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Chasing a Cure for Hepatitis C | The Fix

dorriolds — Tue, 17 Mar 2020 09:32:42 +0000

Hepatitis C Cure

When I quit drugs and drinking, I found out I had chronic persistent hepatitis C. I’d contracted it in 1978 when I was 17. As the years went by, my chances increased for developing cirrhosis, liver cancer, or liver failure. I might even need a liver transplant. I’d heard about interferon and its brutal side effects, including suicidal depression. I had HCV (hepatitis C virus) because I’d been so depressed as a teen I shot drugs and shared needles in hopes I’d croak.

But, in addition to stirring up thoughts of killing myself, interferon would’ve meant six months of using needles to administer the drug. It had been nearly impossible to kick drugs and harder still to stay off them, so I was terrified that injecting drugs might steer me toward relapse. Interferon also had a puny 45% success rate, so I opted out.

A few years ago, I found a primary care physician specializing in infectious diseases and staying up-to-date on HCV treatments. He was waiting and watching for Harvoni (ledipasvir/sofosbuvir) to go on the market. “Now we’ll be able to cure you within 90 days,” he’d said. “And with only one daily pill.”

Hepatitis C Virus is divided into six genotypes. I have genotype 1, the most common type in the US and the most difficult to treat. In October 2014, when the FDA approved Gilead’s miracle drug, Harvoni, my insurance company refused to pay for it—three months of Harvoni costs upwards of $95,000. I was told I wasn’t sick enough. They were willing to gamble with my health, but my doctor wasn’t. He and his staff submitted appeal after appeal. I switched insurance companies three times, hoping to get Harvoni coverage, but to no avail.

Finally, I received an okay for AbbVie’s Viekira Pak with ribavirin. It costs $12,000 less than Harvoni and has a similar cure rate (97%), but Viekira Pak comes with a frightening warning: “It may cause severe liver problems.” My doctor reassured me that the treatment was worth it and that there would be no side effects.

My doctor reassured me that the treatment was worth it. He also said there’d be no side effects. He knew how scared I was. If I’d known how difficult taking the medication would be, I would’ve chickened out. That would’ve been stupid, so I’m glad I took the meds and survived the awful experience.

My three months on this cocktail have included severe gastrointestinal issues, including nausea, constipation, and diarrhea. I’ve had skin rashes and chills, confusion, forgetfulness, high anxiety and depression. The worst was the exhaustion, which often made it impossible for me to work. As a freelancer, no work equals no pay.

The ribavirin caused anemia, and I’ve had to stay in bed most days, not knowing if it was day or night. Instead of one Harvoni pill, I’ve had to take three Viekira Pak pills (two different kinds) with three ribavirin pills with breakfast and one Viekira Pak pill plus two ribavirin pills with dinner. If my husband hadn’t kept me on schedule, I would’ve slept through most of the doses.

Even when I set my alarm, I couldn’t move most of the time. Thank goodness I have a mate who kept track of the pills and woke me up at the correct intervals to bring food and drug cocktails. He also shopped, cooked, did laundry, vacuumed, massaged my aching legs, and took over full-time care of our dog. Without a support system, I don’t know how anyone could manage.

Hepatitis C Blood Tests

On the upside, my blood tests showed that my viral load went from 1,000,000 from the time I began treatment to 20 at the end of the first month. Now, after a total of three months, it is at zero. My liver inflammation has gone way down as well, and my doctor assures me that my side effects will cease now that I’ve finished the meds. Still, I wish I could’ve been treated with Harvoni and had known about the multiple class action lawsuits against insurance companies for not covering it.

Eleanor Hamburger is a lawyer at Sirianni Youtz Spoonemore Hamburger, the Seattle firm litigating two class action lawsuits against Washington state health insurers Group Health Cooperative and BridgeSpan, a subsidiary of Regence BlueShield. Hamburger told me, “We had people approach us who had been denied Harvoni. In most states, there’s just a handful of lawyers who do cases involving denials of treatment that people need by their insurance companies.”

