Quick followup -- Undetectable

Still undetectable. That's a good thing. For practical purposes, I'm cured. Anticlimactic, but I'm not complaining. Kids are well. Oldest married and teaching elementary school. Son is, well he's getting there. Some job and education setbacks, but nothing serious. He'll get there. Youngest started college. We're officially empty-nesters. Occasionally notice how quiet things are, but then get called off to something else. Life is good. No complaints! Best to all.

Two years? Really??

Those people at Google are updating things and I discovered an email urging me to recover my blog. It took a bit, but I finally got in. Since I'm here, I may as well give a brief update. If you've followed this journey, you know that I appear to have beaten the bug. Hoping that's still true. I dropped a blood sample off at the lab yesterday and I have an appointment with the GP for a physical next week. Nothing has led me to think that the bug is behind me. Knocking on wood nonetheless.

I've mentioned my friend Ken here. He is once again in treatment. He has Genotype I and it came back on him after the first go-round. He took a second shot at the beast with Infergen shortly before I started treatment. It put him in such a horrible mental state that he had to drop after a few weeks. I saw him the other day and he's once again in the midst of the fight. He's using a new regimen — Telaprevir? — and the outlook is good so far. The virus was undetectable after three months which could mean a shorter time on treatment.

My life post-treatment has been busy — making up for lost time. Eldest daughter got married last year to a great guy who we are happy to claim as our own. Ten days before she got married, I got a layoff notice from my employer. They are well-known for calling their layoffs "Resource Actions." Google it and you'll know where I worked. It being too close to the wedding to do anything different, I kept my mouth shut and had a great time. Less than a month later I had a new job doing very close to what I had been doing and making more money (plus, got to bank the severance). All things work together for good. Son is still at school, but having second thoughts about finishing. College isn't for everyone and he's not sure what he wants to do. See above. He'll be fine. Youngest is off to college in the fall. At that point Wife and I will have the house to ourselves. I'm sure we'll find something to keep ourselves busy.

In all these post-treatment check-ins I have tried to encourage anyone reading who is on or contemplating treatment to be encouraged that people disappear from the forums. There is a world out there, and if you spend a year on treatment, there's much to be done. Hang in there. There's an end to it and it can be a really great one. Anyone in or facing treatment should feel free to drop a line. My somewhat-obfuscated address is fretblog (commercial at) gmail. If I start getting spam at this address, I'll hide it again.

I'll check back here when I get my results back. I have every reason to remain optimistic.

Best

Chris

Check-in after a long absence

I loathe spam, spammers, and everything related to them. But "all things work together for good." A spam comment prompted me to open this blog for the first time in over a year. Since I'm here, I may as well check in.

I've been over to visit my friends the Nomads a few times. My recurring theme there is that the reason you see so many folks who relapsed in the forums and on the blogs is that they are still fighting the bug. We who are fortunate enough to have beat it are making up for lost time. It's a full time job.

The three years since I completed treatment have been busy. Elder Daughter is in her junior year at Northern Arizona University and got engaged on New Year's Eve. Wanna-Be-Son-In-Law had the talk with me at the shooting range. I had ready access to lots of weapons and we both survived, so I guess he'll do.

Son is in the Marine NROTC program at the University of Arizona. He has this notion that he wants to crawl through the mud with a knife in his teeth. So we go north to see one, south to see the other. It's a hassle.

Youngest is a sophomore an high school and gets lots of attention. She just finished her season as a cheerleader and wants to take a tumbling class. Cheerleaders get hurt. They throw them around over a wood floor or a track. Youngest weighs about 90 pounds, so she's the one they fling around. She also expects to start driving this year. I'd swear she was eight years old last time I checked. Henry David Thoreau: "A father's life is one of quiet dread."

The big event for me since completing treatment is gathering a collection of my dad's writing into a book. We lost him to colon cancer the year before I went on treatment. Two rough years, '05 and '06. He was a magazine editor who moved into political stuff. He was well-known in his field and what he wrote remains important today. The book was something he and I had talked about for years. I had been working on it off and on for a couple of years before he got sick. I didn't do much on it during the year he was sick because I was attending to other matters. I had just picked it back up when I found I needed to go on treatment. Frankly, I think it's a better product for the hiatus. Feedback has been good, although sales are slower than I'd like. It's getting some good reviews now and I think it will pick up.

If you've been touched by HCV, best of luck and blessings. You have my prayers. If you have questions for me, post a comment here or PM me (I'm cwk) in the Nomads forum.

Come to think of it, Doc wanted to see me this month. I think he's going to want another PCR. So, something else to talk about here.

All best,

Chris

"Suburban Mom" says...

suburban mom said...

update:
I am genotype 3a and I saw the GI doctor yesterday. He was very encouraging. I will most likely start treatment after Christmas.

Your time frame is similar to mine. Yes, good idea to wait until after Christmas. A poster on one of the forums commented that treating Hep C is not an emergency. It's a slow bug. That's both a blessing and curse. It's slow and insidious. More like a leak in the basement than a fire in the attic. Frankly, it's much better suited to the state of our medical arts. You have time to put things in place. I'd suggest getting long term disability insurance lined up if that's an option. That, and getting regular blood tests were the only overt actions I took when I learned I had been exposed to the bug.

Note that I say I learned I was exposed to it -- I never had a viral load test or showed any symptoms until August of 2005. I had a life insurance questionnaire that asked whether I had ever been diagnosed with any liver disease. I accurately answered in the negative. I had never received a diagnosis. I knew I had been exposed, but at the time I filled out the form I had no symptoms and was, as far as I could tell, virus-free. Maybe I split hairs, but I think it was an accurate statement.

'Burb Mom, having genotype 3a, you're in a lucky group. It typically indicates a 24-week treatment, although that may change with your situation. Basically, your bug is easier to kill, so be thankful small favors. As we head into October, typically the time that Americans make their insurance arrangements, you might also consider putting some extra dollars in a health care reimbursement account. Better to pay for the likely extra medical expenses with untaxed dollars.

