THE HEP-C GENERATION

part 2 of 2
In 1990, Cathy, who had moved to Manitou Springs with her husband and nine-year-old daughter, went to donate blood, something she had done regularly in the past. A few days later, though, she received a call from a blood bank official who told her she couldn't donate blood.

Cathy panicked as her mind leaped to the logical conclusion. "Oh, my God," she thought, "I must have AIDS."

But her fear dissolved into confusion when the voice on the other end of the line told her, "You've got hepatitis C."

"What's that?" she asked.
The official told her it was no big deal and suggested she talk to her doctor if she had any questions.

Cathy did. Her doctor said that the hepatitis C virus had only recently been identified. There was no real treatment, he told her, just rest and avoiding alcohol and caffeine.

Cathy felt fine, so she decided not to worry. About nine months later, though, when she couldn't seem to shake a flu-like feeling, she went in for blood tests. They indicated her liver enzymes were elevated: The hepatitis C virus was actively attacking her liver.

Still, the doctor said, there wasn't much she could do about the disease. Cathy decided to try a homeopathic practitioner. The woman put her on a strict diet--no nuts, no cheese--and told her to take certain herbs, especially milk-thistle. Later tests indicated that her enzymes were almost back to normal.

She felt good again and chalked it up to a victory of homeopathic medicine over modern science.

Soon after that, she and her family moved to Fort Collins when her husband got a new job. Cathy's only reminder of the virus she carried was when the new employer's insurance company--which she told about the hepatitis C--refused to cover any medical problems that might arise with her liver.

Mark moved to Colorado to attend college and ski. In 1992 he went to his doctor for a routine physical. The results of his blood test were far from routine, though: His liver-enzyme levels were almost four times higher than normal.

He didn't think it was anything to worry about. After all, he'd been told eight years before that those levels would stay high.

His doctor was more concerned. He told Mark his hepatitis non-A, non-B might actually be hepatitis C, which was capable of greater damage than had previously been believed. He wanted Mark to undergo more tests.

But since Mark was feeling fine, he didn't want to go looking for trouble. He ignored the doctor's advice. It wasn't until five months later, when he received a letter from the doctor urging him to come in for testing, that Mark reluctantly agreed. The tests proved he had hepatitis C.

Mark began reading the limited material available about the virus. What little he could learn frightened him. He agreed to a liver biopsy. The results indicated he had fibrosis, a scarring of the liver that's the stage before cirrhosis.

Mark's doctor suggested he contact University Hospital regarding its interferon treatment program.

Over the past fifteen years, liver transplants have become an increasingly acceptable way of treating patients with advanced liver disease.

Colorado was an early pioneer in liver transplants, thanks to the early work of Dr. Thomas Starzl at University Hospital. When Starzl started performing the operation in the Sixties, it was before the development of drugs that would keep the body from rejecting donated organs. As a result, the transplants could buy patients a few more years, but long-term survivors were few. When Starzl left in the mid-Seventies, University's transplant program came to a halt, and Colorado patients in need of new livers had to travel out of state, many of them to the large transplant program at the University of Nebraska.

Everson had been a medical student at Cornell University in the mid-Seventies when hepatitis non-A, non-B was discovered. He had a particular interest in liver disease, which meant he soon was brought face to face with the danger of viral infections.

In 1981 Everson was on University's medical faculty when he became fascinated with one patient's case. The man had what would later be called AIDS. His was one of the first proven cases of blood-transfusion-related AIDS, which at that point was a matter of great debate, particularly between CDC researchers and the blood banks.

Studying this AIDS patient, Everson was struck by the insidious way viral infections could hide for years before emerging as a significant public-health hazard. A decade later he would be reminded of his early thoughts on AIDS when he started considering a new epidemic: hepatitis C.

In the meantime, Everson and Dr. John Vierling, with the blessing of the hospital's administration, created a new liver program. They began testing interferon on patients with advanced liver disease caused by viral infections years before the FDA approved testing the drug.

They were also instrumental in developing a team approach to dealing with liver disease, drawing together everyone from those involved in drug research and patient care to transplant surgeons.

In 1988 doctors Igal Kam and Fritz Karrer reinstituted liver transplants at University. Soon the hospital had one of the best records in the country for long-term survival of transplant patients, as well as an excellent reputation for its work in the field. Vierling went on to Cedar-Sinai Hospital at UCLA, and Dr. Charles Howell, who'd trained under Everson, moved to the University of Maryland as the medical director of its liver department.

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