Treatment Adherence a BRANT ™ and God
Treatment is no different to life, when faced with a challenge the first question you should ask is “what can I do?”. On treatment for Hepatitis C the number 1 thing that is within your control to influence the outcome is adherence, thats a fancy way of saying you need to take your meds when you are supposed to and take them and as often as you are supposed to take them. Life is rarely black and white but in this case lets go out on a limb, the only acceptable level of adherence is 100%, 99.9% is not acceptable. Really people buck up, how hard is it to do one injection a week and a few pills twice a day?
MartinB says it better than me in one of his famous BRANT’s ™ [Martin B + rant = BRANT ™ geddit?].
The issue of compliance, or adherence, surfaced again the other day. Just about all the accepted drug trials are done in the US where compliance is considered to be 80% of the medication for 80% of the time, and this is for properly conducted trials! The effects of getting this figure nearer to 100% seem to have been vastly under-estimated. This explains the poor success rates continually achieved in the US in the ‘real world situation’, where actual compliance is probably even less than the quoted figures, and of course the temptation to ‘meddle with the medication’ is stronger. Adding extra medications to treatment, both herbal and conventional, is commonplace, and the effects of alcohol and even excess fluid intake all contribute. It explains why the UK gets better results, as there is less temptation to meddle. The average UK medicine cabinet usually contains aspirin and plasters, and not a complete drugstore!
The effects are quite significant. The study I am reading at present shows that genotype 1 patients can add up to 13% to their chances of a cure just by doing what they are supposed to anyway. There is a lot of difference between a two to one chance of a cure and just 50/50.
In my opinion he is spot on [apart from the water issue but lets not even go there!], the figures back it up and in my experience of trawling the various hepatitis c forums so does the anecdotal evidence. The number of posts I see from our American comrades along the lines of “I didn’t feel too good so I skipped the meds for a couple of days” or “I’m going away for a few days is it OK to forget the meds” would amaze you. There are no circumstances whatsoever when you skip meds without your Doctors specific instructions, and even then you should demand he/she makes a good case and says pretty please, twice.
So where does God come into all this, apart from the obvious fact that I am an arse let me run this by you. Draw some graphs with 1 being least belief in God [of the Christian variety] and 10 the most, do the same with “success” on treatment including how well it was tolerated, join the dots. I wouldn’t be surprised if you saw a direct relationship between the belief in God and the “success” of treatment, more God = less success.
Now seeing as I have dug a hole for myself lets dig some more. Maybe I am thinking too deep, maybe its just related to intelligence, maybe its as simple as Americans have a lower IQ than Brits and also the lower the IQ the more likely you are to believe in God. Lets call it the Bush Rule of treatment.
Maybe its a simple as Americans and Christians are more likely to be retarded and dumb people have less success on treatment than others.
And yes I can hardly believe I said that either. Flame away, but remember don’t hate the playa, hate the game.
December 21st, 2005 at 11:43 am
Working on week 1
WOW ! I am not sure how to respond to that last paragraph. I am a Born Again Christian, American and highly educated. I do believe in God and in fact He has seen me thru several life threatening illnesses in the last 52 years. I am confident this treatment will be sucessful as I know God’s will is for me to be well and strong. I plan to live a long time and see my 6 children and my new baby granddaughter grown.
I, too, am a positive person, always see the glass half full. I agree with the 100% adherence to treatment, no excuses! Thank you for the side effect site, it was helpful. I have exprienced several other side effects over the last few days, fatigue, nausea, insomnia, none too severe.
Thank you again, and Merry Christmas! Remember, Jesus is the reason for the season !
December 21st, 2005 at 12:03 pm
Interesting take you have there.
I’ve run into quite a few people who have been through near-death situations, whether health, accident or otherwise and many have stories about being alive due to divine intervention.
I don’t think I’ve ever heard anyone say they got through something like that due only to their own will and perseverence, but maybe I wasn’t listening.
December 21st, 2005 at 12:07 pm
Thanks Jimmy!
I have to be honest I was being somewhat provocative. I have a lot of American friends, comes with my work, spent a bit of time in that wonderful country the last few years. Quite a few are of the born again variety too. These are well educated people, just not as educated as the Brits is all I’m saying [thats a joke btw :)].
I suppose the point I’m trying to “provoke” some discussion on is what really are the reasons for the big differences in sucess rates between the countries. The treatment itself is pretty much the same with the exception that as a rule in the UK there is little in the way of intervention with procrit etc. Maybe, just maybe this could be one of the reasons, maybe dose reduction is more benificial than intervention?
