Hep C Discussion Forum

Canuck wrote:

 so, HOW MUCH water are you drinking per day? Good you are trying to drink lots. I got some headaches if I did not drink enough water.

Did you mean you are drinking MORE water because you are MORE thirsty, or, do you mean you are just drinking more because you know you should be drinking lots?

 

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 about water more than I was drinking before but not too much because then I have to go too often to a toilet. I feel that at night when I get up I need to drink some water as otherwise I am very thirsty which was not happening before.

To be sincere I am not sure if I feel better because I eat more fat in the morning (bacon, eggs, some chees, avocado, butter) and I have more energy or the drugs are working. Today I was not feeling too much about it. I hope it works.But now I forgot that I take anything so it is not disturbing at all

Hi Mak,

Before I got my Vosevi treatment i already had very profound fatigue - this fatigue did not at all get any better during treatment, nor right away after. It took a while to recover my strength and energy. It took quite a while after I was finished the Vosevi for the fatigue to improve, but eventually it did.

Same for "clear thinking", for me it got a little better for me shortly after i stopped the Vosevi.

You are very lucky to feel more energy and have clearer thinking as an effect while on Vosevi! 

It's also nice you are having no problems with your diet, or stomache, and have no diarrhea. My stomache used to "gurgle" for a couple hours after I took my pill and I did not really experience any diarrhea. My worst feelings while on treatment was the heavy fatigue and dull mind - but I was already like that before i started the Vosevi - so I cannot blame the Vosevi for the fatigue, but the fatigue and "fog" was very thick for me during treatment. Obviously these will not be problems that you will be having while on treatment - and that is very good, a real bonus for you!  

These positive feelings you are having (more energy/more alertness)... I believe you when you mention that this is happening, and no, I do not think they are just "auto-suggestion" - I think these feelings are a good sign that the drugs are working away and working well in you! We have had others here (but certainly not everyone) say similar things (many being on completely different DAA's), that they felt good things/improvements while on treatment. Most often they reported fatigue improving, or clearer thinking, or just a "clean" feeling, if i recall the most common ones accurately.

You mentioned drinking more water - so, HOW MUCH water are you drinking per day? Good you are trying to drink lots. I got some headaches if I did not drink enough water.

Did you mean you are drinking MORE water because you are MORE thirsty, or, do you mean you are just drinking more because you know you should be drinking lots?

Nice you will be getting some quite early blood tests soon and you will be able to get some feedback on how you are doing so far - but it all sounds like it is going very well indeed.

I too was lucky and got some early and frequent blood tests during taken my Vosevi trial (because the trial required the tests be done frequently) and it was nice to see the VL and LFT's drop throughout treatment. You will soon start to see that reward too.  C.

Hey mak, 

I am so glad you are on Vosevi, and I am so glad, that you are glad, you are on Vosevi!!  

Nice you are NOT noticing anything bad happening to you (negative sides or such), on the contrary, that you are noticing things that can be viewed as positives! Like the energy and the clear brain you describe.

Do not fret, Vosevi will work for you - it was designed exactly just for people like you - it is just the right thing for you and you were so lucky to get it.

Nice that you are taking good care of yourself, trying to be attentive to your body and needs.

Nice you are making sure you are taking a moderate fat content meal with your Vosevi, but don't make yourself feel sick by trying to take in too much fat for breakfast, especially if you are not used to it (eating a lot of fat for breakfast)! We don't want to make your stomache feel yuck just from eating too much fat for breakfast! Just a normal amount of fat in your breakfast would be sufficient, (a moderate amount) you don't have to overdo it.  I am guessing that the breakfast you described probably contains more than enough fat and might considered quite a high fat meal versus a moderate or low fat meal! A moderate fat content meal was just a "middle-of-the-road" suggestion, not high, not low, just moderate. Even if you just took your meds with an everyday ordinary meal without really heeding how much fat exactly the meal contained, they have designed the drug to be in sufficient quantity and powerful enough to cure you even without knowing how much fat intake you are taking in with a meal that might be might be enhancing your absorption.

It sounds like you are doing everything right, and there is nothing more to do than that! Just keep eating well, drink lots of water, get your rest.

Before you know it, you will have some labs drawn, and start to get some feedback from your doc on how he thinks you are doing.  C.

i am so happy for you too, that you are on this treatment mcmacklin .... i'm sure that's the feeling of wellness taking over your whole self.!

