What You Need to Know about Hepatitis C

Living with Hepatitis C: Personal Stories

Wanda:

"I need to stay healthy, because I have two little girls and they keep me busy! I had a biopsy and my doctor says my liver is doing okay. So far, so good..." "... but I worry about my family. Sometimes I let my kids drink from my glass, or I forget to cover my mouth when I cough. Could that give them hepatitis C? And what about my partner? Can you get hepatitis C through sex?"
Hepatitis C is not spread through casual contact like coughing, sharing cups or eating utensils, hugging, or kissing. Hepatitis C is only spread through contact with infected blood. The most common ways that hepatitis C is spread are:

• sharing needles and other equipment (" works") used to inject drugs or other substances
• mother to baby during birth
• accidental needle-stick injuries, mainly to health care workers on the job
• sex without using a condom (this is a rare way to get hepatitis C, but it does happen)

It may also be possible to spread hepatitis C through:

• sharing razors, toothbrushes, or nail clippers with a person who has hepatitis C (because these items may have traces of blood on them)
• tattoos or piercing, especially if it is not done by a professional with sterile equipment

A woman can pass hepatitis C to her baby during birth. About 5 out of 100 babies born to women with hepatitis C will be infected. Talk to your child's doctor about when to test your child for hepatitis C.
Before 1992, people also got hepatitis C through infected blood transfusions and organ transplants. Now, all blood and organ donations are tested for hepatitis C, so it is safe to get blood or organs.
It is possible to spread hepatitis C during sex, but this is rare. On the other hand, HIV and other STDs (sexually transmitted diseases) are easily spread during sex. Always use condoms to protect yourself and your partners.

Keeping your loved ones safe

Hepatitis C is spread through blood. To avoid giving hepatitis C to others:

• do not share needles, syringes, or other injection equipment (" works")
• do not share razors, toothbrushes, nail clippers, or other household items that could have blood on them
• clean up blood spills right away with bleach
• keep cuts or sores covered with a bandage

Carlos:

"When I found out that I had hepatitis C, I was really angry. I worked so hard to get off drugs and was just starting to get my life together. Then they told me I had this disease. I couldn't believe it. I didn't go back to the doctor for a while - I didn't want to deal with it.
Later I realized it wasn't going to just go away. I want to stay as healthy as I can. Is there is a treatment for hepatitis C?"
You are not alone. Dealing with recovery and hepatitis C can be stressful. It may help to know that there are many other people in the same situation. Ask your doctor, counselor, or case manager about support groups for people in recovery who have hepatitis C.
There is a treatment for hepatitis C, but it does not work for everybody. The treatment is a combination of two medicines: pegylated interferon and ribavirin. Pegylated interferon is injected under the skin (like a shot) once a week. Ribavirin is a pill that you swallow. Treatment usually lasts for 12 months; sometimes it is shorter.
Hepatitis C treatment does not work for everyone:

• About half of people treated with pegylated interferon and ribavirin have healthier livers and no hepatitis C in their bodies at the end of treatment.
• Some people's livers get healthier during treatment, but the hepatitis C is not completely removed from their bodies. They may still have liver damage from hepatitis C in the future.

"I'm also in a methadone program. Will I have to stop taking methadone if I want treatment for hepatitis C?"

No. You can be treated for hepatitis C while you are on methadone.

Michael:

"My doctor says I should think about getting pegylated interferon and ribavirin treatment for my hep C. She says it has a good chance of helping my liver.
But I've heard that interferon has side effects that really mess you up. I have HIV, and when I started taking HIV medicines, I felt sick all day long. My doctor changed my HIV treatment, and I feel okay now, but I don't know if I want to deal with side effects like that again.

What are the side effects of hepatitis C treatment? Do most people get them?"

Pegylated interferon and ribavirin are strong drugs. Many people treated with them get side effects like:

• flu-like symptoms (fever, chills, headache, muscle pain)
• feeling very tired (fatigue)
• mood changes (depression, bad temper)
• temporary hair loss
• anemia (reduced red blood cells)

Some people have mild or no side effects. Some people have very severe side effects. For many people, the side effects become less severe over time.

"I don't know if I'm ready for all that. Do I have to start treatment for hepatitis C right away?"

This is not an easy question. There are good reasons to delay treatment - and good reasons to start treatment sooner:

Reasons to delay hepatitis C treatment

• Side effects from interferon and ribavirin could make you sick.
• Better treatments may be available in the future.
• Your hepatitis might not get worse— some people never have serious liver problems.

Reasons to start hepatitis C treatment sooner

• Treatment might not work as well later.
• Your hepatitis C could get worse very fast.
• If your liver gets too badly damaged, you might need a liver transplant.

When and how to treat your hepatitis C is a hard decision. Family needs, side effects, work, substance use, health issues, and many other parts of your life will affect your choice. Your doctor or nurse can help you look at all of the factors to decide what is best for you.

