In this chapter you will find information that should help you deal with symptoms, whether they seem overwhelming or barely noticeable. We’ll also talk about other health problems, including other infections, that might affect your treatment, or just require extra attention. Fortunately, symptoms can be treated in a number of ways.
- 1 How do I take care of my symptoms?
- 2 HOW DO I TAKE CARE OF MY SYMPTOMS?
- 3 Fatigue
- 4 Headaches
- 5 Nausea and loss of appetite
- 6 Stress and depression
- 7 Other ways to relieve symptoms
- 8 Other health conditions: Hemophilia
- 9 Pregnancy
- 10 Alcoholism
- 11 Drug abuse
- 12 HIV
- 13 Kidney failure
- 14 Q U I Z
- 15 ACTION STEPS
How do I take care of my symptoms?
– Coping with other infections
– Other health conditions
HOW DO I TAKE CARE OF MY SYMPTOMS?
When a person is infected with the hepatitis B or C virus, his or her body can respond in several different ways. Some people, particularly if they are infected with hepatitis C, have no symptoms at all. That means that even if you are infected with the virus, you may not feel any different than you did before. You may not even be aware that you have the virus.
On the other hand, some people do experience symptoms. Soon after getting hepatitis, you may experience a flu-like illness that includes fatigue (tiredness), fever, muscle and joint aches, and nausea. Some people infected with hepatitis also notice that their urine has become a darker color, and their skin has a yellowish tint, which is a condition called jaundice. (See Chapter 2.)
These symptoms usually go away by themselves without treatment, particularly if you have hepatitis B, and you may have no further problems. (Also, some symptoms of chronic hepatitis B and side effects of interferon treatment are similar.) but for some people, the symptoms of hepatitis may be longer-lasting, become more severe, and interfere with daily life. In fact, sometimes dealing with hepatitis may seem like an overwhelming challenge.
The most common symptom of hepatitis infection is fatigue, or tiredness. You can take steps to lessen fatigue.
Even though it may be the last thing you feel like doing, you should try to exercise. Exercise is very important, and there are no restrictions on what kind of activity you can do. It depends on your level of fitness before you became ill with hepatitis and on your present level of tolerance. For example, if you enjoyed jogging before, you can jog now, if you feel up to it. If you don’t feel that you can continue running, find another way to exercise, even if it’s a short, regular walk. And if you weren’t exercising before, now is a good time to start. But start out slowly, as you should when beginning any fitness program under any circumstances. Check with your doctor before beginning any new exercise program.
Walking may be the best option. It is free and easy to do almost anywhere, and it gives your body a good workout. Build up speed and distance slowly; the most important thing right now is just to be doing it. Other good choices are swimming, using an exercise bike, and yoga. (See chart of exercise ideas below.)
Another way of coping with fatigue is to get on a regular schedule. Rest is very important. You need to make sure you get a full night’s sleep every night. A 30 to 45 minute daytime nap can help give you an energy boost.
You should let your doctor know if you are having any difficulties sleeping. If you have a stressful job, you may need to make some changes to lessen your workload. (See Chapter 11 for more about hepatitis and your job.) The same holds true for a hectic home life. Other family members may need to take over some of the responsibilities. (See Chapter 10.) Sometimes the fatigue is severe, especially with hepatitis B. If you feel very tired, let your doctor know so you can discuss the best way to cope with this.
Joint and muscle aches
You may experience joint and muscle aches and pains with hepatitis; the symptoms can seem like those of arthritis. But hepatitis does not cause arthritis and these symptoms typically go away when the virus has been cleared from your body. Over-the-counter pain relievers can help relieve the pain. However, any medication may affect your liver. Talk to your doctor about what types of pain relievers you can take, how much you can take, and for how long.
SOME HEALTHFUL ACTIVITIES
If you’ve been active, you can continue with your activities, if you feel up to it.
– Walking (easiest and cheapest)
– Riding an exercise bicycle
– Low-impact aerobics class or video
– Yoga or T’ai Chi (good for stretching and reducing stress)
Some symptoms of hepatitis
– Fatigue is the most common symptom. Nearly all people with hepatitis complain of some degree of tiredness.
– Muscle, joint aches and pains
– Anxiety and irritability
– Sleep disturbances
– Other less common symptoms include pain or discomfort in the abdomen on the right side, itching, nausea, appetite/weight loss, mental fuzziness.
Joint pain can also be caused by a condition known as cryoglobulinemia. About 1/3 of people with hepatitis C have this problem, which is caused by antibodies attaching themselves to the hepatitis C virus. If you are having joint and muscle pain, let your doctor know. He or she may want to test you for cryoglobulinemia because it can also cause problems with blood vessels.
Some people with hepatitis also complain about headaches. These headaches may go away completely after a while, but then come back. Sometimes they are mild, but at other times they are severe. They are not like migraine headaches. You can treat the headaches with over-the-counter medication. (Again, check with your doctor about what to use.) Also, take time to relax and drink plenty of fluids. Staying rested and drinking lots of fluids may prevent headaches.
