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St. Louis Second Wind
Lung Transplant Association
Newsletter |
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| Volune 12 Issue 6 | June 2011 |
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Generic Version of Prograf®
By Paul Austin, PharmD
Bioscrip Pharmacy, St. Louis, Missouri and
Emily Owen, Pharmacy Intern St Louis College of Pharmacy StLCOP
In August 2009, a generic version of Prograf®, called tacrolimus, was approved by the Food and Drug Administration (FDA) for manufacture by Sandoz. Because tacrolimus is a drug that needs to stay within very specific levels within the body, transplant physicians hesitate to switch their patients to the generic formulation. At the time that tacrolimus was approved, Sandoz had not done any studies to compare drug levels of the brand name Prograf® with the new generic equivalent. The only studies published looked at how the drug affected healthy patients, not those with transplants. This caused even more uncertainty in physician's minds. Some physicians also choose not to prescribe tacrolimus because of past experience with cyclosporine, another drug that helps reduce post-transplant rejection.
With cyclosporine, the concern of the physicians was not unfounded. A study published in the journal, Transplantation, in 2006 demonstrated that a generic cyclosporine (Cysporin®) was found to have absorbed less active ingredient and at a slower rate. A study of 188 patients done in 2005 comparing Neoral® and Gengraf® showed that the percentage of rejections were doubled in the patients using Gengraf®. These studies should not alarm patients, but the physicians should be aware of the need for increased monitoring if a switch in therapy is necessitated by the insurance company.
Just as the switching of Neoral® to the generic equivalent required monitoring, so would a switch from Prograf® to tacrolimus. Such a switch is doable, but would require discussion between the physician, pharmacist and patient, proper education, and monitoring. Because tacrolimus has to stay within a very narrow range within the body, monitoring the patient's blood levels of the medication monthly is important. Because the generic tacrolimus can cause a change in the level of drug in the body of a patient already taking Prograf®, physicians should be notified of the switch by the pharmacist so that the physician can monitor properly. By closely watching the medication, much like when a patient is initiated on the therapy, generic tacrolimus can be just as safe and effective as Prograf®. Since switching from Prograf® to tacrolimus will require close monitoring, physicians should speak with their well controlled Prograf® patients prior to deciding to switch to tacrolimus. However, physicians could start a new patient on tacrolimus just as easily as Prograf®.
To help ensure a smooth transition, pharmacies should choose only one generic manufacturer of tacrolimus to carry, ensuring more reliable blood levels of the drug. Patients and physicians should always use the same pharmacy to ensure that they receive the same generic medication every month.
Dr. Lawrence Yu discussed previous studies about tacrolimus at the American Transplant Congress in Philadelphia earlier this year stating that drug levels of tacrolimus fell within the 90% range required by the FDA. He also addressed the concerns that the studies were done in healthy patients instead of transplant patients by saying these patients are more sensitive at detecting formulation differences.
By the end of the year, we should have definitive clinical data on the Prograf® vs tacrolimus debate. A study comparing the Sandoz version of tacrolimus to
Prograf ® was completed in May and results should be published by the end of the year.
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We Remember
Robert Henry Augustine
Robert Henry Augustine passed away Thursday, June 16, 2011. Beloved husband of Deborah Augustine; dear father of Brian (Karen), Angie (David) Hennigh, Robert Jr. and Scott; loving grandfather, uncle and friend to many.
Bob received a bilateral lung transplant at Barnes-Jewish Hospital on January 19, 1995.
In lieu of flowers, memorials may be made to Second Wind Lung Transplant Association and mailed to St. Louis Scond Wind C/O Peter Nicastro, 2169 Willow Ridge Lane, Chesterfield, MO 63017.
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Reality of Life
By Traci Snyder
I am Traci Snyder and I am here, in St. Louis, awaiting lung transplant. My husband, Scott, and I have been located here since March 2009. We have met some wonderful people and have received such great support from Second Wind.
When I was younger, I never went to church nor felt a spiritual need. I felt secure in life and carried on. Then, getting my diagnosis and gradually declining in health, I had a wake up call. I needed to know that whether I died of this present disease or received lungs that I had committed to God. I decided to be baptized.
My family rallied. They were excited for me and planned to attend.  I started classes at Christ Church Cathedral in preparation. I asked Tom Archer and Frank Kriegel. friends I had secured since locating to St. Louis, whether they would be my sponsors. They were delighted and them some!
I was officially baptized on April 23rd at 7PM at Christ Church Episcopal Cathedral in St. Louis, Missouri. My family traveled all the way from Nebraska to witness the ceremony. Friends also attended.
Since my baptism, I have had a calmness I did not have before. I feel taken care of and that my life is in my Maker's hands. I had a wonderful weekend including a barbecue birthday party!
Whether you are a person waiting for lungs or have another medical situation it tends to sharpen your senses about life and what it means to you because there is possibility of losing it. So, I encourage everyone to live each day to its fullest. My best regards to everyone and thank you for reading my story.
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8th Annual Lung Walk 2011 -
Every Breath Counts
October 15, 2011
- Forest Park Visitor's Center
- 8:00 am Registration Begins
- 8:30 Memorial Service
- 9:00 Start Time
- 5K Race and Walk, One Mile Fun Walk
- On-line Registration Coming soon!
