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Liver Transplantation PDF Print E-mail

Libby John & the Liver Transplant Unit

Libby John has been a nurse for many years, and recently completed her Masters of Nursing (Nurse Practitioner) in liver transplantation. She has long specialised in this area, having been involved with the Liver Transplant Unit when it started at the Flinders Medical Centre back in 1992, and working with liver transplant units in the UK. She has been the co-ordinator of the Liver Transplant Unit for 12 years. The Hepatitis C Community News interviewed her at Flinders about the unit’s work and history.


The Liver Transplant Unit

“We’re the only liver transplant unit in SA, so patients from the other hospitals, like the RAH and the Queen Elizabeth, come here. We also have doctors from each of the hospitals come here as part of the unit—we’ve got liver transplant physicians at the Queen Elizabeth and the RAH who can refer patients here. They come to our weekly meetings here, and they also consult in our liver clinic here once a week.

“We follow patients all the way through the process. There are some who are referred to us for transplants, and some who we work up through the process for transplants. Then there’s the transplant operation itself, and after that they continue to see us here for monitoring for the rest of their lives. We usually have around 150 patients, pre- and post-transplant, at any one time.

“The first successful liver transplant was done in 1963, in Denver in the US, and then in 1968 in the UK, at Cambridge. In Australia the first successful liver transplant was in 1985, in Brisbane. State-based liver transplant units started soon after that—Melbourne in 1988, us in 1992, and Perth in 1993. There’s now one in each State, with SA covering the NT, and Victoria covering Tasmania.”



 

 

Last Updated on Friday, 07 March 2008 07:49
 
Exercise & Hepatitis C PDF Print E-mail

Official Article By Linda McInnes (AHCS)

Here we are going to look at Exercise, Hepatitis C and other chronic illnesses. Having completed searches using the keywords ‘hepatitis c’, ‘diet’ and ‘exercise’ in Pub Med and Advanced Google Scholar, I was surprised to find only 3 articles. Two of these I talked about in the ‘Preventive Strategies for Chronic Liver Disease Parts 1 & 2’ where it was demonstrated that exercise can improve liver function in patients with fatty liver as well as information on diet.  The 3rd is a Literature Review by Mary Ann Gapinski called ‘Factors Influencing the Development of a Hepatitis C Exercise Protocol’.

In this review the author notes that there has been little attention in research studies, yet other studies report the value of exercise, improving health and reducing risk factors.  This article examines exercise and diet in hepatitis C and other chronic conditions.

Fatigue, mild upper right quadrant pain, nausea, poor appetite, muscle and joint pains are all symptoms of hepatitis C depending on the amount of liver damage.  In addition the person may report muscle weakness, weight loss, itching, dark urine, fluid retention and abdominal swelling.


Last Updated on Saturday, 12 April 2008 08:02
 
Depression/Antidepressants PDF Print E-mail

A Depression story and Hepatitis C

My story with depression dates back to the late 1979, I was in a violent relationship and subject to abuse and physical violence over a 9 year period.  I am often asked why I stayed in this relationship and the answers are simple:

  • You love the person.
  • You think you can change them (which lasts for years).
  • Then comes fright and being scared.
  • You fall out of love and begin to hate.
  • You live in fear, try to leave but you can’t because you are being stalked.
  • Eventually you find a way, plan a route of escape, I left town in 1988.

I managed to get away but I was living with anxiety and depression, so I saw a Doctor who put me on an antidepressant.  I was on these for 6 months, where I commenced on a journey to get my life in order and start over again with my 2 sons aged 4yrs and 6 yrs.  It wasn’t until 2007 that I was diagnosed with Post Traumatic Stress Disorder.  My sons also suffered from a nervous condition.

In 1993 I found a job I loved, helping others find work, this lasted 2 years until two women I worked with decided to get rid of the Manager, and because I didn’t agree with them, they set upon me.  I was subject to workplace violence and harassment, I ended up on antidepressants again, this time I had a nervous breakdown. I was put on Prothieden and Endep, high doses.  I was out of this world, living in another planet, I couldn’t function mentally, lost control of my life.  My sons ended up confused but tried to help me even though they didn’t understand what was happening to their mother.  I was on this medication for 6 years; I gained weight because of the antidepressants, which adds to the depression.  After 6 years I came off this medication to start again.

