A Quick Guide to Hepatitis C

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What is hepatitis and HCV?

Hepatitis is a general term for inflammation of the liver. Any number of conditions can cause hepatitis, but one of the more common causes is a viral infection from the hepatitis virus, of which there are three types: A, B, and C. Type A is a short-term infection often caused by consumption of a contaminated food or water source. Type B is also short-term, though chronic hepatitis can evolve from an HBV infection in some cases. This type is spread by blood, semen, or saliva from an infected organism entering the body of an uninfected one – IV drug use, sexual contact, and animal bites can all lead to an infection of Hepatitis B. Vaccinations for both Type A and Type B hepatitis exist.

Hepatitis C is of particular concern because the virus can remain dormant for decades, often failing to manifest symptoms until an infected person’s immune system is compromised by age or a separate medical condition. Untreated, Hep C can lead to cirrhosis, liver cancer, and death. It’s also a factor in the fastest growing cause of cancer-related deaths in America presently, hepatocellular carcinoma (HCC). In fact, HCV is the leading cause of HCC in the western world. There is no vaccine for Hepatitis C.

How is HCV spread?

Hep C isn’t spread by casual contact with a carrier or through a vector (mosquitoes, animals, or contaminated food products). Needle-sharing is presently the most common cause of an HCV infection. Prior to 1992 HCV was spread through blood transfusions, but rigorous screening of blood products has eliminated that concern. In some cases, sexual contact, sharing of contaminated razors, and contact with unsterilized tattoo needles has led to an HCV infection, though these are much less common causes of the disease. Finally, a baby born to a mother with HCV will also carry the HCV virus.

What are the symptoms of hepatitis?

An acute infection of hepatitis C manifests with fever, fatigue, abdominal pain often accompanied by nausea and vomiting, jaundice (a yellow discoloration of the skin and eyes), joint pain, clay-colored stools, and dark urine. Bear in mind, however, that an acute infection from HCV is less likely than a chronic infection, which typically manifests no symptoms and takes years or even decades to cause damage to the liver (in the form of scarring or cancer). Many carriers of HCV will have no reason to suspect they’re infected (and as carriers they can still infect another person with it).

Who should be screened for Hep B and why?

Anyone who’s ever been an IV drug user or shared needles should strongly consider HCV screening. Currently, there’s also a huge push for baby boomers (anyone born between 1945 – 1965) to receive HCV screening because of the risk from contaminated blood products. Moreover, because of the time required for HCV to cause liver damage, baby boomers entering middle age are now at the greatest risk for complications. In fact, baby boomers are five times more likely to have an HCV infection than the general population and may not even know it. Health care workers who’ve been exposed to HCV by needle-stick injury or handling blood products should be screened. Some experts also suggest that incarcerated individuals living in close contact with others should also be screened.

Getting an HCV screen promptly will help anyone with an HCV infection receive care to prevent the potentially serious side-effects of hepatitis.

What’s the procedure for HCV screening? 

The first step in HCV screening is a routine blood test ordered by your primary care provider (PCP). This test is used to determine the presence or absence of an antibody for HCV. However, a reactive antibody test (meaning the antibody is present) only indicates that the person is a carrier. To determine if an active HCV infection is present, a second test for HCV ribonucleic acid (RNA) is done (See: “Screening and Management of Hepatitis C,” American Nurses Association). Both tests are required for a positive diagnosis of HCV, however, because (for reasons we don’t fully understand), 1 in 4 people eliminate the hepatitis C virus on their own – meaning they will have the HCV antibody, but not the active infection. Baby Boomers take note: Medicare covers the cost of the PCP-ordered blood test for anyone born between 1945-1965. 

How is an HCV infection treated?

HCV used to be treated with interferons with limited success. However, since the introduction of a new class of drugs called direct acting antivirals (DAAs) in 2012, the success rate for eliminating HCV is now an impressive 90-95%.  DAAs are given as an oral medication with very few side-effects. Unfortunately, they’re also very expensive and this is a major barrier to treatment.

Summing Up

Hepatitis C is a viral infection of the liver, sometimes leading to an acute set of symptoms but most often developing over decades with little or no obvious symptoms in the carrier. However, this chronic form of hepatitis can lead to serious outcomes later in life – scarring of the liver (cirrhosis), liver or blood cancers (HCC), and death.

