The most common misconceptions about hepatitis C (or HCV) is that it is usually contracted by engaging in risky lifestyle practices. But that is hardly the complete picture. While the 26 letters of our alphabet are well known, another group of ABC’s now deserves our attention: The ABC’s of Hepatitis.
Hepatitis is an inflammation and swelling of the liver, caused by a viral infection and diagnosed through a blood test. There are five types: A, B, C, D and E. The first three are the most common. Hepatitis D is a co-infection that occurs only in the presence of hepatitis B, and E is rare in the United States. However, all forms of hepatitis have the potential to damage liver cells and can lead to long-term complications and liver disease.
Hepatitis A (HAV) is transmitted primarily via the fecal-oral route, by either person-to-person contact or consumption of contaminated water or food. Dirty hands, water from an untreated source such as a lake or river, and fish and shellfish that feed in those polluted waters are all carriers of these disease-inducing organisms. HAV can cause symptoms for three to six months, but most people (85 percent) recover fully and the illness never becomes chronic. While it is most prevalent in third-world countries, there is now a vaccine to prevent HAV entirely should you be traveling in those regions.
Hepatitis B (HBV) is the most contagious form of viral hepatitis. It is transferred through blood or other bodily fluids, often at birth or through sexual activity. It can be acute (short-term) or chronic (long-term). People with the more common acute form typically recover without treatment. Once an acute infection is over, you are no longer contagious and your body develops permanent antibodies against the illness. However, the chronic virus continues to be present—and transmittable—so it’s best to keep being monitored by your doctor. A vaccine is available for all age groups to prevent HBV infection; the Centers for Disease Control and Prevention (CDC) recommends vaccinations for all children, starting at birth, for children and adolescents up to age 18 who have not previously been vaccinated, and for adults with certain risk factors for being exposed to the virus.
This column, however, focuses on hepatitis C (HCV), a whole different story. It can be silent—but serious. And it doesn’t strike only the promiscuous or intravenous drug users. Doctors and nurses, for example, can accidentally get pricked by contaminated needles. Blood transfusions before 1992 were a major source of contagion, as donor blood was not screened for the disease until that year. Since HCV is transferred by contact with infected blood, sharing items such as razors, manicure and pedicure tools, and even toothbrushes, is ill-advised.
Most people infected with HCV have no symptoms. In fact, they may not know they have it until liver damage shows up, sometimes decades later, during routine medical tests. In the worst-case scenario, if not checked, it can develop into cirrhosis, liver cancer, and ultimately, liver failure. There is no vaccination to protect against HVC, but it can be cured.
Some celebrities with HCV, such as Naomi Judd and Pamela Anderson, are vocal about their illness. But the public in general, and baby boomers in particular, still remain in the dark. Indeed, 82 percent of the nearly 5 million Americans with HCV are, in fact, boomers, and of those infected, 75 percent don’t know they have it. According to a new survey by the American Gastroenterological Association (AGA), 80 percent don’t even consider themselves at any risk for the disease. The national survey of more than 1,000 boomers (those born between 1945 and 1965) also found that fewer than one in five boomers know that HCV can be cured.
The CDC is taking action and recently issued new guidelines, proposing that everyone born from 1945 through 1965 have a one-time HCV screening. Compared with current risk-based screening, age-based screening could identify more than 800,000 additional cases of chronic hepatitis C and, when treated, could reduce total deaths by 121,000.
Of course, in the case of a confirmed hypochondriac, such as myself, since HCV can strike with no symptoms—and I have no symptoms—for that reason alone, I think I might have it. And since I am also a boomer, I will definitely get tested just in case. I suggest that you do, too. The good news is that even if you do have it, you can fully recover. That said, the following are 12 additional ways to help you on your journey to feeling Better Than Before.
