Wondering what you can do?

             ... or what you did might have done to ya?

                                     ... or what you might do, might do?

                                                                        ... HUH!?!?

Well, we're pretty sure Rock n Roll won't do anything bad to ya.  But we'll try to answer your other questions here. 

Q.

"Great Web site, one of the best i have seen! I was wondering if you can please help me with a question. I am 22 had hep-c my whole life (born with it) last month my biopsy said Stage 1 and grade 1. So I was wondering if you had any information on non-alcoholic beers like Odules? contain <0.5 I have not been able to find really good information on if its safe to have a NA beer. Some Hep-c websites went nuts when someone asked others i have seen it recommended in the site. Thanks for your time!

"Matt"

A.

Well, hello there, Matt.  This is a good question – and like other questions in this category, I’m gonna start out with Hep C Straightup’s philosophy ...

With that said ... the deal-io with alcohol is that it speeds up the virus to  replication (like it says here).  But like you point out, NA beer has like less than a half percent of alcohol.  Personally, I don’t see how it could hurt, unless you plan on drinking like a couple cases in one sitting, or something. 

Enjoy!

Q.

"Hey there,

“found your website (it's fantastic by the way) and was wondering if you could point me in the right direction.

“My partner of 2 years has had hep c for at least 10 years.  He will not treat it with the treatments, and in addition, is a heavy smoker of cigs and pot.  Also, he drinks at least 12-14 beers a nite.  Sometimes he goes for a couple of days without eating.

“I've been feeding him milk thistle for the past year--sometimes up to 3 pills a day.

“I've been doing a lot of research on the internet re hep c, and I guess I'm trying to find out what I can expect as he nears the end of his life.  He has had lot of problems in life and wants to 'go home' to visit people [close to him that he’s lost].  I can't convince him to save himself, and he tells me he drinks for the pain...of his liver.  He goes through spasms of pain (from his insides) and says his knees and hips hurt constantly.

“I've noticed over the past few days that things seem to be taking a turn for the worse.  He has been sleeping a LOT the past few days, then wakes up, drinks 7-8 beers and crashes again for hours. It's not always easy to tell he is sloshed, as he is an accomplished drinker, and can consume vast quantities of beer and say, still [work].

“I don't really know what I'm asking for ....  I guess I just need to find out what I can expect from him as he gets worse.  I know that he can get confused due to the toxins in his brain adding up (the liver can't process), but I haven't seen that.  I know that he may be at one point, vomiting and it will be all blood, which he may or may not live thru. Distended abdomen I have heard about also.

“Any advice you can give me to find out what I can expect as he gets worse?

"Thanks in advance, man.
                Susan A.”

A.

Well, first of all, let’s be clear that we here at the Straightup don’t give medical advice (like it says here).   Secondly, I can appreciate the difficulty in watching a loved one with hep C still hitting it hard like that.  This damn disease takes its toll – not only on the people who have it – but on our loved ones as well.   

That said, I gotta tell ya that I just don’t know what it’ll be like “as he nears the end of his life.”  Cuz – for all we know – he could get hit by a truck before he reaches ESLD (aka, End Stage Liver Disease).    

You’re doing a good thing to educate yourself about this disease.  The symptoms you’ve found are accurate – for someone with more advanced liver disease, or cirrhosis.  BUT, as you rightly noted – you haven’t seen them yet.  So, how about let’s stick with the facts here.

See ... while it’s different for everybody, hep C typically moves real slow.  There’s a whole bunch of us wandering around who’ve had the virus for 20 – 25 years, and didn’t even know anything was wrong till they stumbled on their diagnosis; or who’ve had minimal symptoms (like it says here & here). 

Some pretty common symptoms – that usually come on early – include a loss of appetite, nausea, joint pain, fatigue & insomnia.** 

Without knowing a bunch of stuff about your partner’s particular virus – like genotype, viral load, or biopsy results – it’s hard to even give an educated guess on what’s going on with him.  But, if I had to just take a crap shoot here ... from what you’re saying, it sounds like he’s a bit depressed.  This isn’t all that uncommon with us.  I’m not aware of any scientific data linking depression & hep C, but it’s not a real big leap to imagine that a guy can get sick & tired of being sick & tired.  Ya with me here?

Sounds like his extra-curricular activities are a concern for ya, too (the drinking & such).  Now, I don’t know when he was diagnosed, but it might be helpful for ya to understand that everyone has their own process of acceptance.  Yours truly here was diagnosed in '95, but didn't give up the booze for another 6 years, till it made me so damn sick, it just wasn't fun anymore. 

