Newsletter Issue 07 | March 2014
HEPATITIS B WITH JOANNE VALLVE
A round-up of Articles on virAl hepAtitis
Please take one!
LIFe on tHe stReets
FAMOUS P E O P L E WITH HEP C
HEP C AnD YoUR MEnTAL HEALTH
AGE SHALL NOT WEARY THE GALLERY | THE LATEST IN BODY MODIFICATIONS
04 Blood Brothers A personal perspective on Warrin’s
06 Going Viral A round-up of articles on viral
18 The Latest In Body Modifications: Using Steroids
discovery of hepatitis C and a reflection on his past, present, and his future.
10 Famous People with hep C Hepatitis C attacks the liver silently, and many people don’t even know they have it until liver damage shows up decades later. Here are some famous people who were affected by hepatitis C – past and present...
15 Age Shall Not Weary the Gallery Injecting Clients Get Older Written by Jessica Clement. 16 Hepatidings
Sir Charles Gairdner Hospital’s Joanne Vallve (Clinical Nurse Consultant Hepatology) and talks hepatitis B.
08 Talking hepatitis B HepatitisWA sits down with
HEPATITISWA Newsletter // March 2014
HepatitisWA Community Activities.
HEALTH & LIFESTYLE
deal with the emotional aspects of having hepatitis C. This article explores some of the most common feelings associated with a diagnosis of hepatitis C and suggestions on how to cope with these feelings.
Feature by the WA Substance User’s Association (WASUA).
PROMOTIONS 17 On-line Resource Ordering System
HepatitisWA launches it’s on-line resource ordering system on March 24th.
20 SiREN Symposium 2014
12 Hepatitis C and Your Mental Health There are things you can do to
Building the foundations for innovation SiREN Symposium. 7 April 2014, Technology Park, Bentley, Western Australia.
tHe eDItoR Welcome to the March edition of the HepatitisWA Newsletter! The personal perspective story in this issue is written by Warrin from WA. Warrin’s story reflects on his past, life living on the streets, getting back on track, his discovery of being hepatitis C positive, and his journey in supporting his brother, while getting help for himself. As usual, we cover a round-up of viral hepatitis articles in our ‘Going Viral’ section and cover HepatitisWA’s recent community activities in ‘Hepatidings’. We also “Talk hepatitis B” with Joanne Vallve, from Sir Charles Gairdner’s Liver Clinic, and feature an article on famous people with hepatitis C. ‘Age Shall Not Weary the Gallery’, is an article on Sydney’s Medically Supervised Injecting Centre’s aging clientele and our health and lifestyle section features an article on hepatitis C and it’s effects on mental health. Last but not least, we feature WASUA’s article on the latest in body modifications: using steroids.
on tHe coVeR Blood Brothers Personal Perspective PAGE 04
The cover image is available under a creative commons license at www.graphicriver.net. Image is licensed to Felicia Bradley.
Editor Felicia Bradley Graphic Artist Felicia Bradley Board of Management Executive Members Chair Dr Susan Carruthers Treasurer Ms Maria Kroon Secretary Ms Lyn Tolliday Non Executive Members Ms Ursula Swan Ms Sara Bayati Ms Max Taylor Executive Director Frank Farmer Postal Address PO Box 67 Francis Street Northbridge, WA 6865 Information & Support Line Monday – Friday | 9am – 5pm (08) 9328 8538 Metro 1800 800 070 Country Office 134 Aberdeen Street Northbridge, WA 6003 Telephone: (08) 9227 9802 Fax: (08) 9227 6545 Web: www.hepatitiswa.com.au Proof Reading Frank Farmer Ms Maria Kroon Email the Editor email@example.com
www.playthebloodrule.com www.facebook.com/HepWA www.twitter.com/HepatitisWA Opinions published in the HepatitisWA Newsletter are not necessarily those of the editor or of HepatitisWA (Inc). Information in this newsletter is not intended to take the place of medical advice from your GP or specialist. You should always get appropriate medical advice on your particular needs or circumstances. *Disclaimer: The copyright of external articles published in this newsletter remain with the original authors and publishers, unless otherwise stated.
HepatitisWA (Inc). HepatitisWA is a community based organisation which provides a range of services to the community in response to viral hepatitis, particularly hepatitis A, B and C. Please contact us for more information, or make an appointment to call by and talk with an appropriate member of our staff.
HEPATITISWA Newsletter // March 2014
“I got hepatitis from sharing needles... i used to shoot up everyday, I didn’t care about anything else...”
Source: Article written by Warrin and published with permission. 4 HEPATITISWA Newsletter // March 2014 Image available under a creative commons license at www.photodune.net. Photography by Talrevivo. © All Rights Reserved Talrevivo. The photography used for this article is for illustrative purposes only and any person depicted therein is a model.
