More Anemia

Just got back from doc. My HGH level is 8 and my white blood count is 1000 (normal is about 15 and 5000). He wants me to take a break for a week. No interferon tonight, no riba through next week. He wants me to build back up before resuming tx, possibly with a reduced dose (I'm presently taking 1200 miligrams, 6 tabs per day) and I'm pretty small, 5'-6" and 145 pounds. I've seen other people's dosages in the boards and I seem to be taking a pretty large dose. He also bugged me to stay out of the gym, saying I could go over the edge without realizing it. [Grumble] Never had a doc tell me to get less exercise.

I asked him about the risk of letting the virus adapt and he said that the meds will stay in my system for several weeks, so I'm still fighting the virus even skipping a week. Right now he's more concerned about the blood levels. Procrit is a possibility, but he wants me to take a break first. My friend Ken took it and felt much better, but the sides from that were also pretty bothersome -- diarrhea, headache. Everything has a price.

The grind grinds on.

Late Week 17 Check-In

I've been spending some time on a couple of support boards. I recommend them both. One, http://hepcassoc.org/messbrd/ is kind of U.S.-centric, but with a fair amount of Canadians. The other, http://www.ronmetcalfe.com/hepcforum/, is hosted out of the U.K. There is a good deal of overlap between the boards. I found that Carol, who raised concerns about my earlier misunderstanding of my treatment plan, is Mrs. Ron of ronmetcalfe.com. So this is a pretty tight-knit little club.

Another blog I've been reading lately is http://www.hepcboy.com/. Another Englishman. He's been kind enough to post a comment or two here. I really like his British stiff upper lip. The best bit of wisdom I've picked up there regards self-discipline. "Be your own tyrant!" He's facing some challenges with his treatment, but doing it with good humo[u]r and a measure of courage.

It's helpful having folks around -- even in virtual space -- who understand what's going on. I feel like anyone who hears me talk about it is going to think I'm whining. My friend Bob checked in with me yesterday. He has pointed out some of the weird little side-effects and occurrences that go with treatment. The taste changes (which he pointed out unprompted) are driving me nuts. The lunch meat I've been making my lunchtime sandwich with for years suddenly seems like it's soaking in brine. I skipped lunch today because nothing looked good. Just ate some cereal and nibbled fruit all afternoon. Dinner was good -- scrambled eggs and hash brown potatoes.

The physical effects are certainly present. I think I've just gotten used to being tired. My son wanted to go to the gym and I figured it's time. He's getting all pumped up for football and didn't think he got enough time in the weight room. He went off and worked on his legs while I spent a half-hour or so on an elliptical trainer. It's easy on the knees and it's easy to vary the intensity. After that I did some stretches and a some light weight work. I'm feeling much better now. My back has been bothering me; that's usually a sign that I'm being too sedentary. Before we left I got on a scale and found that I've lost about five pounds. I'd been working out pretty steady before treatment. Weight is getting redistributed the wrong way.

The physical side-effects are an annoyance, but what's really bugging me these days is the emotional effects. A maudlin country song can make me tear up. My daughter's cockatiel bolted last week and I'm all bummed out. I'm going to the doctor tomorrow. We're going to talk about exercise (I need more -- I'd been avoiding the gym on his orders) and anti-depressants. I'm also having some attention problems. I'm easily distracted and the things I need to pay attention to (like maybe WORK!!??!!) don't hold my attention. I suspect I've always been a little on the ADD side. I suspect I'm like I've always been, only more so.

I'm rambling. That's something else -- once I get into something, I won't let it go. Time for bed. Work tomorrow. Doc. Hey! An outing!

Best to all.

My doctor just called

I've been operating under a misconception. My doc has no intention to stop treatment for two weeks at Week 24 as I thought. Once I'm on treatment, I'm on for at least 24 weeks, and hopefully 48. If I'm not in or near remission at Week 24, treatement stops and I look for alternatives.

