Author Topic: Anyone on Viekira Pak or completed Viekira Pak? (Read 134686 times)

skycatcher · « **on:** February 18, 2015, 05:36:06 pm »

Hi everybody!
Monday (02/16/2015) went to the Doctor and the bottom line is she is suggesting the Viekira Pak for me. I was very "ready" for Harvoni especially reading the literature and peoples experiences and all of the positive results folks are getting during and after Harvoni treatment. She was saying that it looks as though the Insurance Co does not want to cover Harvoni but instead the Viekira Pak. Which makes no sense to me due to cost of the additional ribavirin. Right now I am in the waiting period: blood work results, Insurance Co approval. You know just chillin' right now - could be up to 6 weeks.
I have read many, many, many testimonials of people on Harvoni but nothing about the Viekira Pak recipients and their experiences. I've read the insert and it sounds like a really powerful drug combo. I would like to know what is the Viekira Pak experience....

I was first diagnosed in 1993 with HCV. My liver nums have always been very low and in general I have done pretty good. I am GenoType 1a. I have just recently gotten insurance so once everything is in place maybe I can become well and slay this HCV beast.

Any feedback would be greatly appreciated. ~ Thanks all

sapphire101 · « **Reply #1 on:** February 18, 2015, 10:43:06 pm »

Yes Skycatcher our numbers are not big, but we are out there. Look for posts by sapphire101, RedHen, Zeena, and ekaraeana.
Viekira has the same high success rate as harvoni that is the good news. It is a lot more pills though, I take five in the morning and three at night.
Also more pills means more chance of side effects and that is especially true with the addition of ribavirin.
I will be posting weekly (stared yesterday) so by the time you start I will be half way through my journey.
One thing I have learned from this forum is that knowledge is truly power. Learn from us who go before you and you will be able to strongly advocate for yourself.

best regards and best wishes for your approvals to come through.

dogdave · « **Reply #2 on:** February 19, 2015, 12:50:35 pm »

Hi skycatcher, it looks like you and I are in a very similar situation. I ran out to get labs yesterday because the last (6 week labs) expired. Insurance won't pay for anything but Viekira. It looks like 24 weeks of drugs including ribaviron. Had Hep C for 40+ years. Liver biopsies were coming back at stage 2 fibrosis. Finally had a Fibroscan and that revealed stage 4 cirrhosis. Now I am waiting for the approval of Anthem. Did several clinical trials in the 90's. At least a year and 1/4 of interferon and ribaviron. GT 1a-b. I want to beat this thing so bad. I am sick and tired of being sick and tired.
Good luck. Looks like we will be in the class of 2015!
Dave

skycatcher · « **Reply #3 on:** February 19, 2015, 04:30:55 pm »

Thanks Sapphire101 and dogdave for your replies and sharing what's going on with you.. It means a lot to me that we can jump into the fire together ...

I have never had a liver biopsy -- I am a big chicken when it comes to things like that and avoid being stuck as much as possible. Just recently had an ultra sound on my liver and indicates slight fatty liver issues. I am hoping the HCV treatment will help this by reducing inflammation. In the mean time I am really eating small meals and much lighter foods and just what ever sounds right or feels good. I have a good understanding of foods and eat close to nature most of time.

In the '90s I went to a support group for a while. A few people in my support group were on interferon and riba. Out of the 4 people I knew 3 had major side effects. One guy had to quit the treatment. One person seem to fair pretty good and did not seem to have any issues. But I only knew him during the first month of his treatment. As you are well aware the success rate was only 12 - 13 % then and has climbed slowly over the years.

At that time I was very stable , numbers were low, felt mostly ok 'cept bein' tired.

I entertained the idea of doing trails but decided not to. I looked at it over the years but never did. Then I started seeing the promise of these drugs today and wanted to look into trails but I was living too far away from the trial studies at that time. And here I am.

Hats off to everyone who did the trails and studies! The volumes of work and the studies that have come out of all of this research offer a real promise today. Everyone who has participated in the research and studies are worth your weigh in gold.

In a lot of ways the Viekira Pak sounds like it is a more multi pronged approach. Almost like a shotgun blast for a flea... So I am hoping to learn more about it's action. Sappire101 I will definitely follow your posts. And dogdave yours too. I am ready to get on with the rest of my life and I know you are too.

skycatcher

skycatcher · « **Reply #4 on:** February 19, 2015, 04:35:16 pm »

Hey dogdave! To the class of 2015!

dogdave · « **Reply #5 on:** February 19, 2015, 05:40:40 pm »

I worked for nearly a year to get this treatment. I was talked into it by a GI who was doing a per-colonoscopy screen. Its taken so long there is a part me is not ready to trust Anthem to come through. It is with a little bit of bitterness that I used myself as a guinea pig for trials and then given such a hard time getting treatment. One doctor told me that Insurance companies are waiting for you to get new insurance or die. I get it. At thousand plus dollars for a pilland 90 pills? There should be a laws.

Anyway, I will take this. I did interferon and ribavrin in the 90's and worked at the same time. Now I can't even mow the whole lawn at one time. I hope the full treatment of Viekira kicks butt! Good luck and post how your doing!
Oh yeah, I belonged to support groups also. Many of those people have died. Take Hep C seriously. Dave

Red Hen · « **Reply #6 on:** February 19, 2015, 06:28:23 pm »

Hi. I stopped posting for awhile because no one else had used Viekira Pak. Now, I'm seeing some are. Sapphire is one of the few I knew of. I completed 12 weeks of Viekira and ribavirin about a month ago last week. So far, so good. My main side effect was intense itching which started in my first week of taking the drugs. Fortunately, my doctor said I could take o.t.c. benadryl. One benadryl at bed time was enough to calm the itching at night and help me sleep. I took benadryl all through the 12 weeks and beyond for 2 weeks afterwards. Drinking lots of water helped. I also developed hives and other skin rashes which came and went. One Benadryl at night, drinking water and wearing loose fitting clothing helped. I also experienced slight nausea the first couple weeks and feeling "brain dead" for about 2 hours every morning. That went away. I was tired most of the time but did not have trouble doing routine work. What I did have trouble with was socializing with friends and going out at night. My husband says I was more cranky than usual, too.

dogdave · « **Reply #7 on:** February 19, 2015, 07:19:56 pm »

I hope that you cleared the virus!

rando archer · « **Reply #8 on:** February 19, 2015, 10:20:20 pm »

Hello skycatcher - I will probably obtain Viekira Pak w/o Ribavirin in a couple of weeks. Be back with updates and my story later. I am really interested with any feedback on side effects with VPak w/o Riba.