Good luck with treatment. I'll be following your blog, so keep it updated.

Chris

Still in my undies...

Just posted the following to the Hep C Nomads Forum and to the UK Forum

Hi all --

Haven't been here in a while, partly because I had no new news, and partly because I've been crazy busy. But I wanted to share this. I dropped off the sample for my 18-month post tx bloods a couple of weeks ago and just got the call from Doc. UNDIE-tectable! Doc, being a conservative fellow, says I'm "still in remission." I look at it like this: It's gone. It's stayed gone. There's nothing to make me think it will be back ever! I'm done and I feel great. No significant souvenirs of treatment that aren't attributable to the calendar.

To those facing the start of treatment: You have to make your decision based on your situation, but I'm proof that there are good outcomes.

To those in the throes of treatment: Hang in there. There's a finish line and it's worth the work to get there. This bug is beatable, but you have to do your part. When you really start feeling sorry for yourself (you do, admit it!) consider the blessing of being reminded of your own mortality without having to actually face it.

To everyone dealing with this disease either directly or indirectly: There are good results. Keep in mind that this group's post-tx crowd is skewed toward those who didn't have a good outcome. They're still feeling lousy and still need and deserve support. Those of us who have been blessed with a successful outcome have the opportunity (not to mention the responsibility) to make up for six months, a year or more of being out of commission.

All best,

Chris

Not much else to say. The kids are great, Spouse is going crazy with her new job (office manager in junior high school). Eldest is away at school being a dormitory Resident Assistant (kind of a designated adult/babysitter) and Orientation Leader (sell the school to prospective students). It's paying for this semester. She has gotten very serious with a young man we've known for a while. And they're up there with no curfew! Difficult for a dad to get his head around.

Middle (aka Son) is a senior in high school. He is the student body president (as was Eldest) and is playing football. We're having the doors widened so he can get his head through them.

Youngest has also decided to follow the example of the older two and entered school politics as freshman class president. I showed her the "Destiny" clip from Young Frankenstein. Spouse and I wonder at the wisdom of her taking on student government. She's the smart one of the bunch and is in lots of advanced placement classes. "Stugo" takes a lot of time out. On the other hand it's fun and keeps her from burrowing too deeply into the books.

On the whole we've got things down to boring. I'll take boring. Guess that's the definition of middle-age: you learn to appreciate boring.

Physical Time

Went in for my annual a couple of weeks ago. Blood pressure and such were all normal; cholesterol was a tad high, which is new to me. Going to work on that. I've been eating like my teenage son and have not been exercising as much as I should. The really good news is that the liver panel was normal. I have an appointment with the gastro doc this month and will be getting another PCR (virus count -- see previous post).


I spent last week in Colorado in business meetings and classes. I work for a big technology company you've definitely heard of. The team of guys who do what I do are scattered across the country and we all work on separate projects. We rarely get together, but had an opportunity to have an intact team class. I recounted the last time we got together in a previous post. That was a rough one. I had not seen most of these guys face-to-face, including my boss, in nearly two years. Several comments from the guys. They knew I was going through something and that I was pretty weak last time, but I didn't advertise what I was dealing with. They knew I was kind of a mess from the way I got lost, and from my appearance. What a difference this time. I ran 2+ miles on three of the five days I was there. Much better! I think the PCR test later this month will bear out how good I feel. Sure hope so, anyway.

Long overdue check-in

I recently got a note from a member of one of the Hep C forums asking me to check in. As I had pointed out in the past, those of us fortunate enough to see SVR often disappear. Consequently, treatment veterans on the boards tend to be those who have relapsed. That skewing of the sample can be discouraging to those who are going through treatment. So, I paid a visit. I had nearly forgotten the vocabulary list below. I wrote it while on treatment and they posted it at the top of the board.

There's been some kind of rift within the two major UK-based Hep C boards. Not having a dog in that hunt, and having friends in both places, I herewith ignore it.

Anyway, here's the list:

Hep C Vocabulary

acetaminophen -- North American generic name for paracetamol. British and other European countries trade name Panadol.

AD -- Anti-depressants. Depression can be a significant side-effect of treatment. Hepatitis C patients often take anti-depressants to counteract the side effects.

ALT -- Alanine aminotransferase. One of the markers for liver inflammation. Typical (non-HEP C) values: Men--10 to 32 IU/L, Women--9 to 24 IU/L. The normal range is 5-40 IU/L, although the numbers can vary.

AST -- Aspartate aminotransferase. One of the markers for liver inflammation. Typical (non-HEP C) value 8 to 20 IU/L, although the numbers can vary.

bx -- Biopsy. Broadly, a diagnostic tissue sample. In this forum it almost alway means a needle biopsy of the liver. A thin needle is inserted into the liver and a small piece examined microscopically. From the biopsy a determination is made of the extent of liver damage. Results of the biopsy are expressed as the HAI score (see HAI score below.

dx -- Diagnosis. In the context of this forum, it specifically means the Hep C diagnosis. Diagnosis is not necessarily the same thing as being positive for antibodies. A certain percentage of people clear the virus and so their diagnosis is negative, even though they have and will continue to have the antibodies.

EVR -- Enhanced Viral Response. A treatment milestone, usually meaning that virus levels have dropped to a point where there is a good chance of a cure.

genotype or type -- Strain of the hepatitis C virus. Several strains or genotypes have been identified. The identification is a number, sometimes followed by a letter. The difference between the letter subtypes is generally academic. There is no difference to a patient whether he or she has type 1a or 1b, it's still a 48-week ride. Genotype 2 and 3 are usually treated for 24 weeks, although some doctors go longer given medical history. Genotype 4 is rare outside the Mideast, although it is widespread in Egypt. It is treated for 48 weeks like Type 1. There are rumblings of more Genotypes out there, but for the patient, the details of the differences are probably academic. It's the same program -- so far.

