Ah, I git ya now, only the week 8 one will happen (with no "additional" week 12 one happening). Nice your doc is giving you a fairly full compliment of VL testing, I like that. (4 weeks/8 weeks, then EOT+12 and EOT+24).   I hope you do not have to pay out of pocket for this 8 week one! That he agreed with you. That the week 8 would be covered as standard testing? 

Well hop-along, aside from the toe, how has the rest of the body been feeling? Hope you're feeling as good as your labs are looking!  C.

Great News JB and glad you are finally getting some relief with the toe. That will certainly be some story to tell in the years to come. "How I broke my toe"

Bloodwork at EOT+12 weeks and EOT+24 weeks is what would usually be your "Sustained virological response", (your "official" SVR12 and SVR24)  - the UND you have acquired while on treatment, it will be retested and ascertained again  (via taking VL's) at EOT+12 weeks and EOT+24 weeks. In all likelyhood they will do LFT's at those times too. (I think you and your doc had previously discussed doing labs at EOT+12 and EOT+24, right?)

What I was really asking/getting at, was why you had a VL done at 8 weeks, versus (more commonly) a VL done at 12 weeks (nearer to the EOT) - perhaps it was just your docs preference/choice/planning/managing/timing. I wondered if he might STILL do a EOT VL on you, even though you had one done at 8 weeks (perhaps your 8 week VL was an extra one for some reason or as is his preference), or maybe the 8 week one will just suffice to be considered your EOT one (basically). 

Aug 18 EOT is not far away, your toe should be feeling way better by then, and I think your liver is already feeling waaay better right now.  C. 

CONGRATS JB!

UND, and that's just the way we do it bro! Us epclusa folk are jes killin it! Welcome to Club Zero.   

Whadya mean you were disappointed with your 4 week!, jeez, <15, crashing virus and labs all over the place - it was a huge messy massacre "done deal" way back then!

I sound like a waiter - would you like a little ALT and AST with that delicious UND. If you did get LFT's for this 8 week VL let us know what they are.

So, if you got an 8 week VL, does that mean they skip any EOT VL? I know you said they planned on doing the SVR12 of course, and a SVR24.

Hey, so glad you got the boot (heehee), you DO mean a "medical" type boot  don't you? That would please me no end, as I think they are seriously a good helpful idea for a toe fracture. They take some gittin used to in themselves though, like crutches do, you can break something else learning how to walk "with " appliances! 

Wish you could take a bit of beach time off and rest that foot, and have nothing to fret over cept keeping the sand from getting inside it. 

So glad to know you are UND now. C. 

Congratulations, JB! The Dragon has left the building.....

JB  

that UND is music to the ears.

Congrats...

Glad you found a walking boot that helps. Hope your toe recovers soon.

JB !!! , money well spent to hear "undetectable". so awesome. congrats 

5

Greetings, friends!

I'll start with the boring news. My toe still hurts. I was just wearing a comfortable sneaker and it wasn't helping. Today I started with a walking boot and it helps so much when I need to be on my feet (which I must do for work). This will certainly help the healing process and make things a bit more comfortable for me. 

And now the good news! I had my 8 week blood work done on Monday. The doctor called today to let me know that I'm undetectable! Finally. I was annoyed after the four week blood that I was still <15. Fingers crossed it's smooth sailing to the finish line and to the 12 weeks post treatment blood draw.

On a side note, I had to pay $79 out of pocket for the blood work because I wasn't a liver transplant patient. It seemed odd, but I didn't care. That's not even my deductible for insurance. I thought for sure since the doctor ordered it, it would be covered by insurance. I told the doctor this today and she was pissed and said that wasn't right. Maybe I'll get a refund :)

Hope everyone has a good rest of the week!

JB 

Details, details JB!

Which toe, which bone, what kind of fracture? How bad is the break?

Are you required to work, you mentioned a desk?? hm, OK to sit at a desk but ... still, the foot ends up being dependant too long, if you are still having swelling/pain issues.

The ideal would be not to weight bear much on it, move it/use it/abuse it (the fracture line that is) at all, until you have sucessfully knitted the fracture intact again. Worst thing is to keep distrubing/disrupting/moving a fracture line while it is in that important initial process of trying to heal fracture. 

