Living with Hepatitis
Living with a chronic illness can have its challenges such as dealing with a change in lifestyle plus navigating disclosure and perceptions of your positive status.
People living with chronic hepatitis can do a number of things to stay healthy, including:
- limiting or avoiding alcohol
- getting regular exercise and eating a healthy diet
- reducing stress
- not smoking
- managing fatigue
- discussing alternative therapies with a medical practitioner, as some can affect the liver or interfere with treatment
Alcohol is poisonous to the liver. If you have hepatitis B or C, one of the best things you can do for yourself is to stop drinking or reduce this as much as you can. Alcohol may increase damage to your liver and may cause liver scarring (cirrhosis) and liver cancer.
If you have hepatitis B or C, the ideal is that you don’t drink any alcohol at all. If you do drink it is important to limit the amount consumed to reduce further possible damage to your liver.
How much can I drink?
If you have hepatitis it is recommended that you drink no more than ONE standard drink per day, with at least THREE alcohol-free days per week. If you have liver scarring or liver cancer, it is recommended that you do not drink any alcohol at all.
To reduce your alcohol intake:
- Set a limit, such as one standard drink per day, or less
- Switch to low alcohol or alcohol-free drinks
- Avoid situations where there is pressure to drink, such as drinking in rounds
- Mix beer with lemonade
- Mix wine with mineral water
- When you go out in a group, be the designated driver to avoid pressure to drink
- Alternate a non-alcoholic drink with an alcoholic one, and
- Aim to have two or three alcohol-free days each week
A well balanced diet should provide all the vitamins and minerals you need. A healthy diet can be an easy diet: one that includes a variety of nutritious food eaten regularly and that doesn’t follow strict dietary restrictions unless medically necessary.
People who have livers in the advanced stages illness, such has cirrhosis(scarring), fibrosis (hardening) or cancer, may require a specially tailored diet. This diet is usually based on low salt, low sugar and low fat principle. Speak with your medical professional for advice.
Dietary advice should be based on individual circumstances, but a healthy and balanced diet as recommended for all Australians in the Australian Guide to Healthy Eating is appropriate for most people with viral hepatitis. The guidelines recommend enjoying a wide variety of nutritious foods:
- Eat plenty of vegetables, legumes (beans) and fruits
- Eat plenty of cereals (including breads, rice, pasta and noodles)
- Include lean meat, fish, poultry and/or vegetarian alternatives
- Include milks, yoghurts, cheeses and/or alternatives
- Drink plenty of water
- Limit saturated fat and moderate your total fat intake (like butter, cream, fatty
meats and fried foods)
- Consume only a small amount of sugar and foods containing sugar.
Managing Fatigue and Sleep
Many people with hepatitis experience fatigue.
Fatigue can be managed with a few adjustments to your day-to- day life, which
will also support you in managing your health, including:
- Planning your meals ahead of time
- Exercising regularly
- Planning your day around times when fatigue usually occurs, and
- Pacing yourself and taking regular breaks so you don’t tire quickly.
Sleeping difficulties are common among people with hepatitis, which can affect quality of life and increase other symptoms, such as fatigue. There are many ways to manage sleeping difficulties, such as:
- Going to bed at the same time every night
- Reducing caffeine intake, especially before bed
- Reading before bed
Many people worldwide have found an increase in well-being through using complementary therapies, whether they have hepatitis or not. It is important to be informed about natural therapies if you have hepatitis, as some treatments can be very dangerous for people with liver problems (such as chronic viral hepatitis).
Commonly used therapies include:
- Chioo, a type of Chinese medicine
- St Mary’s milk thistle and dandelion
- Massage or touch therapies
- Meditation and yoga.
It is best if your doctor, specialist and natural therapist are able to talk directly with one another. A reputable natural therapist should be able to communicate with your GP, and have respect for the different health options available to you; to present you with the best options for your health. Make sure your natural therapist is registered with the appropriate professional association.
Who do I need to tell?
People living with viral hepatitis may feel that they have an obligation to disclose their hepatitis status. In most situations, a persons’ decision to disclose their hepatitis status is a very personal one of whom to tell, why, when, where, how, and so on.
The Workplace and Hepatitis
The risk of transmitting hepatitis in the workplace is negligible, as it cannot be passed on through the general day to day contact between people. Standard Occupational Health and Safety (OH&S) legislation, and the First Aid Advisory Standard (1999) include guidance which states that all blood should be considered potentially infectious. This means that all OH&S or First Aid responses to blood should be the same for everybody, regardless of whether or not an injured person has disclosed that they have blood borne virus.
Disclosure and Confidentiality
A person’s decision to disclose hepatitis status is a very personal one. Deciding who to tell, why, when, where and how can be difficult and confronting. Generally speaking, people living with hepatitis are not legally obligated to tell anybody their positive status. However, there are four exceptions:
- Healthcare workers who engage in “invasive or exposure prone procedures,” e.g. surgery, or any situation which requires them to work inside the body of a person with a sharp instrument
- Donating blood or organs – you cannot donate blood, blood products, organs, ova or semen if you have hep B or hep C.
- Employment in the Australian Defence Force (ADF)
- Insurance and superannuation (in some cases), as you would for any other pre-existing health condition
In these four situations, people are required by law to disclose their hepatitis status.
Stigma and Discrimination
Discrimination is when someone is treated unfairly due to a particular characteristic they have (or are thought to have).”
In general, discrimination against someone who has hepatitis is against the law. This includes:
- In most types of employment, for example when someone is applying for a job, when they are in a job or when they leave a job.
- When someone tries to get most types of goods or services, such as from banks, shops, pubs and government departments.
- Employers should not prevent someone from getting a promotion or dismiss them because they have hepatitis.
- Employers also have a legal duty to provide employees with any special facilities or services they need to help them do the job, as long as it won’t cause the employer ‘unjustifiable hardship’.
- People with hepatitis are entitled to proper medical treatment from doctors, hospitals and dentists, and access to IVF technology.
- When someone rents or tries to rent accommodation, for example, a unit, a house, commercial premises, hotel or motel room or a caravan.
- When someone applies to get into a course or are studying in any state educational institution, in a government school, college, TAFE or university.
- When someone with hepatitis tries to enter, join or get services from a registered club.
Broadly, discrimination against people with disabilities (including hepatitis) is against the law. The Anti-Discrimination Commission of Queensland (ADCQ) administers the Anti-Discrimination Act (1991) (QLD). This Act says that it is against the law to harass or treat someone unfairly because:
- a person has hepatitis or someone thinks they have hepatitis
- a person had hepatitis in the past, or someone thinks they had it in the past
- someone thinks a person might get hepatitis in the future and
- a person has a relative, friend or work colleague who has (or someone thinks has) hepatitis.
If anyone is being harassed or treated unfairly because of their hepatitis status, they should contact the Anti- Discrimination Commission of Queensland (ADCQ) who provides information about everyone’s rights. All complaints are treated confidentially and services are free.
The ADCQ have the legal power to investigate a complaint and, if it appears to be against the law, try to conciliate it. Conciliation means helping someone with hepatitis, and the person or organisation they are complaining about, reach a private settlement that everyone can agree on.
The settlement will depend on each case. People may receive their job back, an apology or financial compensation. Most complaints are conciliated. If a case isn’t conciliated, it may go to the Tribunal or Anti-Discrimination Tribunal, a court that provides legal judgments in order to try to settle complaints.