She explained, “Here’s the problem. The insurance companies and payers, like Medicaid, are putting patients in the middle of this tug-of-war with pharmaceutical companies. Payers, whether it’s Medicaid or private insurance, have a responsibility to pay when all the requirements for coverage are met. The whole point of health insurance, and the safety net provided by Medicaid, is to be there with medically necessary treatment when those terms and conditions are met.

The fact that it’s expensive requires the payers to take action against the pharmaceutical companies to get the right price. What clearly should not happen and what has been occurring is, instead of pushing on that process to get to a fair price between pharmaceutical companies and insurance companies and payers, the payers have been saying, ‘No, we’re just not going to give coverage.’ The ones that get harmed are the patients. It’s wrong.”

Hep C Hadn’t Made Me Sick Enough?

When I told her, “Insurance companies told me I wasn’t sick enough,” she raised her voice in anger. “No one should be forced to walk around with a viral time bomb in their body, gambling on the chance that they’re not going to get sicker while they’re waiting. When you pay your premium, the whole point of insurance is transferring the risk of having that catastrophic cost to the insurance company.

At the end of the year, you don’t get your money back if you haven’t needed anything expensive for your health insurance! The same is true if you have a year when you’ve got high healthcare costs. Insurance companies can’t suddenly say, ‘Well, even though you’re entitled to coverage under the terms and conditions of our policy, we’re not going to cover it for everyone because it’s too expensive.’ The policies do not allow insurance companies to wait around saying, ‘Oh, but it’s so expensive we have to ration it.’”

Hamburger led me to Michael Ninburg, the executive director at the Hepatitis Education Project (HEP), a nonprofit whose mission is to provide support, advocacy, and services for those affected by HCV. He was eager to discuss updates regarding the Washington state class action lawsuits. The lawsuits allege that denying treatment to HCV patients unless they demonstrated significant liver damage was illegal and improper.

“We applaud the Regence group,” said Ninburg. “They’re one of the largest insurers in the Pacific Northwest, and as of February 16, Regence will conform to recommendations of the HCV guidelines issued by IDSA and AASLD.”

He said, “This change is important to HCV patients because Regence and its affiliated pharmacy benefit manager, Omega Rx, removed all previous restrictions on coverage.”

Ninburg then put me in touch with Sean Hemmerle, a 43-year-old ex-heroin addict and ex-con who is now a full-time college student in Olympia. Hemmerle served time in prison “for a robbery related to my heroin use,” he said. He was diagnosed with HCV in 2010 at Harborview Medical Center in Seattle while undergoing surgeries “to repair wounds from injecting black tar heroin.”

Hemmerle said he was sure he’d gotten Hepatitis C Virus from “sharing cookers because I’ve never shared a needle in my life.” When he was on his way to prison, he said, “I looked forward to receiving interferon while I was locked up. I figured it would be an opportune time to go through all the BS associated with it. Unfortunately, the prison medical staff, once they finally got my genotype and viral count, told me that I had too little in my sentence left to begin.”

“When I got out [of prison],” Hemmerle said, “Obamacare happened, and I got a primary care provider in the winter of 2013, who referred me to the liver clinic at Harborview in the summer of 2014. Once the liver clinic saw me, they sent a script for 12 weeks of Harvoni to DSHS [Washington State Department of Social and Health Services]. DSHS denied it, but the clinic appealed.

DSHS denied it again. The clinic then sent my script to the patient assistance program at Harborview, which contacted Gilead. Once the patient assistance program got involved, it was only a week before I received my first month of Harvoni. I completed my 12 weeks in July 2015 with absolutely no side effects, and my viral load was undetectable by week 5.”

He added, “I have loads of survivor’s guilt because I lucked out—literally days after approving me, Gilead began approving only levels 3 and 4 for patient assistance for Harvoni. Some HMOs, like Group Health, have recently begun approving 1s and 2s for treatment.”