Now, if it we me? I'd book off work, get someone to carry me around, get to a beach (like that nice one in your avatar) for some R&R therapy, and make use of lolling around on floaty things in the water.  C.

Ah darn it!  Broken toe = annoying pain. I guess the Universe wants you to take it easy while you kick dragon butt ...and is making sure you do. 

Yes bummer JB....Broken toes are no fun...they are only little but by crikey they hurt. An arm or a leg once they put a plaster on the pain almost vanishes but with toes where they can't do anything. Hope the pain eases quickly for you...

Last month coming....Great. Pity the toe getting in the way, and what a way to break it! You poor devil. Thinking of you.

OUCH!! 

I had a feeling it was fractured, bummer. Sorry you’ll have to put up with it, but at least you know why it hurts so much. Time to kick back, elevate the sore toe and catch up on some daytime TV!

we're on our way over for rice and beans JB,  

guess we'll have to do the cooking and serving tho cos of your foot.. 

5

OK, JB, rice and beans for everyone eh?  C.

ok, now i want some rice.

Glad you’re feeling better, John. That entire statin thing sounds like it was hard on you. Good thing you discovered that right away and didn’t suffer through weeks or months of it before figuring it out. Sadly, that happens to a lot of people while they figure out something that will work for any given condition.

JB, stay off that toe! Don’t keep ice on it too long. If the swelling doesn’t go down, you need to get it looked at. There are meds they can give you to help with any inflammatory processes, your doctor can advise you on them. It is unfortunate that just about everything we take is filtered by the liver and all cause varying degrees of hepatic stress. I‘m still a firm believer in that organ though. It’s a tough and has to be simply because of the job it was designed to do. It can take a lot of punches, but we have to help it dodge and weave as many blows as possible! How’s that for a boxing analogy? Ha, ha!

I will never take Tylenol again. I want to keep the meds my F3 liver has to clear as low as possible. On prescription I take one 50 mg tramadol daily for arthritis pain; two on the occasional bad day when I have significant pain. As well as a centrally-acting opioid analgesic tramadol also has anti-inflammatory activity (the mechanism underlying the peripheral anti-inflammatory effect of tramadol remains unknown.) Still cleared the virus at ten weeks.

6 more weeks before I check viral load again at EOT + 12 weeks. Very thankful for this forum. Thinking about buying a rice cooker now:) Canuck I'm feeling better as each week passes once that side effect problem I had with the Crestor incident passed. Sorry to hear about your toe JB hope you are feeling better soon.

heehee JB, I LOVE rice! Reminds me of my cousin when we were kids, being served supper by my Mom, cous says ... "what's THAT"! ... "rice" my Mom says, cous being an Prairie Orangeman farmers daughter I guess and never eating anything but good ole spuds, informs my Mom, "we don't eat rice" ... my Mom informed her that ... "here you will eat rice and you will like it!" hahaha. Oddly enough, in the end as it turned out, she did like it! 

You are not alone in the toe dept JB! It seems to me that we have had a few here with the very same or very simlar unfortunate nocturnal mishap, some just to do it in the dark of the night, with the help of pets, or furniture we swore had mysteriously aligned itself to show it's not known before hardest corner, or just blame it on a urinary urgency race, but all had to do with being on hep c treatment. A temporary occupation hazard it seems. I guess be glad you did not do a header as well. 

4 grams, 3, 2, 1 or 0 grams of tylenol (or, more often than not) no drugs or sups of any kind while on treatment or when you have liver disease is a call lots of people make all by themselves, all on their own, and, right or wrong, folk often just naturally decide they do not want to add anything to the mix of having a body that is already busy dealing with a systemic disease - can't blame them either, but nor do we want to see anyone suffer for lack of a little medication - it all boils down to common sense, and perhaps a little advice when one is unsure or unfamiliar, and your doc preferences. Good you had already cleared tylenol use with your doc aforehand, as you and he know the most about you - to ask ahead of time, that was the wise thing to do.

If we must nuance tylenol opinions/studies, then I agree with Dr. Eric Yoshida, the evolution of extra-strength 500 mg tablets versus 325 mg tablets and other OTC acetaminophnen products at least present a problem as far as overdosing. Seems a person jes kint be too kareful these days! I agree with you JB in the lament about how it is too bad about tylenols lack of anti-inflammatory properties. Aspirin will always have it's place of honor at the table too, when deciding on choosing a safe and appropriate med for what ails ya. Some docs forbid aspirin-based (acetylsalicylic acid) ones, others do not, and for their own good reasons. Common sense consensus is the thing.    C.