Nausea and loss of appetite
Sometimes people with hepatitis have nausea and loss of appetite. You should try to eat, even if you don’t feel like it. Nutritious food is very important to your body at this time, as we describe in greater detail in See Chapter 8. It may help to eat many small meals rather than 3 large ones. But some patients find it is easier to eat a larger meal in the morning. Dry crackers, weak tea, ginger ale, and ice pops may be easier for you to eat than other foods. If the nausea lasts, or if you are vomiting, let your doctor know. He or she may be able to prescribe a medication to relieve the problem.
Stress and depression
Having an illness can be very stressful and sometimes downright depressing. Some of your coworkers and friends may believe false information, particularly about how the disease is spread, and this may change their attitudes toward you. You may also feel somewhat isolated because your friends and family don’t understand how you feel. You might feel tired all the time, or that you don’t have enough energy, or that no matter how much you sleep, you just don’t feel like getting out of bed. By 9 AM, you feel as if you’ve put in an entire workday. But you can get help to cope with these feelings. (See Chapter 9.)
Other ways to relieve symptoms
Perhaps the most important thing you can do to cope with symptoms is to have a positive attitude. Replacing negative thoughts with positive ones is easier said than done, but it will make a difference in how you cope with your illness. Increasing your activity level, making yourself smile more often, and even volunteering your time to help others are all ways to start feeling better about yourself. Having a better attitude may not lessen muscle aches, but it will go a long way in helping you live with the symptoms of hepatitis.
Many people also have looked beyond traditional medical care to find relief for their symptoms. For the symptoms of stress and depression in particular, many hepatitis patients have used stress management and relaxation techniques, including the following:
– Meditation. There are many different meditation methods, but they all work to quiet the mind and make you feel more peaceful and relaxed.
– Yoga. This is a slow stretching exercise that tones the body and relaxes the mind.
– T’ai Chi. One of the Asian martial arts that is different from judo or karate. The movements are slow and energizing, and, like yoga, it relaxes you as well.
– Relaxation tapes. There are a wide variety to choose from. Some are musical; others have guided medication. Choose a tape that works for you.
– Journal writing. Recording your thoughts in a journal often helps, especially if you do not feel comfortable discussing certain issues with friends or family. In addition to writing about your thoughts and feelings, you can keep track of your progress and list your goals so that you can see that you’re taking control.
Some people also use alternative or natural remedies to treat their physical symptoms. Among the options you have are herbs and homeopathic medicines (which contain tiny amounts of substances that, in large amounts, cause symptoms like those of the disease they are aimed at treating), altering your diet, and taking vitamin and mineral supplements. Some people go to chiropractors (who believe that better bone alignment improves health) or naturopaths (who only use “natural” remedies, such as herbs, sunlight, and massage). Be sure you speak to your doctor before using any other therapies or beginning a stress management program; it will help your doctor to better plan your overall care. (See Chapter 6.) He or she may also have advice about what to try, whom to see, or where to get better information about the possible good or bad effects of such therapies. (See Resource List.)
Coping with other infections
Having hepatitis does not make you more likely to get other illnesses, even though you may feel like it does. It’s sometimes hard to take good care of yourself in general, let alone when you have an illness like hepatitis. You may not be eating as well as you should because you feel sick to your stomach or don’t have any appetite. You may feel tired and need to rest but are unable to change your schedule enough to do so. All of these things can make you feel run-down, which may make it more likely you’ll get a cold or the flu. If you do get sick, your cold or flu won’t be any worse because of your hepatitis. You should speak with your doctor, though, about which medicines would be best for you.
Sometimes people may have both hepatitis C and hepatitis B at the same time. They are caused by two different viruses, and having one does not make you immune to any of the others. If you have hepatitis C and feel that you may be at risk for hepatitis B, you can be vaccinated against the B virus. (There is also a vaccine available for hepatitis A.) You can also have hepatitis B and hepatitis D (a lesser-known virus that is also called delta hepatitis) at the same time. In fact, a person must have hepatitis B in order to be infected with hepatitis D.
Some people with hepatitis also have HIV, the virus that causes AIDS. The reason for this is that the hepatitis viruses, particularly hepatitis B, are spread in some of the same ways as HIV –for example, sharing needles for drug use and having unprotected sex. (See Chapter 4.) We’ll discuss HIV in more detail later in this chapter.
Other health conditions: Hemophilia
If you have hemophilia (a disorder that stops your blood from clotting properly), and you get hepatitis, your treatment will be the same as that for hepatitis alone. The only difference is that your doctor will probably choose not to do a liver biopsy. (See Chapter 5.) Although most people have no complications from a liver biopsy, it can cause bleeding, so the hemophiliac patient must receive special treatment if a liver biopsy is done. You can receive interferon therapy, provided that your doctor thinks that it may help you. Having hemophilia does not make your hepatitis worse, or make the course of the illness more serious. (For more information, you can contact the National Hemophilia Foundation. See Resource List.)