While the drug companies battle it out in a price war, Merck’s rock-‘n’-roll-sounding pill, Zepatier (elbasvir/grazoprevir), became available January 29 for $54,600 per three-month treatment. Like the other meds, Zepatier has a cure rate of 97%. Due to its lower price tag, insurance companies are more likely to cover it. Unfortunately, Zepatier’s side effects are similar to those I’ve experienced on Viekira Pak with ribavirin.

Gilead has earned approximately $20 billion for HCV treatment, and AbbVie has earned billions from its Viekira Pak. It’s too soon to know how much money Merck will earn from Zepatier.

Regulus Therapeutics is the newest threat to Gilead’s profits. On February 17, Regulus announced test results showing that RG 101 administered two times in one month, along with a month’s worth of Harvoni, can reduce an HCV cure to a total of four weeks. Regulus is working on testing RG 101 with GlaxoSmithKline’s NS5B inhibitor, which would eliminate Harvoni. If that pans out, Gilead will suffer, but insurance companies will benefit. Hopefully, that means that more people with HCV will receive coverage.

The post Chasing a Cure for Hepatitis C | The Fix appeared first on Award-Winning Writer and Graphic Designer.

Top Ten Most Bizarre Facts About Japan

dorriolds — Fri, 30 Aug 2013 09:22:45 +0000

When Americans hear the word “Japan,” a mishmash of ideas pop into our heads — sushi and rice, manga and anime, kimonos and sumo wrestlers and Japan’s alphabet that looks like hieroglyphics in black brush strokes. We see mosaics in our minds of Samurai swords, origami, geisha robes and Mount Fuji, soba noodles, and oodles more. Here is a carefully compiled list of ten tantalizing and, well, weird aspects of Japanese culture that you probably never even thought of:

1. Hygiene:

Stick deodorant is not available. Spray deodorant exists, but it’s not commonly used.
Companies hire people to hand out small packages of tissues to pedestrians. But, get this, using tissues in public is considered rude.
People carry around a small towel to wipe sweat from their forehead.
Before one takes a bath they must shower first. Members of a household use the same bath water.
Most toilets in Japan have a built-in bidet system, called Washlets, for spraying water on your tush. These are the norm in homes and nicer restrooms. In some public bathrooms you may still find the traditional Japanese “floor toilet” where you will need to squat. Oy.

2. Shoes

Most people know that the Japanese remove their shoes indoors, but you may not know these interesting specifics:

Genkan is a Japanese entranceway. At the entrance to a home in Japan, the floor will usually be raised about 6 inches, indicating you should take off your shoes and put on house shoes, which are like slippers. If the house has a tatami mat room, its floor may be raised 1–2 inches to indicate that it is time to take off your slippers.
Whenever shoes or slippers are taken off they are placed neatly, pointing towards the door.
Most homes have extra house shoes for guests.
Now get this, when you use the restroom in a residential home, you will put on designated bathroom slippers so as not to “contaminate” the rest of the home.

3. Table Manners

When eating noodles, especially soba (buckwheat), you must slurp loudly. That indicates the food is delicious. It is considered rude not to slurp.
Sniffling, clearing one’s throat, or swallowing phlegm is not considered rude, but eating or drinking while you’re walking is.
When you have a bowl of food — rice, for example — you must pick it up and bring it up to your mouth to eat. If you don’t pick up the bowl, people think you are eating like a dog.
Never stick your chopsticks upright in your rice. That is only done when food is offered to the dead. When it is not an offering it’s considered a bad omen.

4. Transportation

Bus drivers turn off the bus during red lights to help reduce pollution.
Public buses have no priority over other cars, and no separate lanes.
Bike riders wear gloves to protect themselves from the sun, but no helmets.
In Tokyo, a bicycle trip is usually faster than a car.
Gas stations are usually full-service; attendants will bow as the car pulls out of the station.
Trains are so crowded that railway staff workers are employed to shove passengers inside before the doors close.