HAI Score -- Histology Activity Index. A standard system of grading the level of inflammation and scarring in the liver based on a biopsy sample. The HAI score is expressed as two numbers between zero and four. One is given for the level of inflammation, the other for the level of scarring.

HCV -- Hepatitis C Virus. A blood-borne viral pathogen that causes Hepatitis C. Probably the reason you're reading this.

HGB -- Haemoglobin/Hemoglobin. The red part of red blood cells. Part of the Complete Blood Count numbers. Ribavirin tends to depress hemoglobin counts which results in anaemia/anemia.

Howdjuhgiddit? -- "How did you get it?" A rude question. Sometimes asked innocently by well-meaning people, sometimes asked by the morbidly curious who want to know whether you're a closet junkie. How you answer can depend on your mood, your threshold of rudeness, and your willingness to share your medical history.

hx -- History. This is medical chart abbreviation that occasionally makes it into the forum. It is also what people are asking for when they ask Howdjuhgiddit?

ifx or ifn -- Interferon. There are two major brands. Pegasys, manufactured by Roche, and Peg-Intron, manufactured by Schering. Both products are about equally effective, although anecdotal evidence indicates that where one is not effective, the other might work better.

LFT -- Liver Function Test. A blood test that measures various liver-related enzymes in the blood. Also sometimes called a Liver Panel.

neutrophil or "neuts" -- A type of white blood cell. Neutrophils are critical for fighting bacterial infections such as staph or strep. Interferon tends to depress production of neutrophils.

paracetamol -- British generic name for acetaminophen, North American trade name Tylenol.

PCR -- Polymerase Chain Reaction. A test for presence of the hepatitis C virus. There are two types of tests. The "qualititatve" test is a yes/no determination of whether the virus is present or not. The "quantitative" test estimates virus particles per milliliter of blood.

RBC -- Red Blood Count. A measure of red blood cells or haemoglobin/hemoglobin. Normal values are Male: 13-17 (g/dl) Female: 12-16 (g/dl). Values below 10 are cause for concern.

riba -- Ribavirin. An anti-viral drug that has been found to enhance the effectiveness of interferon in fighting the hepatitis C virus.

RVR -- Rapid Viral Response. An inordinately early negative result to a four-week PCR. When the virus is undetectable at four weeks, some doctors call that patient a "super-responder." It might make the patient a candidate for shortened treatment, but RVR status is only one of many factors to be considered. At the very least, it's good news.

Rx -- (Chiefly American) Medical shorthand for Prescription

score-- See HAI Score

SVR -- Sustained Virological Response. The goal of treatment. A medical hedge word used when they don't want to say "cured." A negative PCR six months after treatment is considered an SVR in the UK and US.

sx or sides -- Side Effects. Side effects from treatment can range from none to mild to debilitating. Effects can be mental such as "brain fog," or difficulty concentrating, emotional, such as depression, irritability, physical such as fatigue, headache, "flu" symptoms, or clinically measured such as low white blood cell counts. No one can predict when, if, or how long side effects will appear.

sux -- What sides do.

type -- See genotype.

TV or telly-- Television. Something you will be watching a lot of while you are on tx. Other terms and acronyms you may become familiar with during this period are DVD, VHS, CBS, ABC, NBC, HBO, CBC, BBC, and Tivo.

TX -- Texas. Postal abbreviation for the State of Texas. Not to be confused with tx (lowercase) which see below.

tx -- Treatment. Specifically the 24 or 48-week combination therapy usually consisting of once-weekly subcutaneous interferon shots and twice-daily ribavirin tablets.

undetectable -- The positively great news that the PCR test is negative. The virus, if it is present at all, is in such low concentrations that the test can't find it.

VL -- Viral Load. The presence of the virus in the blood, usually expressed in number of particles per milliliter of blood. Determined via a quantitative PCR.

WBC -- White blood count. A measure of white blood cells in the bloodstream. Interferon can depress white blood cells. Normal range is usually expressed as a number between 4 - 11, but the decimal point can move with your location.

Thanksgiving Week

Discovered I had left the previous update in a draft state when I posted it two weeks ago. Back from the business trips and the hunting trip. Son got his deer, I missed my shot (it's been replaying in my head for days). I now count the miss as an act of kind providence as we were more than a mile from camp and had pack out the quarters -- two rucksacks at I'm guessing 40 pounds each. Lot of work, not to mention a mess. I'll spare you the details.

Much to be thankful for this year. I have a new appreciation for feeling good. I know that not everyone gets this blessing, so I'm especially thankful that I'm able to undertake some pretty strenuous challenges. Thinking about a marathon next year. I've fallen off my running lately and need to get back to it.

Happy Thanksgiving,

Chris

Checking In After Three Months

A comment to the previous post brought me back, so I may as well check in. Yes, I'm in a hotel again. A new project, a new nightmare. I'll say it's a mess and leave it that.

I'm due for another liver panel this month. I'm not worried about it.

I've spent the past six months making up for a year with my life on hold. I'm working to bring a book into print (unrelated to both work and Hep C) and trying to get home projects taken care of. That's difficult now, as I'm paying for the bye year from work. Lots of air miles these days. I was looking at my calendar for the rest of the year and I'm back to back. I've been in Tennessee for the past two weeks, going home for the weekend. I'm taking a couple of days to go deer hunting with Son and so won't travel next week (historically, Bambi is pretty safe). The following week is Thanksgiving, after which I have two classes for two consecutive weeks. After that, I'm back here to see what's happened on the project. Who knows what happens after that.

I have to get some work done for tomorrow. To those on treatment, blessings and best wishes. There's an end to it and you can get your life back. That life can be overwhelming at times, but it's sweetened with a new appreciation for health.

