Treating kidney stone while on Harvoni

[NotToday2017]

Hi all,

I was diagnosed with Hep C, 1a about a month ago. It was discovered when I went to an internist for a full check-up because I was having back pain (back specialist said there was nothing wrong after x-ray, MRI, physical therapy, anti-inflammatories, muscle relaxers, massages did nothing to assuage) in addition to general aches and pains.

The hepatologist I was referred ordered an ultrasound, as per proticol. Liver was unremarkable (praise God), but the scan showed a 1.2cm stone in my right kidney. My hepatologist suggested I see a urologist. I will have x-rays and a CAT scan on Monday to determine location of the stone and if there are others that weren't detected on the ultrasound. The stone is too big to pass on it's own.

Meanwhile, I was approved for an 8-week treatment of Harvoni (again, praise God) and the specialty pharmacy has the medication ready to ship. However, I am concerned about starting the Rx while treating the kidney stone(s). While I will have the CAT and X-rays on Monday, the earliest I could get an appointment to follow up with the urologist is Aug 18. I am guessing, depending on the treatment needed, it could be September or October before I get the stone issued cleared up. My hepatologist said the hep c tx could wait until afterwards, but I'm anxious to get started on the Harvoni and I'm worried that if I put off tx, my insurance would recind the approval.

If I were to start treatment for Harvoni now and then needed to have Shock Wave Lithotripsy or surgery for the stone if it suddenly becomes a blockage, would I have to stop taking the Harvoni?

I've also read that some folks develop kidney stones while on Harvoni or post-tx.

I'm conflicted. TIA for any wisdom.

[gnatcatcher]

Your stone, being under 2 cm, would seem to be a good candidate for Shock Wave Lithotripsy (SWL). Based on the Harvoni prescribing information and what I read here:
https://www.kidney.org/atoz/content/kidneystones_shockwave
SWL shouldn't interfere with Harvoni. However, since it isn't possible to tell ahead of time whether SWL will work in a particular case, how advisable is surgery while on Harvoni? I found this link about MDs okaying surgery during Harvoni treatment:
https://www.inspire.com/groups/hepatitis-c/discussion/surgery-while-taking-harvoni/

Hep C does its damage over many years, so delaying the Harvoni treatment until October isn't a big deal healthwise. Your ultrasound found that your liver is in good shape. Back when I was seeking treatment, many people waited 3-4 months for insurance approval before they could start treatment.

If your hepatologist (who can communicate with the urologist long before August 18) thinks there are good reasons to wait until after the stone removal, then your hepatologist ought to be able to help you get your insurance to approve the delay due to "medical necessity."

HTH,

Gnatty

[NotToday2017]

Thank you very much, Gnatty. That helps put my mind at ease. Thank you also for the links. I am so ready to be healthy and anxious to get everything taken care of. Now hoping the CT scan and X-rays don't reveal anything else!

[gnatcatcher]

I have a CT scan scheduled for Thursday, so maybe we can keep each other posted. In my case, it's because a lab result that probably has nothing to do with my liver and had always been well within normal range started going noticeably higher than normal 4 months ago. The cause could be benign, or it could be any of a number of cancers.

FWIW, the first time an ultrasound noticed gallstones was more than a year after I finished Harvoni treatment. (It's probably just due to my being a senior citizen -- every ultrasound seems to find something new.) I'm asymptomatic, so I'm leaving them be. No kidney stones (yet?) in my case, but spouse had a kidney stone many years ago which SWL or something like it pulverized effectively.

Good luck Monday!

[NotToday2017]

Hi Gnatty,

Yes, please keep me posted on your results. I am waiting to hear from my doctor on the results of my scan and X-ray yesterday. I got a copy on disc so I am going to look at it today. I won't know what I'm looking at or what to look for, but that's what the internet is for, right?! 

I'm a doctot's worst nightmare...I will find every disease I could possibly have and ask a million questions about each one!

/NotToday

[gnatcatcher]

Wow, a copy on disc -- they don't do that here. My PCP will probably show me the scan on his computer, but that'll be a while -- the radiology report might be ready Friday (my guess), but my PCP is off all week and will probably be swamped early next week. Which is fine by me -- in this case, ignorance may well be bliss, so I've probably got another week to enjoy not yet having any new diagnoses 

I've had so many major diagnoses already, and it takes so long to research how any new treatment might further harm my damaged body parts, that I don't have time left to be a hypochondriac 

Fingers crossed for you.

Gnatty

[gnatcatcher]

Amazingly, the CT scan results were posted to my patient portal right around the time I got home from being scanned! Everything's normal. (That is, I still have the gall stones and assorted other oddities, but nothing new.)

NotToday, do you have results yet? Here's hoping you're in the clear to pursue Hep C treatment.

Gnatty

[NotToday2017]

Hi Gnatty,

I had written a long reply yesterday, hit spell check and then lost everything. Grrrr.

First of all, I am glad to hear about your scan (and how quickly they posted results)!

I got the report from my scan yesterday morning and there doesn't seem to be any issues other than the kidney stone. Hallelujah. The report doesn't say where it is and I don't know if it has a chance of becoming a block any time soon. My follow up isn't until Aug 18 and I can't get the nurse or doctor to rerun my calls. I think I am going to look for another urologist.

In the meantime, I am going to start the Harvoni. I spoke to my hepatologist today and said, "let's get started". They will place the order on Monday (it's already been approved), so hopefully a week from today I'll be able to start!!

Hope you have a fantastic weekend!

NotToday2017

Ps - pls excuse any typos. Not going to chance losing my reply again. :-)

[gnatcatcher]

How wonderful that you don't have any new issues! I hope your Harvoni journey is as easy as mine was and you'll be undetected in practically no time. -G