5. Masks

People wear masks in Japan, and they’re sold everywhere in various sizes. You can find masks in any color, with Hello Kitty, flowers, hearts on a leopard print, or with a lemon or orange smell.
If you’re sick, you wear a mask so you don’t spread your sickness.
If you work in a hospital or in a store, you wear a preventative mask in case you’re exposed to sick people.
Masks are used by hay fever or allergy sufferers — most likely so they won’t sneeze on you.

6. Mochi

For New Year’s Day and during the beginning of January, the Japanese eat mochi. It’s made with boiled sticky rice.
To make it, one person places it into a shallow wooden bucket and pats it with water. Another person then hits the mushy mess with a large wooden mallet to mash the rice. This forms a sticky white dumpling.
Mochi is an extremely sticky texture, so there are many January choking deaths.
Each year the death toll is reported in the newspapers.

7. Hikikomori

The word means “pulling inward, being confined.” This is an extreme social withdrawal, similar to what we call agoraphobia.
A person stays in their room.
Oddly, the sufferer doesn’t seem to have any other psychological problem that would explain this peculiar behavior.
Some people remain in isolation for years or even decades.
The Ministry of Health estimates that about 3,600,000 hikikomori live in Japan.
One third are 30 and older.
Among these are the hikikomori that are now in their 40s and have spent 20 years in isolation; this group is generally referred to as the “first-generation hikikomori.”
This age group is known as “the 2030 problem,” because when they are in their 60s, their parents — who have been taking care of them — will start to die, so there is concern about whether to try to reintegrate them into society. If not, there may be no one able to take care of them.

8. Consumerism

In Japan, Hello Kitty is everywhere.
Japan is the number one importer of reggae.
Japan imports approximately 85% of Jamaica’s annual coffee production.
Japan is the world’s largest consumer of Amazon rainforest timber.
Japan is the largest automobile producer in the world.
After you’ve shopped in a store, the cashier or clerk will follow you outside; they will bow and offer you cookies and tea.

9. Food

Kit Kat bars have the following flavor choices: Sweet Potato, Passion Fruit, Sakura Flower, Pumpkin Cheese Cake, Red Bean Paste, Apple Vinegar, and Green Tea covered with chocolate.
Japanese pizza toppings include corn, mayonnaise, and sesame seeds.
The most popular pizza topping is squid. Ew.
It takes 1–2 hours for a pizza to be delivered.
Raw horse meat is a popular food in Japan.
Although whaling is banned by the IWC (International Whaling Commission), Japan still hunts whales under the premise of research. The harvested whale meat ends up in restaurants and supermarkets.
Tsukiji market in Tokyo is the world’s largest fish market.
Octopus, squid, jellyfish, and other unusual seafoods are very popular.
Ramen noodles are a popular food in Japan, and it is widely believed extensive training is required to make a delicious soup broth. This is the subject of the movies Tampopo (1985) and The Ramen Girl (2008).
Some farmers grow square watermelons in Japan.
There are touch-screen menus at bars and restaurants.
Beer cans have braille next to the flip top.

10. Vending Machines

Japan has around 5.5 million vending machines. You can find them on almost every block.
Japanese vending machines contain batteries, beer, wine, condoms, cigarettes, comic books, hot dogs, lightbulbs, crepes, soft drinks, coffee, juice, noodles, eggs, sandwiches, and toys.
It is difficult to find a vending machine in Japan that dispenses chips or candy bars.

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A Different Kind of Love: Top 10 Killer Couples

dorriolds — Fri, 30 Aug 2013 08:52:08 +0000

Most people fantasize about meeting the love of their life. They are looking for that special connection, a perfect click with a soon-to-be lifelong mate. A typical checklist of desired traits includes physical attraction, a sense of humor, and shared interests. Then there are those unorthodox types who are seeking a special kind of spark — their dream soul mate snuffs people out. Here is a top 10 list of killer couples.

