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My opinion is that Pegasys is the better of the two, but that guarantees nothing in terms of results or side effects. I assume since you have been reading this board for three years that you probably know this already.

Your smoking may be as responsible for the progression that you have as any other single factor (again, articles are on the website) You must stop in order to have the best chance at the result that is most important for you, namely improvement in your liver health. Viral response is good, but the histological improvement will be the key goal for you and that means no smoking at all ever.

Even if you do have an SVR, the chances of your liver being cured of the damage already suffered is remote. In the best possible scenario you will have improved the architecture of your liver and be able to forestall any further damage. That will not happen if you continue to smoke. You cannot heal a wound and pick at it at the same time. Prevention of more scarring is the name of the game and you have no more wiggle room.

Ask your doctor about the steatosis. I think this means fat in the liver, so your diet is going to be important from this point on. (website)

Anti-depressants have side effects, too. I cannot understand the theory of prophylactic use of anti-depressants without any evidence of their need. Have you ever been suicidal? Do you have any psychiatric conditions that would indicate the need for them? The psychiatrists and neurologists I have consulted on this do not support this practice. Having said that, the antidepressant Wellbuterin is FDA approved for smoking cessation, so you might discuss this with your doc and kill two birds with one stone. I have no idea whether the Lexapro would serve as well.

You may not have serious side effects at all. There is no way to tell in advance. Your weight is on the slight side, so that is a big plus in terms of response rates.

Make sure your finances and your homelife are all in order. This can put a strain on the best marriages. Childrearing during treatment can be very hard, so prepare those around you for a time of chipping in with more than their share of the chores and for understanding that you are not going to be yourself for a whole year. This is serious. Do not go into this treatment without getting your support system onside and clearly understanding that this is going to be hard on them, too.

Likewise, form a plan around your worklife and make sure you know in advance what you are entitled to, what your short term disability is like and, if you have the option, sign up for the extra (AAFLC) insurance that pays your salary if you cannot work for a period of time. Get everything assembled in one file or drawer just in case you need it. Treatment is stressful enough without the addition of fighting with people for what you atre entitled to.

Lastly, but not least, make sure you have a conversation with your provider BEFORE beginning treatment regarding what you can expect in terms of support for side effects (just in case) Some providers think that an anti-depressant is enough. And, for some (those that need them, that is) it is. For many patients, it isn't enough. Make sure your provider is on board with pain medications, sleep medications and any other medication you might need during this year. Also make sure in advance that they WILL co-operate with any disability forms, letters or plans as required. Big red flag: "you won't need any of that" or "we'll cross that bridge when we come to it." Do not allow them to minimize the potential for having side effects. Back them up right there and make sure you have an understanding and IT IS WRITTEN CLEARLY IN YOUR CHART. These situations always seem to occur when doc is on vacation! The office nurse can be your best friend or your worst enemy. Know in advance which one she is.

I have stressed the things you will not hear from other sites and other people. There is no question in my mind that, barrring anything you have not told us, you should treat. Make sure you have no condition that will complicate things for you, and that you read through the manufacturer's material found on their website.

Prepare for the worst, then expect the best. We will be here if you need us all the way through.

I hope this helps,

Hi Cathy,
there is no SUBSTANTIAL difference between the two drugs. Both are Interferon. I am not a doc, but my doc suggested me Pegasys, and it was conform with all infirmations I have - Pegasys is probably slightly better. The reason is PEGYLATION. What is it?

Interferon itself disappears from the body very quickly. Thats why you must shot "plain interferon" three times a week (at least). Pegylation means, that Interferon is bound with a very small particle of plastic stuff (PolyEthylenGlykol = PEG ?) and in this form stays in the body longer.

From different sources I have heared, that: 1st) Pegasys stays in body a little longer than PEG-Intron, and 2nd) Pegasys is cumulated in the liver and PEG-Intron is spread in the body (blood). For this two attributes is Pegasys better.

Well, when it comes to side-effects: Be a fighter!
Perhaps I have had a good luck, but I was on Tx (Pegasys) for 6 months, and colleagues did not know! Well, I must say that i work in the office, and have the possibility to go home earlier, if I need, atc.

If you ask, how fast this illness goes on - well, it depends.
I think Thanbey already wrote something about it. Only one think I will stress: Do not smoke!

I live with HCV for 30 years, and I am still in a good shape
(no alcohol, no smoking, no coffee :nono: )

Good luck! :wave:

Thank You Soooooooo Much! You are an :angel:
I wish I could give you a hug, but since I can't, I hope a BIG Thank You will do!
I have learned so much! You were so right! You stressed things I have not heard from other sites and or anyone else, including my own doctors! I appreciate you so much!

My liver specialist, whom I have been seeing for 3 years, whom by the way, is said to be one of the top specialist in this field in the U.S., I can't beleive that he:
1- didn't start me on a treatment sooner considering I was at stage 3 when
I first became his patient. He told me I had plenty of time!
2- never stessed to me about the importance of my diet,
3- never once stress the importance of not smoking, or explain to me that smoking damages the liver and it could speed up my progression of liver damage. He only stressed no alchohol. Which was not a concern for me because I don't drink. All doctors say at one time or another that you shouldn't smoke, but they never tell you what the real dangers actually are.
I sure wish I had known what I know now about smoking many years ago.
I probably would not be as far advanced in this disease as I am now. :mad:

What is important is that I do know now. (I hope there is some wiggle room left for improvement to my liver at this point, but if not, hopefully I can manage to help control further damage) I have faith in God and I beleive that through him all things are possible.