Wow.  What a team.

Mak,

Different people can feel different things, we can all feel different things even when we are on the exact same drug - but for me, I felt about the same all throughout taking Vosevi, from soon after I started taking it, right up to when i finished taking the pills, not much fluctuated/changed while i was on the drugs. - I found it about the same all throughout, with not much variation. Headaches could occur and fatigue could increase though, when i did not drink enough water.

I found that if I felt headaches developing I could actually prevent it from getting worse by making sure to increase my water intake. I did feel, quite strongly, an association between headaches and not drinking enough water.

Lamassu, I liked seeing your hand-written log, marking off the days, until you were done!  C.

You should drink lots of water when you are on these pills Mak.

Hi Mak,

Tig and Canuck are serious about drinking the gallon (4.5 liters) of water every day. When I was on Epclusa it seemed key to keeping the side effects (fatigue) down. Treatment will pass quickly I kept a daily log:

Before you know it you will be rid of the virus for good. Best wishes!

-- Edited by lamassu on Thursday 13th of September 2018 11:41:11 AM

Keep on chugging Mak !!! I'm rooting for you!

[video=https://m.youtube.com/watch?v=X3BoneLVUYg]

-- Edited by Iris Dragonfly on Thursday 13th of September 2018 12:39:54 AM

Hi Mak,

Congratulations on finally getting your treatment started. Diarrhea is common in the beginning, but shouldn’t be an ongoing issue. The important thing is to drink 3-4 liters of water everyday and take your medicine at the same time each day.

The first two or three weeks will be an adjustment period. Your body takes some time to adjust to the new medicine, so don’t be surprised if you feel kind of different. That happens to some people, but not everyone. Just stay on course and do your part, the medicine will do the rest. Good luck. 

Dont worry about your blood tests now. All of them will fluctuate during treatment. Things will steadily improve, so sit back, relax and slay that Dragon!

Mak,

If you have to/need to keep giving it some thought (about your RAV's) here are a couple more links to read - aside from the info Tig directed you to today (but these too are links we have already given to you in the past/directed you to via your other threads). I think at this late date and with the perfect treatment for you now at hand and it's start just days/hours away - i would give it a rest trying to learn every nuance about your RAV's - and just mainly concentrate on performing your treatment well and read if you must about how successful Vosevi is in general with any GT with any RAV's.

RAS Impact-Vosevi - that was a good basic one, sometimes it's good to re-read these things.

Also, here's another that was provided to you in one of your other threads ... https://www.infectiousdiseaseadvisor.com/hepatitis/hcv-variant-resistant-to-ns5a-inhibitors-susceptible-to-protease-inhibitors/article/567033/ ... note, near the bottom it indicates the new PI's (protease inhibitors) NS3/4A's (just what VOX is) in Vosevi, overcomes much of these failure problems of the past.

How are you feeling about things Mak, now that you are so close to starting? I'm excited for you. Your hepc worries will soon start being relieved now that you are getting Vosevi!

Do let us know what some of those recent labs of yours were.  C.

Tig,

Nah, I don't think Mak was being picky! heehee More like .... nervous, happy, excited, relieved maybe, like we all are, when we get near to our DAY ONE!  Mak's Day one is going to be a grand day alright!  C. 

Hi Mak,

I see today you were posting in what was intended to be a "general" informational thread about epclusa and vosevi, but being that your post was very much "in depth" personally about you and your RAV's and your soon to start Vosevi treatment, I am replying to you over here in a thread that might be better suited to carry you through your Vosevi journey.

You have had several threads going over the years, but it might be easier for everyone to keep coming back to the same place to pick up on your information seamlessly, without missing any of your details from other threads.

I am so glad you get to start your Vosevi in 3 days!! YAY! Long awaited - and you will see, it will work. I think you should just concentrate on doing everything you can to contribute to the success Vosevi will be giving you.

Taking your meds at the same time each day, with a meal, drinking lots of water throughout the day. Eating good nourishing meals, getting good rest, and going to the doc and for lab work when they tell you.

So, you never did answer us back when we inquired about if you finished getting your hep A and B immunity levels checked?? And what your current LFT labs were? ALT, AST, etc? You were having these labs done and another VL drawn and having your GT confirmed again - what were all these lab results?? 