Anyone with a history of needle sharing/IV drugs use, Baby Boomers (individuals born between 1945 – 1965), and anyone who received blood clotting products or an organ transplant prior to 1992 should consider being screening for HCV through a routine blood test ordered by their provider.

Remember, no one can diagnosis or treat an illness except a qualified, licensed medical professional like your primary care provider. If you’re concerned about HCV, contact your doctor or APRN and schedule an appointment to discuss your concerns. 


Legal disclaimer: Advice offered on this website is for educational purposes only. The information herein is not intended for use to diagnose, treat, or manage any health conditions or offered as an intent to treat any individuals. ALWAYS consult your primary care provider with questions regarding your health.  

The Incredible Shrinking Pie (and Free Photo of the Day 9/4/16)

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Mansfield Hollow, September 2014. Free to use with attribution to Jace Paul and link to this site. 

Hello friends,

Have you ever noticed that working in America is subject to the law of diminishing returns?

Yes, once upon a time you got a lot more for your, well, time. Forget about pensions, which long went the way of the Dodo. Raises are smaller, benefits leaner. We all know the one percent have been squeezing the lower- and middle-classes for every drop of sweat they can get, and the money flowing to the top means less of the pie for the rest of us.

I listen to the nursing staff at work, and they talk of halcyon days when every employee got a mandatory wage increase every six months. They speak of holiday bonuses that became a holiday turkey, then a holiday gift-card, then nothing at all. They remember when working Christmas meant double pay. These days it’s time and half – if you use your personal time and work the holiday at the same time.

The scarcity should unite us against the oligarchy, but instead it inevitably puts us at odds with each other. Morale has been low at work, and I wondered to the charge nurse why the aides and nurses were practically screaming at each other. “We’re always working short,” she said. “People are working eight, even nine days straight to cover the shifts. Every year we’re asked to do more with less.”

We’re all increasingly desperate. Wages are stagnant while cost of living rises. In Connecticut, taxes are raised repeatedly as services are cut – the local court that handles family and DSS matters is closing, the Department of Motor Vehicles is slicing hours yet again, the DEEP was forced to close three state campgrounds. Our local vocational school may close. The hospital lost 1/4th of its staff, and statewide health services are facing a nearly half-billion dollar budget cut.

All this to say the obvious – the working person’s share of the pie is getting smaller. Even the crumbs are running out.

When will we demand change?

June (Came Upon Us Much Too Soon)

If you’re like me, the honeysuckle scent in the air gives you a bona fide frisson. It’s wonderful to encounter spring in a cautious arrival, and here in Connecticut the vernal season has settled in with a rare beauty this year. Far too much ink and too many pixels have been expended extolling the magnificence of spring, so don’t worry: this isn’t another weary encomium to the prelude to summer.

Nope, I’m just feeling a bit grateful for having finally found a place to call home. River and I moved into a small studio apartment earlier this month in Willimantic (as I’ve previously noted). It’s no luxury accommodation, to be sure. But it’s clean, safe, and has a few pleasant surprises to boot. A roomy kitchen with nice tiling and new appliances, tall and broad windows that let streams of golden sunlight in, and a south-facing wall that allows me to cultivate a few fresh herbs and window box flowers compensate nicely for the spare dimensions of the place.

To River it may as well be the Magic Kingdom. She’s just delighted to have a swath of soft carpet on which to frolic and a small desk for reading and coloring. I’m ever amazed at just how thoughtful and mature she is for a mere three years old. I just hope all of this moving isn’t eroding her sense of consistency and security, or that my anxiety over our poverty isn’t obvious to her. As far as I can tell, however, she’s brimming with joy.

Once all of the boxes are unpacked I’ll be setting out to take some editorial shots of the town, and getting back on the trails for more portraits of the “Last Green Valley,” as Eastern Connecticut is called. And thanks to a generous friend, I can now register for Microbiology at QVCC. (Thank you, Jessica!)

In the spirit of seeing the good, here’s a little poem I wrote some years ago. A little reminder that positivity isn’t believing all things are possible, but learning to acknowledge the things are.

 

That Dragonfly Painting In The Bathroom*

Day one,

I stepped out of the shower and there it was;

Awful, that dragonfly painting on the wall

Fighting with the paisley wallpaper over who is tackier,

I curled my lip and raised an eyebrow thinking

How could any mother have such poor taste?