SVR

I went to see the doc last Wednesday. I had returned from a business trip and dropped off a blood sample, but the PCR took too long. The ALT and AST liver enzymes were 16 and 22 — which is which is irrelevant — and the red and white count levels were normal.

But the real news came in a phone call fifteen minutes ago. Undetectable.

Doc says I'm in remission. He's hedging by calling it "remission." He said that he's seen it come back even after being gone for months. Maybe so, but what I've read leads me to suspect it might be re-infection.

For practical purposes, I'm done. I see a few residual signs of the fight, but how many fights do you go through without some scars? I'm functional. I have my life back.

Thanks to those who have followed my fight here. The encouragement and advice have been invaluable.

If you're coming to this because you or a loved one are facing the disease, hang in there. This is a beatable disease. There's an end to it, and it need not be a sad ending. I'll leave this blog up and will check in periodically, but its main purpose is fulfilled.


All best,

Chris

No updates since April???

Wow! I've really let this thing slide. Naturally, I'm traveling on business again. It hasn't been constant — I didn't travel at all during May and June. Eldest graduated from high school, and was appropriately feted. She's going to Northern Arizona in Flagstaff. I'm hoping to see her take college a little more seriously than she did her high school classes. She took school very seriously as far as student council and prom planning went. But those pesky classes... Now that she's starting out life in debt, she's beginning to get a glimmer of why we nagged and bitched at her so much when she was slacking in her freshman and sophomore classes.

The deal is that we've financed the first year. It's now up to her. Scholarships and her own work and credit. Actually, I think she'll be a better college student. She's certainly smart. And she either has us totally snowed (always a possibility) or she's a very straight arrow. I went around the block far enough to know what being drunk, stoned, or otherwise altered looks like. I've never seen it in any of my kids. And yes, I look for it.

Anyway, here's where I am with the bug. I'll be dropping off a blood sample as soon as I get home on Friday for my would-have-been six month PCR. I had a liver panel and CBC a couple of weeks ago. The doc had not ordered a PCR. I nearly circled the PCR on the lab order form. Called the doc from the lab, but didn't hear back from him until the next day. "Yes, it'd be a good idea to get that...." Brilliant. Anyway, all the rest of the bloodwork looked good, so I'm pretty hopeful. I've even allowed myself the occasional beer. I even had one this evening — along with sushi! I'm totally out of control. I think that's like four since May.

Back in February I ran down my list of sides. Here's an update for the record.

• The Itch

What itch? I'm still taking Claritin, but that's for a constant "harumph" and sneezing. I've always had a touch of allergies, although they seem worse now than they were years ago. But that's common for Phoenix residents. Recovery: 100%


• Hair

My hair is much darker and definitely thicker. Oddly, it's now straight. When I it puberty it curled up and stayed that way. Not curly like a Black person's hair, but definitely wavy. Recovery: 80%


• Nails

My nails are far stronger, but they do tend to crack more than they did. Recovery: 90%


• Brain Fog

I've been amazed at what I had trouble doing before treatment. I work in the computer industry and in my business, if you aren't on the front end of a learning curve in some aspect of your job, you are going to get passed by. I'm reading books again (e.g. Shirer's tome Rise and Fall of the Third Reich, something I've tried unsuccessfully to wade through in the past). In retrospect, the cognitive effects were the worst. I'd revise my previous assessment. I was about 60% then. Recovery: 90%


• Fatigue

I really think this one has gone. I feel good. I don't have that overwhelming "blah" feeling. Recovery 100%


• Mood

I'd now describe myself as a happy person. Frankly, I have few excuses not to be. My friend Bob, who rode through this thing with me described himself as less willing to tolerate bullshit. I'm not so much intolerant as willing to laugh things off. Recovery: 100+%


• Sleep

I sleep well. I still stay up late. I'm far less able to fake it than I was, but that isn't an entirely bad thing. If I get less than seven hours of sleep, I pay for it. But at least I can sleep, and the sleep refreshes me. Recovery: 100%


• Diet and Appetite

I think I'm recovered here. In fact, I'm having to dial it back. I want to drop about five pounds. Recovery: 100%


• Exercise

Still not enough! I have a year's worth of sitting on my (widening) ass. I need to make some lifestyle changes and schedule time for exercise and do it. On this trip I've been off and on. Need to get back on. I'm certainly not limited by anything physical. Recovery: 100%


• Aches and pains

Done with this one. The aches and pains I have these days are pretty identifiable (often traceable to people I work with). Recovery: 100%

Summary: I'm not in bad shape for the shape I'm in. I turned 50 two weeks ago. There was a time that I thought 50 was pretty old. I've seen 50-year-olds who certainly looked and acted older than I feel. I just need to continue in that vein. I'm hopeful about the PCR test, and not terribly anxious. If it's back, I evaluate. I don't think it is though.

If you're reading this from the depths of treatment, there is an end to it. The recovery, while not instantaneous, does come. Hang in there.

Okay, Enough Nagging

My Uncertain friend wants an update. I am capable of updating this blog outside of airports. To prove it, I am presently ensconced in my own office chair in my own converted dining room home office and typing on my vintage 1984 IBM Model M "Clicky" keyboard. I bought it on E-Bay a couple of weeks ago because my hands were killing me from typing on my laptop keyboard. I briefly considered taking it with me on my last trip, but decided against it. Th thing weights about six pounds (three kilos). This is as close to a perfected machine as we have in the IT industry.

And of course, it's obsolete.

I've been in this industry long enough to be a curmudgeon.

Dodgeball

But dear UC wants to know about family and kids, being as how she can no longer read minds. The kids are great. Winding down the school year. Eldest is committed to NAU. I cut yet another business trip short last week to referee a dodgeball tournament at the high school on Firday. Eldest and Middle (aka Son) are in student council and had come up with the tournament as a fundraiser. A fun, but exhausting evening. The team registrations paid all their expenses ($40 per eight-person team and they had 20+ teams) and they committed the door receipts to a charitable cause, the family of a kid in Middle's sophomore class who had turned up with leukemia (of which more shortly). The concession was their fundraiser and netted them over $600 which made it a decent night's work.