The lack of a 12-week viral load test is a bit of gamesmanship with the insurance companies. He has had patients who failed to achieve a Log-2 drop in viral load at 12 weeks and their insurance company refused to pay for continued treatment. He believes that everyone should get a minimum of 24 weeks regardless because of the therapeutic effect of giving the liver a break. He said that in my case in particular, he wants to continue treatment since my liver enzyme levels are and have been normal since about Week 3.

So far so good. Thanks, Carol for flagging this and helping me get straightened out.

Week Sixteen

I've been spending some time over in the Hep C Association forums. If you aren't familiar with it, it's a good resource. I'm cwk on that forum.

I posted a question regarding my treatment plan (two-week interruption at Week 24 for evaluation and viral load test). It generated a number of questions there, just as it did from Carol. I have a call into my doctor's office to go over those questions. I haven't had a Week 12 viral load test, and the plan to interrupt treatment for two weeks stirred some concern. This just goes to show that it's a good idea to manage your own care. The doctor wants to be in control, but I'm viewing him as a consultant and advisor.

I took shot number sixteen about 14 hours late. My wife and I had gone to the resort where we were married twenty years ago and frankly, I really didn't feel like dragging needles and sharps containers with me on a romantic getaway. The idea just did something to the mood.

It was a good trip -- just an overnight. The restaurant was the highlight. We spent over US$100 in the restaurant and that's without wine (which I really would have liked, but obviously I'm on the wagon). I had a swordfish steak and she had halibut. Truly an amazing dinner.

I'm feeling pretty good this week. I had some concentration problems yesterday. It seems like Monday is my day for congnitive issues lately. I'm a little better off today, but I don't think this is a good time to take up a new skill.

I mentioned Bob, who went through the program some four years ago. He called me again on Saturday just checking in. Interesting guy and very encouraging to talk with. He has tipped me off to several side-effects. One is the funny metallic taste (he calls it lead-like, I think of zinc) that I have in my mouth. He says that post-treatment one of the things that has stayed with him is an appreciation for good food, well prepared. Having a taste for good food, I was pleased to hear that. I suspect I may have a similar experience.

Bob says that he usually has one or two people in his queue that he checks in regularly with and talks them through treatment. When this is over I intend to return Bob's favor by helping others in the same situation.

Cheers, all.

Monday of Week 15

Took shot 15 Friday night. I was up and active Saturday and Sunday. Sunday, is usually the toughest day. I was tired, but functional. Today is Monday. Again, I'm tired but reasonably functional.

I'm getting some annoying minor side-effects. One corner of my mouth or the other constantly has a crack. I sometimes get those when I have a cold. Not a cold sore, but similar. Last week it was the left side, this week it's the right. I keep Car-Mex or some similar greasy product on it to keep it from drying out and breaking open. Another thing I'm dealing with seems like constant sinus problems. I seem to be having lots of allergy issues -- something that never bothered me previously. I get a lot of bloody noses, too. Never a lot, just a minor seep. I'm also getting a funny metallic taste in my mouth. It's not terrible, but it seems to distort the taste of some foods. Those are all annoyances. I'll take them compared to other issues I've had or, worse yet, heard of others having.

A friend of a friend who has been through this called me last week. "Bob" is four years out of ending the 48 week course. I commented that he must have been a pioneer. He was. When he did his round, the peg-interferon with Ribivirin wasn't approved in the US. His doctor had him ordering two different medications and he was throwing away half of each. I didn't quite understand it all, but it was an extra hoop. He had Genotype 2, but did the full 48 weeks because that was the protocol then and they hadn't really sorted out the genotypes when he started. I have Genotype 4 and they recommend 48 weeks, but the disease is new enough that they may have some new research. The doc keeps saying he'll find out for me whether there are any new changes. He made the call while I was there last time, so hopefully next month I'll have an answer. If I were to bet, I'd bet I'm in it for the full 48 weeks. Bob's call was really encouraging. The mutual friend was with him on a 100 mile bike race last month. In other words, he has his life back. If anything, he's stronger than ever, according to our mutual friend.

To Sue in Toronto, yes, the weather's nice this time of year, but when it's 115 F/46 C we'll see how envious you are. I've kept my walks up pretty well. My dog nags me, which helps.