Best regards to all!

skycatcher · « **Reply #9 on:** February 20, 2015, 12:07:54 am »

Hello to all! Thanks bunches for all the feedback. You go Red Hen!!! That's great info about the itching - Benadryl makes a lot of sense. And thanks you are the first person that has shared about being on and completing the Vpak.

I agree with you Dave. HCV is serious business. Always heard that the enzyme count is no real measure of the virus. It is sneaky like that.

Later....

skycatcher

Lynn K · « **Reply #10 on:** February 20, 2015, 03:26:43 am »

Hi Red Hen

Glad you found you way back we missed you :-)

Red Hen · « **Reply #11 on:** February 20, 2015, 11:18:16 am »

Hi, Lynn K. Hope I can be of some help. I got discouraged for awhile and needed to be more involved with off-line life; dogs, outdoors, art etc.
To reply to dogdave's question about clearing the virus: Well, My viral load dropped from 250,000 to 170,000 in the first week! I get a ton of tests because of being on a drug study. By the 3rd week the HCV was undetected. Stayed undetected from that time. I still had to finish the meds and do the whole protocol. My doctors at the clinic contact me if they see anything of concern in my lab tests, etc. I am not one to follow all the details because I'd really rather think about other things. If anything concerned my doctors I would be more concerned, of course. At this point, 5 weeks post treatment, still undetected. However, the 12 week blood work is more important and then the 24 week blood work is more important yet. Long process. I have a lot of faith in my clinic, which specializes in HIV and HCV. Lots of experienced people there. I'm expecting that we will all get over this disease in the long run!

dogdave · « **Reply #12 on:** February 20, 2015, 12:34:11 pm »

Red Hen, thanks for sharing your progress. It looks like I am approved for the V-pak and Ribavirin. I look forward to putting this behind me.

David

skycatcher · « **Reply #13 on:** February 20, 2015, 03:14:14 pm »

Hi to everyone!

Welcome Rando Archer! I just started posting the other day too.

Congrats DogDave on getting approval for the Vpak. I hope you feel lots better very soon. It bugs me when I have no energy. it's difficult to explain to others that have never been through this. I usually find something to do that I can instead. Be it a nap or drawing (or attempting to...) I've recently been in the "LowGo" mode for several weeks now. One day just to run the vacuum around the house was all I had that day. I take it one day at a time. My energy has started coming back now though.

I just got my blood work from Monday.
Not as bad as it could be I guess. This is the first time though I have had
AST and ALT up 20 and 43 points. ALK PHOS up 12 points.
My viral load has gone from 32,521 in 2000 to 929,000 02/16/2015.
Big difference.

Over the years I have read that HCV kind of can sneak up on you without you being aware. I've been very aware of what my body has been saying and that is "help I need treatment now".

I also think the cost for treatment is unreal. But I know the companies have spent billons in research dollars. Thank goodness they have chosen this virus. I hope everyone gets clear and viral loads go to "0".

SkyCatcher

aveinc · « **Reply #14 on:** February 22, 2015, 01:55:56 pm »

I'm 24 days in and I've posted how its effecting me. The worst part of this whole experience beside the harm caused to my body was the God awful DENIAL LETTERS EXPRESS SCRIPTS HAD THE NERVE TO SEND OUT DENYING HARVONI, WHILE DR. STEVE MILLER NEGOIATED WITH OUR LIVES FOR $....TO CALL HARVONI AND VIEKIRA WITH RIBA THE SAME IS JUST NOT RIGHT..IM PISSED SORRY BUT IF I DONT GET IT OFF MY CHEST....I HAD ALOT MORE HOPE FOR OUR NATIONAL HEALTH CARE SYSTEM. THANKS FOR ALL THE HELL YOUVE PUT A LOT OF DECENT PEOPLE THROUGH,AND I JUST WONDER IF DR MILLERS DAUGHTER WAS FACING THIS WHAT PROTOCOL HE WOULD CHOOSE FOR HER? I THOUGHT I HAD THE BEST INSURANCE YOU COULD OBTAIN, I JUST WAS UNAWARE THAT CORPRATE AMERICA COULD DECIDE INSTEAD OF MY DOCTOR HOW TO TREAT A LIFE THREATING DISEASE,

??

Lynn K · « **Reply #15 on:** February 22, 2015, 02:13:43 pm »

Aveinc

I had a hard time with express scripts until I found this email address:

expressrxhelp@express-scripts.com

I wrote them an email explaining my health situation and why I felt that I needed to have Harvoni. I was called the next day but an Express Scripts Accredo supervisor and had the meds the next day.

You would still either need to be F3 or F4 or have a reason you cannot tolerate Viekira Pack but this email have gotten 5 people Harvoni when they were being denied

Good luck

aveinc · « **Reply #16 on:** February 22, 2015, 02:53:47 pm »

Thanks Lynn,I've read many of your post and so glad to see you got results.I was answering Express Scripts denial letters during Nov.and Dec. with out media protest and had approval for viekira with riba during Jan. I am grateful not to be going through what so many have before me with inferior treatment and applaud our the many recent medical break through, however our system has a major flaw and if we don't expose the problem then we all will suffer at wall st.s profit...I hope to complete my 84 days and not have to go through any more of this.One day at a time.but i wont forget or be quiet about anything I've learned or experienced through this.

dogdave · « **Reply #17 on:** February 22, 2015, 03:26:26 pm »

Havoni is my first choice for treatment. Refusal has been consistent from Anthem because liver biopsy said f2. Finally had a Fibroscan which indicated f4 cirrhosis. So apparently I am getting Viekira. I have been fight this for a year. I am tired for this illness and I will try this. I understand your anger at ExpressScript's aveinc, so am I. I am trying look at this like my best chance at this moment. Good luck with your treatment. Dave

aveinc · « **Reply #18 on:** February 22, 2015, 04:01:56 pm »

Dog I feel you. I have chosen by default to use what express scripts mandates,my Dr wanted as did I to use Harvoni. I wonder how this will all play out.I really feel for those suffering with no insurance, Its not that hard to imagine.My mind went through allot when i was being denied not having a clue as to the game being played out by express scripts/Gilead and Abbvie.I hope the stigma that I believe is plaguing this disease is soon put to bed. Hep C affects anyone not just those whose lifestyles are questionable,and the sooner everyone realizes; we are all human beings and everyone deserves help and the right to choose there Dr. and his or her right to choose the method of treatment for their patients.