1. Alton Coleman and Debra Brown
This pair raped and killed on a tear through six states in 1984. By the time they were arrested they’d racked up eight murders, seven rapes, three kidnappings and 14 armed robberies. They were prosecuted in Ohio because the state has the death penalty. Both were found guilty and sentenced to die. Brown wriggled out of her death sentence, but Coleman got the needle.

2. David and Catherine Birnie (see photo above)
The Birnies were an Australian couple that murdered four women in their homes in the 1980s. The Birnies lived at 3 Moorhouse Street, so the press referred to their kills as the Moorhouse murders. David grew up in a messy, dirty home full of alcoholism and incest. Catherine met David when she was 12 and he was 14. The rest is history.

3. Faye and Ray Copeland
The Copelands gained infamy as the oldest couple in America sentenced to die. In 1990, when they were tried and convicted, Ray was 76 and Faye 69. They murdered five drifters, each via a single bullet to the back of the head. Ray had a long history of crime. Faye’s lawyers argued that she was a victim of battered woman syndrome. They were caught when a drifter told police he’d seen the remains of human bodies on their land. Faye swore she had no idea her husband was a murderer, but police found a written list of drifters and those who’d been killed had an X marked next to their names.

4. Fred and Rosemary West
Between 1967 and 1994, between the two of them, this married couple killed at least 11 young women and girls. Rosemary killed Fred’s stepdaughter while he was serving time in prison for theft. Rosemary was infuriated that the girl wouldn’t cry during the beatings she gave her. In 1995, Rosemary was convicted on 10 counts of murdered and sentenced to life. Fred killed himself while in custody pending his trial. Fred claimed his childhood home was full of incest and his dad taught him bestiality. Fred encouraged Rosemary to become a prostitute and she obliged. These two deserved each other.

5. Gerald and Charlene Gallego
This lovely couple killed 10 teenage and young adult victims after using them as sex slaves from 1978 to 1980. Charlene was raised in a decent family, but went off the rails when she turned to alcohol and drugs in high school. Perhaps it was the cocaine that fueled her sexual depravity. Her first husband was a heroin addict who complained that Charlene had lesbian tendencies. Meanwhile, Gerald grew up physically and emotionally abused by his mother. After Charlene’s two divorces she met Gerald and the two fell wildly, passionately in love. They completed each other . . . how romantic.

6. Jens Söring and Elizabeth Haysom
Jens is the son of a German diplomat. In 1984, he fell in love with Elizabeth. In 1985, they murdered her parents. In 1986, they were arrested in London for a check fraud scheme, and they transferred to the United States in 1990. Jens was under the impression that his father could get him diplomatic immunity for the murder. How wrong he was. He hasn’t spoken to his dad since 2001. Jens received two consecutive life sentences for the murders. Elizabeth has a mandatory release date of 2032, when she’ll be 68 years old.

7. Judith and Alvin Neelley
Judith met Alvin when she was 15 and he was 26. He’d been born in Georgia and became a teenage car thief. By the time they hooked up, armed robbery was their crime du jour. Things escalated — as they often do — and the pair was convicted of kidnapping, torturing and murdering a 13-year-old girl and later, a 22-year-old. Judith was sentenced to death for injecting the young victim with Drano, shooting her in the head, then throwing her into a Canyon. In 1999, her sentence was commuted to life without parole. She’s serving her time in Alabama. Alvin pled out for a life sentence and was doing his time in Georgia, but dropped dead during surgery in 2005.

8. Michelle Michaud and James Daveggio
On September 18, 2002, a Sacramento couple named Michelle Michaud and James Daveggio were sentenced to death for kidnapping, raping, torturing and strangling a 22-year-old student in December 1997. The deranged dynamic duo had committed additional crimes, but that’s the one they were convicted for. They cruised around in a Dodge-van-turned-torture-chamber that was rigged with ropes and hooks that made many an abductee very miserable. Here’s the kicker: Michelle was a Catholic Church volunteer when she wasn’t busy indulging in depravity and mayhem. Prosecutors said the two modeled their crimes after Gerald and Charlene Gallego (see above).