Take a test run. “There are 15,000 Americans a year dying from hepatitis C, and that death rate will skyrocket to about 50,000 per year by 2020 unless we do something and do it early in the disease course when it’s easiest to cure,” warns Dr. Douglas Dieterich, professor of medicine in the Division of Liver Diseases at Mount Sinai Medical Center in New York City. So follow the CDC’s advice and get tested if you were born between 1945 and 1965. Hepatitis C is diagnosed with a simple blood test—although one you specifically need to ask your doctor for. Your regular physician can perform the tests, but “if you have a confirmed positive result, go see a liver specialist,” advises Dieterich. The newest drugs approved by the FDA for hepatitis C have changed the outlook for treating the disease, and there also are many other drugs in development. “It’s a good time to have hepatitis C,” Dieterich concludes. No matter what, if you do have it, a healthy lifestyle should be a top priority.
Don’t worry. “Any significant threat to our health is naturally alarming and concerning,” says Dr. R. Duncan Wallace, psychiatrist and psychotherapist in Salt Lake City, Utah, and author of The Book of Psychological Truths. “We worry what will happen to us, how will we fight it, will we die from it?” He explains that when we feel stress, anxiety or fear, the cortisol leveling our brain rises to warn, alarm, and mobilize us to take action and get medical help. However, if it does not shut off within a few days, it can become toxic, depressing us and lowering our energy. To that end, Duncan recommends some psychological solutions to best handle the stress of an illness. First, know that the cause of mental pressure is thinking illogically about the future in absolutes, such as I must have a good result, or I can’t let the illness get me—trying to force future certainty. “So instead,” he suggests, “replace that with, I’ll take whatever happens in the best way. This recognizes the true uncertainty about any outcome ahead of time and immediately takes the pressure off your mind. When we say, Oh, my gosh, what if (bad outcome), we build tremendous pressure in ourselves. If you answer the open-ended fear question with, So what if it did happen, the pressure and fear immediately disappear because the uncertainty is removed with the certain answer.”
Practice girth control. Your liver plays a vital role for almost every system of your body. From hormone and digestive enzyme production to blood filtration that removes bacteria and toxins, it responds to all your metabolic needs. In fact, it’s the last stop for everything you eat and every drug you take. Therefore, it must be functioning well to maintain normal metabolism of carbohydrates, fats and protein, and to process vitamins. While there is no special eating plan solely for people with HCV, an unhealthy diet, according to the National Liver Foundation, can put a strain on the liver, making it work overtime and actually causing more damage. “Try to avoid alcohol and also keep the carbs low,” advises Dieterich. “An excess of carbohydrates has been associated with a buildup of fats in the liver cells. Also, be sure to take 2000 international units (IU) of vitamin D a day.” Since those infected with the virus also can have higher rates of diabetes, reducing body fat and controlling blood sugar lowers the risk of developing that disease later on.
Find your comfort zone. Alan Shackleford, an IT specialist at Johns Hopkins University and Medical Center, attributed his HCV to a blood transfusion in the 80s when he worked as a paramedic on an off-shore oil rig. “People who have the greatest problems coping with the side effects of the medications are the ones who aren’t in good shape,” he maintains. “As soon as you are diagnosed, you don’t have to rush to get treated. Take time to get your body right.” For Alan that meant staying extremely active in sports, which included snowboarding, kayaking, tae kwon do, even participating in long-distance charity bike rides. “But listen to your body,” he cautions. “Participate at a comfortable level, and don’t push yourself over your limit.” If you need to slow down, reduce the number of reps or the length of time you exercise, and if you ride, put the bike in a lower gear. If you don’t want to walk for a full half hour, take three 10-minute breaks and you’ll get the same benefit. Get plenty of rest, and remember to drink a lot of water all throughout the day.
Avoid “tress” stress. On average, we lose between 50 and 150 hairs every day. It’s not a big deal when you consider that you have about 100,000 hair follicles. It only becomes problematic when you start to lose more than your body can grow. Sometimes that happens when patients begin HCV treatments. But not to worry—you won’t go bald. True, your hair might become thinner, more brittle and easily break off. But that happens gradually, not like during cancer chemo when hair falls out in bunches. Similar to chemo, though, the texture may change during therapy—straight hair may become curly and vice versa. But use a wide-toothed comb so that you don’t tug or pull, and forgo blow dries or perms for the time being. Here’s the good news: Hair that’s damaged will grow back, sometimes even thicker and fuller (better?) than before.
