Hepatitis B-A silent Killer

HEALTH
Hepatitis B—A Silent Killer
“I was 27 years old, recently married, and I looked and felt healthy. I was holding down a high-pressure job while caring for many responsibilities in the local congregation of Jehovah’s Witnesses. I was unaware that hepatitis B had begun to destroy my liver.”—Dukk Yun.
THE liver filters poisons from the blood and performs at least 500 other important functions. That is why hepatitis—inflammation of the liver—can devastate a person’s health. Hepatitis may result from excessive alcohol consumption or exposure to toxins. Most often, though, viruses are the culprit. Scientists have identified five such viruses and believe that there are at least three more.—See the box below.
Just one of the five—hepatitis B virus (HBV)—kills at least 600,000 people a year, comparable to the toll taken by malaria. More than two billion people—nearly a third of the world’s population—have been infected with HBV, and most recovered within months. For about 350 million, however, the disease became chronic. For the rest of their lives, whether they have symptoms or not, they will have the potential to infect others.
Proper medical care, started early, can help some with chronic HBV to ward off serious liver damage. But most are unaware that they have been infected, as only a specific blood test can detect HBV. Even routine liver function tests may come back normal. Thus, HBV can be a silent killer, striking without warning. Obvious symptoms may not appear until decades after infection. By then, either cirrhosis or cancer of the liver may have developed. These diseases take the life of 1 in 4 HBV carriers.
“How Did I Get HBV?”
“My symptoms first occurred at age 30,” says Dukk Yun. “I had diarrhea, so I went to a doctor of Western medicine, but he treated only the symptoms. I then saw a traditional Asian doctor, who gave me medicine for my intestines and stomach. Neither doctor checked for hepatitis. Because the diarrhea persisted, I returned to the Western doctor. He gently tapped the right side of my abdomen, which caused me pain. A blood test confirmed his suspicion—I was carrying the hepatitis B virus. I was shocked! I had never had a blood transfusion, nor had I been sexually promiscuous.”
After Dukk Yun learned that he had HBV, his wife, parents, and siblings had their blood tested, and all had antibodies to HBV. In their case, however, their immune systems had cleared the virus from their bodies. Had Dukk Yun acquired HBV from one of them? Had they all been exposed to a common source? No one can be sure. Indeed, in about 35 percent of cases, the cause remains a mystery. What is known, though, is that hepatitis B is not hereditary and is virtually never acquired through casual contact or the sharing of food. Rather, HBV is spread when blood or other body fluids, such as semen, vaginal secretions, or saliva from an infected person, enter another’s bloodstream through broken skin or mucous membranes.
Transfusions of contaminated blood continue to infect many, especially in countries where screening for HBV is limited or nonexistent. HBV is 100 times more infectious than HIV, the virus that causes AIDS. Even a tiny amount of infected blood, such as may be found on a razor, can pass on HBV, and a dried bloodstain can remain infectious for a week or more.
The Need for Understanding
“When my company learned I had HBV, they put me in a small office away from most of my colleagues,” recalls Dukk Yun. Such treatment is not uncommon and may spring from a misunderstanding of how the virus spreads. Even otherwise well-informed people may confuse hepatitis B with hepatitis A, which is highly contagious but less life threatening. Further, since HBV can be transmitted sexually, even morally upright sufferers are sometimes viewed with suspicion.
Misunderstandings and suspicion can create serious problems. For example, in many places people needlessly ostracize HBV carriers, young and old. Neighbors do not allow their children to play with them, schools do not admit them, and employers avoid hiring them. Fear of discrimination, in turn, keeps people from getting tested for HBV or revealing that they have the disease. Some even risk their own future health and that of family members rather than disclose the truth. Thus, the deadly cycle of the disease can continue for generations.
The Need for Rest
“Although my doctor prescribed complete rest, after two months I returned to work,” relates Dukk Yun. “Blood tests and CT scans showed no sign of cirrhosis, so I thought I was fine.” Three years later, his company transferred Dukk Yun to a big city, where his life became more stressful. With bills to pay and a family to support, he kept working.
Within months, the virus count in Dukk Yun’s blood shot up and he began to feel exhausted. “I had to quit my job,” he said, “and I now regret that I worked so hard. If I had slowed down sooner, I might not have become so sick, further damaging my liver.” Dukk Yun learned a vital lesson. From then on, he cut back his work and his expenses. Moreover, his whole family cooperated, his wife even taking on a small job to help make ends meet.
Living With Hepatitis B
Dukk Yun’s health stabilized, but his liver increasingly resisted the blood flowing through it, elevating his blood pressure. After 11 years, a vein in his esophagus burst and blood gushed from his throat, sending him to the hospital for a week. Four years later, he experienced mental confusion. Ammonia had built up in his brain because his liver could no longer filter it all out. Medical treatment, however, corrected the problem in a few days.