 

Day two,

Dripping wet, I regarded the cruel vision once again

Marveling at the artist’s disregard for harmony

The childlike brush strokes, scribbles, scribbles!

Wishing I could toss out this quaint relic of the garish Sixties;

Dried off and dressed for the afternoon picnic.

 

Day three,

Pulled back the curtain to a lapsed friendship,

There I was. Packing for the trip back home, I asked

May I take that dragonfly painting in the bathroom with me?

Outside in the neighbors driveway a boy flew his basketball at the hoop and missed;

picked it up and tried that third time.

 

A perfect shot!

 

* First Published in Eggshells & Entropy (Love Poems to Madness and Misanthropy), copyright (c) 2013.

Reaching Goal #1

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Thank you friends (and complete strangers, wow) for getting me this far! Just $101 more and I will be able to register for my first nursing program prerequisite, BIOL260: Genetics. I’m so grateful for everyone who’s donated to date, you are amazing.

I’ve already paid for admission to the Connecticut Community College system – it’s a small accomplishment, but it’s the first step toward the larger goal. Now that I’m in the system I’ve also applied for financial aid, too – I will update the number if I receive any. And once I’m into a program, I can also apply for nursing-specific scholarships. Every small success paves the way for the next!

http://www.gofundme.com/8ws7bs

The Power of Kindness (And Free Photo of the Day!)

I’ve been thinking these past few days about the power of kindness to shape my life, and form a better destiny for humankind. This thought process was sparked, in part, by last week’s episode of the FOX series Cosmos (memo to Neil deGrasse Tyson: stop blowing my mind, damnit!). If you haven’t been watching the show, for shame! The reboot of Carl Sagan’s series is a beautifully crafted love letter to science and the many men and women who’ve fought to increase human understanding. But more than that, it proves some very important ethical points. A running theme throughout the series is that small acts of compassion had immeasurable positive effects for human progress and flourishing. Or, in simpler terms, that kindness is rational.

Sunday’s episode, “The Electric Boy,” told the story of a young boy born into poverty and the lowest of the British classes. With a little initiative and hard work on his part, he made a connection with Humphry Davy, one of the premier English scientists of the time. Davy’s act of kindness was to invite the young man to work in his lab at the Royal Institute. Once established in the Institute, the young man, Michael Faraday, would go on to revolutionize modern science with his invention of the electric engine and the generator, and his discovery that electricity, magnetism, and light were one unified force. This last discovery paved the way for James Clerk Maxwell and Albert Einstein’s work, and many of the useful devices we enjoy today – radio, television, computers – would not exist without Faraday’s work. And none of this would have happened without the initial act of kindness. Another wonderful example took place in episode 4, when a different boy – Joseph von Fraunhofer – was rescued from a life of servitude and hard labor by the king of Bavaria, who gave him an education and a job at the Optical Institute. Fraunhofer would add his invaluable insights to the development of lenses and telescopes and, in his biggest discovery, synthesize physics and astronomy by discovering spectral lines in the light of stars. Once again, a simple act of kindness pays off big time.

Of course, the kindness of others in my own life is the primary reason I’m presently mindful of how good deeds can have great dividends. I can’t promise I’ll revolutionize modern science (in fact, I can pretty much assure you I won’t!), but I can promise all of those who’ve donated to my nursing school campaign to work hard and help as many others as I can in my new career. I can promise, in other words, that I’ll show kindness in my life and keep the investment paying off.

Right now, as I sit and listen to River laughing jubilantly and lounging on a carpet of spring sun, I’m feeling optimistic for my life and hers. It’s a good feeling. On that note, here’s a free photo of the day!

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Camera Photo: Nikon D40, 1/160 sec;   f/6.3;   ISO 200

Help Me Cross a Class Off This List!

Not too far to go to reach $538 and cross a class off this list. I’ll register for “Anatomy & Physiology 1” as soon as we reach that goal!

Five prerequisites to get to nursing school!
Five prerequisites to get to nursing school!

I don’t like getting something for nothing, so I’ll continue to update this blog with quality content. I’ll be sharing photos that will be free for anyone to use soon, too. That’s my way of gratefully acknowledging how much I value everyone who visits this blog and supports me. We all sink or swim together, and I believe there are enough good people out there to help me make my goal. Love is the only answer!