Thanks to you Thanbey, I am going to quit smoking!!!!
I know it will be one the the hardest things I have ever done!
I have been smoking since I was 12 years old. Hum...That's 34 years! :eek:
Gonna be tough, but I can do it. I got to! I'm working on quiting now.

I'm gonna ask my doctor about the Wellbutrin verses the Lexapro.
I may need all the help I can get with these smoking cravings.
(The anti-depressent Lexapro was recommended by my liver doctor for reversing depression side effects caused by interferon. I am not depressed at all, but I am concerned about the risk of the interferon toxins causing depression)

I have the most wonderful husband in the world! I know he will support me and help me get through any rough times I may have. But I worry about him, because of the stress it may cause him. He had a minor stoke 3 years ago. (100% recovery) He has a high risk for heart attack & stoke. He has to take anxiety pills and his doctor told him to avoid any stress. That is another reason I am thinking the anti-depressent is a good idea for me.
I don't want him to have to deal with me having bad mood swings or depression. He will have enough stress on him with out that.

I have 3 grown step children who are all married and on their own. They are great. I have 6 wonderful grandkids that are truely my heart. I take care of my Mom, she lives with me & my husband. She is 81. She does pretty well for her age, but she depends on me for a few things that she can't do.
I do not work outside the home now. I have been doing bookkeeping out of my home for several years now, so there is not problem with stoping that at any time I may need to.

I had a physical last week through my regular doctor. I'm waiting to hear the results from the blood work he done. They found cyst in both breast. One that is rather large and is sore, but ultra sound confirmed it was cysts & no signs of cancer. :) :bouncing:
I do not know of any other health problems I have. There is a history of heart attacks & cancer on my Fathers side & diabetics on my Mothers side. I have a brother who has severe Rhumetiod Arthritis due to what they said was a staff infection.
I feel bad all of the time, mostly tired & weak, but I feel like that is due to the Hep C & smoking. I have to push myself to do things, but I plan to stay active as possible.

I will be in a Clinical Trial for my treatments. My doctor has assigned me a nurse that I will be able to contact 24 hours a day if needed (so they say) He says that I will get the best care possible. He said I will see him once a month for bloodwork once I begin treatments. The trial I will be in is called "Head-To-Head" Comparison of PegIntron w/Ribavirin Verses Pegasys w/Ribavirin. This is suppose to give them results as to which of the two are better, or if they are equal in eliminating the virus.

My doctor told me I could choose the one I wanted. I could be in another trial if I preferred, I can't remeber the name of it, but it's the one with the stuff in it to help the immune system side effects , but my doctor told me that he prefer I chose the Real Deal instead of a new experiment, because it had not been FDA approved yet and they did not know what the side effects there may be, and if it didn't work for me, then I would have to go back on one of these other two for another year, but it was my decission. He said he will monitor me for anemia and adjust dosage if necessary.
I am going to tell him I choose the Pegacy's option. From what I have read and from what you have said it sounds like it may be a little better.

Thank you so much for all the information. I am waitng for my doctor to call me any day now for me to come in for my trial screening. He said they will do more bloodwork, a chest xray, electricardiagram, etc. (can't spell that one).
I plan make a list of questions to take with me when I go.

If you or anyone else reading this can think of anything else that might be helpful to me, or anything I might need to ask my doctor, I would sincerely appreciate it.

Thank you from the bottom of my heart!
I'll try to keep ya posted on my progress.
Thanks so much for all the wonderful and helpful information!
Thank you for explaining the differences in the two.
I can't get over how much I have learned in the last few days that I was unaware of.
I am so grateful to all of you that replied!!! I can't thank you enough.
My doctor says he thinks I may have had Hep C for 30+ years as well.
But now that I have learned that smoking damages the liver, I'm not so sure it was that long. I am working hard to quit smoking!
I do have one quick question for you if you don't mind.
I do drink coffee, but I've only drank decafe now for the last 4 years.
You said no coffee. I just wonder if decafe coffee is ok?

Thank you for the information and advice!
I am learning more each day things that I wish I had learned much sooner, things that could have made a big difference and possibly slowed my progression.
I am trying hard to eat better and stop smoking. I normally only eat one time a day and rarely snack. I have learned that is not good for my liver. The biggy that shocked me was to learn that smoking could actully cause liver fibrosis. I have smoked for approx. 35 years. I may have had some liver fibrosis from smoking before I ever got infected with the Hep C virus, and I know now that the two things together have been attacking and damaging my liver. I never knew these things until I read the information from the site that Thanbey refered me to!
I am starting to try to get some things organized (as you say getting my ducks in a row). I got a lot of ducks... LOL!
I want to make things as easy as possible for my husband.
I am the one who normally takes care of things.
I am in the process of making up a special divider notebook to keep up with all of my medical records and misc. paperwork, a daily journal, and misc. notes to help myself & my husband to keep track of special things to that one of us might need to remember, etc.
Hum.. I guess I had better clean out my kitchen cabinets. He'll never find anything he's looking for if he needs to cook. LOL!
If you ever have any other suggestions or advice to offer, I will greatly appreciate it.
I sincerely wish the best for you.
Thanks again!
Hey Cathy...Sounds like you are doing great! Yeah the smoking thing surprised me also as I never knew that it could progress liver damage. I'm not a smoker but do know people on treatment that do smoke and we are just now reading about this also. Yeah I don't know if your GI would want you on choloestrol medicine with the treatment and you should definitely run that by him. hahaha yep...clean out kitchen cabinets now because you definitely won't want to after getting started!! LOL Email me for anything you need as I'm on week 10 and will be able to help you! Good Luck Lady!

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