She lives for her walk. That's when she gets to chase cats. She doesn't do anything to them, just the chase. One night the cat on the next block mosied out in front of her and paused looking back waiting for her to give chase. All in good fun.

If they don't run, she just kind of sniffs and moves on. Australian Shepherd -- great dog, but they need to be active and stimulated, hence the walks off the leash. She won't cross the street to visit another dog and won't start chasing a cat unless she gets my okay. I wish I could say it's my great training. No, she's just smart enough to know what she needs to do to get to walk without the leash.

Week 14 - Who really gives a... ?

I'm nearing the end of Week 14 and I now think I understand what someone here referred to as "hitting the wall." I wouldn't characterize it as hitting a wall so much as trying to run across a mud flat. As I've mentioned previously, I work from home which is both good and bad. One bad side is that I work on the Internet. I'm having trouble concentrating and find myself aimlessly surfing. I've learned a lot about things I might not have looked up otherwise -- musicians I hear on the radio, drugs both therapeutic and illegal, topics on Slasdot (http://slasdot.org/).... None of which is particularly helpful in getting work done.

I didn't even have enough ambition to post this -- I had it virtually finished on Wednesday, posted on Saturday.

Week 13 mid-week check-in

I'm into the second quarter. I don't know whether I'm feeling better, or just used to feeling lousy. What I'm having a very difficult time with is the limitations. It's already getting warm here in the sunny southwest. We're expecting above-90° F / 33°C this week. Consequently, it's time for one of the little rites of spring in this part of the world, opening up the swamp cooler.

For you fog-bound folks in northern latitudes, a swamp, or evaporative, cooler is a form of proto-air conditioning that works by forcing outside air through a wet pad. It only works when the humidity is low -- that means a dew-point of no more than 60 °F / 16 °C . Current dew point is 37 °F / 3 °C, so it's ideal. Above 60 °F / 16 °C and it's miserable.

There are other disadvantages as well -- the increased humidity in the house can cause doors to stick and rust in the ductwork, and since it's pushing outside air through the pad, it brings dust into the house. Not a good plan for those who have allergy problems. I doubt that I'd install a swamp cooler, but it was on the house when I bought it and it's a better quality system. And the thing runs for pennies a day which appeals to my Scottish heritage.

Anyway, it was time to clean the swamp cooler up and get it ready for the season, but my wife had a fit at the idea of my going up to the roof. I occasionally get dizzy, but I've never blacked out. At her insistence I called a friend. He was anxious to find a way to reciprocate us for when he was down with a bad back, so I guess what goes around comes around.

I have a friend who I've written about previously. He has Genotype 1 and relapsed six months after going through the full interferon/ribivirin program. He also went onto Infergen, but that caused some horrible psychological problems including depression. He made the mistake of answering a question about self-destructive feelings half-seriously and found himself in a lock-up on suicide watch. That was a couple of years ago. Now they're just monitoring. His liver's in pretty bad shape. I don't know what else they'll do; it's like a company that is in financial trouble and puts the accountants in charge. They can tell you the exact moment that you're broke, but I don't know what they'll do to solve the problem.

Anyway, he had a biopsy last Tuesday. On Friday he was in the emergency room. Apparently the biopsy clipped a bile duct which caused approximately the same issue as a gall bladder problem. They may be able to treat it with anti-coagulants. I need to call him. I think he's coming home today. Real role-reversal there -- it started out with him holding my hand through the beginning of treatment. Now I'm trying to be someone he can lean on.

Meanwhile, I'm doing comparatively well. I'm tired and I don't feel like running or doing other hard exercise, but I walk the dog a mile or so nearly every night. I come in feeling like I've run a couple of miles, so I guess it's a good thing. Emotionally, it seems that everything is right on the surface. I'm irritable, but I have enough of a sense of humor to recognize it. My daughter was telling me the other night that it's like her daddy isn't around. There's a stranger. He's nice enough, but it's not the same. I asked her if it's that she's not used to me being wimpy. She laughed and said maybe that was it. I know I've kind of disconnected with all the kids. I have to make an effort to talk with them and see what's going on.