sapphire101 · « **Reply #19 on:** February 22, 2015, 05:58:04 pm »

Day #24 Aveinc!
Woot WOOT!!
I can not wait to as far down the road as you are. It is day #7 for me tomorrow on Viekira pak with riba.
I too was mystified as to why we did not get the harvoni option and had V-pak been less as efficacious I would have fought the good fight. As it is... I just don't have the energy and I am instead going with this and keeping my eye on the prize.
I do believe that our struggles will be noticed and will be a catalyst for big pharma change in the future.
We are part of something big here and it can happen again even after HCV is a distant memory there will new viruses and new cures and a whole planet of people who deserve to have a fair chance at health.

llory86 · « **Reply #20 on:** February 23, 2015, 09:48:43 am »

Hello everybody. I'm here to share my father's experience with Viekira Pak.
He's 72 yo, geno 1b with cirrhosis and he failed all the previous therapies with Interferon and Riba but he didn't try neither Telaprevir nor Boceprevir.
He is on 12 weeks of Viekira plus weight-based RBV (1000 mg [<75 kg] so he takes 9 pills a day with food. (3 pills of Viekira + 2 Riba in the morning and 1 Viekira + 3 Riba in the evening)

Now dad is on his 5 week of treatment and he’s still waiting for his 4 week blood exams. Till now he didn't have any sides from the drugs and could barely say he is on therapy just because he had to swallow a lot of pills.. At first he was scared from Riba because in the past he had to discontinue one of his treatments for the horrible rash and itching the Riba gave him but maybe it was the interaction with interferon, in fact today he has no sides at all.
These are his blood work results till now
pre tx 1 week 2 week 3 week
Vl Rna <600.000 216 125 18
Ast 298 123 50 46
Alt 200 125 x 31
Alb 43 44,4 44,7 44,3
Bil tot 1,9 1,7 x 1,9
Plt 58 81 119 92
Wbc 3,64 5,3 6,6 5,5
Rbc 3,99 4,03 3,95 3,9
Hg 13,6 13,8 13,2 13,3

Wishing you all the best

Red Hen · « **Reply #21 on:** February 23, 2015, 04:56:41 pm »

Hi, Ilory86. Glad to hear your dad is not having trouble with side effects. Wishing the best of luck to all of us!

skycatcher · « **Reply #22 on:** February 23, 2015, 09:29:40 pm »

Big Hello to everybody! Thanks for all the great input. All this great news about every ones numbers decreasing is really exciting. Also the really great input about the not too awful side effects is reassuring me. Or at least I should say the side effect of the "dark ages" (15 - 20 years ago) compared to today.

Sapphire101 really appreciate your story as you go along the treatment path. I will be sharing my story once I get the approval.

RedHen I think it is absolutely important to focus on life off-line. I think for me it is very important to have days that have nothing to do with computers or HCV. I call it a mini vacation.

~ SkyCatcher

Red Hen · « **Reply #23 on:** February 24, 2015, 10:51:24 am »

Thanks, Sky Catcher. My spell check wants to change your name to Skywalker.

It helps me most to get outdoors or to go somewhere fun, hear music, eat out, etc. Not to always identify with being in HCV land.

llory86 · « **Reply #24 on:** February 28, 2015, 02:34:49 am »

Hello again. Dad got his 5 week blood test. He's still waiting for the 4 week's one and both the VL. Everything is going on, he feels just less hungry than usual and his blood pressure was surprisingly a bit high. Anyone has having the same issue? He found it just before the CT done to investigate the course of his cirrhosys.
Results at the end of 5 weeks on Viekira + RBV:
3 week 5 week
Vl Rna 18 ??
Ast 46 35
Alt 31 23
Alb 44,3 45,9
Bil tot 1,9 1,6
Plt 92 100
Wbc 5,5 5,2
Rbc 3,9 4,10
Hg 13,3 14
Well, that's it, I am hoping for the best

dogdave · « **Reply #25 on:** February 28, 2015, 12:09:15 pm »

Well, after calling Accredo in attempt to expedite my treatment with Viekira and Ribavirin, my GI called and said they were going to get Harvoni for my treatment. I have been down this road before with Anthem. Accredo called me to inform me that I was indeed denied the Viekira. While I was looking forward to treatment and Harvoni is my preferred choice, I want to get on with this treatment. This whole thing is wearing me down. I have to wait again while the doc/insurance fight it out. I feel a little down, after a year of messing around with Anthem.

David

Red Hen · « **Reply #26 on:** February 28, 2015, 06:33:24 pm »

David, don't feel too bad. Just keep trying. The Harvoni really is the "drug of choice" because of shorter time to take, fewer pills and fewer side effects for most people. I hate that you have to keep waiting. Let us know what happens.

Red Hen · « **Reply #27 on:** February 28, 2015, 06:39:41 pm »

llory86, I had the lack of appetite, too. I didn't mind that. I also had high blood pressure more than once and a high heart rate sometimes. I don't know if this was a side effect of the drugs or another condition. I hope your father is doing well.

dogdave · « **Reply #28 on:** February 28, 2015, 09:03:09 pm »

I will do that, I prefer that choice myself. It just that I haven't seen anything except denials from the insurance, so I have to tempered myself not to get my hopes up. I really need to vent also. Thank for your kind words, Red Hen!
David

llory86 · « **Reply #29 on:** March 01, 2015, 03:01:44 am »

Red Hen thanks for your answer. No his high heart rate was normal. I'll check with his dr in the next apt. I think his very stressed for his 4 week vl didn't come yet. I read all people advice to drink a lot of water while on tx and I am sure this is a healthy lifestyle but why it helps especially with this new drugs?

skycatcher · « **Reply #30 on:** March 01, 2015, 01:53:46 pm »

Hi All!

Sorry for the delay -- incommunicado moment -- David it really angers me that all of this is happening to you. At one point throughout the years I was told by a mental health person, probably a social worker, that because of my HCV plus a few other issues that I could not be discriminated against. Throughout the years I have always just paced myself and have been able to live a fairly normal live. But because HCV folk can become disabled and unable to do normal stuff, I wonder if you can seek informed help from state and federal agencies. Maybe things have changed a great deal over the last 25 years with all of the changes for insurance and agencies, but don't you just wonder if someone who deals with disability services could put a fire under that insurance co for you? Or perhaps with a little help you could look at disability law as stated and perhaps send them an "informed" letter stating your legal rights as a human under protective laws.... Sometimes if you let them know you understand their game a little better then they think you do it just might get their attention. All sorts of information is online ... just saying...And you may already know this.