Hands on. To combat an illness such as HCV, John Kroneck, author of Reiki Energetics, recommends that we increase the vitality of our body, mind, and spirit through an energy-based healing technique called Reiki (Ray Key.) The experience of Reiki, which is gentle, yet profound, works with your own energy to restore balance and jump-start your immune system. The treatment is administered by “laying on hands” and is based on the theory that an unseen “life force” energy flows through us. If this energy is low, then we are more likely to continue to be sick or feel stress. Conversely, if it is high, we are more capable of being happy and healthy. So Reiki practitioners allow a high frequency of spiritual energy to flow through their hands to the individual receiving treatment. Kroneck’s techniques are designed to engage recipients in their own healing process. “We can do self-treatments,” he says. “For example, I start each morning by placing my hands on my body and bringing Reiki energy into my personal day. It’s a great boost—and its caffeine-free.” For more information on how you can use Reiki Energetics for health, click on www.ReikiEnergetics.org. .
Create sound surroundings.“Nothing is etched in stone when it comes to your health,” says registered dietitian Ruby Hillsman, author of If I Knew Then What I Know Now—Time to Stop Recycling the Same Old Mistakes. “Even though the sky is the limit where hepatitis C or any other disease is concerned, a person has to make necessary changes to reclaim or regain his/her well-being.” Ruby adds that a phrase she once heard says it all—in order to make positive and lasting changes, a person must sometimes change his playground, his play friends, and his playthings. “It is important that anyone on his path to wellness surround himself with people who have a great deal of honesty and can show both the positive and negative sides of an illness,” she says. And talking with someone who has gone through a similar health experience can be indispensable in providing hope.
Seek a higher power.“Emotionally you feel violated, and it shakes you to your core, thinking something so horrendous is lurking in every cell of your body,” says Mark Prater, chief meteorologist for CBS 42 in Birmingham, Ala., and author of Silent Storm, Finding Spiritual Shelter During Hepatitis C, about his own bout with the disease. But for Mark, facing what he calls a silent killer, his faith was the most successful drug. “Letting the medications have their way is the toughest hurdle,” he contends. But his belief in God was unwavering and helped him accept that he had been chosen for this role and eased the doubts, pains and frustrations he faced daily. “I never searched for this battle,” he says. “It came to me. It was not easy. My spirit was shaken but never destroyed. And living off of the energy my spirit provided me vanquished any impending doom.”
Keep on keeping on. Survivor Barbara Day was shocked to learn that she had HCV when she received a letter from a blood bank after donating blood. She had contracted it years earlier when she got her own transfusion. After participating in several clinical trials that failed, she tried another with a new drug, Incivek, and her viral load went down to zero at week two. What kept her going throughout, though, was that she didn’t forgo the activities she loved to do—riding and breeding horses. “Don’t just sit around and feel sorry for yourself. That just continues to foster unhappiness,” she says. “Engage in your creative side. Everybody has creativity waiting to be expressed. Find your passion. You’ll discover that it will distract you from your pain and help you feel a whole lot better.”
Change your attitude.“When we acknowledge, with both appreciation and gratitude, all that life has given us, we can feel joy and satisfaction,” says Duncan. So when you are home and alone, either before bed or waking up in the morning, taking time to reflect on all you have learned and gained, experienced and loved, puts you in a wonderful frame of mind.” This is paramount in making an excellent quality of life a function of our mental capability rather than a product of chance or circumstance.
Sooner is better. Early treatment with one of the new regimens can potentially clear the virus from your body and prevent the progression of hepatitis C–related liver damage. Therefore getting tested, diagnosed and treated before liver damage progresses is crucial. Indeed, the rewards of doing so can be lifesaving. Need I say more?
Hep Hep Hooray. I.D. Hep C is a new campaign from the American Gastroenterological Association (AGA) to educate people, especially baby boomers, about hepatitis C and encourage them to speak up and get tested to learn their status. For more information on where and how to get tested, visit:www.IDHepC.org. The AGA also is encouraging people to show their commitment to stopping this silent killer by taking a virtual pledge to get tested and spread the word.