Rough Treatment

We've known the kid with leukemia for several years. Son played Little League baseball with him. He was playing in a baseball game and started feeling bad enough that the trainer told his dad to take him to the ER. I would not trade 48 weeks of treatment for one day of what those parents are going through.

As for the kid, well, we all know that hep C treatment is long and grueling. To those on treatment: when when you start feeling sorry for yourself (and you will), consider what this kid is facing.

• He has one of those ports installed in his chest where they can dump chemicals directly into a major artery because the stuff is so toxic it will destroy veins.



• He has lost his hair. Not thin hair, no hair.



• He is on massive doses of steroids giving him a moon face even though he's lost twenty pounts.



• His white blood count was so low last month that he was confined to two rooms of the house. Anyone entering had to leave their shoes at the door and wash up. If he went out, he had to wear a mask



• Oh, and his treatment calendar? Three years.

I know what treatment is like. I won't minimize it. But, it's a piece of cake compared to full-on chemo. Never forget that. If I have to face a potentially life-threatening disease, hepatitis C is my first choice.

I'm putting my foot down and I won't travel for the month of May — and will probably get more done without the overhead of traveling. Our anniversary is coming up next week (21 years! Our marriage is an adult!). Of course we won't be doing much to observe it until maybe June. Youngest is in a musical and Eldest is graduating from high school. Family and friends, and all that.

With that, I'm out of here. I have an 8:00 AM Eastern Daylight Time (that would be 5:00 AM Arizona time).

Friday the 13th

I'm traveling on business again. I've been to the Richmond, Virginia area three times in the past six weeks. And I'll probably be back again. I'm rusty at this road warrior thing. There was a time I did it pretty regularly as an instructor, but for the past ten years or so I've stuck pretty close to home.

Much has changed.

First of all is the process of traveling itself. I'm old enough to remember a time when you walked straight from the ticket counter to your flight. The advent of metal detectors provoked predictions of the death of American civil liberties and the Fourth Amendment. The Fourth Amendment didn't die then, but it started getting sick then.

I don't think the current practice of a partial strip-search would bother me quite as much if it made me feel any safer. It doesn't take too much imagination to cause lots of havoc on an airplane that might not be detected by current methods. Conversations with a friend who took a temporary job screening baggage for TSA have done little to ease that concern.

Nothing to do about it.

Today is Friday the Thirteenth. I've been operating on the assumption that things will go worse than they have so far.

I cleared out of my hotel this morning and had that sinking sensation that I'd forgotten something. I could not find my jacket anywhere. I remembered taking it off in the restaurant the night before. Aw shit moment.

Go back to the restaurant. Nobody there.

Back to the hotel check the room. Not there.

Check the car. Not there.

Dial into a conference call on my cell.

Call the restaurant. They don't see it.

Another conference call.

Sudden realization: It's in my suitcase. I remembered hanging it up.

Get my jacket and go to the customer site using my handy little navigation feature on the phone. Make a wrong turn despite the navigation tool. Realize it just as the navigation thing tells me to turn around.

At the airport. Eat lunch in the Appleby's at the airport. Get my computer out and do a bit of work. Finish lunch and walk out with laptop. Sudden stop and return to get case from under table.

Boarding the airplane at last. But first, I can't tell my seat from my gate on the boarding pass. A nice young lady takes my pass from me and tells me where I should sit with the same caring look that I might give as I hold the door for my grandmother.

At the connection. Where's my boarding pass for my connecting flight? No, that's from my last trip. Get the current one. Check gate information. Good. Throw away boarding pass (that's speculation -- I just can't find it). The gate agent printed a new one. Might have been even more interesting if I hadn't put my drivers license back in my billfold before losing the boarding pass.

I'm still in the air. There's plenty of time for things to go wrong, but I'm not going to borrow trouble. Besides my battery is low. In more than one sense.

April 18 Post-Trip Addendum

I survived. The plane arrived an hour and a half late. We were dodging the weather in the accompanying picture. I've flown on all kinds of planes, big and small. We were above 35,000 feet (10,000 meters) and the clouds out the window were a good 10,000 feet (3,000 meters or more) above us. The pilot confirmed my guess.

Was all this the aftermath of treatment? Or did I just have my head in my ass? It's really hard to say, and it probably doesn't make much difference. I have to go back next week.

Back Home — For Now

My business trip to Virginia got extended into the following week (Valentine's week — yeh, that went over big with my wife). I spent the weekend with family, and then returned to the job site on Sunday night. I had a commitment to take my daughter to a university open house this past weekend, plus an appointment for a physical on Monday (today, as I write), so I put my foot down. I had to be in the air going home on Thursday and would not be returning until late this week (the week of February 18), or better, next week. I hope to push the trip out to next week. I have what I need to get started, and all the standing in security checkpoint lines and riding airplanes is time poorly spent.

Medically, I think I'm doing well. This physical today will tell the tale. I've mentioned a few lingering side-effects with how much I think I've recovered. The Recovery percentages are compared with how I felt before treatment. Purely subjective, but perhaps useful for comparison.