You really hit the nail on the head when you observed that, you “can't convince him to save himself.”  Now, that’s a fact.  While probably not comforting or helpful, I gotta tell ya that, as hard as it is to see, it's really their decision.  Our philosophy:

We just provide the info ... like ....

Hitting the beers like that may not throw him into end stage*, but booze does cause the virus to replicate faster.†  It’s also true that people who don’t have hep C & drink a lot, can get cirrhosis.  In fact, before hep C became known as an epidemic, chronic alcoholism was the leading cause of cirrhosis in the U.S.**

I can tell ya, from personal & a whole bunch of heppers’ experience, is that when we put down the booze, we feel a hell of a lot better. 

But, hey ... it’s a good thing that he doesn’t wanna do the treatment.  Most liver docs won’t put someone that drinks or drugs on the treatment.††  Some usually require a couple years of sobriety.  But that ain’t all bad, when you consider that the symptoms are – more often than not – worse than the disease.  Plus, less than half the people who do this clear the virus.  In fact, most of us who have hep C choose to not do the treatments that are out there right now.††

You can also read about deciding whether or not to do treatment here ... and it ain’t all bad.  Check out our Dragon Slayers (aka, hep C success stories) here. ... and finally, the future holds promise (like it says here).

So ... sounds like your heart’s in the right place there, Susan.  The milk thistle is usually helpful in terms of symptoms & stuff.  It’s been shown to help in liver regeneration even.**  But I gotta speculate that when someone’s hitting the booze real hard, it may be kinda like pissing in the wind there.  Know what I mean, jelly bean?

I hope this was helpful to ya in some way.  There’s probably a lot of stuff outta your control here, but, for sure, you can take care of YOU.  It may not be pretty, but it’s the Straightup.  Good luck to ya! 

* Cirrhosis screening I alcoholism consultation using FibroScan®. Pascal Melin, MD, Saint Dizier
    Hospital, Saint Dizier, France.  Poster presentation. 2005 AASLD.

† Alcohol Treatment increases HCV-RNA and viral Protein Expression in Huh7 cells expressing HCV –
    replicon, and this Effect is Modulated by 5-UTR HCV Region. K.D. Trujillo-Murillo, M.D., School of
    Medicine, Hospital Universitario, UANL, Monterrey Mexico. Poster Presentation, AASLD 2005.

** From cnn.com’s health library – June 2006.

†† Expectant management of chronic hepatitis C infection – the patient perspective. Omar Khokhar,
      MD, University of Illinois College of Medicine, Peoria, IL. Poster presentation. 2005 AASLD. 

Q.

"i was diagnosed hep c 8 months ago, my biopsy came back 2stage fibrose geno 1,i went on treatment,at 3 months it was undetectable, doctor took me off meds at 6 months, viral load came back undetectable, doctor said i was rapid responder, can i drink a couple of beers on weekends?  ... or should wait until i get my 6 months follow-up?  i know this is a loaded question. thanks mike. by the way I’m 45 years old."

A.

Can you drink a couple of beers on weekends? 
Well ... not until you clean your room. 

heh, heh ... not really.

First. let me extend to you a hearty congratulations for clearing the virus.  Right on, man! 

But seriously ... it’s up to you, Mike.  If you’re one of those people who really do drink a couple beers, and the doc gave ya the go ahead ... then, what the hell.  But if you’re one of those guys who thinks a couple of beers is like ... a 6 pack ... then ... what the hell.  Again ... we’re of the philosophy:

Hmmm.... a rapid responder, eh?  That’s pretty cool.  Not too many of us genotype 1’s are.  I’ve also heard these folks called “Super Responders.”  Neat-o.  But it also sounds like your doc hasn’t pronounced you SVR (like it says here).  We here at the Straightup sure wish you the best there, Mike.

Still ... unless you can fly, got a big, red S on your chest & are more powerful than a locomotive, then I’d still be good to yourself.  Your 45 year old bod’s been through a helluva battle ... and now ya got a real good shot at a second chance.  Good luck to ya, man.

Q.

"I was reading through your questions and wondered whether you had encountered this link: http://www.emedicine.com/med/topic400.htm

Is this article saying that cocaine is especially toxic to the liver and can be lethal when mixed with alcohol? And if coke is metabolized in the liver, do you think it might be particularly bad for a person with hep c?"

A.

Well hi there ... and thanks for the article.  No, actually I hadn’t run across this one – but I usually read stuff that’s more hep C-specific.  This article pretty much focuses on excessive cocaine use, and its effects on the body.  It was also pretty technical ... so it really had me (ya-a-awn) on the edge of my seat.  

    ... just kidding. 

