How did you make the final decision to begin HU protocol for ET?

Posted by eansgardengirl @eansgardengirl, Nov 28, 2022

Hi, I continue to research and learn from others with ET. I am 57, and diagnosed this past year. Jak2 positive, ET. I may have suffered a thrombotic event post-knee surgery in 2021, therefore my MNP specialist ( Hematologist) is recommending I being Hydroxyurea ( HU). I am so hesitant to take it, for many reasons, and trying to connect with others' decision-making process. My doctor did a fellowship with Mayo Clinic, however, I am still considering going to the Mayo clinic for a second opinion. Mainly for a timeline of when I truly HAVE to being HU protocol to reduce risks of stroke, heart attack, and clots. My counts are between 570-680 platelets. I do suffer from headaches, very cold hands, and feet, and tingling in my calves ( I am told this is not related, but I can feel my calf muscles twitching almost all the time. I get fatigued, but I remain very determined to keep healthy movement. I cycle 5 days a week and hike when the weather allows. Mostly, I would like to hear others' experiences from diagnosis to when they started on HU, and what ultimately helped YOU cross the line to treatment. Thank you,

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@colleenyoung

@treeore, do share with your doctor or someone on your medical team about the financial pain. Social workers or someone on the team can look into options. See this article about oncology social workers:
– How an Oncology Social Worker Can Help https://connect.mayoclinic.org/blog/cancer-education-center/newsfeed-post/how-an-oncology-social-worker-can-help/

I don't know specifics about Besremi or Pegasys in particular. But in general your provider can help with:
- finding co-pay assistance programs through pharmaceutical companies or foundations
- navigating off-label medications not covered by insurance companies
and more.

I wonder if Besremi or Pegasys have financial assistance programs?

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Thanks, Colleen, The financial officer at the oncology clinic is running numbers and I'll talk to her soon. She did mention she looks into/applies for corporate (pharma) "grants" or assistance. There is also a program through the clinic itself, not for drugs, but I think I won't qualify for that.

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@erikaerika

It's very helpful yes. Thank you for sharing. Everyone around me keeps telling me everything will be fine. But they don't quite get how I'm feeling. It's nice to be able to connect with others that truly understand. I too have migraines with visual auras. I feel my vision has changed too & I recently noticed a ringing in my right ear that has lasted over 1 month now; my hematologyst seems to think it's all unrelated to the ET.

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Doctors dismiss what isn't "in the literature." I wish they would at least note these symptoms in rare diseases and then pass them on to researchers to look for commonalities, patterns, and causes. If nothing else, they could tell you that other patients report something similar, no one has established a direct relationship with ET, but it's not in your head. But specialists can be very narrow in their view and very sure about what they think they know.

Fwiw, I have tinnitus all the time. I assumed it was age or possibly jaw issues. I use a brown noise machine at night that helps.

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@treeore

No one has hypothesized as to why I have not had thrombotic problems despite high platelets for 20 years, but since I should have had problems based on family history, but have not, I personally give some credit to 40 some years of organic, vegetarian (lately vegan) food, bike commuting, yoga, & dog walking (ha!) Reading, art, writing and gardening are my go-tos for "lifestyle." If my personality wasn't stress&worry-based, I might have escaped this mutation, but personality is pretty hard to control. Trying qi gong now, as it helps me to breathe deeply. I'd love to read what doctors and other medical folks advise to MPN patients. I hope people chime in with advice they've been given. I know diet is not a big part of many docs' training, so we might have to go further afield to find answers. Anyhow, here I am amongst the beleaguered and frightened, so I have no boasts to make! Best of luck sent your daughter's way!!

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I think we need to get away from the idea that we caused our own disease by eating impure food or having the wrong personalities.

Research suggests that the driver mutations for ET are not themselves inherited, but that we likely inherited a predisposition to mutate when exposed to certain triggers. We lived near a chemical plant that made Agent Orange and napalm before EPA regulations were imposed. Dad and I got ET, but not my mom or brother.

Fwiw, I suspect my biological grandfather had ET. He experienced sudden onset of fatigue in his last year and died of a massive coronary thrombosis at age in 1959, before anybody really knew what ET was.

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I have been on medication since 2010. I am 64. I have been taking Hydrea and suggested to take asprin, which I did for a short period of time. Then I stopped after discovering the asprin is not the best to take. I was over 900 and after a decade finally got down to normal between 150-450. I stopped taking HU. Now I am about to go back to gain a blood test to check my readings.
My life style has been up and down over this period. On many occassions I feel fine and able to function very well.
My quality of life has been positive except when I do get tired and fatiqued etc
I found my own positive thoughts helped a lot and having company around talking about everything else but this condition has helped.
Hope this helps a bit. Please stay calm and positive.
This condition is very rare. I have been to over 13 doctors now and many oncologists etc specialist etc and many hospitals.

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@hdollar1

It is absolutely an overwhelming diagnosis to receive. I spent many weeks worrying and crying, wondering if my children would find me after throwing a clot somewhere. I taught my then 7 year old how to dial 911 if it ever happened. My hematologist is amazing, and after many visits crying in the office with him, he reminded me that stressing over it will do absolutely nothing for me in the present, and that really the only long term studies on life expectancy after this diagnosis are done on older people anyways, as this is most commonly a diagnosis of older aged individuals. There's really no way of knowing what other conditions they could have had that could have potentially led to a faster death than younger individuals. He explained that studies have not really been done on younger people diagnosed with this, and there is the potential to live a full life if properly managed. As an ER nurse, I see very often how no matter how healthy you are, your life can be taken in a split second by tragic events. I was initially very stuck on the 20 year life expectancy as well, but I try not to dwell on what may happen in a couple of decades and try to live for today. You never know when your time to go is, and I'm not willing to let this take me down any faster. Processing the diagnosis absolutely got better with time for me, and I try not to stress over what I cannot control. Hugs to you ❤️

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This was a wonderful, encouraging reply, Thank you.

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