Try setting yourself up a container (something like this) so as to encourage yourself to get enough water into you while you are on Vosevi.

Happy day one is coming.   C.

Dear Robertsmx. Thank you SO MUCH for your reply!

I wish you all good health. I will probably prefer to take it in the morning. And I hope I will be UND in the weak 2...

Hi Mak,

What kind of problems are you having? The discussions I have had with people taking Vosevi have all been very positive. Nobody mentioned experiencing any major side effects. The time you take your pill is up to you, as long as it’s at the same time each day and with food, preferably something with a moderate fat content. If you want to change your administration time, I would do it gradually over a week to 10 days, two to three hours at a time. Of course, you should talk with your doctor if you’re having problems. 

Hi Mak,

Hey thanks for the info about your kPa's and repeated Fscores (and the Cap score) - yes, indeed, with that many Fscores all saying about the same thing, you can feel fairly assurred that your liver firmness is NOT high - a very good thing. So is youth in your favour, another thing that will always be of good assist in your "for sure" cure, this time! 

I would not fret the treatment, I would be kicking up my heels in relief that you are about to start it soon!, you are very lucky to be getting it -  it is the very best thing for you - whether you have any sides or not!

Like I was saying before - use the "search" box above and enter the names of the 4 people (that I know of on the site) who have done Vosevi - and read their threads and see if you can discern what were their sides or not. For example "webtomass" (when you search his name) you will find he created 4 threads all about the sof/vel/GS-9857 (Vosevi) he took in trial - all four of his threads are good reading - here is one thread ... Enrolled in Sofosbuvir/Velpatasvir/GS-9857 clinical trial . Webtomass was a fairly young, healthy, VERY athletic/fit person who had not too many complaints about the Vosevi. But you should search and read all the threads here of anyone who has done Vosevi, aside from webtomass (myself, Pablito and robertsamx).

Nice your job is not too physically exerting just in case you do experience the odd day or some periods of feeling a little under the weather while on treatment. Is fatigue one of your current hep c symptoms? Do you have any hepc symptoms? - you rarely express how you have  been feeling.

The breakfast you normally eat (that you described) sounded OK to me as to qualify as a fat content meal, what with the fat content in the butter and cheese. Tig is right, don't over think it - it's good to make sure you are eating a mod fat content meal with your Vosevi, that would be the ideal, but even if moderate fat did not happen at every meal, then the dose (when taken with "a meal" or "with food", period) would still allow adequate amounts of the drugs to be absorbed. Tig is correct, just make sure you take the drugs with a meal, and just try to make sure there is some fat in that meal, and you'll be fine. 

As mentioned before, Page 25 Table 9 of the monograph speaks to how fat affects drug absorption.

So, what was the word about your hep A/B immunity status again? Sorry, what were your current labs? - have you had any current ALT/AST etc, back yet? Did you decide to hurry up and get your VL/GT drawn?  C. 

Mak,

If yellow cheese doesn’t agree with you, then eat anything that has a higher fat content. Peanut butter, any cheese, ice cream, yogurt, or a tablespoon of olive oil will even work. As mentioned, Vosevi will be adequately absorbed with any food, just take it with food. Research shows a higher/faster rate of absorption with something fatty in nature. Don’t overthink it. Take it with food and you’ll be fine.

Mak,

There isn’t a specific necessity to take your medication with a fatty food, but research has shown that these DAA’s are better absorbed when taken with a fat rich food item. The medication is adequately absorbed without it, but better absorbed with it. We like to think that any advantage we can give ourselves, the better!

A lot of the info is in the Vosevi monograph:

Download Product Monograph - Gilead Canada 

In relation to "food", see pages 22, 25, 27, 51.

In relation to "side effects", see pages 9, 51.

BTW, you said you already had an abdominal U/S done - did they note anything of any interest, see any kind of abnomality in your U/S?

And you mention you had a fibroscan, and that you are F1-F2 - I was wondering what the actual kPa measurement was (the kPa number they write on your fibroscan result) that is used to derive your F1-F2 level from. Do you happen to know what your kPa number was?

Please don't forget to confirm with your nurse and doc that they have finished assessing your hep a/b immunity levels.

Will you be working during your treatment? C. 

PS - you can use the search function box above and search members by name and look for their threads, posts and comments about their vosevi treatment - myself, "robertsamx", "Pabilto" and "webtomass". 