LIFE ON THE STREETS
WARRIN HAD A ROUGH PAST. HE LIVED ON THE STREETS AS A TEEN AND WOULD SHOOT UP AT EVERY OPPORTUNITY. HE DISCOVERED HE HAD HEPATITIS C TEN YEARS AGO AFTER AN ACCIDENT AT WORK. HE SHARES HIS STORY WITH HEPATITISWA.
probably got hepatitis when I was about 16 or 17. I didn’t know at the time, but I was sharing needles with my brother and we didn’t think about HIV or hepatitis.”
Warrin moved from Broome to Perth with his older brother when he was 15 years old. They moved in with their uncle, but not long after, were living on the streets. “We were living with my uncle and his family, but it got to the point that we just wanted to do our own thing, and living in the house with six other people wasn’t worth it”. “We soon both got into the piss and drugs and that was our life... getting drunk and shooting up”. After about three years living on the streets, Warrin decided that enough was enough. “I didn’t want to be in jail and I was tired of living on the streets. I didn’t want to live
like that for the rest of my life”.
seriously sick when I’m older.”
Warrin ended up moving back to Broome and got clean. Unfortunately his brother stayed on the streets and ended up in and out of jail.
Warrin but at about to his
“I knew it was only a matter of time before the law would catch up with us, and that’s what happened to my brother”. Warrin was well off the alcohol and drugs by his twenties, and had worked in a stable job as a picker for a local grocery store. “I was cutting up boxes in the back dock and accidently cut my hand badly. My boss told me to go to the hospital coz I might need stitches.” After getting a blood test and his hand stitched up, the doctor told him he was hepatitis C positive. “I didn’t know what that meant, but I knew it wasn’t good. The doctor told me I had to get treatment or I would be
went back to work the time was worried disclosing his status boss or colleagues.
“I didn’t want anyone to judge me. They already knew a little about my past, I didn’t want this to be the deal breaker”. A little after a year Warrin moved back to Perth, but this time it was all for the better. “I came back to Perth to see my brother. I wanted to know if he also had the virus, and he did... he had been off the drugs for a while, so I moved in with him for support. It’s better now. We’re both working.” Warrin has been speaking to HepatitisWA for information, guidance, and support, and is now looking into treatment options. SOURCE: Story published with permission. Warrin’s name has been changed for the purpose of this story.
HEPATITISWA Newsletter // March 2014
Going VIRAL A round-up of articles on viral hepatitis
FLINDERS TRIALLING hep b vaccine
new hepatitis B vaccine for vulnerable adults now being trialled at Flinders Medical Centre (FMC), is likely to be available in about three to five years, researchers believe. The vaccine is in the final stage of a 12-year research program and will be administered over a 12-month period to at least 200 adults. Children are protected against the hepatitis B virus since the introduction of an Australia-wide immunisation program in 1998, but most Australian adults have not been vaccinated. Existing vaccines are considered very effective for children but have only about a 50 per cent success rate in healthy adults. This falls to 10 to 20 per cent for those in the high-risk category, including patients with diabetes. The new vaccine, partially developed at FMC, aims for improved effectiveness among this vulnerable group. FMC director of endocrinology Professor Nikolai Petrovsky said patients with diabetes respond poorly to the existing vaccine.
”Hepatitis B is still a significant problem in Australia, so we need a more effective vaccine” Prof Nikolai Petrovsky. “The people who really need a better vaccine are people who will end up on kidney dialysis, but unfortunately the current vaccine is failing to work for many of them.” 6
Principal investigator for the study Professor Jeffrey Barbara said more volunteers were needed to help with the study. He said a more effective vaccine for people with diabetes was vital as hepatitis could lead to kidney failure.
BY BRAD CROUCH.. Feb 21, 2014 for The Adelaide Advertiser.
PATIENTS TOLD OF POSSIBLE EXPOSURE TO HIV, HEPATITIS
lmost 1000 patients treated by a Sydney dentist over the past decade may have been exposed to HIV and other infectious diseases because medical equipment was not properly sterilised. Patient advocates say the case raises “deeply concerning” questions about patient safety in dental clinics and the quality of medical regulation. A public health investigation of two dental practices operated by Nuha Kamil at 255 Castlereagh Street in the city and Alfred Street, North Sydney, has found evidence of poor infection control, including problems with the cleaning and sterilisation of reusable dental instruments used at the surgeries. About 980 patients received a letter from the South Eastern Sydney Local Health District on January 6 advising them there was a “low risk” they had been exposed to HIV, hepatitis B and C if they “underwent certain dental procedures” at the clinics between August 2002 and August 2013. A spokesman for NSW Health said patients received the letter if they had
“any procedure where a sharp instrument was placed in their mouth”. Consumers Health Forum spokesman Mark Metherell said evidence Dr Kamil had failed to follow standard sterilising procedures for more than 10 years raised “deeply disturbing questions about failure of oversight in a crucial public health matter”. He said the response of health authorities – alerting potentially affected patients by letter – was a cause for concern, given many would have changed addresses. “While it may be that a public announcement of this episode would create public anxiety, there will be many patients who could be affected who may only learn of their potentially infected status as a result of publicity,” he said. NSW Health said while some patients may have been exposed to a blood-borne virus, the overall risk to patients was very low. Only 12 people have contacted the public health unit since the letter was sent and investigations are still being made to confirm whether any patients have contracted HIV or hepatitis. “NSW Health has looked at which procedures each individual patient had, and has made direct contact with all patients thought to be at any risk,” a NSW Health spokesman said. “We recommend that they attend their local general practitioner for precautionary screening for hepatitis C, hepatitis B and HIV infection.” The NSW Health Blood-Borne Viruses Advisory Panel, recommended NSW Health contact the patients directly, as it was the “most effective” way of informing those people
HEPATITISWA Newsletter // March 2014 Disclaimer: The news articles and excerpts displayed in the HepatitisWA Newsletter remain the copyright of the original authors and news publications.
