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BANGKOK 19 March 2019 21:39
Captor

Hapatite C, what hospital?

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1 hour ago, mogandave said:

Double

Yes blood to blood that is what I was thinking too. Yes we think it is very likely it comes from that or maybe the pedicure. Not easy to know.  But no more pedicure now. And tattoo´s she only have one. And regarding the eyebrow tattoo she do it is maybe better to stop with that so no one get Hep C from her. Or at least be very, very protected with gloves and glasses and so on. I think she will stop it at all.

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4 hours ago, Captor said:

Sheryl, Yes we will do that.

So the most desireble medicine is still not in the 30 bath scheme? OK, so what you think about getting the medicine cheaper from India? I have read that many people do that. Maybe dangerous?

 

Also you say Sofosbuvir is the best. Is that not same as Sovaldi?

Then there are a hole bunch of medicines: Hepcvir, resof, Sofovir, Sovihep, Twinvir, Harvoni....

Are those older medicines?

Very confusing...

 

Sovaldi and Sofovir are both Sofosbuvir. Sofosbuvir is the chemical (generic) name, Sovaldi and Sofovir are brand names.

 

Sofosbuvir is recommended to be taken in combination with one of these: ribavirin, peginterferon-alfa, simeprevir, ledipasvir, daclatasvir, or velpatasvir. Which one will depend on the genotype of Hep C.

 

Harvoni,  Hepcvir and Twinvir are all brands of   Sofosbuvir combined with Ledipasvir. Hepcvir is made in India and Twinvir is made in Bangladesh.  Of the two I would recommend the former (Hepcvir), the company which makes it (Cipla) is very reputable.

 

 

Sofosbuvir combined with Ledipasvir is the preferred teratment for  Hep C genotypes 1, 4, 5 and 6.   If she has genotyoes 2 or 3 treatment will differ somewhat. The doctor at Rajawithi (or any other competant GI specialist or ID specialist) will be able to advise the optimal treatment once her genotype is known.

 

 

 

 

 

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Sheryl, a short update: We have called NHSO now and they confirmed that all the government hospitals are full so they have open up for private hospitals as well. As soon as there is a free hospital close to Nong Kheam my gf will apply for that instead. First of all we must use the closest to the address according to tabian ban (as you said) but if there is no one close she can also apply for Siriraj for example which is reasonable close to Nong Kheam. Or wait for another closer government hospital to open up.

 

There is a webpage to look what hospitals are open for new patients and what is not. We will look there every week. So in the meantime it is Praram2. We can of course change to another private but better wait until a government will be free and open up.

 

Webpage: https://bkk.nhso.go.th/main/

 

About the issue with Praram2 and their deny to send my gf to a BIG government hospital instead of that beauty clinic they said that we can demand that anyway if we think that gf not get the best treatment for her decease. And also they NHSO can check up Param2 closely if we get problem with the healthcare there. So far she have not meet a doctor there. she have to go there on an appointment that she has on the 28:th. Who know, maybe that doctor is more reasonable then the administration there at Praram2. And also who knows if the administration know what they talk about when they say that they have this Plasma scan examination. I think that we need to go the the appointments that we have got and then see what will come out of that from there.

 

24:th - Blood samples and ultra sound at Praram2

25:th - Plasma scan at Rajawithi

26:th - Meeting the doctor (professor actually) at Rajawithi for all the test results done before this date

28:th - Meet the doctor at Mali

3:rd - Ultra sound at Rajawithi (we cancel this if getting Ultra sound at Praram2)

 

Already done at Rajawithi: Blood sample for checking Hep C again + Geno test

 

 

 

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14 hours ago, Captor said:

..... We can of course change to another private but better wait until a government will be free and open up.

 

 

IMO it would likely be worth changing even to another private hospital while waiting for an opening at a govt hospital top open up. Can you post here what the options are? The link is all in Thai.