Might be worth checking in to if you haven't already. If you have and it's been awhile call that agency person back. Or find a new person to advocate for you.
I am keeping my fingers crossed for you David and sending positive energy to Ya...

Just adding my two cents....
I don't believe in "NO" when it should be "YES". You just have to look, and ask, and look, and ask... I always find I gleam more information this way. A little piece of info here, there, then I piece the puzzle together... Then finally I have an answer. On most stuff anyway.

My latest news: I got a call from the RN for my Doc and she was saying that the insurance will not approve Vpak but instead is approving Harvoni. This week I will be getting a call from a lady at the specialty pharmacy about setting up delivery. My insurance co worked out a deal with CVS CareMark a few months ago to handle Harvoni (I told my Doc that) but she was wanting to prescribe Vpak.

But in the mean time I found a website that has very insightful info about how these drugs work at a cellular level. The sight is "Medscape". Personally I want to know to the best of my ability how a med works. I haven't done the big search on Harvoni yet but will tomorrow.

After hearing about everyone's positive experiences and reading about Vpak ALL of my uncertainty has gone out of the window about Vpak. It is really impressive how it gets to the "heart of the matter" and stops the virus from replicating.

To a speedy and permanent recovery for all! ~ Later ~ SkyCatcher

dogdave · « **Reply #31 on:** March 01, 2015, 04:04:22 pm »

Skycatcher,
I will advocate to the insurance commission in my state if necessary. Part of this thing is not knowing what going on in the background. Because I have not actually seen results, I don't exactly have knowledge of where I am at. I've seen Solvadi appear on my prescription list then disappear with denials. Same with Viekira. Although I have talked to Accredo and my GI that I am learning that that does not make it so. My GI apparently has several cases in this status. So I am not in despair yet. I am hopeful and impatient. I am also very fatigued, so yes cranky. I appreciate everyone's concern and am glad you also are getting Harvoni.
My best, David

skycatcher · « **Reply #32 on:** March 01, 2015, 07:55:40 pm »

Yes David seems getting answers can be difficult and it certainly can be very tiring. Hope you can get resolution soon. Oh being cranky is OK. Every one can get to that space sometimes T-o-o-o soon. But I haven't noticed it...
I appreciate every one and their stories. All of the sharing...
~ SkyCatcher

Lynn K · « **Reply #33 on:** March 01, 2015, 10:03:13 pm »

Hi David

I also Have Express Scripts and Accredo and was also initially denied Harvoni. I found and article they had written in sort of a peer to peer article about reducing Hep c relapse which I felt compelled to comment on. They asked me to contact them by email at
expressrxhelp@express-scripts.com

with my member ID and contact information. I sent them an email describing my medical situation and my extreme frustration at dealing with their company especially with essentially my life on the line.

My closing remark to them:

"I am frustrated to the point of considering contacting my local media to bring to light my distress with my Express Scripts experience and their cavalier, indifferent attitude toward its customers and their health."

That seemed to get their attention.

They called me the next day and the following day I received Harvoni by overnight express UPS. I have shared this address with several others people and about five others have been able to get meds previously denied by contacting this email.

It hasn't worked for everyone but it is worth a shot.

Good luck

dogdave · « **Reply #34 on:** March 02, 2015, 03:26:48 pm »

Hi Lynn,

Today I logged on to check my express-script's account and found that my Viekira was cancelled, along with ribavirin. I expected that, but I was didn't see Harvoni being listed. I called Anthem and they told me that they received the prescription for Harvoni which was denied along with the Viekira on the 25th of Feb. The representative told me I could appeal the decision so I need to have the paperwork organzied.

The last conversation with my GI office the medical assistant told me that they would call me and that I need not call them. Of course I called and got voice mail. This is like a roller-coaster, I've been here before! Before I use the email address I want to make sure that I understand whats going on at the doctor's office. I am dismayed.

The GI who did my Fibrosure told on the spot what tests to get, Cancer scans, hepatic encephalopathy tests, and that I had f4 cirrhosis. She said that it explained the fatigue and for the 1st time I felt that was validated for feeling the way I did. Something in her manner seem to be not overly optimistic about getting treatment. My GI office was much more optimistic about.

I am the type who that wants to take on the problem as fast as possible. This has taken the wind out of my sails. I found all my denials from Anthem. Now there are at least 5.

The GI office just called me and my physician's assistant called me back and she was surprised that I was declined. She said that they suggest Harvoni and why had they not request that. She is calling them now. She said it will be back to the transplant center for me to see if they will get it for me if she didn't have results. Ahhh!!

I reread your post and I will regroup to fight them.

Thanks for your response,
David

skycatcher · « **Reply #35 on:** March 02, 2015, 03:32:31 pm »

Big Hello to everyone!!!
Well it looks as though Wednesday is the day I take delivery of my medication and it is Harvoni!
Been living with HVC for 40 years. I am ready to get on with it. I think I will start taking it Thursday get a nice even start. I will post my progress to you. It is so important to not be alone in this process and to be able to share all things.

Yours in Health ~ SkyCatcher

skycatcher · « **Reply #36 on:** March 02, 2015, 03:36:21 pm »

David! Dude! pulling for you brother.
~ SkyCatcher

Lynn K · « **Reply #37 on:** March 02, 2015, 03:49:44 pm »

Hi Dave

As you have advanced cirrhosis you are not even a candidate for Viekira Pak which only is ok basically Child Pugh A well compensated cirrhosis.

I got tired of the run around back and forth between Express Saying they didn't get faxes my doctors office had sent. To the phone answerer people who could not pronounce the names of the meds or my medical condition.

In frustration I commented on their article which in the long run was basically a stroke of luck the email gets you to people who know what is going on and can truly help the woman spoke with has been my advocate on the inside a couPoe of times now. Her job title is Express Scripts/Accredo supervisor she has been great.