potentially affected. The investigation was launched after the NSW Dental Council and the NSW Health Care Complaints Commission received complaints about Dr Kamil. Dr Kamil is still registered to practice but only under conditions set by the Australian Health Practitioner Regulation Agency, which include not treating patients unless a dental nurse or assistant with infection control training and experience is present. A spokesman for the Dental Council said information about individual practitioners could not be given out because of confidentiality laws. Dr Kamil declined to comment. Contact South Eastern Sydney Public Health Unit: (02) 93828333.
BY LUCY CARROLL.. Jan 17, 2014 for Sydney Morning Herald. tinyurl.com/poor-infection-control
Laws could Increase risk of Infectious disease, Say tattooists
ew licensing laws to regulate tattoo parlours could give credibility to backyard businesses and increase the risk of infectious disease, operators warn. The licences, a NSW government measure to crack down on organised crime and bikie gangs, came into effect in October last
year. Since then, 177 licences have been approved, with more than 700 still pending. But tattoo artists say the licences are “misleading” because the legislation requires no mandatory medical training, health checks or qualifications. To obtain a three-year licence, tattoo business operators must pay $2094 and individual tattoo artists must pay $699. All tattooists must be fingerprinted, palmprinted and pass a full police criminal check. “The licences are not only horribly misleading to the public but also not in the best interests of the industry,” says Josh Roelink, founder of the Australian Tattooists Guild. Mr Roelink, who received his licence in July last year, said they do not ask for crosscontamination knowledge, which he says is essential to prevent the spread of HIV and other blood-borne diseases, including hepatitis B and C. “It’s hard to see if the licences will do any good,” he said. “It’s putting pressure on the police and they’re already overburdened and under-resourced.” The owner of Penrith’s Wicked Ink tattoo studio, Kelly Fielding, said the laws were an opportunity for the state government to introduce health checks and ban the growing use of home tattoo guns.
“We’ve got a hepatitis C epidemic going on,” said Ms Fielding.
“And in the middle of it, we have the government handing out licences to untrained people who work from home. It’s dangerous. We’re dealing with permanent disfigurement. I don’t understand the logic of it.” Fair Trading acting assistant commissioner Rhys Bollen said the purpose of the licences was to remove “inappropriate people” and reduce criminality in the industry. He said the “health aspects” of the industry would be dealt with by the Public Health Act. In October 2012, when the legislation was being debated in Parliament, the then Fair Trading Minister Anthony Roberts said any new health requirements would add unnecessary red tape. “Licensed operators and artists must ensure they comply with necessary health regulations,” he said. Since February last year, the government has received 878 licence applications – 250 from tattoo business owners and 628 from individual tattooists. Of those, just 19 businesses and 158 artists have been approved. Mr Bollen said it was likely some tattoo parlours across NSW would be shut down or sold. “Police are looking at businesses who appear to be operating but have failed to apply,” he said.
BY LUCY CARROLL.. Jan 14, 2014 by Sydney Morning Herald. tinyurl.com/increase-risk-of-backyard-tatt HEPATITISWA Newsletter // March 2014
TALKinG HEPATiTiS B Joanne Vallve works as a Clinical Nurse Consultant Hepatology at Sir Charles Gairdner Hospital’s Liver Clinic in Nedlands. HepatitisWA sits down with Joanne and talks hepatitis B.