 

I see no point at all in keeping the appointment at Mali. GF should tell doctor at Praram2 that she has spoken with NHSO and been told she has the right to insist on referral to a hospital with appropriate specialists. Knowing that she is in touch with NHSO will help.

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Dear Sheryl,

Yes we agree but we will talk to the doctor at Rajawithi what we can do. We believe that he will send a letter to Praram2/Mali that we bring to Mali on 28:th.

We can be sure how to do after the 26:th how we shall proceed.

 

She has to go to the hospital where she is registered and they have already sent her to Mali for meeting a doctor there. At Mali (the last hospital in the chain) she can talk to the doctor and they can send her to another hospital or clinic. If they not have the resources to take care of Hep C. However, our doctor at Rajawithi want to take care of this. He has no confidence in the private hospitals. But now that we are in the loop it is not sure that we can come out of it the way we want. I think we have to wait and see what will happen on the 26:th. And also my girlfriend can start talking with the people at Praram on 24:th and mention NHSO. Not sure that she will meet a doctor there.

And I am not sure if I should go with here because if they see a foreigner then maybe they smell the send of money and that makes it more difficult.

 

About the hospitals on the webpage there are now 5 private hospitals and no government hospitals in Nong Kheam:

Laparam1 > Param2

Anunputthana > Anunputthana2

Phutthrakcha > Samutsakhon

Bangkhuntean > Param2

Bangboon > Suksawat

 

The left are clinics that send the patients to the hospitals to the right. Need to go trough the clinics.

 

 

Hospitals.jpg

Edited by Captor

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Samut Sakhon Hospital is a government hospital and looks to be the best bet on that list.

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On 12/14/2018 at 3:51 PM, Captor said:

Sheryl, Yes we will do that.

So the most desireble medicine is still not in the 30 bath scheme? OK, so what you think about getting the medicine cheaper from India? I have read that many people do that. Maybe dangerous?

 

Also you say Sofosbuvir is the best. Is that not same as Sovaldi?

Then there are a hole bunch of medicines: Hepcvir, resof, Sofovir, Sovihep, Twinvir, Harvoni....

Are those older medicines?

Very confusing...

There are a few newer meds now available for hep c .  The one that was the "breakthrough" is Harvoni.

which costs a fortune (like 100k dollars).   There is now a generic licenced by the original company called Ledifos. This is made in India.  It works !   The drug is  Ledipasvir 90mg combined with Sofosbuvir400mg.

It is almost 100 % effective.... a tablet a day for 90 days... and very few side effects if any.

Going to India to the pharmacy directly is one way....Cost for 3 bottles (30 pills each) is total approx 1500 dollars.     Because of the pharmaceutical control of profits it is not available in Thailand.  Any Dr here recommending interferon based treatments is WAY behind the curve.   Do not do it !

Try whatever you can to get harvoni or equivalent.   BTW:  what is her viral load?    after 30 days of harvoni ( or generic) viral load should be non detectable ! 

Harvoni is a new medication used to treat hepatitis C. It is a combination pill containing sofosbuvir (sold separately as Sovaldi) plus ledipasvir. It was approved in Europe in November 2014 for treatment of adults with genotype 1 or 4 chronic hepatitis C, and for some people with genotype 3.

Edited by rumak

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Dear Rumak,

Thanks for answering. We still don´t know about the viral load or genotype. I hope after the 26:th when we visit the doctor again we get to know that.

You mean that Harvoni or Hepcinat LP (which both are Ledipasvir 90mg combined with Sofosbuvir 400mg I think) are not available in Thailand?

I have searched in India and there it seems to be easy to get that.

But I wonder if a prescription from a Thai doctor is needed for order that? And what about the custom?

Is it illegal to order from India?

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3 hours ago, Captor said:

Dear Rumak,

Thanks for answering. We still don´t know about the viral load or genotype. I hope after the 26:th when we visit the doctor again we get to know that.

You mean that Harvoni or Hepcinat LP (which both are Ledipasvir 90mg combined with Sofosbuvir 400mg I think) are not available in Thailand?