• The Itch
  An annoyance. This is actually a recovery from a recovery symptom. I'm taking an anti-histamine (Claritin). When I back off the anti-histamine, the itch starts again. Even with Claritin, I get bumps similar to mosquito bites that come to a head and leave little sore — much like a mosquito bite that's been scratched. I also have gotten a few mild canker sores in my mouth (never more than one at a time, and never especially bad), which I suspect are also related. I never had any significant skin issues on treatment, so this all came as a bit of a surprise. Recovery: 50%
  
  
• Hair
  I don't know whether the nails and hair issues stem from interferon or ribavirin. Since it takes a while for the drugs to go away, and then for the hair and nails to grow out, it's not surprising that these side-effects linger. The strange effects on my hair are definitely present — it's all thin and wispy. But my wife and kids swear that the hair on my head is getting darker. I've read other reports of being able to see new hair with a different texture coming in. I haven't seen that yet, except for my beard which is definitely changing. My would-be mustache is darkening and getting more coarse and the dark whiskers seem to be spreading. It's like puberty all over again. Recovery: 10%
  
  
• Nails
  My fingernails started getting thin and brittle several months into treatment. I just learned that fingernails grow at about 0.1 mm per day, or a centimeter in 100 days. So it will take about three months after the drugs work out of my system for fresh nails to grow in. Again, an annoyance. I have to keep them cut short as they tend to split and the split can work its way down into the quick. Recovery: 0%
  
  
• Brain Fog
  I'm a reasonably bright guy, but I've always been easily distracted and not terribly disciplined. I'm still dealing with that. On treatment I had a very difficult time focusing. I'm still having some of that. Case in point: I'm playing with my blog and really need to get back to reviewing a proposed solution that our enthusiastic sales team has concocted. But that's boring and not nearly as fascinating as my treatment adventure. Recovery: 80%
  
  
• Fatigue
  I think the main issue here is my bad habit of not sleeping enough (five to six hours per night) coupled with a sedentary lifestyle for the past year. One thing I've learned is to nap, however that's been tough while I've been on a Death March travel schedule. Toward the end of the day, I find myself fading and not paying attention well. Recovery: 75%
  
  
• Mood
  I went off my anti-depressant at the same time that I quit the rest of the medication. I was on a pretty light dose anyway. My family says I'm more fun to be with. I certainly do better in social situations. I no longer tear up at the slightest provocation, which is a relief, although I think I'm still a little more emotionally sensitive than I was at the start. I also think that being in a better mood, I may be more creative and more willing to explore possibilities. Recovery: 90%
  
  
• Sleep
  I still have trouble falling asleep. That's normal for me — I tend to ruminate when I go to bed and it's often difficult for me to fall asleep unless I'm dog tired. That has been a fact of life for me for years. Where I've gained some ground is that I'm more willing to take a nap during the day. I'm more aware of performance falling off. If I'm able, I take up a prone position on the couch. If not, I at least shut up, as I sometimes get kind of manic when I get tired. Recovery: 100% Plus
  
  
• Diet and Appetite
  My diet was pretty good going into this adventure and it hasn't changed significantly. What has changed is that the metallic taste has disappeared and I no longer have to force lunch down. That's a relief. I do seem to have a bit more of a sweet-tooth than I had previously, and I don't crave fruit like I did while I was on treatment. That's bothersome, particularly having a suddenly heavy travel schedule. At the very least I need to be aware. Recovery: 85%
  
  
• Exercise
  Not enough! But I'm certainly more capable of exercise than I was back in December and January. I can get on an elliptical trainer and get my heart rate up to 185 or 190 in about 15 minutes and keep it up for a half-hour. I haven't started running yet. I expect to get clearance to run today. I have an appointment for a physical today that should include things like an EKG and probably a pulmonary function tests. Recovery: 75%
  
  
• Aches and pains
  Adding this later. I had nearly forgotten it until I took my daily dose of ibuprofen or acetaminophen. I rarely took either prior to treatment. It isn't bad, but it's definitely there. Joint pain, headache, undefined discomfort that goes away as the analgesic kicks in. Like virtually everything else, I'm not miserable. But I know I'm not all the way back. Recovery: 75%
  
  

So that's where I am as of February 19. I was fortunate to have mostly moderate side-effects all the way through treatment and feel like I'm being blessed with an easy recovery period.

If you're interested enough in this sort of thing to read this far, then you must be dealing with treatment in one fashion or another. Hang in there. There is an end to it, and even if treatment doesn't kill the bug, there are long-term benefits to giving the liver a chance to heal. The fact is that we're all going to die. Winning in this case is defined as not dying of liver failure caused by Hepatitis C. A knockout is cool, where the treatment kills the virus, but it's also possible to win on points. Many people die with the virus but not from it. Thar's a win as well and treatment improves the odds.

In the air

I'm traveling on business. I was trying to work on some drawings, but the turbulence on this flight is too bad to do anything that requires working with a mouse. So, I'm writing this in a text editor that only requires hands on a keyboard.

This is my second trip in three weeks. Last month I was in Chicago and Milwaukee. I've been working on that project since July. It was a slow-motion train wreck, but seems to be getting better. The solution sold to the customer was impossible. Neither the customer nor the sales team talked to the technical teams. Hint: To move a data center you don't back a truck up to the old data center, load it up, and ship everything 1000 miles to the new data center, and move everything inside. There are things to go wroing. What if something doesn't come up? Are you going to ship it back? How about a scenario involving a truck in a river? I work for a big company, and they can get stuff pretty quickly from the vendors. But it isn't likely to arrive fast enough to keep from doing a lot of damage to the business.

A realistic solution eventually emerged, but the dates from the original contract were totally whacked. My job is to plan the transition piece. Implementing those plans takes it into another stage, so my piece is done. The Boss popped up in my online chat window on Wednesday. "Looks like you're done with {customer}. Be in Virginia on Monday. Here's the guy you need to talk to for details." Cool. I have family in Virginia. I'm traveling a day early and will watch the Super Bowl with them.

Recovery continues. The itch has pretty much subsided, but I notice that my lips are still swelling like they do sometimes when I eat cantalope. I'm continuing to take antihistamines with a break every couple of days to see whether it's still an issue.

The most noticeable lingering side effect is the hair. My barber recently took on a regular job (it was time for a job with benefits) and I went to a new one. I had not been to this shop before and the girl cutting my hair commented how thin it was. As my previous barber said, the only thing to do is cut it short.

Battery dying. Time to go.

"Ichabod is itchy...

