Saturday, March 31, 2012

Mar 31-Hep C Weekend Reading

Happy weekend folks,
Another Saturday is upon us, someone tell me where does the time go.

Each weekend this blog attempts to point the reader to a few inspiring stories, information, healthy tips or medical updates on HCV.

One story I wanted to share with you this weekend can be found on JB Smiths blog, written by Jared Bryan Smith, a man who has overcome addiction, alcoholism, and battled hepatitis C.

In Mr. Smiths newest blog entry Post Interferon Syndrome – Headaches and Celexa (Citalopram) he describes his post-treatment experience with brain fog, headaches, and the reason he made a conscious choice to use Celexa, over opiates.

Mr. Smith has also written his painful memoir, sharing his experience with addiction, family, hepatitis C and the turbulent road to sobriety, titled Hippopotamus Sea: My viral sobriety.

Here is one review of the authors book, click here to read additional reviews.

Jared Bryan Smith with his hippopotamus sea; my viral sobriety transports his readers to a place that most would not dare to go, or wouldn't even think of going.

In excruciating detail, Smith's biographical account details the life of a tragic individual who was bombed out of his mind for seventeen years beginning in his teens until his early thirties when he sought the help of Alcoholic Anonymous (AA). 

What makes this book so powerful and at the same time disturbing is that we know that the narrator is a real person that did in fact live a life of hell as an alcoholic and drug addict, and as he states, "becoming a paranoid delusional nut," who unfortunately has now wound up with Hepatitis C. 

Luckily, Smith has survived the ordeal and is still alive to share his deepest feelings, emotions, experiences, and remorse with his readers. According to Smith, the book has provided him with an opportunity to apologize to some of his friends and relatives, explain to others his behavior, to thank AA that ultimately came to his rescue, and perhaps give hope to other alcoholics and drug addicts.

How can one comprehend a life such as Smith's? To answer that question, we have to look to his early childhood where he was raised in a dysfunctional environment with a father that had succumbed to alcohol and who engendered much agony to his wife and family. At the age of eleven Smith was to experience a traumatic event that would have long lasting repercussions when his father blew his brains out. No doubt, this was probably one of the determining factors in his own downward spiral into self-destruction that expressed itself in his extreme rage and nastiness that lasted for many years thereafter. Quite alarming and disheartening was just before he killed himself, Smith, after receiving a phone call from his dad where he talked about suicide, told him, and as he informs us, he meant it, "why don't you just do us all a favor and kill yourself?"

Throughout his high-school days and into his early thirties Smith was continually lying to himself that everything was just fine when in fact he was living a decadent life jumping from one relationship to another, drinking and drugging himself into a continuous stupor, hallucinating, being fired from one job after another, blaming everyone for his misfortunes, abandoning his son, being arrested several times, and committing the most despicable act in stealing his mother's pain killing medication who was dying from cancer.

A consistent theme among alcoholics and drug abusers is the seeking out of buddies that will share in their drinking and drug habits, and I guess Smith's many relationships with the opposite sex bears this out, as for the most part his female companions were just as messed up as himself. Ironically, through all of this, Smith did manage to secure some great jobs where, when fairly sober, was able to earn a descent salary as an executive recruiter.

Although Smith's memoir is honest and moving, his message would have been much more effective and not have read like a rambling day-by-day journal of the author's life, if there had been better content editing, organization and proofreading. Nonetheless, writing a 355-page painful memoir of a drug addict and alcoholic is not only a cathartic exercise but also quite a daunting task and I commend Smith for his courage and candidness. In the end, hippopotamus sea; my viral sobriety may not exactly be a feel good book, it still left me pulling for Smith and hopefully he has finally found the path to combating his addiction that will eventually lead him to a normal life.
His sobriety, battle against Hepatitis C, and subsequent spiritual awakening is written, first hand for anyone to read, for free if need be, on or download it on Smashwords for less then a dollar.

For Your Viewing Pleasure

Yesterday I found this uplifting video over at Scope a medical blog published by Stanford University School of Medicine. The video highlights two lovely nurses who sing to their patients. When I was at my fathers bedside following his stroke, I'm not sure I could have made it without his devoted nurse. I LOVE NURSES!

Uploaded by on Mar 29, 2012
Stanford's Marilyn Antipuesto, a nurse's aide, and Mavis Dzadey, RN, were found one morning singing to a semi-conscious patient while caring for him. In this video, Antipuesto and Dzadey explain why they love their jobs and what taking care of patients is really all about.

 In The News

On the topic of inspirational nurses---

Nurse lobbying for hep C treatment changes
A NanaimoPharmaCare coverage for patients suffering from hepatitis C.