Words by: Joanne Vallve | edited by: Felicia Bradley | Photography by: Felicia Bradley
HEPATiTiS B Hepatitis B notifications have increased in the last three years according to the WA Department of Health’s Notifiable Infectious Disease Reports. The total number of hepatitis B notifications in 2013 was 983, compared to 650 in 2011. With the increasing number of people immigrating from countries with a high prevalence of hepatitis B, there is a need for GPs to screen patients, and test them for the hepatitis B virus, with a goal to increase referrals to Liver Clinics, allowing patients to receive treatment sooner which can prevent long-term liver damage, and liver cancer. Joanne Vallve (Clinical Nurse Consultant Hepatology) at Sir Charles Gairdner’s Liver Clinic discusses the increase in hepatitis B outpatients, clinical trials, the challenges faced, treatment options, and the future of hepatitis B treatments.
inCREASE in HEPATiTiS B The number of patients with chronic hepatitis B have really increased in the last few years, and that’s to do with the immigration patterns, with more people immigrating from African and Asian countries into Australia. I now see probably 50% hepatitis B patients, and 50% hepatitis C patients, whereas it used to be around 25% hepatitis B patients and 75% hepatitis C patients. The age range of hepatitis B patients range from people in their 20’s 8
HEPATITISWA Newsletter // March 2014
up to their 60’s. A lot of people with hepatitis B have had their transmission as a baby so they’ve got chronic hepatitis B when I see them. We’re not treating nearly as many people as we could – we need to get more people referred into the clinic.
CLiniCAL TRiALS Clinical trial work is really rewarding, because you get to give people treatment that is not on the open market, so often the treatment is quite effective. In order to get on a trial, you must first be referred by a GP. Your GP will determine whether you have hepatitis B or C through a blood test. It doesn’t matter if you think your liver function is normal, because we now know that normal liver function doesn’t mean you don’t have any damage going on, so its always good to get an expert opinion. Once the patient sees a hepatologist at our liver clinic, they can either consider treatment or a trial (if there’s a trial available). Right now, we have about 2 or 3 trials on – two hepatitis B trials and one hepatitis C trial.
CHALLEnGES There are some particular challenges with the hepatitis B population because not all of them are from an English-speaking background, and sometimes treatment goes against their belief systems – there are a lot of myths out there, so we have to look at other ways of promoting treatment of hepatitis B, and I’m not quite sure we are doing that as
successfully as we could – there’s always room for improvement in every service. One of the other issues we commonly see is the interpretation of blood tests. It can be quite confusing for some GPs, so sometimes they are not quite sure when they need to refer a patient. If you have a hepatitis B patient, just send them to a hepatologist and we can decipher what’s going on, because there are a number of different stages that people go through with hepatitis B. There are a number of different ways we can approach the disease and one way is to just get the patient to do regular blood tests and we can monitor them.
Taking medication There are not that many sideeffects for the tablets you take for hepatitis B treatment. It may be that once the patient is stable on one of the medications, like Entecavir or Tenofovir, that they just have to have a blood test every six months, and come into the clinic and get a new script, so the important thing to remember is that you can’t take breaks when taking the medication. The patient needs to take their tablets regularly – they just can’t go off them for a week, or run out of their script, (which sometimes happens with the young people who have the virus). They often think, because they feel so well, they can stop taking their tablets, but they can’t, because their liver function can flare, and every time you have a flare, that damages the liver and can increase the development of cirrhosis. The more damage you have, the more likely you’ll get liver cancer.
THE FUTURE I think the future for hepatitis B treatments is very promising. With the advent of these new medications there have not been too many side-effects. We still have to watch our patients, as some of these medicines can affect rental function, but the rates of liver cancer can go down from about 25% for people not on treatment, to about 2 to 3 percent for people on treatment, so that’s quite a comforting statistic. That means that 98% of people who are on medication won’t develop liver cancer.
It is important to always remember to take your medication, get your blood tests and attend outpatient appointments. If English is not the patient’s first language we can get an interpreter to translate. We just need to get GPs to refer the patients into our hospitals. Hepatitis B is treatable and we can prevent a lot of problems in the future if treatment is being done. Also, the medication is not expensive, as patients only pay the monthly dispensing fee, which is around $25.00. There are other medications in the pipeline that will also
improve treatment rates in time. The main message to get out is, if you do have hepatitis B, get in and get assessed by a hepatologist. If you come from an Asian or African background, and you know that someone in your family has had hepatitis B or had liver cancer, then you should go and get tested. At the end of the day, knowledge is power. If you get checked, and you don’t have hepatitis B, then that’s great, but if you do, at least you know, and you can receive treatment and manage it accordingly.
The number of patients with hepatitis B have really increased in the last few years. We need to get more people referred into the clinic.
About Joanne I’ve been a registered nurse for about 22 years.
evaluations, allowed me to work part-time,
I started off in immunology and HIV at
which suited clinical trial work around hepatitis.
Royal Perth Hospital, and then I went into
That then fueled my interest in the area, and
the Cardiothoracic side. I travelled overseas
I’ve been working with clinical trials and
for a couple of years and when I returned,
treatments for hepatitis B and C ever since. I’ve
always enjoyed this area because I think the
people you care for have made a lot of life
I initially started in the neurology ward, then
changes, and it’s great to help them on their
I moved into gastro, and have been in that
journey and give them better opportunities for
area ever since. Completing a post-grad in
mental health, and one in research and
HEPATITISWA Newsletter // March 2014
FAMOUS PEOPLE WITH
In March 2002, actress Pamela Anderson publicly stated that she had contracted hepatitis C from ex-husband Tommy Lee (reportedly from sharing their tattoo needles).