PS - I always love gazing at your avatar, how did you get an advance booking/seat at the exclusive Club Zero, which umbrella is yours? Soft warm sand between the toes will be good rehab/phisio. 

Thanks everyone! I've taken Canucks' advice and am eating lots of RICE. Thank you! I enjoy brown - a bit healthier.

On a more serious note, I appreciate everyone's concern. I did confirm that my doctor did state initially that I can take Tylenol as needed for pain. I took one yesterday evening and it helped. Too bad Tylenol doesn't help with the swelling, though. As you all know, I was advised not to take any NSAIDS. I'm not in so much pain, though (knock on wood). It is just uncomfortable when I walk and feels very stiff. 

I had to work yesterday (at a desk) - so I stayed off my feet and iced it and elevated it when I could. When I got home I didn't get off the bed - and have my foot elevated and am icing it. I applied some tape today to stabilize it and that seems to help as well. I cancelled all my weekend plans and will just be taking it easy. No 10,000 steps for me for the next several days. 

If it is not better on Monday, I'll go to the doctor for x-rays. However, there is not much to do for a broken or sprained toe. Lots of doing what I'm doing now - RICE. 

Thanks again, guys! 

JB

willbb wrote:

---

Always best to discuss any medication with your physician

---

 Exactly! As much as we would like to advise people on what medications to take, we can't do that. That's my rule here. The references are always welcome, but you're right, Will, people should always consult with their physician before adding any new medications. Especially while they're on treatment with these DAA's. My niece OD'd on Tylenol, by accident and her liver suffered greatly from it. I always get a bit nervous when I see people taking large doses of Tylenol when they are already experiencing a hepatic injury or disease.

Good article!

Hello JB,

I negated to reference(which is always a good idea) one of the  "many" peer-reviewed articles(inclusive of exerts from the CDC,American Liver Foundation and the FDA) on pain mgmt. in patients with chronic liver disease,when I commented(not advised)on your statement: I'm pretty sure I can take 2000mg. of Tylenol per day".

Always best to discuss any medication with your physician

https://www.practicalpainmanagement.com/treatments/pharmacological/non-opioids/safe-usage-analgesics-patients-chronic-liver-disease-review.

Sorry JB - I just need to say hello to willbb on your thread for a second, as he seems to have no thread of his own.  

 Hi again willbb!, i see this is your your second "advice" post of today .... umm, when are you going to introduce yourself ? Jes wondering who we are talking to?  No intro, no hx, no sharing about who you are, your hepc experience, treatment(s) done, bio, signature line (or anything!) since January - makes you a newbie mystery man. Soon?  C.

Tylenol is generally safe to take, but we don’t like to advise anyone on what types of medication they should or shouldn’t take in a situation like this. Tylenol, taken on a routine basis is hard on the liver, so keep that in mind. Better get the approval of your doctor. If you have a fracture or severe sprain, the discomfort will get worse over the next day or two. Find out what you did and seek the advice of your doctor. You don’t want to delay treatment if there’s an injury in need of attention! Follow Canuck’s suggestion and ice it periodically and elevate it to reduce swelling. Rest is always a good idea. Good luck!

hi JB, you can always call the pharmacy. we were taking ibuprophen with their blessing.

so sorry to hear about your ankle; so now you will be resting it and your body more and that's ok

I'm pretty sure I can take 2000mg of Tylenol per day, but just wanted to be sure. Any negatives to taking Tylenol while on Epclusa?

----------------------------

Thats correct JB. It has been proven in research that up to 2000mg of Acetaminophen is safe to take over a 24hr. period  for those with liver disease (including chirrosis).

The FDA prescribing info. has no contraindications with taking it with Epclusa.

Good luck with the toe.

oh! OW!! RICE is a priority, hope you have already been on it - the rest, ice, compression, elevation! Especially important to do so the first minutes, first hours and the first 24 hours to prevent too much microscopic bleeding, bruising, swelling at the injured area. 