I’m also happy to send a copy of my book Eggshells and Entropy to anyone who donates at the $75 level, or a beautiful jacket hardcover annotated edition of From King’s Road to Pleasant Street (And Other Poems to Nowhere) for anyone who donates at the $125 level. Both are collection of my finest poems (or so I’m told!). Though I wrote the majority of these in the space of the worst depression I’ve ever experienced, I’m proud of the clarity and honesty in every line – if you’ve ever been depressed, these verses will speak to you.

I’m off to enjoy this beautiful day and then work second shift caring for my ever-wily and amusing convict clients. Stay positive!

The Flower Kings!
The Flower Kings!

P.S. If you’re in the mood for some extremely upbeat music, check out “Love Is the Only Answer” by The Flower Kings. (Warning – it’s a long and complex song, but so beautiful and fun!)

 

 

Life Begins at Forty?

Hello friends. I woke up this past weekend stung by a notion that’s kept me buzzing since: if I don’t love myself by the time I’m 40, I probably never will.

It was a startling thought.

So I decided in short time that I needed to get to work on the “Five Year Plan” I devised last summer. Priority one is getting back to school and getting my Bachelor of Science in Nursing. So I’ve started a GoFundMe project, and I’m also working overtime reaching out for scholarships and grants (I’m not averse to panhandling if it comes down to it, either!) For many years now I’ve been content as a reclining academic and minimum-wage social services drone. I have always loved any job that allows me to help people or increase human flourishing. The greatest pleasure of being a minister in the United Church of Christ was meeting people and listening to their stories, trying to understand their pain. I’ve long left religion behind, but one lesson I cherish from my former calling is that “There’s a broken heart in every pew.” That bluesy bit of gospel expands comfortably into a secular equivalent: “We’re all brokenhearted.” I find that truth especially compelling as a sufferer of depression, and I believe my desire to do good is grounded in a very personal pain.

I knew that a life dedicated to helping others would not be a lucrative one. I’ve always aimed for a very moderate and reasonable standard of living knowing quite well that social services and non-profits are very poorly funded. When I left the church, however, I re-entered the job market with a practically useless degree. Shortly after I’d begun to look for work, I went to a resume critique session at the CTWorks office. The counselor advised me to leave my Harvard degree off my resume entirely, explaining that advanced study in religion and theology would probably deter potential employers, Harvard University label or not. It was a sobering moment.

I’ve made do with entry-level jobs as a living skills trainer for adults with traumatic brain injuries, a mentor for children with developmental and behavioral disorders, and presently as a client supervisor for a Department of Corrections substance abuse treatment center. I’ve also continued to write and to direct films, mostly as a hobby. But the $9 – $13/hour that non-profits pay is not enough to stay afloat. Not in Connecticut where the average apartment is $850. Not as a father with $100 of weekly daycare expenses (to say nothing of food, clothes, and health care). Even with SNAP benefits and HUSKY State Health Insurance I’m not going anywhere, only losing ground at a frightening pace.

For my daughter’s sake, I need to make a change. That “Five Year Plan” includes, at some point, owning a small home – we’re talking 1-2 bedrooms and less than an acre of land. It includes being able to take my child to the Boston Museum of Science or the Connecticut Children’s museum, paying for piano lessons or soccer uniforms, taking her out of the country to encounter other languages and cultures – in short, a very modest version of the American Dream.

A good friend who recently completed her Master of Nursing turned me on to accelerated programs for people – like me – who already have degrees. I was immediately interested, and as I considered the possibilities for a career as a nurse I become more and more excited. Here, I thought, is a job where I can help others and avoid the anxiety and despair of relying on state assistance or being evicted from my apartment. How wonderful it would be to add some measure of goodness to the world and take care of my own child.

My journey begins today. I’ve already begun the process of getting into an accelerated BNS program and now look to friends and compassionate strangers to help me make this happen.

I struggle with my depression daily, of course. But I’ve not had a suicidal thought in nine months, a remarkable achievement given that they were daily occurrences over the preceding three years. My wonderful therapist tells me that, all things being equal, I would not have any depressive episodes at all at this point in my life, because the depression I occasionally feel now is contextual, not biological. In other words, he said, “No amount of medication or therapy will make you happy if your life sucks. So make it better.”

I’m on my way. You can help me out right here: http://www.gofundme.com/8ws7bs