Fran Falconer, the mid-Island's only hepatitis support nurse and a volunteer with the non-profit group HepCBC, chaired a public forum in Victoria earlier this month on new treatment guidelines developed by the Canadian Association for the Study of the Liver.

"We hosted the meeting to push the government to make changes," she said.

Hepatitis C is a disease of the liver caused by the hepatitis C virus (HCV). If left untreated or uncured, it can result in end-stage liver failure, leading to organ transplant or death.

Provincial statistics indicate there are about 64,000 British Columbians currently diagnosed with hepatitis C, of whom about 25 per cent have cleared their infection without treatment, much the way people get rid of a flu virus.

HepCBC, a non-profit organization run by and for people infected with or affected by hep C, estimates about 60 per cent of people with the virus will have a long-term infection that causes no problems or causes levels of liver damage ranging from mild to serious.

Falconer said the group already got one of the things it wants – the province announced this week it has approved PharmaCare coverage for a new drug for hep C genotype 1 patients, which is proven to enhance cure rates.

Without coverage, the drug cost patients about $1,000 per week.

Falconer said the next step is to expand PharmaCare coverage to all patients who want treatment and are unable to fight off the virus on their own.

An HCV patient must prove damage to the liver before the province will cover costs of treatment, she said.

"This is a virus that is attacking the liver," said Falconer. "Why are we waiting until there is significant damage? The earlier we treat, the less sick people are, so treatment is more effective."

Treating patients before damage occurs is more cost-effective because caring for patients with health issues resulting from hep C is much more costly, she said.

"An ounce of prevention is worth a pound of cure," said Falconer. "We want equal opportunity for all patients to access care. When people have diabetes, they get treated. Patients with hepatitis C have to qualify."

She also wants more people to get tested – advocates believe there are many people infected who don't know it because they do not have symptoms.

"We call this disease the silent epidemic," said Falconer.

She said intravenous drug users are not the only population at risk – the virus is spread through direct contact with the blood of an infected person and some baby boomers might have been exposed through blood transfusions, tattoos or piercings.

Dr. Paul Hasselback, medical health officer with the Vancouver Island Health Authority, said anyone who received a blood transfusion before 1990 should be tested, as that's when hep C screening began.

He said the health authority is not seeing as many "new" cases as it is finding people who were infected when they were younger – symptoms take years to develop – and in recent years, an average of 80 people per year in Nanaimo are diagnosed.
"There's still probably a significant number who are not aware," said Hasselback.

He said the Canadian Association for the Study of the Liver's new treatment guidelines are a reflection of a better understanding of the hep C virus and the health authority does look at these recommendations, although it is up to the province to make funding decisions.

In an e-mail, the Ministry of Health said the province spends more than $100 million per year on prevention, education and treatment of hepatitis C and because many patients will recover from hepatitis on their own, providing pharmaceutical interventions to all who contract it would result in spending millions more unnecessarily
Related: VICTRELIS™ Now Available for Eligible Patients in British Columbia

Liver Cancer

Commonly used diabetes drug may help to prevent primary liver cancer
Researchers find metformin inhibits fatty acid synthesis, ability of cancer cells to reproduce
Baltimore, MD – March 31, 2012.

Metformin, a drug widely used to treat Type II diabetes, may help to prevent primary liver cancer, researchers at the University of Maryland Marlene and Stewart Greenebaum Cancer Center report in the April 2012 issue of Cancer Prevention Research. Primary liver cancer, or hepatocellular carcinoma, is an often-deadly form of cancer that is on the rise worldwide and is the fastest-growing cause of cancer-related deaths among American men.

Patients with Type II diabetes have a two- to three-fold increased relative risk of developing primary liver cancer. Also at risk are people who are obese, have hepatitis or non-alcoholic fatty liver disease (NAFLD). Metformin, which is derived from the French lilac, is used to treat NAFLD as well as diabetes, and currently is being studied in connection with the prevention of a variety of cancers. This pre-clinical study is the first to focus on liver cancer.

"Our research demonstrated that metformin prevents primary liver cancer in animal models. Mice treated with metformin had significantly smaller and fewer tumors than those who did not receive the medication," says the study's senior author, Geoffrey D. Girnun, Ph.D., assistant professor of biochemistry and molecular biology at the University of Maryland School of Medicine and a research scientist at the University of Maryland Greenebaum Cancer Center. "Based on these findings, we believe metformin should be evaluated as a preventive agent in people who are at high risk. Many patients with diabetes already are taking this medication, with few side effects."

Dr. Girnun adds, "There have been several retrospective epidemiological studies linking metformin with reduced risk of liver cancer, but our study is the first to formally test whether metformin can protect against carcinogenesis – not just tumor growth and development, but actual tumor formation in the liver." He says he will seek federal funding for a clinical trial to study the anti-cancer effects of metformin in patients who have Type II diabetes.