Dukk Yun is now 54. If his condition worsens, his options are limited. Antiviral treatments cannot clear the virus entirely and may have serious side effects. The last option is a liver transplant, but the waiting list is longer than the donor list. “I’m a ticking time bomb,” says Dukk Yun. “But it does no good to brood about it. I still have life, a place to sleep, and a fine family. In fact, in some ways, my condition has turned out to be a blessing in disguise. I have more time to spend with my family and more time to study the Bible. This calms my fear of untimely death and helps me to look forward to life without illness.”
Thanks in part to Dukk Yun’s positive outlook, his family enjoys a happy life and he, his wife, and their three children all share in the full-time Christian ministry.
[Footnotes]
The disease is considered chronic if the immune system has not eliminated the virus within six months.
Awake! does not endorse any particular form of medical treatment.
Blood from an infected person should be cleaned up promptly and thoroughly using protective gloves and a freshly made solution of 1 part household bleach to 10 parts water.
Concerning the Biblical hope of a time when sickness will cease, see Revelation 21:3, 4 and the book What Does the Bible Really Teach?
[Blurb on page 13]
Early medical care can help ward off damage
[Blurb on page 14]
Fear of discrimination keeps many from getting tested or revealing that they have HBV
[Box on page 12, 13]
WHAT TYPE OF HEPATITIS IS IT?
  Five viruses are known to cause hepatitis, the three most common being designated A, B, and C. Other viruses are also suspected. The symptoms of all forms of hepatitis can be flulike and may or may not include jaundice. Many people, particularly children, have no symptoms. With hepatitis B and hepatitis C, the liver may already be severely damaged by the time symptoms appear.
HEPATITIS A VIRUS (HAV)
  HAV is present in the feces of an infected person. The virus can survive in salt or fresh water and in ice cubes. A person can come in contact with HAV by
● Eating uncooked seafood from water contaminated with human waste or ingesting contaminated water
● Having close physical contact with an infected person or sharing food, drink, or eating utensils with him
● Not washing hands thoroughly after using the toilet or changing an infected baby or before preparing food
  HAV causes acute but usually not chronic illness. In almost all cases, the body clears itself of the virus within weeks or months. There is no specific standard treatment besides rest and adequate nutrition. Alcohol, as well as drugs that burden the liver, such as acetaminophen, should be avoided until a doctor determines that the liver is completely healed. A person who has had HAV will probably not get it again but can get other types of hepatitis. Vaccination can prevent hepatitis A.
HEPATITIS B VIRUS (HBV)
  HBV is present in the blood, semen, and vaginal fluids of infected people. The virus spreads when these fluids enter the body of someone who is not immune. The virus can be transmitted by
● Birth (from an infected mother to her baby)
● Medical, dental, tattooing, or body-piercing instruments that have not been properly sterilized
● Shared hypodermic needles, razors, nail files or clippers, toothbrushes, or anything else that can transfer even a tiny amount of blood through any break in the skin
● Sexual activity
  Health authorities believe that HBV is not spread by insects, or by coughing, holding hands, hugging, kissing on the cheek, breast-feeding, or sharing food, drink, chopsticks, or other eating utensils. Most adults recover from acute HBV and will then be immune to it. Small children are at high risk of developing chronic infection. Untreated, chronic hepatitis B can lead to liver failure and death. Vaccination can prevent hepatitis B.
HEPATITIS C VIRUS (HCV)
  HCV is transmitted in much the same way as HBV but most commonly by the injection of drugs with contaminated needles. There is no vaccine for hepatitis C.
[Footnote]
The World Health Organization provides further information on hepatitis in several languages at www.who.int.
[Box on page 14]
BREAKING THE HBV CYCLE
  Although HBV affects people worldwide, about 78 percent of those with chronic hepatitis B live in Asia and the Pacific islands. In much of that region, 1 person in 10 is a carrier. Most sufferers there acquire the virus at birth from their mother or early in childhood from contact with the infected blood of other children. An effective vaccine for newborns and others who are at risk is helping to break this cycle. Where vaccination has been implemented, prevalence of the disease has plummeted.
[Footnote]
Hepatitis vaccine may be prepared from blood fractions. Concerned readers are invited to consider “Questions From Readers” in the June 15, 2000, issue of The Watchtower and the October 1, 1994, issue. Information can also be found on page 215 of the book “Keep Yourselves in God’s Love,” published by Jehovah’s Witnesses.
[Picture on page 15]
Dukk Yun with his wife and three children
[Picture Credit Line on page 12]
© Sebastian Kaulitzki/Alamy



Kidney Stones—Treating an Ancient Malady
LIKELY you have heard of someone who has suffered with kidney stones. In the United States, some 300,000 kidney stone sufferers are admitted to hospitals each year. The pain can be excruciating, comparable to childbirth.
