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How to Navigate Disclosure, Denial and Drinking with Hepatitis B During the Holidays

Image courtesy of stockimages at FreeDigitalPhotos.net
Image courtesy of stockimages at FreeDigitalPhotos.net

By Christine Kukka

With the holidays come  family reunions and parties that can set the stage for some big emotional challenges for people living with hepatitis B.

  • Do we disclose our hepatitis B to our families or keep quiet?
  • Do we remind relatives to get tested and/or treated, or quietly endure their denial?
  • And, can we resist the host who insists everyone should be drinking alcohol with him?

Is this the holiday when we finally tell our parents or siblings about our hepatitis B?

First, take your family’s cultural temperature towards hepatitis B. Historically, in many cultures people with hepatitis B were shunned and could not marry, attend college or advance professionally. If your family still holds some of these baseless beliefs, be prepared to do some educating as you try to dispel their fears and prejudices. Come armed with printed information, website addresses and other material to bolster your family-focused public health campaign.

If you were infected at birth, you may have family members who are also infected. The most valuable gift you may give them is your disclosure and your education, especially if it leads them to get tested, vaccinated and treated.

If you suspect you are the only one in your family who is infected because of a past medical procedures that transmitted the infection, or sexual encounters or injecting drug use, think carefully about disclosing. Are your family members open and accepting? Will they suspend judgement and be supportive? Perhaps you should tell only one or two relatives whom you can trust, or stick to your community of friends. If you have doubts, erring on the side of caution for the time being may be best.

Should you encourage family members to get tested, vaccinated or treated?

If you know hepatitis B runs in your family, then your parents, uncles, aunts and siblings could also be infected. Should you bring up hepatitis B during dinner and encourage them to be treated?

Many people find denial a far more comfortable option than facing the possibility of having hepatitis B, which is why nearly two-thirds of people with chronic hepatitis B remain undiagnosed and untreated. So how do we bring up hepatitis B without sending everyone running from the dinner table?

  • Bring up an interesting fact, “Hey, did you hear that one in 12 Asian-Americans have hepatitis B and two in three don’t know it?”
  • Or ask about a relative’s health history. “I was wondering about grandpa in Vietnam, you said he died from liver problems, do you think it was hepatitis B?”
  • Or try breaking through the stereotypes surrounding hepatitis B. “Everyone thinks you get hepatitis B because you’re promiscuous or do drugs, but actually most Asian-Americans got it at birth.”

Choose a time when there won’t be many distractions. Try talking to a few relatives ahead of time so they are prepared to be supportive when you broach the topic with your family.

Ultimately, we can’t change other people. Our relatives may simply continue to refuse testing and treatment despite our best intentions. We don’t have to let them off the hook completely, but we must accept they are doing the best they can. If we keep our relationships with them open and cordial, they may be willing to talk to us in the future when they are ready to get tested. To view a video of a daughter telling her parents why they should be tested, click here.

How do you politely refuse the host who insists that you drink?

Practice saying no: Often there are people at a party or event who take it as a personal insult if you do not join them and drink alcohol. You need to prepare for their rudeness and be ready to firmly say no. This can take practice, so do some role-playing if needed ahead of time. It gets easier with time.

Prepare a reason for not drinking: Sometimes, those annoying hosts, friends or relatives just won’t give up, so you may have to lie. “Sorry I’m taking medication and I can’t drink.” Or, “My stomach is upset and I want to be able to enjoy all this food.” You never have to disclose your hepatitis B infection in this casual social setting, but you can come up with another reason not to drink.

Leave the event early if you feel uncomfortable. Over the course of a party, people may get more intoxicated and it might get harder to turn down drinks. Consider leaving the party before people reach this stage, besides it’s no fun to be at a party with drunk people when you’re sober anyway.

Find others who are not drinking. Search out people who are not drinking at the event. Those are the people you may want to talk to and enjoy.

Choose a non-alcohol drink: If you’re at a bar or party, no one will know that your seltzer water with a slice of lime is not a gin and tonic. Many bars now serve non-alcoholic beverages so no one will know your drink does not contain alcohol.

The most important thing to do is to not pick up a drink no matter what. One drink all too easily leads to another. Your liver will thank you.

Ringing in a Happy, Healthy 2012 For Those Living with HBV

Out with the old bad habits and in with the new, healthy habits. The New Year is upon us and for those of us living with HBV; it’s time to make a commitment to habits that support a healthy liver.  Let’s start with New Year’s Eve – A sip of champagne to ring in the New Year? Yes!  Half a magnum of champagne to ring in the New Year… dangerous!

Let’s face it. Drinking alcohol and HBV do NOT mix.  Years of HBV results in liver disease progression. Drinking alcohol to excess also causes liver disease progression. The rate and degree of liver disease progression is not necessarily predictable and may vary with the individual. However, mix hepatitis B and alcohol and you have a deadly combination leading to more advanced liver disease progression.  Make the commitment in 2012 to stop drinking alcohol.

Do you smoke?  Why?  The warnings regarding the risks of smoking never cease.  If you smoke and have HBV, you increase the rate of your liver disease progression and you significantly increase your risk of liver cancer. Once again it’s the combination of HBV and the bad habit that increases your risk of liver cancer even more.  Smoking is bad for you and HBV is bad for you.  Make a commitment in 2012 to stop smoking.

Fatty liver disease and diabetes are on the rise. ALT levels may be elevated by your HBV or by fatty liver disease.  You don’t want either, so do your best to avoid foods that increase your risk for diabetes or fatty liver disease. Take a hard look at your diet.  Do grab food on the go?  Do you shop on the inside of the grocery store or the outside?  Do the food items you buy contain a list of ingredients you cannot pronounce?  Go back to basics. Shop on the outside of the store where the fresh vegetables, fruits and other fresh foods reside.  Make your own meals rather than buying ready-made. There is no specific diet for those living with hepatitis B, but a healthy diet is important. Eat fresh, healthy vegetables, fruits and lean meats.  Avoid “white” pastas and breads, and eat whole grains.  Avoid high fructose corn syrup and refined sugar.  Read the labels on the backs of the packages to compare your intake of sugar and fat. You may be swapping one for the other, which might be important if you are watching your sugar intake. Eat health, monounsaturated fats like olive oil, avocados, and nuts.  Avoid saturated fats such as butter, fatty meats, etc.  Spend a little time learning the healthy-diet basics and gradually implement changes into your diet and lifestyle.

Exercise really is good for you, but sometimes it’s tough to get in the groove. Just because you have HBV does not mean you should avoid exercise.  Exercise as you are able.  You will find that moderate exercise will actually make you feel better rather than worse.  HBF’s Senior Medical Adviser advises those recovering from an acute HBV infection should avoid bed rest unless specifically prescribed by their doctor. Getting up and about actually helps your liver and the recovery process. This does not mean you need to be training for a marathon, but exercise in moderation is good.  So find yourself an exercise partner, and go out for a walk, jog, or swim, or sign up for a Zumba class at your neighborhood gym.

So when you’re getting ready to make your list of New Years’ resolutions, be sure to set goals that are attainable.  You don’t have to quit smoking or drinking alcohol cold turkey.  This is a lifetime commitment. Make a realistic plan to taper off and stick to it.  Ask your doctor for advice, or find friends or family members that are also interested in making commitments to change.

Happy New Year to all!  Out with the old-bad habits, and in with the new, healthy habits for 2012!