Got out of the Chennai Airport at about 2 a.m. after having a panic that my luggage had been lost I realised I was waiting at the wrong baggage point and found my bag all alone going around and around on the baggage conveyor belt.
Walking out of the airport building into the thick perfume of India, some things never change. Traffic jams, piles of rubble, half finished eight land highways, people sleeping on the broken pavement. So familiar, so foreign.
Got to the hotel without to much fuss and found my room quite good for what I need. Woke up at six this morning and went for a walk around my new neighbourhood. There are a few doctors and chemists on the block but I must wait until about 10 before anything opens. I might get a shave before I go and see the Doc.
What a day!
First I got an email from G. who runs a Hep C support group in Thailand. He told me to get in contact with a guy he knew in Chennai who was currently being treated for Hep C with one of the generic Sofosbuvir brands.
I phoned S who told me to come around and see him quickly because his treating doctor was about to go on holidays for two weeks and I would need to see him this afternoon if I wanted to get a script. Once I had the prescription S said it would only take an hour for him to organise the Sofosbuvir.
So I got his address, got a took-took and headed off. Of course on the way out I start worrying: “Right this is almost certainly a scam, the classic setup. Put time pressure on so I have to rush my decisions and then sell me a few bottles of fake tablets.”
So I start planning my strategy. I won’t be rushed. I will be respectful and explain that I have been ripped off in India a few times in the past (true) and I will want a couple of days to do ’due diligence’ before I part with any cash.
So I arrive at the home of S and am brought inside and welcomed. S looks wasted. He explains that he had a relapse a few months back after been given a clean bill of health after an Interferon treatment several years earlier. His viral count was now way up and, because of the geno-type and some other factors I did not quite understand S was having to use the Sofosbuvir in conjunction with Interferon and something else.
S is probably in his late forties or early fifties. Like me he contracted Hep C from shooting up when he was in his early 20’s. He had a successful career and, when he found out he had Hepatitis C, he had told his boss the truth. His boss was understanding and has stood by him. S said he probably missed out on a couple of promotions because of the Hep C but he kept his job.
He explained that the doctor he was seeing was a gastroenterologist with one of the large hospitals in Chennai and that he was going on holidays for two weeks and today was his last day. S wrote me a letter of introduction and told me just to front up at the hospital and bluff my way into the queue of people waiting to see the doctor. He told me once I had the prescription then there would be no problem getting the Sofosbuvir either as one of the generic brands or in the form of GILEAD’s actual Sovadli.
I felt very comfortable with S and forgot about all my worrying.
S’s wife typed out a letter of introduction for the doctor and S signed it and attached his business card.
S’s wife was very charming and, like S, she spoke English perfectly. We had a (non-alcoholic) drink together and then I went down and got my driver to drive me back to the hotel where I picked up all my medical reports and then onto the hospital. I will not describe the process of getting through the paperwork at the hospital and finally ending up in the Doctor’s waiting room other than to say that I was definitely the only white guy in town and that asking Indians for directions through a labyrinth of hospital corridors always gets the same answer: “Oh yes straight down there sir.” Which actually means “Turn left at the first, right at the second, straight ahead until you come to the end and then take a left.” Indians will not usually give you complicated directions like that because they understand that you will not be able to remember them so, rather than cause you the distress of forgetting the directions they just say: “Straight down there.”
Anyway after a couple of hours I ended up in the waiting room with about 40 other folk who found the fact that I was both white and very tall and did not speak their language an excellent diversion from the monotony of waiting to see the doctor. All very good natured of course. I got several handshakes, offers of food and “Where are you from sir?” On the discovery that I was from Australia cricket and all things and people associated with cricket became the conversation.
I became the “white height” guy. As I say all very good natured in a happy head wobbling way.
Several more hours passed and I had engaged in so many conversations that I was on the verge of learning to speak Hindi when one of the nurses handed me my folder and told me I was the next one in to see the doctor.
The doctor was a fellow about my age, maybe a bit younger. His specific interest was livers and when I explained my situation he told me that he could not just write a prescription for Sofosbuvir because the hospital had certain procedures that had to be followed first. Certain tests needed to be done and they could not be done this afternoon and as he would not be back until after I was gone back to Australia then it was all very unfortunate.
Oh dear, my worst nightmare, I had not given myself enough time.
But he was a compassionate man. I explained to him my situation in detail. I then showed him all the recent tests and the historical ones. Fortunately I had a great wad of paper that I had sorted through and organised during the long hours in the waiting room. As it turned out I had everything he needed in the test department except one, the Fibro Scan. Now I had actually had a Fibroscan at the Royal Hobart and it had showed no issues with my liver however for some reason I did not have a copy of the results.
Again the Doctor was very kind and told me that he would write the script for the Sofosbuvir provided I promised to have a fibroscan the next day. I made the promise and he wrote the script. He also said that I was lucky having genotype 2 because it was the easiest one to treat and it would be killed off with only a 12 week course of Sofosbuvir (one tablet per day) in combination with a course of Ribavirin (3 tablets twice a day).
That said I recall that my mate K had genotype 1 and his was cleaned up in 12 weeks also.
Anyway we had an interesting discussion about how the Hep C Sofosbuvir thing was being handled in Australia and other first world countries. He was interested to hear how the government was only using it to treat the most sick. He said that in India they had started that way with the earlier days with the Interferon based treatments but soon realised it was false economy and that it was much more cost effective to treat people before they sustained serious liver damage.
It seems pretty obvious to everyone I speak to!
So tomorrow I go off for a fibroscan, that will cost me about 8,000 rupees ($150) and I do not know what the tablets will cost yet. I will email the supplier tomorrow and find out. I am expecting them to cost me about $1,000 or so. Which means that with the cost of the hotel, the airfares, food and other expenses the whole thing will have cost me a bit over $3,000.
To me that’s a small price to pay for avoiding cirrohsis or liver cancer. Not to mention getting rid of an evil virus that basically screws up your whole life from your brain to your toes.
Well it’s looking pretty good. I will post exact figures on costs tomorrow. Next week I will also investigate other options such as not going through a hospital and just getting a prescription from a normal GP.
This entry was originally published on My Hep C Diary. Reprinted with permission.
Day Two In India