Blood Test Tox Screen and Pods

[edhorfin]

I'm seeing a new gastro doc for the first time this week. Was treated with Peg Intron 5 years ago and relapsed soon after discontinuing tx. I probably need to go back on Pegasys and would rather not tell the new doc about my pod use. If does a tox screen with the regular blood tests I know he'll order, how long will PT show up? Not a piss test, but a blood tox screen. Anyone? Thanks.

[candy]

Edhorfin-

I am not sure if your doctor can legally test you for opiates or other drugs without your consent. I believe he needs your consent to test.

Obviously if he asks and you refuse, it may answer his question regarding your drug use, but his concern is whether or not you will continue with treatment.

Many years ago, patients were only treated for Hep C if they were clean and off of all drugs. Even patients on Methadone, who were clean of all other drugs, were declined treatment.

Today, that is no longer always the case. Most doctors will start Interferon treatment with patients on Methadone and other types of drug treatment. One of the biggest reasons for refusal is that they have found that patients who are illicit drug free tend to comply with daily dosage regimens and will continue with full treatment. So compliance is a big issue and many doctors will request that patients be free of illicit drugs and willing to comply with the treatment.

I myself went through the Pegasys treatment and was able to finish and remain at undetectable levels. I know how difficult treatment can be and there were days I wanted to just give up. I was only on Methadone at the time and for myself, being clean of all other opiates helped to maintain compliance. I only had to worry about taking the prescribed meds and not the hassles of maintaining a habit.
I would encourage anyone else about to take that step into Hep C treatment to get clean first.

Pegasys, while it offers weekly injections, does have a lower incidence of side-effects but that can vary from person to person. Some sail through it with little side-effects and some have a more difficult time. And in my opinion, being able to concentrate on just the Hep C treatment, will help that patient have a better outcome.

You certainly have some control and you don't have to disclose your pod use. You could suggest to this new doc that you would like to get your personal life in order before starting treatment so that you can successfully complete treatment. This can mean anything and most doctors would advice that you have your personal life as well as other issue such as finances, in control before starting.

I realize it can be difficult to stop using. I have personally done it myself and failed many times, with more than a few relapses under my belt, but I am glad I went through the Pegasys treatment while I was clean and remain clean today for my own reasons.
I think it comes to a personal decision that you have to make for yourself. If treament is an option and offers a healthier and longer life span, than maybe getting off the pods is a good option for now. But, that is a choice that you have to make.

I know you only wanted to know about drug screening, but this is an important issue and I thought I would expand on it further having gone through Pegasys treatment myself. If treatment is available, I suggest you consider all your options!

But, I think your doc needs your permission to test!

Good luck!

[edhorfin]

Thanks, Candy. I met with him today. Start tx end of week. Will try tx without pods, my pod use is occasional, rather than daily.

Interesting article last week on coinfected patients in SF. Patients who used MJ regularly had a higher compliance and completion rate than those. I can forward the link if you like. My side effects with PegIntron combo were pretty lousy for a couple of days after injection. Should I expect the same with Pegasys? I've read they're similiar, maybe spread a little further with less intensity.

Thanks again.
Ed

[candy]

Thanks, Candy. I met with him today. Start tx end of week. Will try tx without pods, my pod use is occasional, rather than daily.

Interesting article last week on coinfected patients in SF. Patients who used MJ regularly had a higher compliance and completion rate than those. I can forward the link if you like. My side effects with PegIntron combo were pretty lousy for a couple of days after injection. Should I expect the same with Pegasys? I've read they're similiar, maybe spread a little further with less intensity.

Thanks again.
Ed


I imagine you are referring to marijuana. Co-infected patients tend to deal with more side-effects because of the drug "cocktails" they take. Nausea, decreased appetite, pain, insomnia, just to name a few can be decreased by marijuana.

You may have the same side-effects with Pegasys, it is hard to say. Maybe not as intense. One of my main side-effects was having no appetite at all. I lost about 25 pounds and was down to about 95 lbs just before I completed treatment. I looked worse than I did when I was at my worst with the heroin use.
Needless to say, I took off work during that time. Kind of scary to the patients when their nurse looks worse than they do.

Your doc may have suggested doing your injections just before the weekend starts if you work. I am still at undetectable levels. I would go through it again and although some doctors say once is enough, research has shown that some with Hep C can have better success the second time.

Just stay positive and stick with it. Not sure what your financial situation is, but I suggest disability if your doctor says he will do the paperwork. Why not if you can afford it! Better to take care of yourself and decrease the stress while going through treatment.

Let me know if you have any questions. Pegasys or Roche has a website that has some good info and reminders to take meds, online support, and all that related to Hep C. Check it out!

[edhorfin]

During my last tx, I took the meds on Saturday night, the logic being that Saturday was the day I'd feel the best, and be able to share in family activities, etc. Sunday was pretty much like the flu, low grade fever, etc, moday a little better, etc. I plan on doing the same for this round. Were you referring to state/federal disability? I'm not working right now, so I don't have insurance through my employer, however I am covered for the tx through my wife's medical insurance family plan. I don't think it offers disability for anyone other than the employee, though. Most don't in my experience. I've researched all the sites, including Roche's, and appreciate the info. I'm just praying for SVR. My genotype has a better SVR rate (I'm a 3). My fibrosis is level 3 ish and if this tx doesn't hold up and I relapse, I'll probably have to go on long-term low dose IFN, which is an idea I don't relish. But if it means I'll live to see my 8 year old graduate high school or college, then what choice do I have.

My doc and I discussed the anti-retrovirals (protease inhibitors) in long term in case of relapse, which weren't available 5 years ago when I had my first tx. He said the treatment model for HCV will probably eventually look like the HIV protocol, even though HCV is RNA vs DNA for HIV. The protease inhibition mechanism is apparently similiar for both viruses.

Thansk again.