If you want to let the wheels spin a while more and let the process try to work that is fine but if it still isn't working for you try the email nothing to lose everything to gain

Good luck

dogdave · « **Reply #38 on:** March 02, 2015, 04:04:30 pm »

Lynn, I will not let the wheels spin for very long. I will use the email address soon if when the physician's assistant calls me with the denial confirmation. This all happened today so I getting myself together.
Thanks for everyone's support and I will let you know the outcome.
David

Lynn K · « **Reply #39 on:** March 02, 2015, 05:29:27 pm »

Good luck

dogdave · « **Reply #40 on:** March 05, 2015, 08:56:04 am »

Lynn, I have sent an strongly worded email to address provided by you yesterday. While the individual I talked with was empathic. After reading the denials he stated that the denials were an Insurance company issue, not pharmacy issue. However he is looking into the matter with my GI's office team and the insurance company. He will be in touch next week. Thank you for your support in the matter.
David

sapphire101 · « **Reply #41 on:** March 05, 2015, 11:11:07 am »

Skycatcher: Did your meds arrive? It was tricky for me when they came because FedEx arrived 3 hours early from the arranged time and it was just a stroke of luck that I happened to be home. I too started the next morning after arrival and for you that would be today -right?. CHEERS! and don't forget the water chaser. I have been going through a case a week.

llory86: any updates on your dad for us? I am awaiting my first labs and am on pins and needles in anticipation.

dogdave: Hang in there bro. From my first doctor appointment to medication arrival it took two months and that was with major advocating on my part and assistance and advice from this forum. 2015 is our year and one way or another you will get your treatment.

llory86 · « **Reply #42 on:** March 05, 2015, 01:09:30 pm »

we usually get the lab results on Friday. Just to let you know so far there are no sides to report. Asap i'll have them be sure I post it. There are so few news on this drug that is a shame don't share how it goes. I know how knowledge brings relief to people who are suffering from disease, fear of the unknown is horrible at least that'is true for me and my father.
All the best

dogdave · « **Reply #43 on:** March 05, 2015, 02:02:26 pm »

sapphire101, it's been since May last year that I been trying for this treatment. However this letter has produced some results. My GI's office called and said the letter triggered an appeal from the insurance company. My finger's are crossed. Thanks for the support!
David

dogdave · « **Reply #44 on:** March 05, 2015, 02:30:46 pm »

llory86, I understand your frustration in your lack of knowledge of sides. Perhaps your reporting yours sides effects are with Viekira will help other understand theirs. I was prescribed the same but was denied by the insurance company. Here hoping that there are few sides and your treatment is successful!

Skycatcher, hope meds arrive safely today, Good luck!

David

sapphire101 · « **Reply #45 on:** March 05, 2015, 02:35:07 pm »

@dogdave
WOW you have been fighting the paper pushers since May? I would be crazy by now and you must be a very zen spirit to keep as calm as you seem in your posts.

2014- Last year was pivotal for approvals for the pharmacy companies to go forward and 2105 -this year, is the year for all of us to get our treatment. Walls will fall down, prices will drop, and you WILL get your medication.

dogdave · « **Reply #46 on:** March 05, 2015, 03:06:30 pm »

I am getting impatient and crazy, otherwise i wouldn't of wrote the letter. The Fibroscan indication F4 liver cirrhosis is an big motivator to get treated. I was in zen mode before, not now! I try not to make sick people sicker by whining, too much!

David

skycatcher · « **Reply #47 on:** March 05, 2015, 06:25:25 pm »

Hi Sapphire, David and everyone! Big Thanks for asking about my meds. Really appreciated. Yes indeed they arrived yesterday afternoon and I started my day 03/05/15 with Harvoni. My partner did a drum roll and pop goes the magic pill... (and a BIG glass of water).

With Harvoni dehydration is a big factor as everybody has been reading all over the post. The Pharmacy Lady said water or non-caffeine beverages are critical to staying hydrated. (Dehydration can lead to headache.) I am a coffee drinker ( my 2 cups a day ) so she said if I have a coffee then drink a glass of H2O. And all throughout the day, decaf tea, juice, water. Also no dairy or vitamins with breakfast. The minerals of dairy and of vitamins bind with Harvoni and can sort of coat or block or possibly reduce it's effectiveness. I have to be careful about the tea also.(Nothing too exotic) I found a nice ginger lemon grass and green tea plus a few fruit flavors. I can have dairy and take my vitamins after 4 hours but I think I will just wait until evening.
My favorite thing these days is this really good juice I get in the grocery store made by Ocean Spray "100% Juice". No sugar. It's great. If I want a bubbly thing I add soda. But mainly I drink good ol' H20. Today I have been pushing it too.

I also ask the Phram Lady about ginger because over the last several weeks I have been feeling kinda bad after eating supper and so I have been drinking a cup of Ginger tea. (It aids in digestion). She checked several places to make sure there was no interaction but said that the ginger tea was OK. For what it's worth I do feel some better after drinking the ginger tea just sayin'.

So Thanks. So far so good.

David sounds like you are doing the right thing. Let them know you are there -- in a positive way.

llory86 sound like your Dad is doing better.

~ Skycatcher

Red Hen · « **Reply #48 on:** March 05, 2015, 06:38:01 pm »

Hi, all.
Ilory 86, I think sometimes care providers are hesitant to bring up possible side effects because they don't want to give us preconceived ideas about what we might or might not experience. Ribavirin is one nasty drug, in my opinion, but not everyone has the same problems with it.
Skycatcher, glad you started treatment! Hooray!
David, I'm wishing you the best. Not an easy path. Hope they send you the darn meds.
Stay hydrated!

Red Hen · « **Reply #49 on:** March 05, 2015, 06:40:58 pm »

Hi, all.
Ilory 86, I think sometimes care providers are hesitant to bring up possible side effects because they don't want to give us preconceived ideas about what we might or might not experience. Ribavirin is one nasty drug, in my opinion, but not everyone has the same problems with it.
Skycatcher, glad you started treatment! Hooray!
David, I'm wishing you the best. Not an easy path. Hope they send you the darn meds.
Stay hydrated!

Red Hen · « **Reply #50 on:** March 05, 2015, 06:43:11 pm »

Shoot. I don't know why sometimes things post twice. I apologize.
David, my heart goes out to you.

skycatcher · « **Reply #51 on:** March 05, 2015, 06:59:40 pm »

Thanks Red Hen!
You can post as many times as you want

~ Skycatcher

dogdave · « **Reply #52 on:** March 05, 2015, 07:45:26 pm »

Thanks all for the support and best wishes. I found the right place. Glad your meds are here Skycatcher. Also the bit about diary, wonder what I'll have do about my morning bowl of cereal... maybe get almond milk. Hydration is key! I guess my verdict will come in next week.
David

Lynn K · « **Reply #53 on:** March 06, 2015, 04:03:45 am »

Hi Dave

Hummm dang. The denials for me were coming from express scripts they never said it was from my medical insurance.