Red Hot Chili Peppers singer Anthony Kiedis revealed he contracted hepatitis C from a syringe while injecting heroin. Anthony has since eradicated the hepatitis C virus.
In 1999, daredevil Evel Knievel underwent a liver transplant after nearly dying of hepatitis C, which, he believed, had been contracted from a blood transfusion. He later died in 2007, at the age 69.
“I had virtually no symptoms. There was no warning or any signs – which really made the diagnosis a shock.
NATALIE COLE The Grammy Award-winning singer was diagnosed with hepatitis C in 2007, after years of drug abuse. She went on treatment, but it was unsuccessful. She currently lives with chronic hepatitis C.
I want people to know you can live with hepatitis... And there are remarkable treatments available to help you do just that.”
Source: (3 February 2014). Images available courtesy of Google and Wikipedia. Copyright © 2014. 10 www.hepatitiscnews.com/20-famous-people-with-hepatitis-c. HEPATITISWA Newsletter // March 2014 Disclaimer: The news articles and excerpts displayed in the HepatitisWA Newsletter remain the copyright of the original authors and news publications.
Hepatitis C attacks the liver silently, and many people don’t even know they have it until liver damage shows up decades later. Here are some famous people who were affected by hepatitis C – past and present...
Front-man, lead singer of the band Aerosmith, Steven Tyler was diagnosed with hepatitis C in 2003 and went through eleven months of treatment to eradicate the virus.
Multi-Grammy Award singer Etta James was terminally ill, and died at the age of 73 suffering through the final stages of years-long battle with leukemia, dementia and chronic hepatitis C.
The Body Shop founder, Anita Roddick announced she had hepatitis C in 2004, after receiving a blood transfusion following the birth of her daughter in 1971. She died in 2007 from cirrhosis of the liver.
David marks Former Beach Boys singer David Marks was diagnosed in 1999. After undergoing treatment, he has been virus free since 2004. His diagnosis inspired him to lead a healthier lifestyle.
“My treatment consisted of two antiviral drugs called Pegalayted Interferon and Ribavirin. I took six pills a day and injected the interferon once a week for a year. I was virus-free after six months, but I continued for an additional six months just to make sure every last virus was killed.”
HEPATITISWA Newsletter // March 2014
HEPATITIS C AND YOUR
HEALTH & LIFESTYLE
aving hepatitis C can have an impact on several areas of your life. Many people are surprised when they learn that they have been diagnosed with
Some people feel overwhelmed by the changes that doctors say they should make in their lives. It is completely normal to have strong reactions when you find out you have hepatitis C, including feelings such as fear, anger, and a sense of being overwhelmed. Often people feel helpless, sad, and anxious about the illness. If you are diagnosed with hepatitis C, your physical health is not the only issue you have to deal with. Along with the physical illness are mental health conditions that may come up. (Mental 12
HEPATITISWA Newsletter // March 2014
health refers to the overall well-being of a person, including a person’s mood, emotions, and behaviour). There are things you can do to deal with the emotional aspects of having hepatitis C. What follows are some of the most common feelings associated with a diagnosis of hepatitis C and suggestions on how to cope with these feelings.
KEEP IN MIND... • No matter what you are feeling, you have a right to feel that way. • There are no “wrong” or “right” feelings. Feelings just are. Feelings come and go. • You have choices about how you respond to your feelings. Source: Living with hepatitis: Mental Health by U.S. Department of Veterans Affairs. Available at: www.hepatitis.va.gov/patient/daily/mental (3 February 2014)
DENIAL People who find out that they have hepatitis C often deal with the news by denying that it is true. This is a natural and normal first reaction. At first, this denial may be helpful, because it can give you time to get used to the idea of having hepatitis C. However, if not dealt with, denial can be dangerous – you may fail to take certain precautions or reach out for the necessary help and medical support. It is important that you talk out your feelings with your a health care provider or someone you trust so that you can begin to receive the care and support you need.
Anger Anger is a common and natural feeling related to being diagnosed with any new condition, such as hepatitis C. Many people are upset about how they got the virus or angry that they didn’t know they had the virus.
HOW TO DEAL • Talk about your feelings with others, such as people in a support group, or with a counselor, friend, or social worker. • Try to get some exercise like gardening, walking, or dancing, to relieve some of the tension and angry feelings you may be experiencing.
• Avoid situations involving certain people, places, and events that cause you to feel angry or stressed out.
SADNESS OR DEPRESSION
medicines such antidepressants. • Get involved support group.
• Spend time with supportive people, such as family members and friends.