- More info call: Tom at 314.664.6360
Start organizing your team now! Team resources available on our Web site www.secondwindstl.org.
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Meet  Matt Alber
In November 2008, singer Matt Alber released "Hide Nothing" on the heels of five years, seven albums and two Grammy® Awards as a soprano in America's premier classical a capella ensemble, Chanticleer.
"Hide Nothing" is a touchingly personal, autobiographical and sentimental collection of lush, dreamy love songs reminiscent of singers like Ben Folds, Iron&Wine and Imogen Heap (the album includes a moving cover of her "Hide And Seek"), all of whom Alber counts as influences. It is an emotional tapestry of beautifully crafted songs that glisten, glow, and gently-and sometimes grandly-unfold; vocals lingering and lyrics resonating long after the songs (and goose bumps) have faded.
HEY MICKEY, YOU'RE SO FINE
As child of The Eighties, both Michael Jackson and Carousel Roller-rama were pivotal discoveries. I'd ditch the Couple's Skate to practice break-dancing and perform my own music videos in the mirrored tiles under the black lights. When I'd memorized every vocal nuance and riff, I'd write my own vocals for the musical breakdowns-and then I'd choreograph them. The eight-year-old with the moves began to draw crowds next to the skate-rental.
I owe this soulfulness partly to LaTonya and LaShonda- my 4th Grade Double-Dutch teachers and best friends. They taught me how to roll my eyes at my teachers and sing louder than the white girls in choir class. I was a lucky white boy to be adopted by the coolest girls on the black-top.
CALIFORNIA DREAMIN'
The Kansas-boy/pop kid/choir geek who'd never smoked a cigarette landed in San Francisco with wide eyes. It was truly the land of the free and the home of the brave. They were waving my flag on every corner. I gave up "just say no," and fell in love on the Golden Gate Bridge.
I was also the newest soprano of the elite professional classical men's ensemble, Chanticleer (www.chanticleer.org). Singing was no longer just a passion, but my full-time job. The group is limited to just twelve men; there was one spot open when I auditioned in 1998. It took three auditions, but I won a seat in the group. I've never been more challenged physically or mentally than singing with this ensemble, but it came with great rewards. We toured the world 150 days a year performing the most difficult repertoires ever composed for voices. We sold-out stadiums and concert halls and became brothers.
In my five years with Chanticleer, we recorded seven albums, two of which won Grammy® Awards. Our director Joseph Jennings pushed us hard with genius, vision and southern perfectionism. In thirty minutes he can transform a mediocre high school choir into a working ensemble with vibrant sound and spark. (And in three hours he can bake you a cake too heavy to take home.)
YOU GOTTA HAVE SOUL
Because of my choir teachers, I'd been given a great gift; the ability to find the soul in any brand of music, be it Michael Jackson, medieval opera, shape-note singing, or Gregorian chant. My harmonic language had been so far stretched through performing and mimicking soul music, styles I was finally immune to musical prejudice.
It was time to start writing an album. I turned my bedroom into a home recording studio and learned to use a Mac. I was starting from scratch on the mechanical side of things, barely knowing where to plug in my large diaphragm condenser. The first year of home recording was a lot of yelling at audio equipment and then feeling ridiculous for yelling at audio equipment. It was an intimidating learning curve in engineering and sound design. Thank god I found Jeff Crerie.
MAKING A RECORD TAKES PANCAKES Jeff Crerie is an audio space cowboy with an intuition and musicianship unmatched. His studio, Utmosis (utmosis.net) is perched on a San Francisco hilltop overooking the Castro. After sitting side-by-side mixing and recording these songs (and savoring some of Jeff's famous pancakes) I would walk home in the drizzling rain listening to what we'd just created out of thin air. |
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August 2011 Transplant Anniversaries
By Jan Kwasigroh
The hot summer sun, the beach, reunions, mosquitoes, county fairs and a good book - all a part of a relaxing summer and enjoying everything with new eyes each day. The following nine celebrate their transplant anniversary with the expectation of newness each day. Enjoy it to the fullest!
17 years Terry Berry
14 years Joy Williamson
12 years Jim Cooper
10 years Tracey Marshall
9 years Jim Davis
7 years Alice Scherzberg
6 years Julie Martin
5 years Kay Turner/Hansen
2 years Randall Hileman
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 Treasurer's Report
By Peter Nicastro
During June, Second Wind received $1,256.22. Because of your generosity, Second Wind provided $819.13 in assistance during May to two recipients. Payments were for rent and medical co-payments. We had other expenses of $1,332.55, mostly consisting of $1,192.50 for completion of our federally mandated form 990 disclosure, for which we obtain the assistance of professional accountants.
New Member
Frank Bonifas
Dues Renewals
Gary & Barbara Naeger
Memorials
Jane McWilliams-Sykes in memory of Debbie Ratliff
Wendy Chen in memory of Michael Poole
Honoraria
Walter & Marcia Wright in honor of Carrie Serati
Other Donations
Ken & Linda Nottestad, Frank Bonifas, and Jean Belford
Corporate Sponsorship
Bioscrip Pharmacy donated $575.00 for the printing of the St. Louis Second Wind brochure |
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