Depression is a common side effect

Severe depression can happen to anyone who is taking interferon. It is more likely in people who have a history of depression or other mental illness. If you have a history of any mental illness or substance use/abuse, tell your doctor before you begin treatment with any type of interferon. Your doctor may suggest that you start anti-depressant medicine or see a psychiatrist before you begin your hepatitis C treatment. Your doctor can also refer you to support services like hotlines or counseling so that if you do have mood changes, you can get help right away.

 http://www.health.ny.gov/publications/1801/stories.htm

15 Remedies for Back Pain Relief

15 Remedies for Back Pain Relief

By Cathy Wong, About.com Guide
http://altmedicine.about.com/od/chronicpain/a/back_pain.htm
Updated September 25, 2011

Almost everyone has back pain at some point in their lives. According to the National Institutes of Health, back pain is the second most common neurological disorder in the United States -- only headache is more common.

If you have back pain, the first step is to be properly assessed by your primary care provider. Back pain has many causes, from muscle strain to more serious conditions such as a herniated disc, spinal stenosis, spondylosisthesis, osteoporosis, or a tumor, so it's important to find out what is causing the back pain.

1) Acupuncture

A study conducted at Sheffield University in the United Kingdom looked at the long-term symptom reduction and economic benefits of acupuncture for persistent low back pain. An average of 8 acupuncture treatments were given to 159 people, while 80 people received usual care instead.

After one year, people receiving acupuncture had reduced pain and reported a significant reduction in worry about their pain compared to the usual care group. After two years, the acupuncture group was significantly more likely to report that the past year had been pain-free. They were less likely to use medication for pain relief.

How does acupuncture work? According to traditional Chinese medicine, pain results from blocked energy along energy pathways of the body, which are unblocked when acupuncture needles are inserted along these invisible pathways.

A scientific explanation is that acupuncture releases natural pain-relieving opioids, sends signals that calm the sympathetic nervous system, and releases neurochemicals and hormones.

An acupuncture treatment generally costs between $60 and $120. Acupuncture is tax-deductible (it's considered a medical expense) and some insurance plans pay for acupuncture.

If you want to try acupuncture, plan on going one to three times a week for several weeks initially.

* Find an acupuncturist
* More about acupuncture

2) Capsaicin Cream

Although you may not have heard of capsaicin (pronounced cap-SAY-sin) before, if you've ever eaten a chili pepper and felt your mouth burn, you know exactly what capsaicin does. Capsaicin is the active ingredient in chili peppers.

When it is applied to the skin, capsaicin has been found to deplete substance P--a neurochemical that transmits pain--causing an analgesic effect.

In one double-blind study, 160 people were treated with capsaicin for 3 weeks, while another 160 people used a placebo. After 3 weeks, pain was reduced by 42% in the capsaicin group compared to 31% in the placebo group. Investigators rated capsaicin significantly more effective than placebo.

Capsaicin cream, also called capsicum cream, is available in drug stores, health food stores, and online. A typical dosage is 0.025% capsaicin cream applied four times a day. The most common side effect is a stinging or burning sensation in the area.

If possible, wear disposable gloves (available at drugstores) before applying the cream. Be careful not to touch the eye area or open skin. A tube or jar of capsaicin cream typically costs between $8 and $25.

* Capsaicin cream profile
* Find capsaicin online
3) Vitamin D

Chronic muscle pain can be a symptom of vitamin D deficiency. Vitamin D is found in fish with small bones, fortified milk and cereal, and exposure to sunlight.

Risk factors for vitamin D deficiency are:

* darker pigmented skin (e.g. Hispanic, African American, Asian) does not convert UV rays efficiently to vitamin D
* digestive disorders, such as celiac disease
* use of glucocorticoid medications for conditions such as lung diseases and allergies
* minimal sun exposure (elderly, institutionalized, homebound, veiled or heavily-clothed individuals)
* latitude and season - for example, people in Boston do not produce vitamin D from sun exposure between November and February

A study by the University of Minnesota looked at the prevalence of vitamin D deficiency in 150 people with chronic musculoskeletal pain. Researchers found that 93% of patients had vitamin D deficiency. All people with darker pigmented skin (African American, East African, Hispanic, and Native American origin) had vitamin D deficiency.

Another interesting finding was that the majority of people with severe vitamin D deficiency were under 30 years of age. Season was not a significant factor.

The researchers concluded that all people with persistent, non-specific musculoskeletal pain should be screened for vitamin D deficiency.
4) Music Therapy

Music therapy is a low-cost natural therapy that has been found to reduce the disability, anxiety, and depression associated with chronic pain.

A study evaluated the influence of music therapy in hospitalized patients with chronic back pain. Researchers randomized 65 patients to receive, on alternate months, physical therapy plus 4 music therapy sessions or physical therapy alone.

Music therapy significantly reduced disability, anxiety, and depression. Music had an immediate effect on reducing pain, although the results were not statistically significant.