Health

Common Sense Health — Hepatitis C Is Silent Like the Fog

by W. Gifford-Jones, MD and Diana Gifford-Jones Views: 54

It’s a shame when you are slowly dying from a disease you don’t know you have.  To boot, what a tragedy if there is a cure.  Yet this ignorance is a reality for many aging boomers who don’t know that they are infected with the hepatitis C virus.

Anyone can contract hepatitis C.  Infection occurs through transmission of tainted blood.  It’s rare to be infected today through the healthcare system, as we’ve gotten much better at screening blood products and of course sterilizing medical equipment.  Today, it is likely the reuse of injection needles by users of street drugs that leads to infection.  Some people become infected from getting tattoos or piercings with poorly sterilized equipment.  But for baby-boomers, born between 1945 and 1965, it’s believed that hepatitis C was transmitted long ago through contact with contaminated blood, before robust infection controls were in place.  About 75 percent of North Americans carrying the virus are baby boomers.  Estimates suggest that 250,000 Canadians are infected and about 3 million Americans.

A good many of them don’t know it.  Just like a thick fog, hepatitis C is eerily silent.  It innocuously takes its toll on your liver.

Our bodies are designed to fight foreign invaders.  For example, when a misstep leads to a splinter in your foot, your immune system kicks into action.  Your body targets a range of immune system cells to the injury, and redness and swelling are signs that the battle to overcome invading bacteria has begun.  In the case of hepatitis C infection, the virus finds a home in the liver, reproducing faster than the body’s immune cell fighters can beat it.  The result is a perpetual state of inflammation in the liver.  The battle also results in a gradual death of liver cells, which in turn causes fibrosis or scarring.  Fibrosis itself isn’t a problem.  But in time, functionality of the liver becomes so impaired that there isn’t enough blood flow for the liver to do its work.

Only after substantial damage is done do symptoms start to appear.  Fatigue, easy bruising, jaundiced eyes, swelling in the legs, dark-coloured urine.  These are some of the signs that not all is well.

The good news is that hepatitis C can be detected through a series of tests.  And it can be treated.  Over the past decade, advances in direct-acting antivirals (DAAs) have led to highly effective treatments lasting between 2 and 5 months.  The only catch is in the cost of the medications, and coast to coast there are different rules about who qualifies for coverage.  Generally, coverage is extended only to those with advanced severity of liver disease.  For everyone else, the price of the drugs may outweigh the cost of monitoring the progression of the disease carefully.

But how do you know you have these options if you don’t even know you have the problem?  The best advice is to talk with your doctor about your likely risk factors.  Did you receive a blood transfusion prior to 1990?  Do you, or did you, inject drugs with used needles?  Have you resided in countries where hepatitis C is a problem (e.g. India, Pakistan, Vietnam, Egypt, even southern Italy) and received medical care or vaccinations?  Have you shared a razor, nail clippers or toothbrush with an infected person?

If concerns are high or if symptoms are present, then have tests done.  Either that or run the risk of blissful ignorance while your liver takes the toll.

Joseph Conrad wrote, “It is not the clear-sighted who rule the world. Great achievements are accomplished in a blessed, warm fog.”  Let’s hope that is the case for those with hepatitis C who go undiagnosed.

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Author: W. Gifford-Jones, MD and Diana Gifford-Jones

Dr. Ken Walker (who writes under the pseudonym of Dr. W. Gifford-Jones, MD) is a graduate of the University of Toronto and the Harvard Medical School. He trained in general surgery at Strong Memorial Hospital, University of Rochester, Montreal General Hospital, McGill University and in Gynecology at Harvard. His storied medical career began as a general practitioner, ship’s surgeon, and hotel doctor. For more than 40 years, he specialized in gynecology, devoting his practice to the formative issues of women’s health. In 1975, he launched his weekly medical column that has been published by national and local Canadian and U.S. newspapers. Today, the readership remains over seven million.

His advice contains a solid dose of common sense and he never sits on the fence with controversial issues. He is the author of nine books including, “The Healthy Barmaid”, his autobiography “You’re Going To Do What?”, “What I Learned as a Medical Journalist”, and “90+ How I Got There!”

Many years ago, he was successful in a fight to legalize heroin to help ease the pain of terminal cancer patients. His foundation at that time donated $500,000 to establish the Gifford-Jones Professorship in Pain Control and Palliative Care at the University of Toronto Medical School. At 93 years of age he rappelled from the top of Toronto’s City Hall (30 stories) to raise funds for children with a life-threatening disease through the Make-a-Wish Foundation.  His hobby is trap shooting.

He is married to Susan and has four children and twelve grandchildren.

Diana MacKay writes in collaboration with her father under the pen name, Diana Gifford-Jones.  The daughter of W. Gifford-Jones, MD, Diana has extensive global experience in health and healthcare policy.  Diana is Special Advisor with The Aga Khan University, which operates 2 quaternary care hospitals and numerous secondary hospitals, medical centres, pharmacies, and laboratories in South Asia and Africa.  She worked for ten years in the Human Development sectors at the World Bank, including health policy and economics, nutrition, and population health.

For over a decade at The Conference Board of Canada, she managed four health-related executive networks, including the Roundtable on Socio-Economic Determinants of Health, the Centre for Chronic Disease Prevention and Management, the Canadian Centre for Environmental Health, and the Centre for Health System Design and Management. Her master’s degree in public policy at Harvard University’s Kennedy School of Government included coursework at Harvard Medical School.  She is also a graduate of Wellesley College.  She has extensive experience with Canadian universities, including at Carleton University, where she was the Executive Director of the Global Academy.

She lived and worked in Japan for four years and speaks Japanese fluently. Diana has the designation as a certified Chartered Director from The Directors College, a joint venture of The Conference Board of Canada and McMaster University.  She has recently published a book on the natural health philosophy of W. Gifford-Jones, called No Nonsense Health – Naturally!

The weekly column by W. Gifford-Jones, MD has been published without interruption for 45 years.  The same no-nonsense tradition now continues in a father-daughter collaboration.

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