I have searched in India and there it seems to be easy to get that.

But I wonder if a prescription from a Thai doctor is needed for order that? And what about the custom?

Is it illegal to order from India?

you can get it by going to India .   I am not sure what you would need , best to contact the Indian company directly or if you feel an emergency just go there !   

Anything from a thai doctor would not have any impact at all !   Maybe you would need an Indian doctor

to prescribe but i am not sure.

If your GF is not sick (no symptoms) then there is no emergency.... it is terrifying to know you have it but

as another poster says it takes  years and years to have symptoms.   The important factors are her liver enzyme levels  ( alt and alp ).  If VERY elevated not good.  And genotype and viral load are MOST important.  Read what is considered  low, med, high as to the viral load.  

Trying to order drugs from India or elsewhere is fraught with danger.   getting ripped off or fake meds,

Read real life experiences (on google) to learn of ways that some have gotten the medication by going to the manufacturer,

SORRY:  a few years ago the meds were not available in Thailand.  period.  And as far as i know nothing has changed.   If available then a major hospital would of course have them.  Sometimes their "liver specialists"  don't even know that they exist !

Edited by rumak

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Harvoni is available here, but extremely, extremely  expensive. The less expensive generics are not yet available here.

 

It is technically illegal to import any pharmaceutical by mail though in practice customs will usually let through small quantities if sent by regular mail (not courier).  But I can't say re reliability of various order by mail companies in India.

 

Flying to India and back to buy the generic will still be much cheaper than buying Harvoni here.

 

you can also purchase by mail through a nonprofit foundation started by an Australian physician

 

https://fixhepc.com/what-is-fixhepc.html

 

 

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i looked at the link from Sheryl.    I am not familiar with them BUT  i do know Greg Jeffrys 

Greg Jefferys was the first patient to come out publicly about his Hep C generic treatment journey and continues to assist patients years after he himself was cured. You will find Greg Jefferys' Homepage here, his blog here, and his Facebook group at Hepatitis C Treatment Without Borders. This is a closed group so you will need to apply to join.

 

He is definitely one of the people you can trust !  

Edited by rumak

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On 12/14/2018 at 1:47 PM, Sheryl said:

I should warn that the preferred medication (sofosbuvir) is not covered by the 30 baht scheme. She will instead receive a different, less desirable, regimen

To the OP :   I am not a doctor ,,,,and Sheryl knows a lot more about care in thailand than i do ,

Having said that, my opinion is that sometimes people take the word of some doctors or hospitals

and follow incorrect  advice or do unnecessaray procedures.   Often the Cat scans or MRI that hospitals

steer one into doing are useless.  And the one reading it is often not really up to the task.  Worst of all

would be a biopsy for your gf if she shows no signs of illness.    

Put your efforts into getting the generic Harvoni....    it works and is available.  Try contacting that group

in Australia.   Eat well,  stay healthy,  take the meds.   Hep C is curable.  And the liver is a very tough

organ and will recuperate unless there is serious damage .

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Hello both, thank you for your very appretiated comments. I have emailed about 10 different Indian pharmacies and they all have Hepcinat LP, Ledifos, Ledciclear, Twinvir or My Heplvir on stock. The prices vary between 150 USD until 275 USD for 1 bottle = 28 tablets. And they all claims that they are delivering by EMS to Thailand and that there is no prescription needed and no problem with the Thai custom. I don´t know. I feels not so good.

Then I think the australian guy feels more safe. I will contact him and see what he has to say. Thank you very much again both Sheryl and Rumak.

Also there is an Indian gay named Gupta or something like that I have read about earlier in links from Sheryl. Look like several people at TV has used him with good result. But I have not been able to reach him. I have sent email to he´s pharmacy but no answer.

 

Another alternative is this Dr. Theea at Samitivej who I have read has a clinic somewere in Sukhumvit. He seems to help Hep C patients but has a long waiting list. I have read.

I have not tried to reach him yet.

Edited by Captor

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