If you have hepatitis and are pregnant, tell your healthcare provider right away, as it may affect your treatment. Patients who are pregnant must not be treated with ribavirin. If you are being treated with interferon alone and thinking of becoming pregnant, you should be aware that interferon may impair fertility and you should consult your healthcare provider. If you have hepatitis B or hepatitis C, and are not being treated, you can still become pregnant.
Pregnancy should not make your hepatitis worse. The main concerns are that you should be healthy enough to get through the pregnancy and the delivery, that you are able to get proper treatment when you need it, and that you may pass the virus on to your baby, particularly if you have hepatitis B. It is rare for hepatitis C to be passed from a mother to her newborn. (Your healthcare provider can tell you more about your baby’s particular risk and how to protect him or her.) In general, the baby does not contract the virus in the womb; rather, it is believed that the infection happens during the birth process. (See Chapter 4.)
Fortunately, there is a vaccine that can be given for hepatitis B right after birth. A vaccinated baby has very little risk of getting the virus or becoming a carrier. Therefore, the mother should try to receive interferon treatment before she gets pregnant or after she finishes nursing.
It is vital that all of your healthcare provider’s staff (including those where you plan to deliver) know you have this disease. This will protect your baby, the delivery staff, and you, because your disease may mean that you will need special care.
Alcohol destroys liver cells. Studies have shown that people with hepatitis C who drink three drinks a day are more likely to get cirrhosis and possibly liver cancer than those who drink less. By far the safest course of action is not to drink alcohol at all. If you are a heavy drinker, you must stop. Doctors do not know whether 1 or 2 drinks a day increases the rate of liver disease. So stopping altogether is by far the safest route. If you have a problem with alcoholism or are a heavy drinker and are unable to stop, you should speak to your doctor about a treatment center. Or you can join a support group such as Alcoholics Anonymous (AA). There are local groups in every city. (See Resource List for more information.)
Using illegal drugs can harm your overall health. If you are using intravenous drugs, you can also infect yourself with another virus, such as HIV, and you can infect others with hepatitis. Drugs affect your mental state and your physical health. In addition, some studies have shown that using marijuana while being treated with interferon lessens the effectiveness of interferon. The best course of action is to avoid all illegal drug use. Speak with your doctor about the best way and place to get help. (See Resource List.)
People at high risk for getting HIV often contract hepatitis B and/or hepatitis C. Whether you can receive treatment while having both of these infections depends on your overall health. In the 1980s and early 1990s, many people with HIV did not survive very long. The virus acted quickly and was quite deadly. When interferon was first cleared for treatment of hepatitis C, it was not recommended for people with HIV for that reason. They were not considered good candidates since they were usually quite sick. But with better drugs and treatments, many people with HIV are living longer and healthier lives. Interferon for hepatitis B patients or a combination of interferon and ribavirin for hepatitis C patients, may be given provided your doctor feels you will benefit from the treatment.
Renal dialysis is a treatment used for people whose kidneys have failed or stopped working. Treating such patients with interferon has sometimes led to severe side effects, and treatment often doesn’t work. Because people on renal dialysis can be quite sick, a doctor must consider each case individually to decide whether interferon will help. (If you have hepatitis C and/or hepatitis B and are on renal dialysis, you can get more information from the National Kidney Foundation. See Resource List.)
Whether you have any other serious health problems, such as renal failure or HIV, taking care of your symptoms is one of the best ways to make yourself more comfortable. Another important way to achieve better health overall is to be careful about what you eat, particularly if you have trouble keeping food down. In See Chapter 8, we’ll look at ways of making sure you stay well-fed despite your condition.
Q U I Z
Q. What is the most common symptom of hepatitis?
A. Fatigue (severe tiredness) is the most common symptom of hepatitis.
Q. What is a good and simple exercise?
A. Walking is a good exercise that can be done regularly by almost anyone.
Q. What potentially serious condition can cause joint pain in hepatitis patients?
A. A condition known as cryoglobulinemia is sometimes the cause of joint pain in hepatitis patients. You need to talk to your doctor if you think you have this condition.
Q. What is the most important step in dealing with symptoms?
A. Your attitude, and how you take control of your life through it, can make the biggest difference in how you feel, despite this disease.
– Keeping track of your symptoms in a diary. Make a list of the approaches that seem to help and how long relief lasts so you can refer to this when symptoms return.
– If you have another infection, such as another type of hepatitis or HIV, ask your doctor how it will affect your treatment for hepatitis B or C and how the other infection can be treated.
– If you have another medical condition, such as hemophilia, drug addiction, or kidney failure, seek out information about these conditions so that you get the best overall treatment.