So there you are just walking down the street minding your own business when BANG you trip up on a bit of paving stone, the first thought that pops into your mind is….

a) “I’m going to sue the people who laid that stone”

b) “I need to watch where I’m going”

Now its not my place to judge what is the “right” reaction but I can tell you this, the person who goes with b) is less likely to break his toe in the future. This post is for people who want to watch where they are going.

“The winds and waves are always on the side of the ablest navigators.” - Edward Gibbon

The Doctor Says I have Hepatitis C, What Can I do to Make a Positive Difference?

You would be surprised but lets face it some things you just can’t change. Number 1 is genotype, roughly from hardest to cure to easiest you have 1,4,3 and 2 and there isn’t anything you can do about that fact. Gender seems to play a role with males tending to respond less well than females, not a great deal you can do about that. Thats the bad news out the way now the good, its my contention that almost everything else you can influence to a greater or lesser degree, you can tip the scales in your favour.

OK I’m Hooked, Tell Me What to do Mr Knowitall.

Lets get something straight, I’m just a boy with hepatitis c not a Doctor. Read this by all means but don’t take it as gospel, use it only as a prompt to encourage you to get up off your lazy ass and do your own research.

Nobrainers

This section assumes that you are on treatment or just about to start, in short that you have no preparation time. These “tips” should be doable by anybody, have no financial cost and have no downside regarding treatment success. The inclusion of Cannabis in this section is somewhat controversial, it may get moved it may not.

1. Alcohol
Do not take any alcohol, none, not a drop, not ever. There is no safe level of alcohol for people with hepatitis c , there is no level of alcohol that will benefit your health. You will come across the occasional Doctor who says its OK in moderation, or that you can have a glass of champers at a wedding, smile and nod and ignore them. If you are unaware that alcohol damages the liver you won’t be smart enough to work out how to get on the Internet, you are on your own. If you continue to drink after being diagnosed with hepatitis c you are a complete idiot, thats being polite I would have been happier using some swear words. If drinking is a problem get help.

Alcohol damages the liver, that is a bad thing.

Alcohol stops the treatment drugs from doing their job.

2. Compliance
This may shock you somewhat but if you take all your medicine when you are supposed to take it your chances of treatment working will improve. Isn’t that amazing? Compliance is something that is 100% in your control. Adherence is slightly different, not everybody can take 100% of their meds, Doctors may order a dose reduction as an example but keep your end of the deal and make sure you comply 100%.

If you want a rough idea of how big an impact this could possibly have think in terms of an “average” genotype 1 having a 50% chance of achieving SVR with 80% adherence, hit greater adherence and you could be looking at over a 60% chance, maybe more if you get 100% adherence.

You need to get a pill box because sooner or later you are going to forget whether you have taken the tablets, a pill box will take the pressure off. The time to buy a pill box is day 1, don’t wait until you forget your pills to realise that you must have one.

3. Take Your Ribavirin With a Meal & With Fat
Ribavirin AKA Copegus, Rebetol, riba is the pill component of the current interferon / ribavirin combination therapy. Dose will depend on a few factors but it is always taken with food twice a day. The bioavailability of ribavirin is increased by having a meal with a high fat content, put simply that means more bang for your bucks [PDF]. While somewhat going against the general health advice to lower fat intake this is one time to make an exception or more sensibly save your fat intake for Riba time.

Ribavirin is a nasty drug, they coat the tablets for a very good reason. If you do not take your Ribavirin with a meal, thats right a meal, you will get an upset stomach, it will make you nauseous. Don’t feel like eating when its Riba time? Tough titties, get the meal down your neck, it is vital.

BTW A cup of coffee and 2 cigarettes is not a meal

4. Just Say No to Cannabis
Let me first declare some bias. I have tried cannabis once or twice and been unable to see the attraction, to me its just like giving yourself a great big shot of lazy and dumb. I know a few people who I would consider regular users, as in daily, and without exception they are the most lazy, demotivated, poor, depressed and generally unable to cope people I know. I understand that at one time smoking the weed was considered quite cool, thats not really the case now, the real cannabis demographic is chavs and pikeys.

Now that the prejudice out the way, lets have a look at some “facts”.

Frequent cannabis use can trigger depression.

Cannabis increases the progression of liver damage in people with Hep C.

Make of that what you will but apart from drinking I can’t think of anything you can take more damaging to your chances of sucess on treatment than “the weed”. The treatment drugs will be doing their best to make you lazy and depressed, I think it is somewhat unwise to pour petrol on that fire, don’t you?

5. Wash Your Hands
The Interferon and Ribavirn drugs used in treatment don’t just attack and destroy the hepatitis c virus, they also attack other healthy cells in your body. As a general guide the effects will be more common in cells that have a short life, such as skin, hair, mouth cells etc, your white blood cells also fall into this category. A vital part of the immune system a simple way to look at the role of white blood cells is that they eat up any germs, bacteria mainly I think, on treatment some people see a drop in white blood cell count this means they are less able to fight off infections.

Infections whist on treatment will not only make the experience less tolerable but in a few cases can lead to dose reductions or even treatment being stopped. The easiest, most effective, way to prevent infections getting started is to wash your hands.

Despite the proven health benefits of hand washing, many people don’t practice this habit as often as they should — even after using the bathroom. Throughout the day you accumulate germs on your hands from a variety of sources, such as direct contact with people, contaminated surfaces, foods, even animals and animal waste. If you don’t wash your hands frequently enough, you can infect yourself with these germs by touching your eyes, nose or mouth. And you can spread these germs to others by touching them or by touching surfaces that they also touch, such as doorknobs.

http://www.mayoclinic.com/health/hand-washing/HQ00407

When should you wash your hands?
You should wash your hands often. Probably more often than you do now because you can’t see germs with the naked eye or smell them, so you do not really know where they are hiding.

It is especially important to wash your hands

* Before, during, and after you prepare food
* Before you eat, and after you use the bathroom
* After handling animals or animal waste
* When your hands are dirty, and
* More frequently when someone in your home is sick.

What is the correct way to wash your hands?

* First wet your hands and apply liquid or clean bar soap. Place the bar soap on a rack and allow it to drain.
* Next rub your hands vigorously together and scrub all surfaces.
* Continue for 10 - 15 seconds or about the length of a little tune. It is the soap combined with the scrubbing action that helps dislodge and remove germs.
* Rinse well and dry your hands.

http://www.cdc.gov/ncidod/op/handwashing.htm

5. Buy a Hat
It must be hard being a Doctor. You sit somebody down, explain about the Hep C virus, what treatment entails and then ask if the patient has any questions. One of the top questions that will come back is “Doctor what about my hair, will it thin, go dry, fall out?”. Its at times like this that we can all breath a sigh of relief that little Hep C Boy is not a Doctor, because I promise you a question like that would lead me to lean over the desk and black both your eyes.

Get a sense of proportion, you have a virus that is attacking your liver, for some of you treatment may be the biggest challenge in your life, this ain’t Miss World or Mr Universe this is the virus killing game.

Yes your hair will go thin, yes some of it may well fall out [mainly the 24 week plus crew], no its not a good idea to dye your hair with a bunch of chemicals. Buy a hat.


[More to follow, this is a work in progress and will be updated regularly. Corrections, suggestions and constructive criticism welcome ideally via the comments or email me at boy@hepcboy.com ]

This entry was posted on Saturday, February 4th, 2006 at 2:28 am and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.