-poly, no veins, or no circulation period, who have to be poked usually have some strategies learned in self-defense. Hate it when they outright refuse to use a small gauge butterfly! But ... sometimes even that kindness, isn't wide bore enough to get all the samples out of you in time before a collapse. It's a crap shoot sometimes, even when I am warm and hydrated. But I'm quite pleased and relieved for you, to hear this one went down with less trauma and insult! biggrin I got the willies listening to how they get blood out of JimmyK! One day, I had just been feeling so rotten and looking so bad, i just wanted to look "nicer", so unfortunately, I picked some cheery little light-weight ensemble, sacrificed "practicality" for looks, paid for it, frozen by the time I got to the lab draw! VANITY OH VANITY.

Ya, vacillating labs, thanks eh! We all rivet on a couple points here and there, how can we be faulted when we do so. But crashed is crashed.

I too - can hardly wait to see your next und!! biggrin C.

Ruby Red · Senior Member

Thanks SF for passing on reassuring information! smile

Shadowfax · Guru

The numbers are looking good.

Don't worry about the ALT fluctuating a little bit, it does that. It happened to me and I was worried until the great friends here told me not to. Now I am passing on their good advice. It will sort itself out.

Four more weeks. Piece of cake with eight behind you. You are almost there.

SF

Ruby Red · Senior Member

Canuck, I also drink lots of water and keep my arm warm prior to blood work. I was given that advice years ago and it does work!

Blood work was no problem yesterday, no VL results till next week but my liver functions are:

AST 25 down from 50 in August/16,

ALT 32, up a few points from last month (26) I don't know why but my RN said it can fluctuate.... I'm not concerned considering it's a far cry from 72 in August/16

GGT 49 Last month it was 46

With a skip in my step, all in all I'm ok with these results and obviously can't wait till next week

Wishing everyone a beautiful day and continued positive results

Canuck · Guru

Ruby,

My self-defense at the lab ( I always had to be fasting for them - you too?) ... I loaded up a fair bit on good eats the night before, and lots of fluids. Drank lots of water after midnight and then more water again, all AM, until the blood was drawn - also very important (to me) was bundling up, and I mean really bundling up, lots of layers of warm clothes/sweaters under my coat! - took forever to strip down to expose my arms for the draw with that pile of clothes mounting on the chair beside me!! - I HAD to stay warm until my blood was drawn, or it there could be twabo. Hope this draw goes tickety-boo for you, this time round. biggrin C.

JimmyK · Guru

Aww Ruby!

wink

Phoenix17 · Senior Member

Awesome Ruby! One more to go! I am sure your labs will look great.

Cheddy · Moderator

Hey Red,

Glad to hear you are handling treatment. You'll be there in no time. I'm eager to hear your lab results.

Love your good attitude.

Cheddy

Ruby Red · Senior Member

Hi All

Eight weeks down, four to go! Fatigue has been up and down but certainly manageable. Waves of nausea and a few headaches which have been lessening.....no big deal!

Blood work tomorrow, lol yes I'm looking forward to having blood work done smile I will get my liver function results Thursday but will have to wait a week for my VL results. I'll keep you posted.

Very happy to read all the positive posts and of course the spectacular VL results

Remaining positive and grateful

RR

Cinnamon Girl · Guru

Good to see your latest update, RR... you`re flying through it now! Best of luck with your labs next week, keep us posted and have a good weekend! smile

Ruby Red · Senior Member

Started week number 8 yesterday! Looking forward to my blood work next Wednesday!

All is well with this Canadian Gal I'm hoping everyone else is feeling well and rejoicing in the cure!!