E. Albert Reece, M.D., Ph.D., M.B.A., vice president of medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine, says, "Hepatocellular carcinoma represents a serious public health threat worldwide. With the alarming increases in obesity, Type II diabetes and hepatitis B and C, an even greater number of people will be at risk of developing this cancer in the future. Not only do we need to find more effective treatments, we must also find ways to prevent it. This study conducted by Dr. Girnun and his colleagues is an excellent first step that may ultimately help us to prevent liver cancer in targeted populations."

Kevin J. Cullen, M.D., professor of medicine at the University of Maryland School of Medicine and director of the University of Maryland Greenebaum Cancer Center, says, "This study increases our knowledge of cancer cell metabolism and offers new insights into a possible mechanism for preventing a difficult-to-treat cancer. Translational research is an important focus of our cancer center, and we plan to continue this important area of research as part of a clinical study to determine if there is a possible benefit to patients."

The study is featured on the cover of Cancer Prevention Research, a journal published by the American Association for Cancer Research. Kavita Bhalla, Ph.D., a postdoctoral fellow at the University of Maryland School of Medicine and a Greenebaum Cancer Center research scientist, is the lead author.

Glucose is converted into fatty acids in the liver through a process called lipogenesis. This process is increased in people who have diabetes, hepatitis, fatty liver disease as well as cancer. Dr. Girnun says metformin reduces the level of glucose and inhibits this fatty acid synthesis. "When you block this process, you prevent the cells from making more building blocks to make more cells. There is also no energy to put the building blocks together, and the cells are not able to proliferate, thereby preventing tumors from developing," he explains.

In the study, researchers found that mice treated with metformin in their food developed 57 percent fewer liver tumors than the mice that did not receive the drug; the size of the tumors was reduced by about 37 percent.

About the University of Maryland School of Medicine
Established in 1807, the University of Maryland School of Medicine is the first public medical school in the United States, and the first to institute a residency-training program. The School of Medicine was the founding school of the University of Maryland and today is an integral part of the 11-campus University System of Maryland. On the University of Maryland's Baltimore campus, the School of Medicine serves as the anchor for a large academic health center which aims to provide the best medical education, conduct the most innovative biomedical research and provide the best patient care and community service to Maryland and beyond.

About the University of Maryland Marlene and Stewart Greenebaum Cancer Center The University of Maryland Marlene and Stewart Greenebaum Cancer Center is a National Cancer Institute-designated cancer center, which is part of the University of Maryland Medical Center and the University of Maryland School of Medicine. The center is recognized for its active clinical and basic science research program. It has comprehensive programs to treat all types of cancer and is a major referral center for patients throughout Maryland and the region. It is recognized as one of the top 25 cancer centers in the nation by U.S. News and World Report. For more information about the center, go to

Off The Cuff

The placebo effect

Ben Goldacre explains what the placebo effect is and describes its role in medical research and in the pharmaceutical industry.

In Case You Missed It

2012 Newsletter - Special supplement to POZ Magazine on HIV and hepatitis C coinfection

Table of Contents
January 3, 2012

From the Editor
by Tim Horn
The fight against chronic hepatitis C virus (HCV) has reached a long-awaited turning point.
Love Your Liver
by Cindra Feuer
This vital organ works hard for you. Here's how.
Overcoming Adversity
by Reed Vreeland
For Wayne Starks, 51, a former New York City bus driver, overcoming addiction and staying sober have been central to his fight to be healthy while living with both HIV and hepatitis C virus (HCV).
Managing HIV and HCV on the Inside
by Laura Whitehorn
Hep C cases behind bars outstrip those on the street by almost 10 to 1.
Double Trouble
by Benjamin Ryan
A second virus confronts people living with HIV.
Let’s Talk About Sex
by Benjamin Ryan
Recent research suggests that unprotected sex between gay men—especially if they are HIV positive—is promoting hepatitis C transmission in major urban areas across the globe.
Needle Knows
by Tim Horn
If you’re living with HIV and hep C and still using drugs and alcohol, typically the best advice for you is to get clean.
Mr. Coinfection
by Tim Horn
Activist Jules Levin battles for awareness for HIV and hep C
Survivor’s Instinct
by Cristina González
When Lillian Anglada, 53, learned she had hepatitis C, a deep sense of shock set in.
Transplant Trends
by Tim Horn
A little more than a decade ago, there wasn't much hope for HIV-positive people with a failing organ, such as a liver ravaged by hep C-related cirrhosis.
Time for Treatment?
by Benjamin Ryan
The odds of curing hep C are now better than ever.

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