I did read it to say that cocaine is “mainly metabolized in the liver.”  ... and yea, has a pretty bad effect when mixed with mass amounts of alcohol – and bear in mind here – they’re talking about people with healthy livers.  But ... Lethal?  Well, hard to say ....  Without reinventing the wheel, check out this real similar Q & A (here).  Do I “think it might be particularly bad for a person with hep c?”  ... It’s pretty hard not to, when you consider that EVERYTHING you put in your body is metabolized through the liver: the good, the bad & the ugly.  It’s like our oil filter. 

So, yea ... I think it’d be particularly bad for (lil’ ol’ editor) me.  So I don’t do that shit.  But Hep C Straightup just puts facts out there (science & experience) for folks – hopefully in a manner that’s easily understood.  But individuals gotta make up their own minds.  ... ya know?  Our philosophy ...

Take care of yourself now ... and best of luck to ya.

Q.

"Hi,
with the news that daily smoking of marijuana may increases risk of fibrosis, does anyone know or been able to make any calculations to see if it effects them adversely over time? I used to drink liberally, but smoked marijuana daily for nearly 30 years (as long as I've had Hep C) - how bad should my liver be given daily pot use over such a long period of time? My doctor says my liver damage on a scale of 1 - 10 is around 4.5. Should my liver damage be much worse at this stage with this history?

“Genotype 1a, just finished treatment.

“The new French evidence suggests smoking pot, but not everyday, is OK...? Does that mean every other day would be OK? If I get the all clear in six months would it then be OK to smoke daily. Id fibrosis progression for Geno 1a much slower and therefore the risk less?

“If anyone who can share their knowledge with me it would be much appreciated. Needless to say I get huge benefits from marijuana and don't want to give up - not using right now, hoping to start non-daily use soon. I'll probably never drink again...

Jake"                                                             

A.

So, you’ve just finished treatment, eh?  I’m assuming you cleared – and if that’s the case – a hearty congratulations to ya.     

Yea ... there’s a bunch of us who’ve been there, smoked that, and therefore carry some righteous concern for how that partying might’ve effected us (like it says here). 

But, enough of the chit chat ... you had some questions.  Like whether or not there’s any data that proves that long-term pot smoking hurts a liver with hep C.  I had asked a doctor friend of mine that same question when I was first diagnosed back in ’95.  He told me that smoking pot, or tobacco, sped up liver damage – just like the news ya brought to our attention – that “daily smoking of marijuana may increase risk of fibrosis.”  Any way ya look at it, fibrosis is the damage that a hep C liver gets.  So ... yea.  It’s not good.

You also ask “how bad [your] liver should be given daily pot use over a long period of time.”  Knowing that smoking (anything) speeds up fibrosis, I gotta think that the question is really, how much better would your liver be if you didn’t smoke the whole time.  But if your doc’s telling you that you’re a 4.5 on a 1 - 10 scale ... well, that ain’t half bad now ... is it?

Still ... even the scientists who study this stuff can’t always put their finger on what makes more or less liver damage.*  there’s a couple of other things that we CAN identify that increase fibrosis in those of us with hep C.  Some of our bodies make little serum auto antibodies – aka NOSA (like it says here).  People with a bunch of these tend to have more liver damage.**  Also ... the presence of a bunch of cryoglobulins – aka, abnormal immune proteins – in your blood can pretty much indicate more advanced liver damage.†

Finally, ya wanna know if it’s ok to smoke daily ... or every other day.  But I’m not gonna.  Man, I’m not your mama.  Nor am I gonna tell ya it’s o.k. or not.  You’ll do what you’re gonna do.  We here at the Straightup are firmly of the philosophy ...

* The source of HCV diagnosis affects the long-term course of chronic hepatitis C
   (CHC). Vincent Di Martino, M.D., CHU Besançon, France. Abstract Presented at AASLD
   2005.

** Do serum autoantibodies affect the severity of chronic hepatitis C. Violaine
     Ozenne, M.D., Dept. of Gastroenterology, Creteil, France. Poster Presentation,
     AASLD 2005. 

† Cryoglobulinemia is Associated with Steatosis and Fibrosis in Chronic Hepatitis C.
   david saadoun, M.D., Department of Internal Medicine, Pitie-Salpetriere Hospital,
   Paris, France. Abstract presented at AASLD 2005.

TOP O' THE PAGE

 Q.

"I know someone who is smoking crack and has hep c will that person die quickly, as isn’t crack just as bad as drinking?"

A.

Hmmm ... like I told someone in another answer (below), I sure can’t tell the future, or I’d have the winning lotto numbers.  But you asked a couple of questions.