Ruby Red · Senior Member

Thanks Canuck for all the info and your concern I'm not too concerned about any of the nausea or heartburn. I feel I am managing and with all honesty this wee bit of discomfort is so worth seeing those sweet letters SVR

FYI: I have enjoyed 2 days without any substantial fatigue....feeling wonderful whoowhoo

RR

Canuck · Guru

Ruby,

Hm, oh dear - I was afraid you might say that - no real firm "rhyme or reason" for it, and if there had been (a pattern), likely you would have already tried addressing the bouts of nausea, by way of avoiding any contributing factors. So, what to do? Well, always search for the simplest reasons or fixes first, which would have been to rule in or rule out whether taking it with food would help some. Given that "with a full stomache" does not "seem to" have any good, or bad effect on the matter, then I would elect to take your pill consistently on a full stomache (especially given you are now mentioning as well, new but ongoing and perhaps associated heartburn), if your stomache/esophagus is irritated, upset, protesting, my best guess is to default to absorbing the med along with a full meal, and not alone with water, that is assuming it IS the med that is the culprit. I assume you are already trying to alter your food intake to avoid things that may not be helping or might be helping to contribute to an already upset/protesting stomache? Try smaller, more frequent meals, softer, blander, soothing, easier to digest foods with less irritating or gas-forming foods. Consider limiting hot/spiced, fatty, hi-fiber, hi-sugar foods, or all-raw diet foods, if you are consuming a fair bit of these. Try "gentle/simple/easiest-to-digest foods" (for a while). Be upright after meals, if you are not. Make sure the meal with your pill is a fairly substantial one.

I only had some (of what i call "true") nausea for the first "days" on meds, some erucitation too. From day one I had "roiling", and for the next few weeks the "roiling" burgling, glub-glubbing gastric symptoms I put up with (and could handle), it got less (or I just got used to it) through the course of treatment, it definitely stopped, but mine was like clockwork, predictably, shortly after taking my pill (lunch), it would build for hours, lessen by evening, dissipate completely at night, only to re-occur all over again the next day with the next dose, and nothing really changed it much, it lessened as I progressed through my course. A "full" meal, and full stomache with the lunch pill, the better it seemed (I think). I was strictly instructed to take my doses with food (due to the VOX), so i did. I do recall reading the % incidences of "gastric" sides listed for sof/vel alone, were less, than the % shown for "gastric sides" for those on sof/vel/vox. Thus partly why I think the vox people were told to always take their meds with a meal only.

You will think of what might be best given how you feel. Wish it was completely smooth sailing tho. smile C.

Phoenix17 · Senior Member

Nausea and heartburn are not fun Ruby. Sorry you are going through this. Hopefully it will stop soon. Who really knows what triggers it. As my Mom says "This too shall pass". It sounds like you are dealing with it in a good way.

We do have to laugh at our experiences! I will never be without water again. biggrin

Ruby Red · Senior Member

Thanks Tig and Jimmy for the info, it's well appreciated for sure! I've decided not to take anything while on treatment. Let me say the nausea is manageable, it's not welcomed when it waves in but it's not like stomach flu nausea. Yogurt and ginger are my friends lol

Staying positive smile

RR

Tig · Admin

Ruby,

Ask your doctor if a prescription for Zofran is permissible, it should be. In my opin, it's the gold standard for treatment of nausea. Zofran (brand name) is expensive, so request the generic if you go that direction.

Sorry you're continuing to have these difficulties. Nausea is never easy to deal with, especially when it's frequent. I remember a discussion we had here some time back and the member spoke with her doctor about daily bouts with it. He recommended she try the over the counter sea sickness medication Dramamine or Bonine and it worked for her (cheap too). You might mention that as a possible solution as well. Knowing it will go away after treatment doesn't do much to help you today, but you can look forward to it! That and a happy liver smile

JimmyK · Guru

Greetings my little Red Sister.

Please understand that with Epclusa, just like Harvoni, use of Antacids should not be considered within 4 hours of taking Epclusa.

Established and Potentially Significant Drug Interactions

Table 2 provides a listing of established or potentially clinically significant drug interactions. The drug interactions described are based on studies conducted with either Epclusa, the components of Epclusa (sofosbuvir and velpatasvir) as individual agents, or are predicted drug interactions that may occur with Epclusa [see Warnings and Precautions (5.1, 5.2) and Clinical Pharmacology (12.3)].