I did see they had me as a partial responder to Sovaldi which was not correct. I did respond to Sovaldi Olysio I was UND at 4 weeks and EOT but relapsed 12 weeks post. So anyway express scripts were apparently denying me for the wrong reason.

Personally I think it is all really arbitrary and makes little sense i seems like a game we are unwilling players

Good luck

dogdave · « **Reply #54 on:** March 06, 2015, 05:56:32 am »

Lynn, my GI said that one Insurance company would ask for a fax to be sent with information. After no response, he'd call again was told he was missing certain pages. he resent it and they still stalled. After realizing that every fax he sent was missing the same pages, he called them out. They would send the drug the next day. I believe it is criminal how this is being played out. The drug manufacturers are just as bad because of the high fees they charged. I understand things are not free, but 1125 dollars a pill? Really!
David

llory86 · « **Reply #55 on:** March 06, 2015, 08:46:01 am »

Results at the end of 6 weeks on Viekira + RBV:
5 week 6 week
Vl Rna <15

??
Ast 35 28
Alt 23 18
Alb 45,9 46,1
Bil tot 1,6 1,5
Plt 100 116
Wbc 5,2 6,4
Rbc 4,10 3,97
Hg 14 13.7
Well, that means 5 weeks and still detect
I am hoping for the best

dogdave · « **Reply #56 on:** March 06, 2015, 09:11:29 am »

Yeah, lory86,

Sounds good so far! David

skycatcher · « **Reply #57 on:** March 06, 2015, 06:44:34 pm »

Greetings All!

My breakfast routine has done a two step with the dairy embargo. So my a.m. cereal of choice is oatmeal (the old fashion variety), until yesterday, with milk and half n half in the café 'olé. So no dairy means something else to make these items work well.

I got started on oatmeal for breakfast after meeting this guy who had experienced a major heart attack and had heart surgery (about 20 yrs ago). At the time that I met him at the workout facility he was so fit looking and worked out regularly 3 Xs a week that I would never had pegged him for a heart attack survivor. He told me that was his wake up call and once he got out of the hospital he changed his routines and started having oatmeal everyday for breakfast. And using canola oil for anything requiring oil. Working out diligently. He believed adamantly that these 3 things restored his life. Brought him to his excellent state of health.

For me frequently over these many years and the last 2-3 almost always have those Quaker Oats. Normally I add dried cranberries, almonds sometimes, cinnamon or nutmeg, honey or brown sugar, and now, my milk substitute, is a diced pear, yesterday, or diced apple today. Maybe applesauce tomorrow. Blueberries Sunday...

Honesty David I was stunned and did not think to ask about almond milk or rice milk. I know that almond milk is very high in calcium -- which is a mineral. But I tend to think of these two products as having lots of minerals in them. I don't know if this is correct but until I can get through to the Rx lady I will just go this course. Fresh fruit is better for me anyway. I love my oatmeal...
For coffee the coffee flavor stuff -- some has no milk products any where near them -- I found one of these to use for now ... ( sob. I miss my half n half....) So for 3 months I can substitute different things. I think I can make it

~ Skyw222222222222221` <----- My cat's comment

~ Skycatcher

dogdave · « **Reply #58 on:** March 06, 2015, 07:36:44 pm »

There is almond milk, also coconut milk and soy milk. Almond milk I was introduce to by a friend with Lactose intolerance. A nurse I told today said she like coconut milk. My problem is ice cream and I do like cheese. From what you said, there is a 4 hr waiting period after taking the pill, am I right?
David

skycatcher · « **Reply #59 on:** March 09, 2015, 04:17:25 pm »

Hi David! yes the Rx Lady from the specialty pharmacy said no dairy and no minerals because they can bind with Harvoni and lock it up or bind or decrease its effectiveness. That is correct for at least the first 4 hours after taking it. So I am OK skipping the dairy until evening and for now I am skipping the vitamins. The oat meal with applesauce and berries is actually very good. I like all of those alternatives for the milk but I know they all have relatively equal amounts of minerals (compared to milk) and so that is my concern until I can speak with my rep. about this issue. I am taking no chances till then.

~ Skycatcher

dogdave · « **Reply #60 on:** March 09, 2015, 05:12:33 pm »

Hey skycatcher, bought some almond milk this week, can't tell the difference.

Lynn K · « **Reply #61 on:** March 09, 2015, 05:22:18 pm »

That is the first I have heard about milk. I live on cereal I haven't seen anything about in the prescribing information sheet included with Harvoni just a lot about avoiding acid reducing medications antacids like tums or PPI's like PRILOSEC or NEXIUM and h2 antagonists like Pepcid or Tagamet

But nothing about milk gonna have to research that one.

Edit
Ok I have zero about milk maybe they were thinking about the herbal milk thistle which many take to try to help the liver. But I can't find any reason not to drink milk or use dairy

Red Hen · « **Reply #62 on:** March 09, 2015, 07:04:45 pm »

I'd never heard about milk or other dairy products being a problem. Did hear that sugary drinks were not a great idea.

kate0b1 · « **Reply #63 on:** March 10, 2015, 06:19:48 am »

agh its to late for me (two days left) but I'm not giving up my milk, it was hard enough to give up whole milk to 2%. thats as far as i can go lol

kate

dogdave · « **Reply #64 on:** March 11, 2015, 08:06:40 am »

Status report, for Harvoni Hep C treatment. Have got a appeal in the works. Accredo called me back on this. Have not heard a thing further on this matter though.

Went to my urologist. Had a complex cyst for over 10 years, and this year it has significantly grown with additional smaller cysts in my kidney showing up. Basically I was told to have my kidney removed, because of the irregular mass growth might indicate cancer. I asked about Hep C treatment and he couldn't respond. If I get approved for Harvoni, I think that I will do that first. Agghhhh!

PS Also, type 1 diabetic, make me hesitate and think which is worst 1 kidney or cancer. Biopsy not an option I don't think as complex cyst is woven amongst vital kidney structure.