The differences in adherence troubles me somewhat, I can’t see a simple reason why. I’m grasping at straws a bit [well a lot] but statements like ” God’s will is for me to be well and strong” make me stop and think. I mean God isn’t going to take the tablets for you, I can understand having “faith” can be a reassurance but worry that it could also take the edge off your game. When push comes to shove many of us got hep c through our own “free will”, in my view its that same free will that will get it out of us, I just don’t really see a role for God in that process.
>Remember, Jesus is the reason for the season !
Nah, the military industrial complex’s need for ever increasing cconsumer consumption is the reason for the season
How goes week 1 so far?
December 21st, 2005 at 2:26 pm
Week 1 so far-
I am working everyday while feeling tired and somewhat strange at times. Only had one really bad day the rest are normal. I am eating cereal for breakfast, a small lunch if any, drinking lots of water, orange juice and tea. I am eating too much for dinner and having some trouble sleeping thru the night. I coach a youth basketball team on Tuesday night and Saturday moring. Last nights practice was more tiring than normal for me so I assume that is the treatment fatigue factor. My wife would say I am somewhat irritable also. I get my shot from her every Saturday afternoon so I don’t need to upset her. Week 2 will begin on Christmas Eve and I am anxious as to how I will be on Christmas Day? Last Sunday I felt pretty rough and slept alot. In the event I feel that way again we will have Christmas dinner and presents on Monday. My wife always has a backup plan.
The success rate thing bothers me too. I think, no, I know, the American mind set is to cease a treatment plan when you feel better or if the treatment feels worse than the illness. We do seem to think as a culture we can do as we please and live forever, chose our own doseage more or less in many things. I learned the hard way to take all the meds prescribed, as prescribed, for as long as prescribed. Once I was diagnosed I wanted to begin treatment as soon as possible. I may be in the minority, but I will be in the 100% compliance mode until I am told to stop. Another issue here may be cost of the treatment. I was in shock to learn that my cost, with insurance paying 80% was $650.00 per month. I have very good insurance and it picks up all the doctor visits, labs, etc., 100%. I am sure other insurance companies are not so generous. I would like to hear any other thoughts anyone has on the success rate issue.
December 22nd, 2005 at 2:07 am
Thanks for the update JImmy, sounds similar to my start. You may find the screw tightens a bit over the next few weeks but keep the faith and eat some lunch!
Good point on the insurance, thanks for the input.
December 22nd, 2005 at 12:16 pm
“Maybe its a simple as Americans and Christians are more likely to be retarded and dumb people have less success on treatment than others”.
As I am a Christian and have just failed tx I must conclude by your standards that I am BOTH dumb and retarded.
Dumb enough to read your blog and retarded enough to understand it.
Paganism is the reason for the celebrations of December 25th actually. The daft bishops of Rome saw that it was a really good knees up so they decided to stick The birth of Jesus tag on it.
It never worked. It just confused the party.
I prefer Easter. There is no confusion about The son of God dying a bloody death on a cross for your sins and mine.
Paul.
December 22nd, 2005 at 12:52 pm
Well said Paul !! I teach my children that this season is about God’s gift to us of Jesus so that he could die that bloody for all men’s sins. I understand the history of the season all too well but in the place and time we live in “Jesus is the Reason” I celebrate this season.
Hep C Boy- I will work on the lunch thing. I remember the nurse saying several small meals would be better for me. As for keeping the faith, many times in my life all I have had was my faith that God loved me and cared what happened to me. I am a man truly belssed with a wonderful wife, 6 fantastic children, 1 grandchild, a great job and I am still breathing in and out everyday. If you know your Old Testament, I have lived much of Job’s life and God has sustained my all the way. Thanks for your encouragement and efforts to post this site. It continues to be a blessing to me.
December 23rd, 2005 at 12:09 am
Just a note so you don’t think I’m ignoring Ken, I’m still recovering from him tearing a few strips off me on AIM, we go back a long ways. Just so you know I can say with 100% certainty that Ken’s life has been much more fulfilled since he found God, maybe there is something in this God thing after all. Remind me to share with you someday my one and only experience with the Lord.
On a more constructive note - some people do better on TX than others, some groups do better than others - I want to know why. I want to know what are the most effective steps that someone can take to rid themselves of the virus and/or prolong and enhance their life.
I am going to start a new post and see if we can get some stuff down on “paper” worth thinking about. Click here for the new post.
December 28th, 2007 at 12:14 pm
I am Genotype 1. I have followed the treatment as prescribed and have abstained from alcohol. After 4 weeks I was a negative viral load. Compliance! Compliance! Compliance! Compliance means NO ALCOHOL either. I would love to know how many people consumed alcohol while on treatment and had success.