I sure hope you do not have to be on your feet with this new toe injury, it's very much worth it staying OFF your foot and most importantly keeping that injury elevated (above the level of your heart) - hope you can (stay off it and elevate it). Next, please do go seek an opinion on whether it is fractured or damaged/sprained. They may well have some helpful advice/devices for you depending on what you have done - from taping to splints to supports to walking air cast thingies - devices can sometimes make a huge difference in getting along with and getting over a foot injury. 

A large obvious fracture will show up right away on xray. If it is a tiny fracture somewhere in there, sometimes an immediate xray might not show it up, a repeat xray days later often can help to show up a tiny fracture previously not imaged, as re-calcification starts to become apparent within days. But even just a physical exam by someone with experience, a clinic or ER doc, will likely provide you a good guess on the likelihoods.

That is a large amount of tylenol you are talking about possibly taking! Yes, if you have pain you can take a single dose of tylenol, but see if that single dose will do it for you and how long it lasts, see if a single dose cuts the pain enough, if not you can always take one more single dose - but if you are on your way to a doc for an opinion about your injury (which I think you should do) you can be sure to ask how much pain meds (tylenol or whatever he recommends) would be the smallest amount you could do and it still be minimal and effective.

To take your mind off your toe, just imagine and envision what hell and pain and death throes you have just put your virus through, and wash it all down with lots of lovely water.  Hope the toe stops hurting soon, go seek some advice for it please.  C.

Good job!

yay JB

i like stl's idea of half baked.hahahahahaha, and her with only 15 beans to go

99 magic beans on the wall, 99 magic beans, take one away and whadda ya got? 98  magic beans on the wall......... and so fort

it's supposed to be bottles of bear

-- Edited by 5-1-18 on Sunday 8th of July 2018 05:50:42 AM

Yay JB - 42 magic beans done for you! : )

And only 15 more for STL!

You and STL running good, and ever closer to that finsh line ... I keep hearing this distant drumroll, heehee ... 

https://www.youtube.com/watch?v=62erF1TM6_E

Before ya know it, you'll both be sitting pretty at Club Zero - we have a special spot reserved just for folk like you at the exclusive velpa club.  C.

Yea JB your half baked then ROFL.... Your doing great. I have 15 to go!

Just realized today was bean #42... half way done!

Today I think I will watch Forrest Gump. JB has kicked off his leg braces and is not looking back.    RUN JB RUN  

RC

Hi JB,

I think it is fine to do what you feel capable of doing, you felt capable of doing the 10k and did it so I think thats all good. It made you feel good to achieve it and I think that is good. Far better than sitting home wishing you had tried it.  We need a positive attitude, and if a good walk run makes us feel good that is good. I have been big on walking too as you know. I started a few years ago when I started working to lose weight. At my age and given the size I was I initially I wasn't capable of much but I improved. Before I got my pup I was doing 5k at least in one go more often 7 - 10 but since she is little and has little tiny legs so I don't do more than 5 k these days. I don't find it hard to do and I enjoy my walks. It is good for me. My liver specialist noticed my excess skin and asked about weight.  I told her I usually do at least a 5k walk a day and had done 9 the day before,  I generally do 12-20,000 steps a day and  she didn't find that a problem. She just said if you don't feel up to it, don't force yourself while on treatment. Good diet, whatever exercise you feel capable of doing, make sure you stay well hydrated and plenty of rest are whats important at this time so I have not changed any of that. These days its more likely the weather that will stop me walking rather than being on Epclusa. Of course I wont know if the dragon is dead until late Oct.

hi JB, mainly it's important to know what your body needs. 

i work so i had to save my energy for work.

i'm glad you feel well and are drinking lots of water

Wow 10K JB onya!!!!!! I try to still do my 10,000 walking but have to admit some days are just "no b bo'd" type days (can't be bothered) - days where I am lucky to get 7/8000. I did get a 20,000 day on the 22 May but not in one big walk. A 10k run without treatment is some achievement and on treatment you are amazing I don't run.

JB,

Congrats on finishing the 10K! You know, you should probably be taking it easy and not pushing those kind of limits, right? Use that energy for fighting that Dragon. There’s plenty of time ahead of you for marathons and the like! The new treatments are so different than what I experienced. I was so sick and weak, it was work just to go into the kitchen for food and drink. I’m glad you’re able to accomplish such things. Don’t push it, you’re taking some incredibly powerful drugs and they are assaulting your metabolism in harsh ways, whether you’re feeling it or not! Slow and steady, Bro...