Table 2 Potentially Significant Drug Interactions: Alteration in Dose or Regimen May Be Recommended Based on Drug Interaction Studies or Predicted Interaction*
Concomitant Drug Class: Drug Name	Effect on Concentration	Clinical Effect/Recommendation
DF = disoproxil fumarate.
* This table is not all inclusive. = decrease, = increase. These interactions have been studied in healthy adults.
Acid Reducing Agents:	velpatasvir	Velpatasvir solubility decreases as pH increases. Drugs that increase gastric pH are expected to decrease concentration of velpatasvir.
Antacids (e.g., aluminum and magnesium hydroxide)		Separate antacid and Epclusa administration by 4 hours.
H2-receptor antagonists (e.g., famotidine)		H2-receptor antagonists may be administered simultaneously with or 12 hours apart from Epclusa at a dose that does not exceed doses comparable to famotidine 40 mg twice daily.
Proton-pump inhibitors (e.g., omeprazole)		Coadministration of omeprazole or other proton-pump inhibitors is not recommended. If it is considered medically necessary to coadminister, Epclusa should be administered with food and taken 4 hours before omeprazole 20 mg. Use with other proton-pump inhibitors has not been studied.
Antiarrhythmics: amiodarone	Effect on amiodarone, sofosbuvir, and velpatasvir concentrations unknown	Coadministration of amiodarone with Epclusa may result in serious symptomatic bradycardia. The mechanism of this effect is unknown. Coadministration of amiodarone with Epclusa is not recommended; if coadministration is required, cardiac monitoring is recommended [see Warnings and Precautions (5.1) and Adverse Reactions (6.2)].
digoxin	digoxin	Therapeutic concentration monitoring of digoxin is recommended when coadministered with Epclusa. Refer to digoxin prescribing information for monitoring and dose modification recommendations for concentration increases of less than 50%.
Anticancers: topotecan	topotecan	Coadministration is not recommended.
Anticonvulsants: carbamazepine phenytoin phenobarbital oxcarbazepine	sofosbuvir velpatasvir	Coadministration is not recommended.
Antimycobacterials: rifabutin rifampin rifapentine	sofosbuvir velpatasvir	Coadministration is not recommended.
HIV Antiretrovirals: efavirenz	velpatasvir	Coadministration of Epclusa with efavirenz-containing regimens is not recommended.
Regimens containing tenofovir DF	tenofovir	Monitor for tenofovir-associated adverse reactions in patients receiving Epclusa concomitantly with a regimen containing tenofovir DF. Refer to the prescribing information of the tenofovir DF-containing product for recommendations on renal monitoring.
tipranavir/ritonavir	sofosbuvir velpatasvir	Coadministration is not recommended.
Herbal Supplements: St. John's wort (Hypericum perforatum)	sofosbuvir velpatasvir	Coadministration is not recommended.
HMG-CoA Reductase Inhibitors: rosuvastatin	rosuvastatin	Coadministration of Epclusa with rosuvastatin may significantly increase the concentration of rosuvastatin, which is associated with increased risk of myopathy, including rhabdomyolysis. Rosuvastatin may be administered with Epclusa at a dose that does not exceed 10 mg.
atorvastatin	atorvastatin	Coadministration of Epclusa with atorvastatin is expected to increase the concentrations of atorvastatin, which is associated with increased risk of myopathy, including rhabdomyolysis. Monitor closely for HMG-CoA reductase inhibitor-associated adverse reactions, such as myopathy and rhabdomyolysis.

Just want to be sure you are informed.

JimmyK

Ruby Red · Senior Member

Hi Canuck :)

The nausea is different and there is no specific time nor any relation to food etc. I have taken my meds (7pm) after I've eaten, in that case I've tried to make sure there is at least a half hour prior because I wash it down with 1-2 glasses of water. I've also taken meds on any empty stomach with the same amount of water...waiting awhile and then eating. There is no actual vomiting just waves of nausea which lasts as long as it lasts. It's just weird how it comes and goes. I simply manage through with the help of yogurt at times.