It is normal to feel sad when you learn you have If your mood swings or depression get very severe, hepatitis C. or if you ever think about If, over time, you find that suicide, call your doctor the sadness doesn’t go right away. Your doctor away or is getting worse, can help you. talk with your doctor or someone else you trust. Finding the right treatment for depression takes time – You may be depressed. so does recovery. If you think you may be Symptoms of depression depressed, don’t lose hope. can include the following, Instead, talk to your GP seek help for especially if they last for and depression. more than 2 weeks: • Feeling sad, anxious, irritable, or hopeless • Gaining or losing weight
FEAR AND ANXIETY
Fear and anxiety may be • Sleeping more or less than caused by not knowing usual what to expect now that you’ve been diagnosed • Moving slower than usual with hepatitis C. or finding it hard to sit still You also may be afraid • Losing interest in the things of telling people – friends, you usually enjoy family members, and others, that you have • Feeling tired all the time hepatitis C. • Feeling worthless or guilty
Fear can make your heart beat faster or make it • Having a hard time hard for you to sleep. concentrating Anxiety also can make you feel nervous or • Thinking about death or agitated. Fear and anxiety giving up might make you sweat, feel dizzy, or feel short of breath.
HOW TO DEAL HOW TO DEAL
• Talk with your doctor about treatments for depression, such as talking • Learn as much as you to a therapist or taking can about hepatitis C. HEPATITISWA Newsletter // March 2014
HEALTH & LIFESTYLE • Get your questions • Talk about it. It helps answered by your health to talk to someone care provider. about your concerns and worries. You can • Talk with your friends, talk to a friend, family family members, and member, counselor, or health care providers. health provider.
• Learn some relaxation methods. Some examples are meditation, yoga, or deep breathing.
More specific ways to care for your emotional well-being include various • Join a support group. • Let it out. A good cry forms of therapy and can bring relief to your medication. • Talk to your doctor anxiety, and it might about medicines for even prevent a headache Used separately or in anxiety if the feelings or other physical problem. combination, these may don’t lessen with time Taking some deep breaths be helpful in dealing or if they get worse. also releases tension. with the feelings you are experiencing.
Stress is unique and personal to each of us. When stress does occur, it is important to recognize and deal with it.
It is completely normal to have an emotional reaction upon learning that you have hepatitis C, such as anxiety, anger, or depression. These Some ways to handle feelings do not last forever. stress are discussed below. As you gain more of an As noted above, there understanding about how are things that you can stress affects you, you do to help take care of will come up with your your emotional needs. own ideas for coping with stress.
Here are just a few ideas:
TIPS • Try physical activity. When you are nervous, angry, or upset, try exercise or some other kind of physical activity. Walking, yoga, and gardening are just some of the activities you might try to release your tension. • Take care of yourself. Be sure you get enough rest and eat well. If you are irritable from lack of sleep or if you are not eating right, you will have less energy to deal with stressful situations. If stress keeps you from sleeping, you should ask your doctor for help. 14
HEPATITISWA Newsletter // March 2014
Therapy can help you better express your feelings and find ways to cope with your emotions. Medicines that may be able to help with anxiety and depression are also available. You should always talk with your doctor about your options. There are many ways to care for your emotional health, but treatments must be carefully chosen by your GP based on your specific circumstances and needs.
The most important thing to remember is that you • Talk about your are not alone; there are feelings with your support systems in place doctor, friends, family to help you, including members, or other doctors, psychiatrists, family supportive people. members, friends, support groups, and other services. • Try to find activities that relieve your stress, such as HepatitisWA is just one exercise or hobbies. place you can contact, where you can talk about • Try to get enough sleep your feelings and get the each night to help you feel latest information about rested. hepatitis C. • Limit the amount of caffeine and nicotine you use. • Eat small, healthy meals throughout the day. • Join a support group.
CONTACT HEPATITISWA For more information, call the Hepatitis Helpline on (08) 9328 8538 (metro), or 1800 800 070 (country).
shall not weary the gallery injecting clients get older It has remained a constant lightning rod in the battle against drug abuse and addiction in Sydney over the past decade. The newly refurbished Sydney Medically Supervised Injecting Centre first opened on Darlinghurst Rd, Kings Cross, amid a storm of controversy 13 years ago. At the time, the city was in the grip of a heroin epidemic and when the Carr Labor government announced the trial of Australia’s first “shooting gallery” the media glare was intense. Today, the now permanent facility operates in quieter circumstances and remains the only centre of its kind in the southern hemisphere. Medical director Marianne Jauncey said recent renovations, the first in the centre’s history, had increased its capacity to conduct research and continue support services. “We managed to stay open for all but three days during the entire build, which is a huge effort for all involved,” Dr Jauncey said. She said the centre’s clientele had progressively become older, a larger proportion were homeless and more were abusing prescription drugs over heroin. “We tend not to see young people as much as we used to,” she said. “The biggest shift was when our trial status was overturned in 2011 and we became permanent. It allowed us to operate so much more effectively.” BY JESSICA CLEMENT..
Image available under a creative commons license at www.sxc.hu. Photography by Leroy Skalstad. Copyright © 2005. Disclaimer: This article remains the copyright of the original author and news publication.