First, will someone who smokes crack die quickly?  Don’t know; nor do we here at the Straightup try to tell people how to live their lives.  We’re of the philosophy...

But you wanted to know if smoking crack is as detrimental to the liver as drinking alcohol.  Right?   So, first things first ....  I looked through a bunch of research and didn’t find anything that showed the impact of smoking crack on folks with hep C.  I suppose it’d be hard to find volunteers for that one – eh? 

But the deal with booze is this.  Someone with hep C has all this virus replicating in us (like it shows here).  Right?  Alcohol speeds up the rate of viral replication*.  When that happens, folks with hepatitis C are more likely to get severe liver injury, get cirrhosis quicker.  Alla that increases the risk of developing liver cancer. 

I did find a study that lumped pot, coke, opiods & hallucinogens together and called it “non-alcoholic substance abuse.” Though it’s not hep-C specific, everyone in it had liver disease, so I thought it might be helpful.  In this small study** (27 patients) looked at the impact of non-alcoholic substance abuse (aka, recreational drug use) in people who had gotten new livers, and post-transplant survival.  It compared the group who went back to using, vs. the group that stayed clean.  29% of the patients went back to drinking & drugging.  Of the 8 who relapsed, 3 died, and of the 19 who stayed clean & sober, 7 died.  In the science world, that’s not considered “significantly different.”  What’s also true, is that a study using 27 people ain’t nothing to write home to mom about either.

Speaking for myself ... I have hep C, so I don’t drink anymore (been there, broke that).  I feel a hell of a lot better since I’ve done that: the symptoms don’t get to me near as bad.  Getting sober wasn’t easy, but it’s the best thing I ever did.  I wish you both the best of luck.

*   Alcohol Treatment increases HCV-RNA and viral Protein Expression in Huh7 cells expressing HCV–
      replicon, and this Effect is Modulated by 5-UTR HCV Region. K.D. Trujillo-Murillo, M.D., School of
      Medicine, Hospital Universitario, UANL, Monterrey Mexico. Poster Presentation, AASLD 2005.  

**  Non-alcoholic Substance Abuse in Liver Transplant Patients and its Impact on Survival Outcome.
       M. Nickels, University of Rochester Medical Centre, Rochester, NY. Poster Presentation, AASLD
       2005.

TOP O' THE PAGE

Q.

"hi.  my liver biopsy showed i'm at stage 2.  my question is, i was drinking and partying a lot – a real lot – before i found out about my hep c.  can that be a cause of the liver damage?  my viral is low 200,000.   chris n.y."

A.

Hi there chris.

I gotcha about the past of partying ... a bunch of us are in the same boat.  But whether damage happened due to partying, is another question – one that would depend on when you got your hep C.

Partying, all by itself, isn’t likely to cause liver damage.  Hepatitis C, however, eventually does.

See, what’s funny about the liver, is that – when healthy – it’s typically the most resilient organ in the body.  Like the old commercial said, the thing “can take a lickin’ and keep on tickin’.”  It’s like your bike.  The liver is the oil filter of the body.  Hepatocytes – aka liver cells – get f-ked up, and just regenerate themselves, when healthy.  So, actually, it’s like the oil filter you wish Harley would come up with, in that you’d never have to change it.

But, the operative words here are when healthy.  So, as we may have put our livers through the wringer in our wild days, that probably didn’t do squat compared to whenever we contracted the virus.  From that point on, it’s a different story.

With hep C, the hepatocyte (aka, liver cells) are under constant attack from the virus (like this little movie shows).  Like the liver, they get swollen (aka, inflammation), sit around and become fibrous (like a callous on your hand), and eventually scar (cirrhosis). It might take 20 or 30 years, but it does happen. 

So if your “real lot of partying” happened after you got the virus, you were definitely helping things along.  Get what I mean?  That was a great question. 

Oh yea.  I'm not throwing around 50-cent words like, inflammation, hepatocyte, fibrosis & cirrhosis just to show off.  These are terms used in your biopsy lab report to describe the condition of your stage 2 liver.  You oughta read it, chris.  Your doc shouldn't have a problem getting a copy to ya.  ... it's your liver.  If they do, now that's a problem.  Lemme know, will ya?

Thanks! ... and stay in touch.

TOP O' THE PAGE

Donate!

 then hit the link.

If you do ask a
question, here's the deal:
Sign your name if you like, or don't sign it: the choice is yours.  Your email address will NOT be shared, sold or disclosed to anyone. 

We respect your right to privacy.

If you're old enough
to remember
Woodstock, turn on
the sound & hit the speaker ....