Was told to lower pegasys dose wk 12 WHY?

[denigreg]

Hello all I had lab work done last week. Did shot and now doctor's office called and told me the doctor
read my lab work from last week and to lower peqasys shot from 180 mcg to 135 mcg. So I asked why and she told
me doc said too much to go into depth over phone. Would need to see me. What the hell is going on? WBC has been down for weeks platlet among a few other things. RBC has been fine. Should I drive 5 mins to get lab work from
hospital? Doc's office is there too. Why would I have to lower dose now after b4 12th shot? Riba is 1000 was @ 1200 but lowered because of shortness of breath. Help! Love you all. Hope everyone is doing well.
Denise
And why couldn't he just say he could call me back and explain?

[merryBe]

opps forgot to say your early lab curve is immaterial, its the curve past the first few weeks that becomes the biggest concern....the first couple weeks you will pull from stored in the spleen.   The cells take time to die off...weeks for some of them, but if you have an early abrupt drop, or a severe drop a few weeks in, they will want to head off at the pass what could happen.  
they also have to cover their arshes, and get paid...I'd just go in, let them get their fee and tell you why...it'll give you a chance to confront about the blood builders...better to do this eyeball to eyebal. You have to get a doctor to want to go to bat for you...and part of that means learning to listen and developing a rapport with them

[merryBe]

it's not just about low or crazy low, it's about how fast you've been dropping.

also, where's you HB and hematocrit?

how they fall from lab to lab determines when enough is enough.

the good news is your pic indicates and average weight, you would have been dosed lower by may docs to start with, small women have less marrow and have the most issues as a result, but you should be fine at 135....I'm glad they gave you a hard punch to start...but dialing it back a little may be wisdom for small people. 180 is for big burly guys and heafty gals....if you are concerned I'd look at all the blood work...if you are UND, a dial back should be fine...if not, both Epo and neupo need to be looked at.

A liver doc doesn't get as alarmed by drops as a GI guy does, they see it more often, but it still is important to do the math.  example..lets say you lost half your platlets in a few weeks, if the curve continued and your marrow didn't kick into hyper at that rate theyd be non existant in another month...so all kinds of things play into what they so.

it's also important what kind of insurance you have. If you are working for a company or agency that is self insured, or by your own insurance you are proteted by Erisa laws...and you can't be denied what the doc recommends...but if not, some of the insurances really fight the docs....as each blood builder costs 5 to 7 K per month.   thats thousands of dollars.   My docs postponed even trying to get me blood builders because they are so used to denials...at the time I didn't know about the Erisa rules.
hope that helps

mb

[copyman]

I don't think reducing your dose is necessary at this point. I wouldn't do it. If this doctor don't know the latest protocols then find one that does!

Take care and best of luck

[joemc34606]

Please don't lower your dose for low WBC, my first time around in 2007 the gastro I was seeing lowered my dose for the same reason, the virus came back within a couple of weeks. I then learn on this forum that I should have been seeing a hepatoligist not a gastro that was the best decision I ever made. Nuepogen is the drug you need and it will help you feel better within a week.
Good luck keep up the dose.
Joe

[denigreg]

Thanks all! Been having drain/brain fog very bad  past few weeks! Husband found me throwing
spoons away, I found pills in bed, cooking accident, drove off road on my way to my sister's in NJ few weeks ago and not 5 mins into an 1 hr 45 min ride and hit gaurd rail. Scraped from one end of the car all the way the other! I'm so stressed! Guess I'll wait till weds when I call to know why he lowered my dose! Need peace right now.... Looking forward for more input!
Denise p.s. I never made it to my sister's - went home to bed for 2 days :/

[can-do-man]

Oh my, he's already lowered your riba, now wants to lower your peqasys. I would ask him why? Your on treatment doe's he not expect to see some decease in you CBC's?

I know what i would do, good luck going forward......... Wishing you the best.