What I have experienced for the first time in my life is heart burn...oh dear that burning lump in my esophagus YUCK! lol I drink more water lol (no worries about taking antacids) I feel sorry for people who have that to contend with on or off meds. It's nasty! lol

Phoenix you poor Gal :( You won't do that again nor will anyone else. I know it wasn't funny at the time but I have to admit I had a giggle. I'm laughing with you...hope you are laughing now. We have to find some humour in our experiences smile

RR

Canuck · Guru

Hey Ruby,

Sorry about the nausea, but I'm interested in yours. You said ... more "frequent waves" of nausea. Would you describe it as a "typical" standard kind of nausea? You take your pill at 7 PM, right? - so, does that mean you're taking your pill "with" food, .... like say within an hour of a full supper meal? Or, is your stomache is empty and you are just washing it down with lots of water instead? Does the nausea start right shortly after the 7 PM dose? Does the nausea build after a dose in a crescendo fashion and then lessen before the next dose? Is there any association with the time(s) you feel the nausea throughout a day, and the time you have taken your pill? Or does the nausea come "any" time, and seems totally unrelated in severity, frequency or duration in relation to the 7PM dose? Is there any rhyme or reason to it you've been able to note? I had some gastric symptoms too, but I was additionally on VOX, so i am curious to hear more on what your GI symptoms are like.

Wish it would quit pickin on you! smile C.

Greg · Guru

Hi Ruby,

Fantastic news, congratulations so happy for you. Take it easy your on the road to beating this beastie.

Love and Light,

Greg

Tig · Admin

Hi RR,

That's a good report, but that nausea thing is awful. Try the Nutrition section and look for the ginger ale recipes, among other things that might help. There are some excellent Rx drugs as well if it gets to be too much. Hopefully things ease up soon. You're on the downhill side of this journey, it won't be long now! smile

I'm loving the autumn weather, even in South Florida! I just returned from a short roadtrip through Appalachia. It was beautiful and chilly! I'm not used to that cold stuff anymore. We had a nice time. Lets hope for a nice, long fall season!

Phoenix17 · Senior Member

Half way done Ruby! Woot Woot!! I hope your nausea gets better soon. We did have some really nice fall weather as well.

Ruby Red · Senior Member

Hi Everyone

Week seven starts today. FYI - I have had more frequent waves of nausea and fatigue but when I have my times of euphoria I take full advantage. So all in all thumbs up! I continue this journey feeling blessed and with a full heart of thankfulness and gratitude

I hope everyone else is doing fine and enjoying this beautiful fall weather

RR

Shadowfax · Guru

NOT DETECTED

Now those are great words to read. Congrats and you are well on your way. Excellent news

We will meet and the SVR line

SF

* Updated my signature line with lab work from Tuesday. No need to start another thread.

-- Edited by Shadowfax on Friday 21st of October 2016 11:21:23 AM

Ruby Red · Senior Member

I love it JimmyK :)

JimmyK · Guru

Try this on and see if it fits.

wendyo · Guru

Love starting my day reading this. Way to go RR!

EricChuckFar1 · Veteran Member

Ruby Red wrote:
Hi Everyone
I just got back my appointment with my RN, she pulled up my VL results and said, come and take a look, NOT DETECTED is what it read. I had to read it again and must admit it made me well up.
Week 6 starts today

Ahh! I got goosebumps reading this and it made me all tingly inside. That's fantastic, congrats!

Onward we go!

Tig · Admin

That's fantastic news! So pleased to see how well you're responding to treatment. Half way and rolling downhill to the finish line. Enjoy the moment, it's such a happy day when you hear that word for the first time. UNDETECTED!!

On to victory! smile

Phoenix17 · Senior Member

Time flies when you are having fun Ruby! Almost half way done. It has gone fast so far, pretty soon it will be the season of SVR!

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Established and Potentially Significant Drug Interactions

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