I'm spending far too much time on this. Got a work call and things are stacking up.

Cheers all! Keep my friend Ken in mind in your prayers, meditations, or whatever you do.

Correction -- This Is Week 11!

Mid-week check-in.

Replying to Carol's note to my previous post, yes, I'm definitely hitting something. I'm really foggy. Example: this is Week 11, not Week 10. I was really surprised to see only two syringes in the box on Friday.

My motivation is somewhere around zero, yet I have this weird inertia. Once I start doing something I just continue doing it. But it's really hard to get started. Emotionally, I'm kind of crabby, but no more anger like I experienced a couple of weeks ago.

The physical aspects are really improving. I was up all day Saturday and was really active all day. Shot a good round of skeet (22 of 25). That's good for me; I haven't shot in six months or more. Quality time with the kid was an important bonus.

Sunday I crashed and slept close to four hours in the afternoon.

Monday and Tuesday at work have been challenging to say the least. I work with lots of complex things and inter-relationships, not to mention lots of people. There are a lot of plates in the air and I have to have an idea where they all are.

A friend of mine is a Genotype 1 relapser. We were planning on going to a support group meeting, but it was cancelled. I detect a change in that relationship. It seems he's starting to lean on me more where at the start of this I was really leaning on him. That's fair - I've got a good chance of seeing this thing go into remission and being done with it. He could be facing a transplant in the next few years. Little dose of reality there. My friend does a good job of keeping my perspective straight.

Week 10 -- Double Digits!

For the past couple of weeks I've been doing pretty well. "Pretty well" is relative, of course. It means I haven't had to punch out and lay down on the couch in the middle of most days. I am blessed to work from home and can do that now and then. Nobody on a conference call knows whether I'm laying down or not.

I have noticed that I'm pretty foggy. That's a fact that was not lost on a project manager at work when I asked him a couple of questions I already knew the answer to. Yesterday I'd have sworn that my wife came in and talked with me.

"Where'd your mother go?" I asked my daughter.

"She's working late today."

Sheesh! I was recalling a conversation from the previous day. It's all running together.

Emontionally, this is a strange time. I caught myself getting really angry over something trivial last week. I realized I was being stupid in time to stop being too much of an idiot. It seems like my emotions are right on the surface. I wonder how much of this is chemical and how much is circumstantial. I'm also cursed to work at home. This is like house arrest. All I need is an ankle bracelet.

My son and I are going to the range tomorrow to shoot a round or two of skeet. Saturdays I'm usually pretty good until mid- to late afternoon. I need the outing.

It's shot time. In Frank Herbert's epic Dune the main character is tested with something called a gom jabbar. "It only kills animals," says the tester. The gom jabbar is a poison needle that the tester holds to the lead character's neck. As long as he keeps his hand in a box, the tester doesn't stick him. "What's in the box?" he asks? "Pain." He puts his hand in and thinks his hand is being burned away, yet he has to endure. To do the instinctive -- the animal -- thing and avoid the short-term pain is death.

There's a parallel here. As long as I keep sticking myself -- and taking the little blue pills (shudder) -- I have a pretty good chance at a normal life. Skipping meds proves that I'm not smart enough to be a human.

So with that thought, I'm off to endure another round with my gom jabbar.

Week Eight

Saturday Afternoon. Took my shot last night. This is usually the time I start fading. I've been up since around 9:30 doing chores -- light stuff, mostly directing my son and a buddy of his. It's now almost 4:30 PM and I'm still somewhat functional, although tired. Way better than last week. I finished off my second box of IFX (or whatever the Hep C cognoscenti abbreviate it to). I'm one-sixth of the way there. The shot was almost routine. My head was clearer as I went through the process and my hands weren't shaking. I'm almost used to it. Maybe that's over-stating it. But at least it doesn't freak me out like it did the first few times.

