Category Archives: Health

Hepatitis C – A Stealth Killer

by on Tuesday

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I recall my Great Uncle Sidney.  He loved to devour a delicious steak for dinner.   Eventually he had to undergo coronary bypass surgery for cholesterol-clogged arteries of his heart.   Within a decade he died!  His heart did not kill him.  He died of cirrhosis of the liver because of a blood transfusion contaminated with hepatitis C virus which he received during his bypass surgery.

Hepatitis C (HCV) is one of those conditions one hardly hears about because most people who have it don’t know they do.  Of the 3.2 million Americans who have hepatitis C, only 5-6% of them have been successfully treated.   It is 3 times more common than HIV in this country, and it is the leading cause of liver transplantation and liver cancer.  The mortality from HCV has exceeded deaths from HIV since 2007, and the death rate continues to rise.

Although there are preventative vaccines for hepatitis A and hepatitis B, there is no vaccine yet for hepatitis C.

How is hepatitis C spread?

  1. Intravenous drug use
  2. Blood product transfusion or organ transplant prior to 1992
  3. Needle stick injury or contamination caused by improperly sterilized surgical equipment or from multiple-use medication vials.
  4. Tattooing or piercing performed without sterile techniques.

Hepatitis C is not spread through food or water, or by casual contact.  There is no conclusive evidence that hepatitis C is spread through sex.  However, 20% of the time it is unknown how the virus was spread.

Who should be tested?

  1. The CDC advises anyone born between 1945 and 1965 should be tested for HCV, even if you have normal liver enzymes.
  2. Anyone who has ever injected illegal drugs
  3. Anyone with certain medical conditions such as those on chronic hemodialysis or who have persistently abnormal liver enzymes
  4. Anyone who received a blood transfusion or organ transplant prior to July 1992
  5. Health care workers who have ever received a needle stick or sharp exposure to HCV-positive blood
  6. Children born to an HCV-positive woman
  7. People who are infected with HIV

Testing
The most common test for screening is an HCV antibody test.  Be aware that it can take up to 70 days for your body to produce antibodies against HCV if you have been exposed.   If an antibody test is positive, your doctor will order a confirmatory test to check if the virus is still present called a PCR or viral load test.

Treatment
Before 2011, HCV treatments could last as long as a year with cure rates 50% or less.  Since 2011, there have been a flurry of scientific advances and new oral medicine such that treatment has been shortened to 12 weeks (and probably will be 8 weeks soon), with cure rates approaching 100%!

Summary
Hepatitis C is a hidden killer.  If you were born between 1945-1965, be sure to get tested.  Treatment is very effective if started early, but if one waits until there is cirrhosis or end stage liver disease, the only hope may be liver transplantation.   Please don’t end up like my Great Uncle Sidney!

For additional information, go to the CDC website.

 

Jerry Saliman, MD is a volunteer internist at Samaritan House Medical Clinic in San Mateo.  He retired from Kaiser South San Francisco after working there more than 30 years.  While at Kaiser SSF, Dr. Saliman was also Chief of Patient Education.  He received the 2012 “Lifetime Achievement Award” given by the Kaiser SSF Medical Staff. 

Editing acknowledgement: Ellen Saliman

Neither the PJCC or our guest columnists provide medical advice, diagnosis, or treatment. Please make your health care decisions in partnership with your health care provider.

Cultivating Good Health

by on Friday

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Any time is a good time to cultivate good health by developing a wellness plan that will help you flourish. Don’t know where to begin? Draw inspiration from your garden and apply the same concepts to your health.

Preparation
Planning your garden is the first step to its success and the same holds true for your health. Buy a notebook and name it your health journal. Begin by writing down two goals that are attainable and aren’t overwhelming. For example, start preparing your afternoon snacks to bring to work instead of buying from the vending machine. This action alone can save you 200 Continue reading

The Meaning of Life – As Seen through The Eyes Of My Patients

by on Wednesday

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As we approach the High Holidays of Rosh Hashanah and Yom Kippur this month, I find myself becoming more reflective, particularly about what’s important in my life. Twenty years ago I was asked to complete a biographical survey for a physician newsletter about my personal interests, which included questions such as the latest book I read, my favorite movie, etc. There was one question that stood out, “What is the meaning of life?” My response, “God knows.” It occurred to me a few years later that I could delve into a better understanding of this existential question by probing my patients for their stories about what has been meaningful in their lives. You may wonder how during a 15-20 minute visit with patients I could have time for such a discussion. One cannot come out and say, “Tell me the meaning of your life,” but I felt I could approach the Continue reading

High Blood Pressure – The Hidden Killer

by on Tuesday

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On April 12, 1945, President Franklin D. Roosevelt was sitting in his living room having his portrait painted by artist Elizabeth Shoumatoff, who later became most renowned for “Unfinished Portrait” of FDR. Also present was Lucy Mercer, Eleanor’s social secretary, but most notorious because of her affair with the president. His dog, Fala, and two cousins were in the room as well according to biographer Doris Kearns Goodwin. At 1:00 pm, FDR complained of “traffic pain at the back of my head,” and collapsed, unconscious. His cardiologist quickly arrived and recognized the signs of a cerebral hemorrhage, a type of stroke. One could argue that one of FDR’s visitors that day triggered his stroke, but it is much more likely that years of untreated high blood pressure led to FDR’s demise at the age of 63.