Thanks for the Independence Day wishes!

Today was a special day. I ran my first 10K (6.2 miles). I had no intentions whatsoever to run/walk it. However, I feel good. I've been averaging 10,000 steps per day (walking) and wanted to prove that I could complete a 10K. As I reached the finish line, I could only think of the symbolism as I near the end of this journey and start this new lifestyle of healthy living. It was only fitting that I finished just in time to take pill 39 after I crossed the finish line.

Thought I'd share...

... And for those of you in the USA, Happy Independence Day!

JB

-- Edited by JB on Wednesday 4th of July 2018 12:54:44 PM

Hey JB,

If she wasn’t concerned about those numbers slightly elevated, nothing to worry about. If you know what they are, just list them and we can review them. As you said, if she isn’t bringing concern to them, don‘t be concerned. There tends to be some fluctuations in some numbers, but as long as the ALT and AST are headed in the right direction, you’re doing well.

4 weeks down and things are looking fabulous! Keep hydrating and you’ll be dancing on that Dragon in no time! Good luck

Wonderful 4 week results JB!

If you are on a budget and have to pay out of pocket for 8 week labs, then it's up to you if you want to have LFT's and VL drawn again at 8 weeks (like your doc said), BUT, if it costs you nothing, then of course I would have lots of bloods done, I always like to see the numbers as I go along! BTW - were there any 4 week bloods they drew aside from ALT/AST and VL? 

I am betting you may routinely be given (at EOT or shortly before EOT) your EOT VL and LFT's anyway. 

You might phone the doc's office just to clarify with them IF they have planned for you to have a EOT VL, and then will also be getting a EOT+12 week VL, and then a EOT+24 week VL done.

If you ever get around to it, you could add/delete from your sig line - 

... " are you a 3a or a 3b, do you know? - BTW - now that you have the actual fibroscan data, we could update your sig line - and show you are F3 only (not F4), being that your kPa's were at 11.1 (thus just another nice indicator showing you are not, according to kPa's, in the F4 cirrhotic range), unless of course you had other tests or other seperate blood tests which were supporting a possible F4 range, then you should include all results, by all testing methods - and, maybe we could squeeze it into your sig. line, add to the sig. line, (after the MRI bit) that the MRI also showed (aside from no cirrhosis) that there is likely no fatty liver as well (as was first suspected via your U/S)." ...

- some of us alternately post our ongoing and updated lab record results in our bio's - like our 4 week labs, 8 weeks, EOT, or SVR12, SVR24 results, etc. 

I bet your doc is VERY pleased for you how stupendously the epclusa is working for you! So are all of us!   C.

Congratulations JB. Isnt it a wonderful feeling to know these Magic Beans really do work their magic.... How lucky we all are to have this opportunity to be free of this freeloader forever. They certainly are amazing drugs. The will finally shine again for all of us dragon slayers.

that is wonderful news JB

better liver panel and proof the magic beans are working.

to get the stick or not would be you wanting to know more sooner.

i got the 4 week but not the 8 week and waiting 3 months is ok with me.  STL is also waiting till oct. to find out the eot score.

for now just enjoy knowing your liver already feels better than in years and can actually get some rest as the beans clear out the virus. your immune system is now having a party cos it can finally get some work done without having to beat back the virus all by itself

rest and water friend. 5

That’s fabulous, JB! They are excellent numbers, well within normal limits. That tells me the treatment is working and making for one happy liver and one pissed off Dragon! If the viral load wasn’t quantifiable but detected, it simply means the viral load must be below <15 IU/ml (<15 viral copies can only be detected, and not quantified). This isn’t uncommon at all. Many go through treatment with the same results. I have a friend that tested that way after treatment was completed, but was SVR12. These drugs work differently, so you have no reason to be concerned with this at all. By today I am certain that you would be undetected, were you to repeat the test. Congratulations! 

I‘m always a big fan of tests every 4 weeks. If your insurance covers them, do it. Mine covered them 100% as long as the doc ordered them. I know they’ll be as good or better in 4 more weeks and good news is always a huge morale booster.