Ran into a neighbor at a school function on Friday. We had told her about my problem. She and her husband went to give blood last week. She got a nice thank-you card, but he got this manila envelope. Yup. He has Hep C. I need to buy stock in Roche (company that makes Pegasys). By the end of this decade there will be few people who don't know at least one or two people with this disease. Got to call him. I won't sugar-coat it -- this is no fun. But there's worse things to face.

Early Week 7 Check-in

Hokey Smokes, Bullwinkle! I'm flat on my back!

Friday is shot night. Saturday morning is usually a better day for me with Sunday my day to really be down. But I was horizontal for 16 hours on Saturday. I didn't even get out of bed until after 10:00 AM, this after going to bed at 10:00 PM. Did virtually nothing.

Sunday I made it to church, and managed to take my son to the sport store to buy some track shoes. I collapsed once I got home and have either been in bed or on the couch since then. I have a bit of a headache, but no flu-like symptoms, I just can't move! This is horrible. My wife is having a hard time with it. She's trying to do what needs doing, but it's hard for her when I'm crashed out.

I'm gradually coming alive this evening. Of course now, it's 9:00 PM and I just took my Elavil (Amitriptyline). Since I started taking it I'm sleeping better. But it that what's whacking me? This is going to be a long year.

End of week 5 (correction! Week 6) check-in

First of all, thanks for the encouraging comments. I have my share of prayers, good thoughts and positive vibrations coming my way. Much appreciated.

The doc had another hemoglobin test run last week, some 5 days after the previous and called me to say the results were about the same as previously. So, I'm at least not going downhill. This week has been comparatively good. The Elavil seems to be helping me (not to mention my wife) sleep. The biggest annoyance right now is the cold/allergies that has my nose and sinuses congested. I don't think it's all sides -- my youngest is home from school today with a sinus infection and displaying many of the same symptoms I have. I went through a round of antibiotics a couple of weeks ago. This week the General Practitioner gave me a new allergy pill and nose spray.

Although the week has been pretty good, I'm starting to see a pattern of really slowing down on Thursday. I suspect it's the time-release characteristic of the PEG added to the interferon. In any case, I'm pretty tired today and should probably be lying down between phone calls. Last call coming up, and then I take up a prone position.

Cheers all!

Saw the gastro doc yesterday

I'm anemic. No surprise there. When the girl took my blood pressure my heart rate was around 120. "What'd you do? Power-walk here?" Uh, no. I mosied from the parking lot to the elevator and sat in the waiting room for 10 minutes before I mosied in here. My hemaglobin level is 9. Normal is 14. The doc says it's like being down 3 pints of blood.

That explains the fatigue. Dead tired. Yet, I haven't been sleeping well. The doc prescribed a light dose of Elavil. I took one tiny white tab at 8:00 PM and was groggy by 10:00. I actually slept last night, but the trouble is, I slept today too. About three hours on the couch. Tough to work like that.

Encouraging news as well. My liver enzymes are back to normal -- I didn't get the numbers. But I know they were trending that way from the last test. The doc raised the possibility that this might might be a 24-week course. I have Genotype 4 which is recommended for 48 weeks, but it's a comparatively new genotype and they may be following the more aggressive protocol as a fail-safe. I have mixed emotions. If I stop after 24 weeks and relapse, I'd be facing another 48 weeks. Not something I would look forward to. I'm leaving the whole matter on the back burner. I haven't made it through the fifth week yet!

Beginning Week Four

Friday was not a good day. It was weird. I was not in pain, not overly tired, nothing, yet I felt just lousy. Uncomfortable. I'm wondering if it wasn't the depression thing that I've heard about.

Friday is shot night, so that may have been a factor. I have to get my head real straight -- last week I had some trouble with the syringe. The genius that designed it made the needle cover fit tighter than the needle fits on the syringe. Consequently, the needle came loose as I was injecting. I had to pull out and reattach the needle before injecting again. Probably a no-no, but I survived. Then as I got down to the bottom I realized I hadn't purged the air -- this as I'm hearing the bubbble entering the needle. Stop pull out. Not enough left to make any nevermind.