Red Hen · « **Reply #65 on:** March 11, 2015, 06:53:01 pm »

David, that is upsetting news. I don't know what would be the best thing to treat first but hope you find a good doctor who can guide you.

dogdave · « **Reply #66 on:** March 11, 2015, 07:43:08 pm »

I should hear from him tomorrow, today I had the dye I.V. This was a curve ball. I have been monitoring the kidney for over 10 years. Didn't expect any changes. I still am going for both. Perhaps the kidney would be first. Will talk to the specialist soon. I didn't even have a chance to think of all the questions I have now.
Thanks for your concern.
David

sapphire101 · « **Reply #67 on:** March 12, 2015, 12:07:40 am »

Dogdave if possible I would do both hcv treatment and remove the kidney that would be my first choice. If you can only pick one then I would remove the kidney first. Cancer is a raging fire and hcv is a slow burn. Hep treatment can wait until you figure this out and maybe once you are clear from the kidney detour the appeal will be approved.

Please keep us updated.

dogdave · « **Reply #68 on:** March 12, 2015, 07:28:15 am »

My thoughts also. I expect to hear from my urologist today (hopefully). One other issue is type 1 diabetes and kidney function. I need to have my urologist contact my endocrinologist also.

skycatcher · « **Reply #69 on:** March 13, 2015, 04:21:48 pm »

Hi All!
The Rx Lady was very explicit about avoiding milk and dairy products and minerals for the first 4 hours after taking the Harvoni. She said indicators were a possible binding effect so I am following her advice to a T. All of my substitutions are working out great. I did get some of the Rice Milk -- the organic original -- because as I compared this to the others -- almond, soy, coconut -- it listed the lowest amount of additional minerals. All of the flavored ones were surprisingly higher in various minerals that were listed like calcium. And after waiting so long for an effective treatment I "ain't gonna do nothin'" that will possibly interfere with the slaying of the HCV beast.

You know if your rep did not say anything about this then don't worry about it especially if you are near the end of treatment or completed it. It is what it is. Be confident.

Ever since Harvoni broke it seems that things have been changing and evolving. After all, clinical trials aside, we are barely at what 6 months with this medication??? I am sure there will be some tweaking as time goes along.

David good luck to you in your process.

~ Skycatcher

Lynn K · « **Reply #70 on:** March 13, 2015, 04:34:26 pm »

Well I sure hope it is not a problem as like I said I live on milk and cereal a lot and all I have heard close to that was antacids interfere with the absorption of the ledipasvir component of Harvoni

Ledipasvir requires a normal acidic stomach acid condition in order to be absorbed. If the stomach pH level is too high so not enough stomach acid this will result in lowered blood levels of Ledipasvir.

As this is my 5th treatment and I have cirrhosis I can't really afford a relapse.

dogdave · « **Reply #71 on:** March 13, 2015, 05:13:46 pm »

Hi everyone! Good news on the Kidney front. A renal IV dye CAT scan yielded a result that the monitoring will be continued 2x a year instead of just once a year! Urologist said go for the hep c treatment. Called the appeals at Anthem, after an hour, the rep said there was no appeals going on. Thats after my GI filed a new one.

? The mistake Anthem made was they denied me Harvoni, then denied me Viekira. The denial stated clearly the reason I was denied Viekira is because I hadn't tried Harvoni yet. That I think is the smoking gun. Anyway the person was compassionate and she set in the motion the process of getting Harvoni. She talked to my GI office twice, had the necessary paperwork and is following it. I gave her the info of my Accredo person and I have her direct phone #. She spent 3 hours on this to day! This day was fruitful, but I been here before and soooo I am guarded!
Fingers crossed.

Red Hen · « **Reply #72 on:** March 13, 2015, 06:30:07 pm »

David, great news! So glad you kept trying and now things are coming together for you. Thanks for letting us know.

Lynn K · « **Reply #73 on:** March 14, 2015, 05:21:10 am »

That is great news Dave!

Got my fingers crossed hope things work out for you soon!

dogdave · « **Reply #74 on:** March 14, 2015, 05:50:54 am »

Thank you Lynn, also everyone else. I hope your treatment continues to be successful. I have read the milk issue and I will pay attention that if I get treatment. 5 more days and I hope to have an answer myself.

skycatcher · « **Reply #75 on:** March 16, 2015, 04:42:42 pm »

Hi Everyone!
Lynn I do drink milk but to be cautious I wait until evening 10-12 hours later. My insurance co is transferring to their specialty pharmacy (CVS Caremark) and I set that process in motion today so it maybe that I will have someone to speak with there. The other pharm Lady is impossible to get in touch with....
But no matter I am just being cautious.

To Everyone in Health ~ Skycatcher

Lynn K · « **Reply #76 on:** March 17, 2015, 02:03:47 am »

Asked my nurse today about the milk question she said maybe not to wash down the harvoni with a gallon of milk but other than that no worries

skycatcher · « **Reply #77 on:** March 17, 2015, 02:44:17 pm »

Well good! No worries then...

~ Skycatcher

dogdave · « **Reply #78 on:** March 19, 2015, 04:04:20 pm »

Well everyone, I got a call from Accredo stating that I was approved for Harvoni. I was well informed by both Accredo and Anthem's appeal. They walked my doc through the process which included a peer to peer conference with Anthem.

I thank Lynn for her tip, hope I'm not premature as just because the drug shows up on the my queue on the web it doesn't mean it will go away as in the past.

I am so ready to get on with this!

David

dogdave · « **Reply #79 on:** March 20, 2015, 02:46:22 pm »

Hi everyone,

Well, yesterday my approval came through, today I just got off the phone with Accredo nursing staff giving my meds and getting instructions. I am getting a six months treatment of Harvoni, finally. I get my Harvoni tomorrow and all I have to do is receive the instruction from my Doc to start. I sure he wants me to do a baseline lab. Hurrah!

David

Red Hen · « **Reply #80 on:** March 20, 2015, 03:27:09 pm »

Congratulations on your good news, David!

dogdave · « **Reply #81 on:** March 20, 2015, 03:38:16 pm »

Thank you! I will start treatment next Friday and have an appointment with the doc for instructions. Hope your treatment is going well!

David

Lynn K · « **Reply #82 on:** March 20, 2015, 06:39:38 pm »

Fantastic news David!

I have a cold right now feel and like crud and the Riba I am sure is now helping at all.

But I have just 45 days to go so hanging in there.