...So am I!" Quoting Dr. Seuss's ABC, the best alphabet book in the English language.

Indeed I am. From scalp, to legs, and -uhm- in between. I know about the last bit. The past year of enforced sedentary living has resulted in a hemorrhoid flare-up. Hopefully I'll get rid of that as I start working out and get more active.

The skin thing has me kind of mystified. I went through 48 weeks of treatment and had hardly any skin problems. The weather hasn't changed significantly since I went off treatment. I did get a bit of scalp itching when I was on my treatment hiatus. I attributed it then either to the Procrit or to the Neupogen. Now — literally now; this just occurred to me — I'm wondering if it isn't a withdrawal symptom. It stands to reason that since my body had to adjust to the presence of the meds, then it would have to readjust to the absence of those same chemicals. Anyway, my scalp is itchy and I've got tiny itchy bumps. It still isn't terrible, not like a case of hives or chiggers. Just an annoyance. During the last couple of weeks of treatment my eyelids also developed rough patches, but that symptom is fading. I'm also finding that the body aches have been replaced with headaches. It will pass. It will all pass. It's beginning to sink in.

I'm done!

This was the first week back at work after the holidays. I'm amazed at how much my mind has cleared in just this week. I'm finding stuff I did at work and I'm a) suprised that some of it is pretty good, b) surprised at the really big things I forgot, left out, or let slide, and c) surprised that some things somehow got done by someone acting as me, but I have no recollection at all. It was also the week of my review. Under normal circumstances I'd consider it a so-so review at best, but given the circumstances, I consdered it a rave. Told the boss and thanked him. He's been a huge part of making this thing bearable.

I have paperwork for a blood test in three months. I think it's just for the standard liver panel. I'm going to ask for a PCR at three months. I think that will tell me what I really need to know.

The Cohiba

I am not an expert on cigars, but I like them. I've had my share of experience with tobacco from dipping snuff as a teenager (a rite of passage among the ranch kids I hung with) and smoking cigarettes in the Army (at a tax-free thirty-five cents a pack, it was no wonder most GI's smoked). I gave up tobacco in college, although I went back to the weed now and then in the years following. But I hate to cough and I like to run. That's incompatible with cigarettes. And since I don't work outside, the frothy cup of the indoor snuff dipper would be my constant companion and bane. Add to that having kids to set an example for, tobacco was just incompatible with the rest of my life.

Putting tobacco back down after an occasional dalliance has never been a difficult thing for me, so I don't go out of my way to avoid it. When a co-worker who had been out of the country on business handed me a few cigars that he alleged to have come from an island nation with whom my country discourages trade, the allure of forbidden pleasure was too much to pass up. I received the cigars some five years ago and had kept the last one for a special occasion. I guess completing a 48-week course of interferon and ribavirin would qualify. On Christmas afternoon as the rest of the family napped or explored new toys, I found a sunny spot in the back yard and lit up. All I can say is that it's a good thing that the things are a) illegal in my country, and b) priced around $12 each. Absent those two factors and they could become a habit.

Merry Christmas

I'm now just about 96 hours post-treatment. I'm feeling the sides from the interferon, mostly fatigue, but I'm enjoying not feeling the ribavirin "hat" — the pressure that forms across the middle of my forehead and encircles my head. Correction: past tense. I don't feel it anymore! That's a serious improvement.

Saturday, the second day post-shot, we went up to see our friend J and her mom in central Arizona. Whether it's chemical or situational, I was much more engaged and maybe even fun to be with on the 90 minute drive. The kids laughed, although I couldn't tell for sure whether it was at my jokes or at me.

I mentioned last time that J has fought ovarian cancer and that it looks like it's back. She and her mom, "M", take care of a nice little house and make whatever money they can through crafts or doing bookkeeping and billing.

Bluntly, the situation looks bleak over the long run. J has a bit of life insurance that will allow her mother to keep the house. She has no medical insurance and a lot of debt. She divested all of her assets putting them in her mom's name and keeping the debt in hers. Nonetheless, she is feeling good right now and stays in the present. A few weeks ago I talked with her about options and she said that she's not going to go through another six-month round of chemo with a 15% chance of remission — remission here defined as pushing the inevitable back six months. She really can't see the point. She's my age, which has brought reality home to me more than once. If she finally decides not to take the chemo, the cancer will not have beaten her and she will not have given in. She will have taken a hard decision not to be defined by her disease. It looks like we're in for another rough year.

J and her mother's avocation (not to mention distraction) is a prolific tribe of feral cats that has adopted them, and which they feed excessively. They remind me of my grandmother who at one point also had a dozen or more cats hanging around. When we were up there before Thanksgiving last month, M, the mom, commented that she'd spent nearly $70 in November on cat food. With my rural background, I might approach the issue a little differently, but it's not mine to say. I privately wondered how long the situation could sustain itself.

The tipping point arrived a couple of weeks ago. They got a cold snap followed by some snow and the hoard of kittens came down with some kind of respiratory infection. Naturally, the kittens went to the warmest spot they knew when they got really sick — M and J's patio. And naturally more than a few turned up dead. It took a lot out of J to spend a week burying a kitten or two every day.

When we were up there this week, they had brought three kittens inside and had set up a kitty infirmary in a bathroom. One appeared to have made it last week and they found a home for it. A second was looking very weak on Saturday and died the night we left. Then there's the third.

Guess who has a new kitten.

My oldest daughter's cat is now sixteen and starting to fade. She's doing pretty well, but the arthritis in her hips is getting worse. My younger daughter got a kitten for her birthday this past summer (three guesses from whom). We got a fair amount of not-so-subtle pressure to take the new one. Alright, alright, whatever. I choose my battles judiciously. Sometimes an appeal to common sense, reason, and practicality is more trouble than it's worth in the long run. We won't have three cats for very long. Needless to say, the kitten is very cute — a calico with a brown patch over one eye and a butterscotch patch over the other — and a fighter. When the dog comes to visit she growls and hisses and doesn't back down for a second. Mother Nature's system is brutal, but it does find the fighters.