This time was better. I went more systematically and made a point of detaching the needle cover and replacing it loosely before attaching it to the barrel of the syringe. Everything went smoothly, but it still creeps me out. It goes against some pretty deep-level conditioning to point a sharp object at one's person and jab!

Today I've felt pretty good. I put some drip irrigation in the front planter (I live in the Sunny Southwest -- we haven't had rain in over 100 days). It's light work playing with 1/4-inch hose and little drip emitters. I kept a glass of water at hand and didn't push it. My older daughter (17) came out and hung out with me. She's good company. This evening I walked the dog down to the corner drugstore -- half-mile round trip. Last month it would have been nothing to run two miles. I'm not complaining, but it's going to be a chore to get back in shape.

Time for meds and bed. Sunday is usually rough. We'll see.

Late Week 3 Check-in

This sucks! I made a bad mistake on Monday night. I was tired but watched Surface (cute show -- family friendly, lots of excitement and intrigue) with the kids. My mistake was to drink a cup of coffee at 8:00 PM. I came in here and worked on another project until midnight. Next morning I was tired, but functional. Where I think I really made my mistake was in not eating anything from 7:30 AM until after 1:00 PM. When I finally got up I was wiped. Had to knock off at 2:00 and slept for a couple of hours. I tried to start working again, but it wasn't happening. I don't think I was up for more than a couple of hours for the rest of the evening.

Lesson: Eat. Sleep. Not so hard, now is it?

Beginning Week 3

But first, a review of Week 2. Took the second shot on Friday and was up but loggy all Saturday. Sunday I didn't get out of bed. I had all the sides -- body aches, fever, chills, coughing, sneezing, congestion ... sneezing? My wife went back to the web and the package inserts. Nothing about sneezing there. I had a garden variety cold. And it was fast turning into a sinus infection. Explained a lot. I'm now halfway through a round of antibiotics and doing better with it. I worked all week, but fortunately I work from home and spend a lot of time on teleconferences and doing heads-down work at the computer. I did have to take off on Friday afternoon -- I was dizzy and totally flaked out. Certainly in no shape to take another shot of Interferon. But that's what I needed to do.

It's Monday now and more than anything else, I'm tired. Dead tired. I'm trying to get started working, but along with being tired. I'm having a hard time caring. That may be a side as well. I'm wondering whether the depression associated with this stuff is something systemic, or is it just a rational reaction to the prospect of a year's worth of feeling like this. In my weaker moments I can really start feeling sorry for myself which is just plain dumb. Waste of time and I have too much going on.

Week One

Summary
Sleep is the biggest issue so far. The ribavirin seems to cause a lot of tension in my back and I tend to clench my fists and arms. My appetite is good and I am having no trouble with any foods. Little chance of this stuff becoming a recreational drug, but I don't feel too bad. This is manageable.

On Saturday after my previous post, I started moving and felt good enough to clean the garage. Between remodelling and having Christmas decorations out, it was trashed. I was doing okay for about three hours when it caught up with me. Fortunately that was just as I was sweeping and ready to shut it down. I went inside and took a two hour nap. When I awoke, I felt exactly as if a case of flu was coming on -- achey, especially in the joints. I took some Tylenol and watched the Broncos beat New England (American tackle football). Life is not all bad.

I went to bed early Saturday night but didn't sleep well due to the fact that I'd already had a lot of sleep and because the achiness was coming on pretty strong. Sunday morning was more of the same. I thought about staying in bed, but then figured that I could feel this way anywhere and laying in bed I was more likely to start feeling sorry for myself which is a downhill slide. It's way too early for that nonsense. I got up and had some breakfast (oh, and my ribavirin, naturally) and some Tylenol or Ibuprofen. I'm trying to mix them up a bit and not take either more than a couple of times in a day.

By the time I got to church, I felt pretty good, just tired and wrung out. The friends who know about this wanted to know how it was going. Pretty good, considering. One guy at church has Genotype 1 and went through the 48-week drill only to have it come back. He's my reality check. There are no guarantees.