If your hep nurse and doc have directed you to go to a certain (particular) lab for all your blood works and VL/PCR etc., then they would know how soon the results usually return from that particular lab facility - ask your nurse and doc how long it takes to get results back so you can coincide with her "suggested" 2 weeks in advance of your SOT. Alternately phone the lab you will be attending for your VL/PCR etc yourself and ask them how long it will take before the results will be back at the docs' office - and plan your draw accordingly. Just common sense - hard for us to know (for sure) exactly how many days it will take for your labs to return to the doc office - I would not procratinate too long, just in case something unforseen happened and you had to have a re-draw for example (unlikely).

You better re-view the Vosevi monograph again (if you have not recently) as far as "sides" info - you may not get sides!(especially if you drink enough water) - but, you should be "up" on the monograph info anyway, especially about taking your Vosevi with a moderate fat content meal. You can think about the time of day you might want your dosing to occur, ahead of time, as to which meal of the day is going to be the best one for you to take your Vosevi with - an evening meal perhaps? Just think about it, and decide according to your work/lifestyle/diet, as to what would be the easiest/most convenient/most reliable time of day (and best meal) to take your Vosevi with. Some people who were afraid of sides (from any DAA)  thought they might avoid the sides if they took the medication late in the day, say with the evening meal and then try to sleep through any percieved sides, but i am not sure how effective a tactic this is - the meds are strong, they are in your blood stream all day long, and will be (in your case) for 12 weeks, the blood levels of the drugs will be some higher in your bloodstream a few hours after taking your dose, and then decrease slightly as you await your next dose - but this does not expressly coincide with any sides you may or may not feel. I took mine at lunch (only because I had to, being in a trial, that was the best time of day, given my particular parameters and restrictions), had I not had those limitations, i probably would have chosen the evening meal instead. When I took my luchtime dose of Vosevi, it was followed by a period of noticably loud but non-distressing burgling and gurgling in my stomache. As well, you should also re-review the monograph to make sure you do not take contraindicated drugs while on Vosevi. 

It is a lot of reading.

Download Product Monograph - Gilead Canada 

They can do a PCR VL and genotype in a day or two now. Certainly in less than a business week. It depends on how far the testing facility is from the lab drawing the blood. It used to take a week or two to get results back, but that has improved greatly. 

If you are sure your Vosevi start is planned for one month from now, then i would go ahead and get all the outstanding labs/tests done and completed now. A rough rule of thumb is they may generally ask that all your assesments be within 6 months current (minimum). 

Treatment should not start sooner than all of your current assessments being taken in to account by your doc.

So, if the doc has given you requisitions to have labs/tests done, then get them done. That way your doc will have all those results to assess you with so he knows where you are at prior to your start.

The tests you describe sound the standard fare that should be done for assessment. Most of these test results can be back to the docs office within hours, days, weeks. Ask your docs office how long it usually takes to get a GT back or a VL back- those sometimes take the longest. Once you have a copy of all your test results, please let us know what they are. Aside from the usual ALT/AST we would be interested in any of your LFT results of course. Bili's, AFP's would be good to know. 

Inquire whether they have finished assessing what your hep A and B immunity levels are.

Nice you will be starting soon. How are you physically feeling right now?? Are you feeling OK?, are you working fulltime?  C.

Hey Mac, very best wishes, hope to see more of your updates. 

CONGRATS 

HOO-RAY MAC!!!!!!!!!!! I am so VERY glad to see this post.  I can't wait for that day when that first pill has passed your lips! What wonderful news, and you've had to wait SO long for this. 

We'll see if anything new (any new news) has come up since we last chatted, I'll look and see, and post to you later if so. I think my last post to you was over in ... Trial for people who failed DAA treatment

So, if your start is only a mere month away, then your pre-treatment labs/tests/imagings must all been done and brought up-to date? Did they give you an abdominal U/S and a fibroscan, and what were these results? What are your current LFT's/VL?  

Really big congrats to you on getting your formal notification that you will soon be starting your Vosevi!. C.

I should have added this link ... SOF/VEL and SOF/VEL/VOX  - I just assume you have always been reading all the "vosevi-related" threads (all along)? All you have to do is type in a search word or two in the search box above and you can find all sof/vel or sof/vel/vox threads that way. Put in your name and you will pull up all the other threads you have started or that we have conversed on.