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Peginterferon-Ribavirin, Failed it twice. Incivek, Failed it. Sovaldi Olysio, failed it. Harvoni, failed it... Transplant Patient Zepatier and Sovaldi...we'll find out!

Wednesday, February 24, 2016

I Heart DP

Oh shit, look that's me in there.

There may be spoilers. Head's up.

JK there are totally spoilers. Deadpool Deadpool Deadpool!

Is he here? Wait sorry, wrong fictional, fourth wall breaking character.

I wouldn't normally talk about a movie, but this super...hero(?) is important.

His name is Wade Wilson Aka Deadpool. For those of you not familiar with the story, he's a dirty mercenary with a heart of silver or a metal similar to gold. He's an antihero.

He is known for narrating his own story and breaking the fourth wall. And his superpower of regeneration is from a treatment to cure his cancer. 

With his voice guiding an audience its easy for them to understand this harsh and brutal universe, but the characters within see him interacting with the audience and believe him to be insane. This detachment from his own universe, is a core component of the insanity brought on by his origin story.

If we were without the narration, we would see the world as he does and the movie is jarring, confusing and violent.

Deadpool is a super "hero" for those of us with Chronic Pain, Mental illness, and Cancer.

Deadpool must endure constant chronic pain, due to his ability constantly fighting his cancer. His weapon x treatment also made him a touch psychotic.

As a person with a terminal illness and chronic pain, I loved being able to relate the tragic experience of diagnosis, the health care challenges, and his humor in the hospital.

From reaction to diagnosis to when Wade argues with Vanessa about priorities and the next step. While she went trough every avenue at her disposal to grasp for straws. His idea of not wanting to bring someone into the "shitshow" hit home in a very real way. The movie helped me see how ridiculous an idea this is, because we all have shit in our lives, we all have hardship at unknown times. We have to regard it as an aspect of our lives rather than as defining our character. Because it's how we react that determines character.  

His sense of humor feels comforting to me because I know that humor. It's a weird self deprecating brink of madness that finds itself in those resilient enough. In a sense it's being jaded by living.

Now on an even more personal level...

The dead pool being a board where members bet against each other to die. The dead pool is a game to deal with the reality of the trauma of life so close to death...

Between a few friends, we call ourselves lifers. We each have diseases that can cause us to die early on, so naturally we're in a life race to see who can die the fastest. There's no betting though. Oh, and no cheating (unless it adds time to the clock). So, When they explained the dead pool, I peed a little in excitement.

The weapon x treatment that Wade went through to become Deadpool felt familiar. Not that level of pain or superpowers, but rather the drugs themselves. The weapon x serum was derived from Wolverine's healing factor and applied to Wade to alter his DNA to combat the cancer.

This is similar to modern DAAs, Genomics is the basis for Sovaldi, Harvoni, Vikera Pak, etc. However, unlike the Weapon X program, the treatment just targets non-structural proteins and like doesn't give you superpowers. So to see a "similar" method was exciting.

I felt like there was an area where they played it safe...

Deadpool also reflects a modern dilemma with healthcare. The movie only touched on the overwhelming amount of options and information available for cancer treatment. To be able to give a patient's view of the process and financial turmoil, would have been so impactful. With a spokesman like Deadpool, the ability to critically poke at it without being too serious is a powerful superhero advocate.

There are plenty of movies that do as good a job or better, but there none of those grossed over a hundred and thirty million on their opening weekend. So...

Watch it. Watch it again, while eating a Chimichanga.

Monday, February 22, 2016

Zepatier Part Ugh

Olysio, Sovaldi, and Harvoni

I have spent the better part of this past month re-writing this post, and on March 11, i will find out much more.
Because I legitimately don't know how to properly convey my despair and disappointment and fear at what will soon unfold.
I had been eagerly awaiting the release of Zepatier,  the announcement last month was terribly exciting.
Zepatier is a Hep C drug that deals with NS5A resistance,has a very high success rate, and is almost half the price of the leading treatments Harvoni and Sovaldi.

It's amazing, and it has shown to work very well in other harder to treat cases.

The drug has one small hitch.
Well, i think it kinda sucks like... a lot.

The contraindication does have a rationale beneath it.
In 1% of cases ALT levels raised 5X within in the first 8 weeks, Clearly, an indicative factor of a problem.

Unless it isn't.
Which it isn't.
Most instances self corrected soon after:

In fact the contraindication seems odd considering the big new DAAs carried no such contraindication:

So... Now it's time to figure out how the hell I get this drug, because I suspect this will be my last treatment. success or failure.
Further research should show it's true efficacy, which i feel will reflect poorly on Zepatier if the drug is prioritized because of its price-point rather than it's efficacy.