We are more than half way through Hepatitis Awareness month. If you have viral hepatitis, you’ll likely breeze through this short, quiz… How about your significant other, family members, and friends? This is a great opportunity to help raise awareness and educate others. Be sure to let us know how you did!
Planning on digging into your favorite dark-chocolate stash, or biting the ears off of a dark-chocolate bunny this weekend? Dark chocolate is popping up everywhere. Even some old favorites have a new, dark chocolate wrapper, replacing the now-passé milk chocolate. Recently, studies have extolled the benefits of dark chocolate, and how it potentially prevents heart disease, reduces the risk of brain damage after a stroke, lowers the risk of heart failure, lowers blood pressure, reduces heart disease, has anti-cancer benefits, slows dementia, raises libido, and last but not least, is mood enhancing. What about those suffering hepatitis B associated liver disease?
Last year there was a study out of Spain that investigated the benefits of dark chocolate to patients with liver disease – specifically patients with cirrhosis. Cirrhosis causes portal pressure to rise, potentially resulting in damage to blood vessels in the liver. Eating causes an additional rise in pressure, which becomes more dangerous as liver disease progresses. Half of the study participants were given white chocolate, and the other dark chocolate. The dark chocolate group saw a larger decrease in the blood pressure of the liver, and increased blood flow. Keep in mind that this was a small study with only 21 participants.
The good news is that dark chocolate, specifically the cocoa component, is rich in antioxidants called flavonoids, and other beneficial components such as phenylethylamine, theobromine, anandamide, magnesium, copper, and vitamins E and B. That’s certainly a mouth-full, but it is these key components that provide all the benefits of chocolate.
Here’s the bad news. Many of us enjoy milk chocolate, or even the dreaded white chocolate, which has little or no benefit due to the processing of the cocoa, and the resulting loss of flavonoids. In fact, the lighter the chocolate, the fewer the benefits. In a perfect world we would be eating unsweetened, cocoa powder right out of the tin, or a chocolate bar with upwards of 85% cocoa. That can be a pretty biting chocolate. The chocolate many of us enjoy has a larger quantity of white sugar , which is not beneficial to the liver, or any other organ, nor is the additional butterfat, which is added to lighter chocolate. However, if you can adjust your tastes a little and learn to adapt to less sugar and butterfat, dark chocolate is great addition to your diet.
Aren’t most of us looking for an excuse to add chocolate to our diets? Ultimately, all things in moderation is the key. A small amount (roughly 6.7 grams) of dark chocolate added to your daily diet is certainly not going to hurt you, and may in fact reduce abdominal pressure and portal pressure in the liver. Perhaps the greatest redeeming quality of chocolate is it’s mood enhancing qualities. If it feels good, and eaten in moderation, then why not reap the benefits of dark chocolate and enjoy your improved mood.
As a mother of a child with hepatitis B, I was always concerned my child would transmit the virus to others. One day a toddler came up and bit her in the finger and drew blood. She was strapped into her stroller, and yet I felt guilty and fearful she might transmit the virus to “the biter”. I rushed my child to the pediatrician, and immediately inquired about the safety of the other toddler. He reminded me that that “blood is a two-way street for the transmission of infectious diseases”. I should worry about MY child. The other child was likely vaccinated since HBV vaccination is required in my state. I heeded his advice, and from that day forth I started thinking about the safety of MY child and others infected with HBV.
Fortunately, hepatitis B is a vaccine preventable disease, so that does ease concerns regarding the transmission of HBV to others. A simple three shot HBV vaccine series does the trick. There is no reason someone should NOT be protected against a vaccine preventable virus that is 100 times more infectious than HIV! Stop feeling guilty, and start thinking about protecting YOU!
If you have HBV, Hepatitis A (HAV) can be very dangerous. HAV is vaccine preventable. A simple two shot series will keep all those with or without HBV safe from highly-contagious HAV.
Unfortunately, there is no vaccine for HCV or HIV. If you are HBV+, a co-infection is complicated and dangerous, and can result in significant liver damage. The best way to combat infection from HCV, HIV and other infectious diseases is to use standard precautions.
Make standard precautions part of your everyday life. Simple hand washing and proper avoidance of contact with someone else’s blood and body fluids is an easy way to avoid transmission of potentially life threatening illnesses, or any illness. Cover open cuts with a Band-Aid. Provide a barrier between someone else’s blood or body fluids, and any open wounds, sores, mucus membranes and orifices. You don’t want to get infected with another blood borne pathogen! Does this mean you need to look like someone out of a bio-hazard lab with goggles and gloves? No! Use common sense, and you can be safe without going overboard. A simple barrier between you and someone else’s body fluids is the best way to avoid exposure. Keep something like a clean diaper, towel or wrapped sanitary pad, in a plastic baggie, in your car, and on each level of your home.
Personal toiletries should be just that…personal. Keep your toothbrush away from your sibling, friend or SO. Neatly dispose of used feminine hygiene products because it’s the right thing to do. Don’t leave your razor or nail clippers lying around. Sharp, personal objects really are a perfect transmission route for infectious disease.
Got HBV? Remember, keep YOURSELF safe! And the kid in the stroller… well she’s a teen, today. Now there’s a whole new set of worries.
No matter where you are with your hepatitis B – chronically infected since birth, or recently learned you are HBV positive, you want to be sure you are surrounded by all of the right people to give you the medical guidance and emotional support you need.
Start with your primary care physician (PCP). You want a doctor that listens to you and is willing to work with your liver specialist. Your PCP’s office may be coordinating your annual or bi-annual lab work for HBV monitoring and is your first line of care .
HBV can be complicated when it comes to making decisions about whether or not you need monitoring, treatment, or monitoring for liver cancer (HCC). There are many phases of HBV, and you want to be sure you are followed through ALL phases. You need a liver specialist that has experience working with patients infected with HBV. This doctor is nearly always a Gastroenterologist (GI doc) or a Hepatologist. If the patient is a child, you need a pediatric GI doctor or hepatologist. Although well qualified, an infectious disease doctor is not really the best fit because of the involvement of the liver. Once again, experience with HBV infected patients is crucial. These specialists are often found at large, or University Hospital centers.
Check out this directory of liver specialists in your area. Keep in mind that living a couple of hours from your liver specialist should be fine. Visits are typically annual or bi-annual. Visits may increase depending on treatment you may require. Lab work can usually be coordinated with your local lab via your PCP.
Get to know your local pharmacist. They are a wonderful source of information on everything from prescribed HBV medications to choosing the best OTC cold medicines, or pain relievers. I am on a first name basis with my pharmacist, and try to visit when the volume of customers is low, so no one feels rushed.
Living with a chronic illness can take its toll on your mental health. Each patient is unique, but generally all patients cycle through initial fear or denial, isolation, worry, and acceptance. If you feel you are depressed and need help coping with your HBV, seek advice from your PCP, liver specialist, or a mental health expert.
Consider joining a support group. Sometimes it’s lonely dealing with a complicated, chronic illness like HBV. Support groups are a great forum for addressing the many concerns when dealing with various aspects of your HBV, from the best treatment protocols to sex and dating. I belong to two HBV support groups and I find the interactions extremely informative, and the list members caring and very supportive of members in all stages of their HBV.
Take a look at The Hepatitis B Foundation’s website. There’s a multitude of information from simple HBV basics to in-depth information from world-renowned liver specialists and researchers, along with personal stories. Ask away if you have any questions. HBF is here to help, and we hope to be part of your team.