I felt good enough after church to go out to eat with my wife and younger daughter. When I got home I flaked out in front of another football game.

Monday was a work day for me. I am fortunate enough to work from home. The commute isn't bad, although I have to occasionally step over the cat on the way to my office. Tylenol and coffee are my friends.

Tuesday I went to the gym. I did my usual ten minute warm-up on an elliptical trainer (kind of like a treadmill, but low-impact). The heart monitor said I hit 189. When I'm real energetic I can usually get it up to about 200 in that time. I wasn't feeling all that energetic. My workout got sidetractked, however as I ended up getting into a pleasantly long-winded conversation about guns and other topics of interest. I've seen this guy, but we've never talked. I think we were both looking for an excuse to slack. He left and I got back on the elliptical for another ten minutes before going home.

As the week progresses, what I'm noticing is that I am just tired, yet I have trouble sleeping. My appetite is good and I have no trouble eating anything, thank God. I can't think of anything that would drag my morale down faster than to have serious stomach trouble for this time.

My biggest gripe (and my wife's) is that I'm not sleeping well. I have this weird tension in my back and tend to clench my hands and arms. I have to will myself to relax. I ended up taking a Benadryl last night to go to sleep. I'd read of that trick in one of these blogs. I'm going to check in with the doc about it, but it worked last night -- except that I'm foggy this morning.

Time and past to get to work.

Carol said in her comment to the last post:

Many people think that when they take the tablets/jab life changes from then on.

You're right, that's exactly what I was thinking. The big changes are the ones that happen slowly over a long time. On the other hand, there is now a division -- before treatment, and during treatment. And the roller coaster has definitely started.

I took the ribavirin about 10:30 last night and the interferon shot about 20 minutes later. The needle is so small and fine I hardly noticed it. I put it into my budding "love handles" -- I'm not very big and I don't carry much extra weight. I was in bed by 11:00 which is pretty early for me. Awoke at 7:00 and made coffee confident that I was up. I then went back to bed and didn't move until 9:00 AM! Ten hours of sleep is really long for me.

This morning I'm a little achy but sleeping for a long time would explain it. I'm not saying I'm having no sides, but I'm having to look for them. If this were an ordinary morning, I'd be wondering if I was getting sick or if I'd just slept for too long. As I write this I feel a headache coming on -- the ribavirin was 30 minutes ago. Or maybe I'm talking myself into things.

The time has come. My medicine arrived today.

I just got back from the doctor's office where the nurse gave me a little orientation and the very stylish Pegassist Kit. Gel eyeshade included. The time may come that I'm glad I have it, but right now it seems kind of hokey.

I haven't taken any meds yet -- enjoying the last few hours before a year of . . . maybe nothing. Maybe a bad time. I'm not in a hurry to do it, in any case. The older kids have gone to a church function for the weekend. The youngest (11) is an only child this weekend. We're taking her out for dinner and maybe a movie. Once we get home, Daddy is punching out.

My wife works with a guy who has genotype 3. He just heard from his doc that the virus was undetectable. He has another ten weeks and he's done. Everybody cheer for Steve.

So there is an end to this. Something to keep in mind at the beginning.

Out the door.

Nearly six weeks since I updated this. I saw my general practitioner a couple of weeks ago and my gastro last week. I asked the GP about anti-depressants. His take (which agrees with mine) is not to start throwing drugs absent a specific reason. I would not describe myself as depressed now. We'll deal with side-effects as they come.

My wife accompanied me to the gastro. He's pretty conservative as well. I got a bit of hard news there. It looks like Genotype 4 is more like Genotype 1. I'm not sure whether it means a 48-week treatment series, but in any case, it's not the easier-to-treat Type 2 or 3. In any case, the gastro doc is saying 50% of patients respond. My wife was working on the assumption that this Interferon round will knock the thing out, like a round of antibiotics for a sinus infection. Unfortunately, it doesn't look like that's how it works. Easy to get discouraged with that.

I start treatment after the holidays. I have the prescriptions. Got a few bureaucratic hoops to jump through with the insurance, but I'll be on treatment by this time next month.