Feb 26, 2014 for Sydney Central HEPATITISWA Newsletter // March 2014
A SNAPSHOT OF HEPATITISWA EVENTS
CHinESE nEW YEAR FAiR On Sunday, 9th of February, the Perth Chinese New Year Fair took place on James Street in Northbridge, WA. The annual community event is organised by the Chung Wah Association to provide activities, excitement, entertainment, and enjoyment to families, and people of all ages. The event aims at promoting Chinese culture and share the festive joy of Chinese New Year together with the general public. Activities and attractions included a multicultural concert, community stalls, cultural activities, lion and dragon dances, games, rides and much more. HepatitisWA had the pleasure to once again have a presence, providing free information to the public on our services, and education on hepatitis B and C. We interacted with the public by providing a ‘Viral Hepatitis Quiz’, with 107 people entering the competition. We also gave away around 400 fortune cookies that were customised with our own health promotion messages. People were quite amused that the messages had nothing to do with their fortune. All in all, we had a great day interacting
de, B ers: Ja
It was a bit concerning that there were a number of misconceptions about the transmission of hepatitis C with some students thinking that you could contract, the virus through everyday contact such as sharing eating utensils, sharing towels and kissing someone who has the virus, so our volunteers were able to educate these students and dispel some of these myths. We disseminated over 85 bags of resources and materials during the two events, making our presence at both the UWA and Curtin O’Days worthwhile.
Viral Hepatitis Quiz winner: Jeremy Knowles
with the Chinese community and beyond.
UniVERSiTY o’ DAYS HepatitisWA had the pleasure of partnering with FPWA in holding stalls at the University of Western Australia (UWA) O’Day on the 21st of February and Curtin University of Technology’s O’Day on the 26th of February. Our volunteers had a number of meaningful interactions with students by providing information, and playing interactive games such as our ‘Traffic Light’ game, where students participated for a chance to win a $50 iTunes card. The winners drawn were Eliza from UWA, and Shannon from Curtin.
HEPATITISWA Newsletter // March 2014O’Leary and Matt Armstrong. Articles16contributed by Rosita D’Adamo, Nadia Photographs provided by relevant projects. Copyright © 2014.
HepatitisWA was also able to engage with priority population groups – not only youth, but also Culturally and Linguistically Diverse (CaLD) students who readily took home hepatitis B multilingual resources to their family and friends.
WoRKFoRCE DEVELoPMEnT HepatitisWA continues to provide free workforce development opportunities to a range of organisations throughout the community. Recently, we have provided training at the South East Metro Community Drug Service Team, WANDOO reintergration facility, Breathingspace, the Oral Health Centre of WA, and Tranby House.
As always, our workshops are tailored to suit the needs of any organsiation. Although our workshops are primarily aimed at priority workforce groups (such as drug and alcohol and mental health organisations), our workshops are open to any workplace with an interest in viral hepatitis. If you would like more information about this training, or feel like it might be relevant to your workplace, please don’t hesitate to contact the Workforce Development Officer at HepatitisWA on (08) 9227 9802.
VoLUnTEER TRAininG HepatitisWA recruited volunteers during the month of March with 10 out of 13 applicants being invited to the volunteer training which took place on the 15th of March at our premises on Aberdeen street. Volunteers came from a variety of different professional backgrounds and also possessed valuable life experiences. Many of them have experience or are studying in the Alcohol and Other Drugs (AOD) field, psychology, nursing, youth work, and nutrition, just to name a few. The training topics covered included hepatitis A, B and C, including epidemiology, prevention, symptoms and treatment, the Needle and Syringe Program (NSP), harm reduction, and effective communication skills. It was great to see the high level of knowledge and enthusiasm, and we feel confident that our new volunteers will be an asset to HepatitisWA’s team.
On-line! Launching march 24th! As of March 24th, you will be able to order HepatitisWA resources on-line!
HepatitisWA’s new resource ordering system has been developed with you, the end-user in mind!
Simply fill out the order form on-line, scroll through the available resources, enter the quantity you require, then click submit!
Your order will then be processed and mailed out in just 5 business days.