The next downfall came when I was diagnosed in 1999 with hepatitis C, I contracted this disease from my ex-husband who was a drug injecting user, from the beatings that he gave me and the exchange of blood I became infected with hep c.  The strange thing about this is that in 1989 I went to the doctor complaining of nausea and being tired all the time.  I just didn’t feel right, she did blood tests but they didn’t show anything, she eventually said that ‘I am just like my mother’ and sent me on my way.  A hypochondriac.  It wasn’t until I was diagnosed with hepatitis C and doing my own research that I found out the symptoms for this is nausea and fatigue as well as depression.


Last Updated on Friday, 07 March 2008 07:50
 
Foods with nutrients that prevent and treat HCV and HIV/AIDS PDF Print E-mail

Researched by George D Henderson (AHCS)

HIV and HCV reduce immune function intially by using up selenium and 3 amino acids. This depresses the CD4 T cell count and allows the virus to spread. Supplementing these nutrients, in both conditions, lowers viral load and raises CD4 T count, lowering the risk of co-infections.
Food sources and advice on amounts to supplement are listed below. Note that l-methionine is also a source of cysteine, as is NAC. Egg yolks and cottage cheese are good sources of l-methionine.


FOODS

Naturally, one way to elevate body levels of selenium and the three amino acids is to eat foods in which they most commonly occur. "What Really Causes AIDS" is freely available at www.hdfoster.com/WhatReallyCausesAIDS.pdf and contains appendices ranking foods according to their selenium and amino acid content. (Selenium content depends largely on the soil where the food was grown.) Below are some examples of foods that are normally elevated in at least one of the key nutrients: Selenium, Cysteine, Glutamine, and Tryptophan.

Selenium: Brazil nuts, garlic, mushrooms, liver, whole wheat, barley, egg noodles, fish and shellfish, soybean meal, brewers' yeast.

Cysteine: Brazil nuts, garlic, onions, broccoli, Brussels sprouts, poultry, egg yolks, yogurt, wheat germ.

Glutamine: Brazil nuts, wild game, wheat germ, oats, granola, cottage cheese, ricotta.

Tryptophan: Almonds, cashews, poultry, anchovies, eggs, cottage cheese and other unripened cheeses, oats, granola, brewers' yeast, bananas, pineapple, yogurt.

(Editor's note: see also: http://www.doctoryourself.com/prozac.html)



SUPPLEMENTS

SELENIUM

There has been considerable debate over which form of selenium should be taken as a supplement. Organically-bound selenium, for example, in brewer’s yeast, is considerably more effective in raising blood concentrations of this trace element than is sodium-selenite. (Passwater RA (1980). Selenium as food and medicine. New Canaan,CT:Keats Publishing.pp 183-196.) How much selenium should be taken daily by HIV-positive individuals is subject to discussion. Perhaps the most logical comments have come from Dr. Will Taylor6

"(R)esearch has shown that there are problems in nutrient absorption even in asymptomatic HIV+ individuals, the suggestion has been made that HIV patients need to take larger amounts of vitamins than uninfected individuals to attain the same blood levels. Since the USDA states that nutritional supplementation in the range of 50-200 micrograms (mcg) of Selenium (Se) daily is safe and effective for healthy individuals, a dose of 400 mcg seems reasonable for HIV-infected individuals, if they do have impaired absorption. For an AIDS patient who is demonstrably deficient in Se, an even higher daily dose (up to 800 mcg) for a brief period of time (say several weeks) to get their blood levels up, followed by a decrease to 400 mcg is an effective strategy that was used in one published clinical study involving AIDS patients. This question of dose level naturally arouses concerns, because in the past so much has been made of the potential toxicity of Se. I believe that the danger of serious toxicity with Se supplementation has been exaggerated. The threat of serious acute toxicity with supplementation is in my opinion nonexistent at doses less than 1000 mcg per day in some individuals. Thus, doses in the 400 mcg range are undoubtedly safe. In any case, the signs of chronic Se toxicity - garlic odour of breath and sweat, metallic taste in mouth, brittle hair and fingernails - are very distinctive, and easily reversed by lowering the dose."

I have nothing to add. Dr. Taylor seems to be correct as usual.



Last Updated on Friday, 07 March 2008 07:51
 
Relationships and Hepatitis C PDF Print E-mail

Relationships and Hepatitis C – Will I find a partner?