Christmas Eve

Several years ago we fell out of the tradition of Christmas Dinner. The time leading up to Christmas is too crazy and Wife didn't want to spend Christmas cooking. We now instead have our big dinner on Christmas Eve. A couple of years ago we made a standing rib roast. It turned out really good that year. We hadn't done it in a while, but this year Wife found one at a good price. I think it's going to become a regular tradition. Wife still had some wrapping to do, and I told her I'd take care of dinner. I spent a couple of hours in the kitchen on my feet. No way I'd have been able to do that last month, or even last week. I enjoyed cooking it and it made Wife so happy that it's probably worth my time to plan a repeat performance. Maybe a New Year's ham and black-eyed peas next week.

It's done!

Last night I injected the last of 48 Pegasys syringes. A call to the doc the previous day yielded orders to stop everything after that last jab. No more ribavirin, no more Procrit, no Neupogen. Still got 3 Neups left in the fridge, but I took the last Procrit the day before. Tonight my cell phone alarm went off to remind me that I'm not taking any ribavirin pills. Cheering from the kids. I'm done with this part. I have a Cohiba cigar that I've been saving for a special occasion. This qualifies, although it will probably make me sick. Just as well. I don't need to get into a cigar habit.

Today feels much like any other post-shot day. Foggy, tired, a little down emotionally, and an incessant, accursed roaring and ringing in my ears. I'm long-used to some ringing, having tinnitus from a lack of ear protection in my immortal youth, but this is getting to be a bother. What's especially annoying is the low-frequency roaring that goes in time with my pulse. But that's okay.... This too shall pass.

We're going up to central Arizona to see friends for Christmas tomorrow. She has ovarian cancer that's come back after six months of brutal chemo and a year of remission. She showed up sick the year before my virus kicked up. Certainly does place things in perspective.

Now starts the wait. I'll go in sometime next week for a viral load test (PCR), and again in June. That's the one that counts.

To all who read this, be well. Be grateful. Be strong. Hold your loved ones close. If you're contemplating treatment or fighting the bug, know that there's an end to it. I may have done harder things than this treatment, but I can't think of one.

A Day At A Time

The AA folks are onto something with that "One Day At A Time" approach. The human psyche really can't can't comprehend the long term. We can make plans and talk about what's going to happen some day down the line, but we're pretty much along for the ride. Not quite like a stick in a river — we can choose which part of the river we will float on to an extent. But in real life, we aren't in charge of much. That brings me to a quote I found on another blog, http://www.hepcboy.com/: "I don’t believe in God but do believe in miracles." I rarely take issue with this extraordinarily bright and combative fighter against HCV. A previous non-responder or relapser, he's on the 72-week plan, which from 47 weeks appears as distant and daunting to me as the summit of Everest.

But I do take issue with that statement about God and miracles. I belive in both, being as how I dont' think you can have one without the other.

Gentle Reader, I'll spare you the apologia, but I do find it necessary to say that I'm a Christian, that I believe that Jesus is the Son of God, that he was crucified, died, and rose again. Literally. Whole kit and caboodle. Some stereotypes probably just popped into your head. Most of them are probably wrong. No, I do not think the world was created 6,000 years ago. I'm okay with the idea of evolution and DNA and with the idea of Adam and Eve being of a mythic (folkloric) origin. I could even make a case for homosexuality as possibly being a biblically valid lifestyle choice. But I won't because it's outside of my purpose here and I don't have a dog in that hunt. I hate abortion (I've seen three children in utero when they would have been legal abortions, no questions asked). But I don't think there should be an inquest every time a gynecologist does a D&C. Some things, I'm very happy to leave up to God.

The short version of the basis of my belief is that it makes sense for me. If what I believe doesn't make sense for you, then there's little I can say to dissuade you. I come from a Christian tradition that would gladly thump a non-believer or questioner about the head and ears with a bible. But that's not my thing. Nonetheless, I do believe that if God wants you, you can dodge Him all you want and He's still going to get you. My willingness to say something might make a difference, and I'm under orders to say something in this regard. So I say something, and let God do his thing.

What I believe is that people are hard-wired, whether they believe it or not, to worship. If a human chooses not to worship God, then they will, believe it or not, like it or not, worship something else. Western culture is lousy with mis-directed worship. Pick any vice, bad habit, fad, or profession. All of them objects of worship.

What are the consequences of believing or not believing? It isn't my place to say. Will my homosexual friend T. spend eternity in a lake of burning sulphur because of his non-belief? Will I be rewarded for my belief with a pair of wings and a harp? Honestly, I kind of doubt both points, and I'm thankful that it isn't mine to say.

What I do know is that whenever humans have tried to anticipate God, we've been wrong. Abraham was promised descendants "like sands on the seashore." He got what he was promised, but not in the way he expected. So I don't waste a lot of time puzzling out alleged end-times prophesies or imagining eternity. I just want to get through today, sometimes the next five minutes. But people have been tortured and burned at the stake because they didn't follow the dictates of some religious authority. My bet is that those guys were surprised as they entered Eternity.

Which brings us back to what I set out to write about. I've been able to get through this experience because of the grace of God and my own belief that I had help. Others may be strong enough to do it without God. Hat's off to them. I wouldn't have been able to make it. In short, I've found my life better with God than without, and during this trial, God has given me the chance to depend on Him. I think that He's active in my life in ways that I little suspect. As my dad said upon learning that he had cancer, "News like that will make you look at your hole card." I have taken a hard look at all my cards this past year. Grace is what got me through it. Someday soon I will run down the little synchronicities that got me here. As a Christian, I know where they came from.

But that's all I have to say to that for now.

"I can do all things through Him who strengthens me."
Philippians 4:13