Volunteer training session: Nadia carrying out a training session
Visit www.hepatitiswa.com.au And try it now! HEPATITISWA Newsletter // March 2014
WASUA’S DOMAIN THE WEST AUSTRALIA SUBSTANCE USERS ASSOCIATION
THE LATEST in
first comic book advert promoted the extraordinary “Charles Atlas work out”. You could send away for a “get big quick” exercise regime alongside a picture of a man getting sand kicked in his face by a muscle-studded dude at the beach in front of his girlfriend. Then came muscle shirts, spray tans, men’s product lines and waxing. Then, the craze of having muscle implants. Implants for calf muscles, abbs and chest etc. Now for the last few years more and more consumers have decided that pharmaceutical enhancement is the way to go. There has
HEPATITISWA Newsletter // March 2014
always been competition with looking good but never as much as what many people experience today. Social standards are all too often decided on how we look, leaving those not looking like Adonis feeling insecure with themselves, and this insecurity can groom them for looking at ways in which to validate using performance enhancing drugs, Steroids. There have always been associated problems when it comes to enhancing one’s image. Starvation being one. Instead of eating the right proportions with the right foods, there has always been
that element in society that just stop eating to lose weight. Changing your diet to such extremes can cause major health concerns, even death. With implants, there is always the risk of scar tissue developing around the implant which results in either having to change the implant, removing it permanently or cracking (breaking down) the scar `tissue around the implant which is very painful. Not to mention the problems that can occur if the implant breaks and starts to leak. Then the greatest worry of all – Blood-Borne Viruses (BBVs). Questioning who performed the surgery and where, knowing all too well the risks associated with medical procedures in countries (particularly 2nd and 3rd world). Now more than ever the Steroid using community needs to understand the harms and hazards of injecting steroids, and the associated health concerns that come with risky using behaviour. Taking proper preventative action when using steroids is the only way to stay free of BBV’s like hepatitis C and HIV, as well as other issues like bacterial infections. Another issue to consider is the correct disposal of needle and syringes. This can be done by putting the used equipment in a sealed, plastic container, and then putting it into a rubbish bin, or bringing back used syringes to the WASUA site for an exchange.
Many users of steroids, who are Fly-in fly-out (FIFO) workers, will fly-in with equipment, but are not safely disposing of syringes. The return rate for used equipment is lower than that of those who are using other illicit drugs of choice. If the equipment is being placed in a sealed, plastic container and properly disposed of in the general rubbish, that would be in accordance to safe procedure, but the dumping of used equipment, wrapped in newspaper, plastic, or in tissues, produces a higher risk for others to receive a needle stick injury, possibly transmitting an infection. There is always the need to be on top of what equipment you are using, and making sure it is ALWAYS your own, sterile, fresh equipment. When using with friends, colleagues or training partners, it could not
be more important to be making sure all equipment is separate from each other’s. It only takes one used draw-up needle, or any other pieces of used equipment making the entire crew at risk. With each person’s cycle of injections, every time, there is the need to be constantly aware of bloodborne viruses presuming everyone could be infected who is in your company, and the only preventative measure you have against transmission, is prevention.
Prevention means that your entire steroid pack is packed sufficiently, (taking care of the sterility issue), and ensuring you have plastic tubes or a bucket available, for the safe disposal of all used needles and syringes.
available for anyone seeking information and education regarding steroid use, and delivers harm reduction strategies to help lessen any side effects due to steroid use. On coming in to the WASUA site, steroid users are able to ask for a steroid pack that contains everything needed for a 10 week cycle. People can also have the chance to meet Andrew who can follow them through the cycle, and offer advice. Additionally, the Hepatitis C Educator is also available to offer education on transmission, prevention, and treatment options available for those who have become hepatitis C positive, or know someone who has transmitted the virus, and may need some general information.
Here at WASUA, Andrew is a devoted steroid worker who is
Written by Mikayla-Jay McGinley Hepatitis C Educator, WASUA.
Van Phone 0417 973 089 Office (08) 9791 6699 or (08) 9721 1449
(08) 9321 2877 www.wasua.com.au Perth NSEP Mon - Weds: 10am-4pm Thurs - Fri: 10am-8pm Sat & Sun: 10am-12pm
Clinic Hours Tues & Thurs: 10am-4pm Closed Public Holidays
WASUA provides a number of services on premises at 519 Murray Street, West Perth, including: • • • • • • • • •
NSEP (Needle and Syringe Exchange Program) Free hep A and B vaccinations for hepatitis C positive people Free blood testing in a friendly confidential environment Drug treatment support and referral Peer education and training Street-based outreach Advocacy and support for users Safe injecting and safe disposal education and resources Hepatitis C/blood-borne virus information and resources
South West Mobile provides a mobile Needle Syringe Exchange Program (NSEP) at the following locations and times: Margaret River Busselton Donnybrook Manjimup Jaycee Park, Bunbury Haudson Road, Bunbury Bunbury Hospital Harvey Collie
Tuesday: 12pm-1pm Tuesday: 5pm-7pm Wednesday: 9am-10am Wednesday: 12pm-1pm Wednesday: 4:30pm-5:30pm Wednesday: 6pm-7pm Wednesday: 7:15-9:15pm Thursday: 7-8pm Thursday: 9-11pm
Hospital Carpark Hospital Carpark Hospital Carpark Hospital Carpark Community Health Carpark Dental Clinic Carpark Hospital Carpark Hospital Carpark
HEPATITISWA Newsletter // March 2014
Published on Mar 18, 2014
Published on Mar 18, 2014
The HepatitisWA Newsletter is a quarterly publication. With each edition we endeavour to capture new developments in hepatitis B and C treat...