I am often asked how I met my partner by other people that have hepatitis C. They find it hard to disclose that they have the virus, and most people often live with this disease alone. There seems to be quite a bit of fear in telling people that you have hepatitis C, but in my own experience I have found that it is a relief to tell others and I feel that being up front in the beginning of a relationship makes all the difference.

It wasn’t until, one day, after taking my son to work that it hit home that maybe I would not have another partner. He came home after work and was telling me that his other workmates were enquiring as to who the “blonde” was that dropped him off at work, he informed them that it was his mother, they asked the normal questions “does she have a partner” he replied “no”, they asked “why”, he replied “she has hepatitis C”. I was quite shocked to hear this; it gave me an insight into what my son was thinking.

I met my partner whilst I was working, we eventually became friends by just talking to each other, after a couple of months we decided to go out for dinner. I was quite nervous, as I had not been out on a date for years, I too also believed that I would not meet anyone or that no one would want to be with someone that had hepatitis C.

However, I was lonely and decided to give it a go. We went to a nice restaurant, and started chatting about all different topics. I asked him about his life, then he asked me about my life, and I told him the truth, that I had hepatitis C. He didn’t know anything about Hepatitis C and he asked many questions.

It was to my surprise that this man didn’t step back away from me, he was genuinely interested and wanted to know.

I had also prepared myself for the fact that if he didn’t want to see me again after I had told him, well, he wouldn’t ring back or be in touch. I was ready for this, I thought that if this happened, well, so be it, at least I was honest. I would have had to tell him eventually anyway, and keeping it from him would have been worse.

I had done quite a lot of research on hepatitis C, I obtained pamphlets on the virus from the Hospital and Hepatitis C Council, any information I could find I gathered, so that if anyone asked me about the virus I had it all there for them to read.

I gave these pamphlets to my partner to read the next time we met so that he could understand more about the virus. We met each other a couple of times a week, then after a few months these meetings were more frequent. Eventually, I met his adult children and his parents, sister and brother.

At this time I was getting myself ready to go on the interferon/ribavirin treatment and we decided not to tell his family about the Hepatitis C, hoping that if I cleared the virus they would not need to be told.

However, I was on the treatment for 24 weeks in which the virus was undetectable, but after the 6 months blood tests I had relapsed. My partner was very encouraging throughout the treatment and was a fantastic support. This was a very difficult time in my life and another story I will share at a later time.

After another 6 months we decided to tell his adult children about hepatitis C, they were quite concerned that their father was at risk, and feared that he may become infected. Once I informed them of all the facts about the disease they were alright, they also respected their father’s choices as long as he was happy. I told them that I had been up front from the beginning of the relationship with their father and that was the best thing that I could have said, they realized that I did not hide the fact that I had hepatitis C and that I was honest from the start. I have a fantastic relationship with his children.

Recently my partner told me that it meant a lot to him that I confided in him about my hepatitis C on that first date, and that trust and respect was built from this in his eyes.

I chose to tell his adult children about the virus because there were times when I have been too tired or confused, depressed or needed to rest and I had to cancel dinners with the family and they often asked where I was or they wondered why I wasn’t there. It became quite a chore hiding the fact that I had hepatitis C, when it was such a big part of my life living with the symptoms. I was always anxious before and during family get-togethers in case anyone asked me questions, it was assumed that I did nothing all day, didn’t work and was healthy but lazy. My usual way out of this was to say I was busy helping my children, gardening or doing housework, and then I would ask them a question to turn the conversation around back to them. This works, get other people talking about themselves to take the pressure off you. However, doing this repeatedly can become very boring and uninformative to the other persons involved, as if you are hiding something or are living a very mysterious life.

There is no reason to think that you may not meet anyone as a person with hepatitis C, there are people out there that are very understanding and once told all the facts, then their fear goes away and you earn respect and trust. We need to educate the public about the disease, to make life easier for ourselves, which is why I don’t hide the fact I have hepatitis C, the more people that come out and be honest, explain the facts, then the more understanding we will receive. Who knows, it may help reduce the stigma we are forced to live with at this time.

This is my experience with relationships and hepatitis C which worked for me, it is my opinion to be honest and up front, but of course everyone has different circumstances which may prevent this from happening, but don’t give up and don’t think you have to live with this disease alone, there is someone out there for you to share your life with.

An AHCS Article www.hepcaustralia.com.au

Any AHCS articles are to be shared on other websites with acknowledgement of the Australian Hepatitis C Support (AHCS)

Last Updated on Saturday, 12 April 2008 08:05
 


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