9. Paul Bernardo and Karla Homolka
This lovely Canadian couple enjoyed sadism, serial raping, torturing and killing. Well, everybody needs a pastime. Unlike other girls he’d known, Karla encouraged his diabolical behaviors. Apparently Paul grew up a happy-go-lucky adorable child despite the fact that his father sexually abused Paul’s sister, and that their mother became so despondent she moved into the basement. By the time he got to college, Paul enjoyed humiliating and beating women. He was just the right guy for Karla, who helped him rape and kill her sister. In 1995, Paul got life in prison for murdering a couple of girls in Ontario. Karla pled guilty to manslaughter in exchange for a 12-year prison sentence. Oy.

10. Ricky Davis and Dena Riley
By 13, Ricky was a delinquent and institutionalized. He graduated to prison for theft, then a few months after his release, he went back in — this time it was a 25-year sentence for raping a woman. He claimed the sex was consensual, but the jury didn’t go for it. He’d held a knife to the woman’s throat. Ricky got sex counseling, drug counseling and showed up regularly for parole visits, then perhaps he grew bored. He decided he wanted to make real snuff films. Meth head Dena was 38 when she met 40-year-old Ricky. Dena lured desperate meth addicts to Ricky in exchange for drugs or money. Ricky and Dena were such morons that they videotaped the murders, got caught and pled guilty.

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Free Advice From A Social Media Consultant

dorriolds — Fri, 26 Jul 2013 10:52:39 +0000

Thanks goes to Gwen Moran and Entrepreneur magazine for interviewing me on DO’s and DON’T’s with Twitter, Facebook, and all online communications:
3 Annoying Online Communication Habits You Need to Break
by Gwen Moran
Today, most communication happens online. With countless electronic exchanges throughout the day, it’s tough to craft a perfect message every time. But there are some online communication faux pas that can actually alienate your audience and make your overall communication less effective, says New York City online communications consultant Dorri Olds. She has worked with hundreds of small businesses, helping them build web sites and master social media. Olds works to cure her clients of these three afflictions.
1. Tone-deafness.
Email especially isn’t known for its ability to communicate tone, so it’s easy for straightforward messages to be misunderstood. Jotting a short direct response may be a time-saver for you, but also may appear abrupt or snippy to the recipient. While you don’t have to pepper your response with emoticons, you should review your email, posts and texts before you hit send to make sure you’re not coming across as unintentionally abrasive.
Softening a direct response with a salutation (such as “Hi, Joe” or “Great to hear from you, Mary.”) or signing off with “thank you” or “best regards” takes a few more key strokes, but can prevent your message from being lost among hurt feelings or annoyance.
Related: 4 Easy Tools for Cleaning Up Your Email Inbox
2. Promotion sickness.
“Some people think that we’re far more interested in what they’re doing than we really are,” says Olds. If your tweets or posts are all about you all the time, your audience is probably tuning you out. Olds likes a one-to-six ratio of promotion to other content — only one promotional post or tweet for every six you send out. In addition, when you’re using email, be sure you’re offering something of value to the recipient like a promotional offer or good content.
She also strongly advises using your platform to promote others and help them build their followings through reposting and re-tweeting good content. Also, if your email signature is seven or eight lines long, no one is reading it. Cut it down to the essential one or two messages about yourself to be more effective.
3. Negative state of mind.
No one wants to read wallowing, complaining or mean-spiritedness. If you engage in this type of communication on a regular basis, you could be hurting your image. At the same time, Olds doesn’t believe that you can’t be personal in your posts. If you’re being authentic and sharing your feelings about a certain matter, it makes you more accessible and people get a better sense of who you are, she says. But how you position yourself online is important.
“Why would you post that you’re desperate for new customers or that you’re goofing off at work because you hate your job? Think about what you’re posting. Would you want your customers to read it? If not, don’t put it out there,” she says.
Related: When to Call Versus When to Email

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