High blood pressure or hypertension still remains a hidden killer at large. It is estimated that high blood pressure kills approximately 1000 Americans each day due to its effects on Continue reading

Summer Smoothie with a Vitamin Boost

by on Tuesday

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Strawberry Peach Refresher Smoothie
Serves 2

Are you ready for something cool, delicious, and good for you?

This smoothie uses the mild tasting green, bok choy, which is known as a cancer-fighting cabbage because of its good source of beta carotene.  In just one 9 calorie cup of bok choy, you receive 63% vitamin A, 52% vitamin C and 8% calcium of your daily recommended value.

INGREDIENTS

  • 2 cups bok choy, fresh
  • 2 cups almond milk, unsweetened
  • 1 cup strawberries*
  • 2 cups peaches*

*Use at least one frozen fruit to make the smoothie cold.

INSTRUCTIONS

  • Blend bok choy and almond milk until smooth.
  • Next, add the remaining fruits and blend again.

Pour into glasses and enjoy!

 

 

Monkey See, Monkey Do — How Behavioral Modeling Influences Health

by on Tuesday

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My 2-year-old granddaughter seemed to welcome her newborn baby sister with bland indifference. I observed her as she played with her blocks and other toys and did not appear to be perturbed by the presence of a new member in her family. After she had dinner, I was surprised when she set out deliberately for the couch, wrapped her mother’s pillow around her lap, lifted her shirt, and clutched her bear to her chest. It was dinner time for her bear! While it was fun to watch her precise imitation of breast feeding, it made me stop and wonder how we as adults subconsciously follow patterns of behavior that may not reach our cognitive awareness. Continue reading

Guilt-Free Edamame “Guacamole” Recipe

by on Friday

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Summertime barbeques, Superbowl parties, and taco tuesdays are all great excuses to serve some guacamole.  But, lets face it, we’ve all struggled with a little guilt over how many calories we are consuming chip by chip.  This Edamame “Guacamole” recipe is about half the calories of avocado guacamole and is higher in protein too. Delicious and healthy! You don’t need an excuse to serve this any day.

Edamame “Guacamole”
Half the calories and 3 times the amount of protein of guacamole made with avocados – 86.7 cal., 6.7 g protein Continue reading

Welcoming The Shadow: Dealing With Negative Self Talk

by on Wednesday

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“When we were one or two years old we had what we might visualize as a 360-degree personality. Energy radiated out from all parts of our psyche… But one day we noticed that our parents didn’t like certain parts of that ball of energy that we were. They said things like, “Can’t you be still?” or “It isn’t nice to try and kill your brother.” Behind us we have an invisible bag, and the part of us that our parents don’t appreciate we, to keep our parents love, put in the bag. By the time we go to school the bag is quite large. Then our teachers have their say: “Good children don’t get angry over such little things.” So we take our anger and put it in the bag. By high school it is our peers whose opinion we value sufficiently to stuff more parts Continue reading

A Healthy Lunch Is In The Bag

by on Tuesday

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A nutritious brown bag lunch is not only easy to prepare, but economical and healthier than the usual cafeteria fare or fast-food options. Not to mention, a good midday meal can help bolster those notorious mid-day slumps and keep you on your game. Here are a few tips for bagging a healthy lunch.

Think Outside the Box
The healthiest lunches should contain foods from three different food groups: a protein, whole grain, and a fruit and/or vegetable. However, this doesn’t mean you’re stuck with the Continue reading

HIV Awareness: HIV Testing Day is June 27

by on Tuesday

HIV-625My twin daughters were born in August of 1981, just two months after a publication from the CDC reported the first cases of a rare lung infection that eventually led to what became known as the AIDS epidemic. Because they were very premature, my newborn daughters required numerous blood transfusions from Irwin Memorial Blood Bank in San Francisco. One daughter received over 40 different transfusions. In 1985, the FDA approved the first blood test to detect HIV antibodies in the blood, and blood banks began their first screening of their blood supply. It was shortly thereafter that my wife and I received a letter from the Continue reading