Wishing you good luck and smooth sailing on tx!

dogdave · « **Reply #83 on:** March 20, 2015, 07:15:08 pm »

Thank you Lynn, it's interesting that I've dealt with a host of issues with the Accredo supervisor. He was 1st class. Also a sub-note the appeals rep I spoke with last week did the heavy-lifting to get all the paperwork, testing done and made it happen. After everything was done, my doc got a call from Anthem and asked them if they wanted to start a appeal on my case. One hand doesn't know what the other hand is doing over there.

Who am I to complain, my script is approved. I got the call from the nurse and talked the pharmacist and my start date is fri a week from now. This forum helped me get the job done! Last issue for what it's worth, Milk is not an issue according to Accredo, however Antacids are, which I can take 4 hours after the pill. It not the calcium, but it is the aluminum-mag@#! stuff that is a problem.

Hope you feel better Lynn, that Ribavirin is toxic stuff according to the GI I had previously.

Have a good weekend and recover!
David

skycatcher · « **Reply #84 on:** March 21, 2015, 11:08:55 am »

Congratulations David!

Long over due! I am excited for you and your recovery from HCV. Like the new pic -- somebody is having fun in the snow....

~ Skycatcher

dogdave · « **Reply #85 on:** March 21, 2015, 01:42:56 pm »

I do Scottie rescue work. He is one of my rescues. He loves the snow, unlike me who has to move it. I smile when I see him running around in it!

I still can't believe it happened to me. I start next Friday after a doctor's visit.

Thanks for your congratulations! Hope all's well with you!

David

Else · « **Reply #86 on:** March 21, 2015, 05:01:30 pm »

Your perseverance is really inspiring, Dogdave. Huge congratulations!!! You show what can be done if you continue to advocate for yourself no matter what. I do think there are some number-crunchers out there counting on people to give up in frustration.
Thank you for the big smile you put on my face!!! And good on ya for your work with Scottie's, btw. They're a tenacious bunch too, aren't they! Looks like you fancy a breed that suits you!

dogdave · « **Reply #87 on:** March 21, 2015, 05:06:19 pm »

Thank you, Else! Had Scotties for 25 yrs now. Love them. Hope your treatment is going well.
David

Red Hen · « **Reply #88 on:** March 23, 2015, 02:34:44 pm »

Love the Scottie photo! Glad things are going well, David.

skycatcher · « **Reply #89 on:** March 23, 2015, 10:33:20 pm »

Hi All!
David that is so great that you help out furry four year olds. A few years back I rescued two strays that showed up. They were sisters about 7 mos. one a blonde -- she was husky/chow and her sister, the redhead -- who was chow/husky. We became friends and they got comfortable and as I came home from work one day about a month later my blonde girl was exceedingly happy, jumping and prancing about and proud of herself because she had brought home a pup (5mos) that looked like a lab mix but could run like the wind. The vet and I decided he was a lab/greyhound. A lasting friendship of 15.5 years ensued. I am a much richer person because of these three magnificent beings becoming apart of my life.

The little guy in the picture looks like he is a happy little fellow... Scotties are neat dogs.

~ Skycatcher

dogdave · « **Reply #90 on:** March 24, 2015, 05:19:08 am »

Hey Skycatcher, I start my treatment on Friday. I am anxious to get going and to see if I tolerate the treatment. There are so many meds that I can't take because my liver is compromised. i.e.anti-depressives, fortunately dog have the same effect as anti-depressives. Glad to hear that I am not the only one that rescues dogs.

David

skycatcher · « **Reply #91 on:** March 27, 2015, 01:59:50 pm »

Big Day!!!!

Just create a time of day -- a ritual if you will-- to taka your med! To make it easy for me so I don't have to worry about taking my med I have set my phone to pleasantly remind me of that.

Good Luck David! ~ Skycatcher

dogdave · « **Reply #92 on:** March 27, 2015, 02:23:11 pm »

There is an app for that. Very excited. Doc said no one has failed yet. He said a man who was ready for SSI changed his mind is going to work another 10 years. i will be content if it works and the constant fatigue goes away. Thanks for great advice!
David

Philadelphia · « **Reply #93 on:** March 27, 2015, 04:25:07 pm »

Good luck Dave

skycatcher · « **Reply #94 on:** March 27, 2015, 04:32:24 pm »

Alright David! Class of 2015 is growing...... Skycatcher

dogdave · « **Reply #95 on:** March 27, 2015, 07:01:51 pm »

10 hours and no sides, but definitively feel like I took a medicine. Thanks to all and I hope every one has continued success!
David

Else · « **Reply #96 on:** March 27, 2015, 09:08:06 pm »

Best to you, Dave! Those pups of yours will keep you whipped into shape!

Red Hen · « **Reply #97 on:** March 28, 2015, 06:35:17 pm »

Hi, everybody! David and Skywalker, I have 2 rescue dogs. One is a long-haired chihuahua/pomeranian? mix and the other is a 5 lb. short haired chihuahua who survived some pretty nasty abuse before I got him. The best way to deal with symptoms from Viekira Pak was to play with my dogs. I bet Harvoni is the same!

dogdave · « **Reply #98 on:** March 28, 2015, 07:02:27 pm »

Absolutely, dogs are good. Lousy 1st night sleep. I'm hoping tonight will be better. The euphoria of starting this treatment is wear off. I getting set for the long haul.
My best,
David

skycatcher · « **Reply #99 on:** March 30, 2015, 04:27:03 pm »

Hi Red Hen and David and everyone!
I think animals are essential through out life. My beautiful dogs are gone today but my heart has been so enriched by having then in my life. Today my best friend is a beautiful kitty girl that we -- what else? -- rescued. I think of her as being pink and grey in color. She is a real character! But please tell me, what critter isn't when one decides to rescue? They are all so-o-o very special. My other half is not very much of a dog person but when we met the realization that my dogs were a very big part of my life, my children and were here to stay, and any kind of separation was out of the question was very evident very quickly. Either me and my 3 beautiful dogs or see you later. My partner, still not a dog person today, none the less was great with them and always very responsible and loving towards them.

Red Hen one of the first things I read that you posted was about taking time to enjoy your life. The outdoors, your puppies, family, in short : Life. I agree 1000%. I do the same. Very important.

David I had read a few times here that different people had trouble sleeping the first day or two. I have to admit I did too. The very idea that I might become CHCV free just blows my mind. But after that first day or two I have been sleeping like a baby for the most part. Be sure to drink lots-o-water. Can't stress that enough...

Just remember it's one day at a time. Each day is different with new possibilities and promises.

~ Skycatcher

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