Some think of kidney stones as a relatively recent health problem, possibly having something to do with modern diet or life-style. Actually, though, stones in the urinary tract have plagued mankind for centuries. They have even been found in Egyptian mummies thousands of years old.
The stones develop when minerals in the urine clump together and grow, instead of being diluted and passed out of the body. They assume various shapes and are composed of many substances. Clinical Symposia says: “In the United States, approximately 75% of all [kidney] stones are composed primarily of calcium oxalate, and an additional 5% are composed of pure calcium phosphate.”
Prevalence and Causes
According to one report, about 10 percent of men and 5 percent of women in North America will develop a kidney stone in their lifetime. And the recurrence rate is high. One in 5 persons who have a kidney stone will develop another stone within five years.
Why some people get kidney stones and others do not has perplexed doctors for many years. The formation of stones may occur for many reasons. These include disorders of the body’s metabolism, infection, inherited disorders, chronic dehydration, and diet.
About 80 percent of kidney stones are eliminated spontaneously during urination. In order to help pass them, patients are encouraged to drink large volumes of water. Although such stones are relatively small, often barely visible, the pain may be great. If blockage of the urinary tract occurs or a stone is too large to pass (they may become as big as a golf ball), medical treatment is needed to preserve the health of the patient.
New Treatments
Until about 1980, major surgery was required to remove kidney stones that would not pass by themselves. In order to reach the stone stuck in the kidney or in the urinary tract, a painful incision, some 12 inches long [30 cm], was made in the flank. The operation was usually followed by a two-week recovery period in a hospital and approximately two months of recuperation at home. But “with recent technological advances,” the medical textbook Conn’s Current Therapy (1989) notes, “the need for open surgical removal is rare.”
Now, difficult stones may be removed by a technique that uses only minimal surgery. Another technique more commonly used today, called extracorporeal shock wave lithotripsy (ESWL), requires no surgery at all. Citing these new medical innovations, Conn’s Current Therapy says that major surgery “is probably responsible today for removal of only 1 per cent of all [kidney stones].”
A Minimal-Surgery Technique
A technique that employs only minimal surgery is sometimes called percutaneous ultrasonic lithotripsy. “Percutaneous” means “via the skin,” and “lithotripsy” literally means “crushing.” The only surgery required is a half-inch [1 cm] incision in the flank. Through this opening a cystoscopelike instrument called a nephroscope is inserted. The interior of the kidney and the offending stone may be seen through the scope.
If the stone is too large to extract through the nephroscope, an ultrasonic probe is passed through a channel in the scope and thus into the kidney. Then, to fragment the stone or stones, the hollow probe is connected to an ultrasound generator that causes the probe to vibrate at approximately 23,000 to 25,000 times a second. The ultrasonic waves make the probe act like a jackhammer, shattering all but the hardest stones it contacts.
Continuous suction through the probe literally vacuums the interior of the kidney, thus ridding it of small stone fragments. The fragmenting and suctioning process continues until careful inspection reveals that all stone debris has been removed through the probe.
At times, however, there are still stone fragments that refuse to budge. In that case, the doctor can insert through the nephroscope a thin tube that has a tiny forceps device attached to it. The doctor can then open the forceps, grab the stone, and pull it out.
As percutaneous surgery developed, many methods were tried. A few years ago, Urologic Clinics of North America said: “New methods of percutaneous stone removal seem to appear with each month’s new issues of the medical journals.” The probability of success of the procedure, the journal observed, “varies with the size and position of the stone.” But the most important factor, the journal explained, is “the skill and experience of the operator.”
Even though sufficient power is generated to smash the stones, the procedure is relatively safe. “Hemorrhage has not been a significant problem,” says Clinical Symposia. One report does say, however, that there has been major bleeding in about 4 percent of patients.
Advantages of this procedure include minimal discomfort and a shortened recovery period. In most cases only five or six days are spent in the hospital, with some patients going home after just three days. This advantage is especially significant to wage earners, who may be ready to return to work as soon as they leave the hospital.
Treatment Without Surgery
A remarkable new treatment introduced in Munich, Germany, in 1980, is called extracorporeal shock wave lithotripsy. It employs high-energy shock waves to fragment stones without making any incisions whatsoever.
The patient is lowered into a stainless-steel tank that is half filled with warm water. He is carefully positioned so that the kidney being treated is at the focal point of shock waves generated by an underwater spark discharge. The waves easily pass through the soft human tissue and reach the stone without losing any of their energy. They continue to bombard the stone until it disintegrates. Most patients then pass the stone debris with ease.
By 1990, ESWL was being used in about 80 percent of all stone removals. The Australian Family Physician reported last year that since the introduction of this technique, “over 3 million patients worldwide have been treated on more than 1100 machines, using a variety of shock-wave generators to disintegrate kidney stones.”
Although ESWL produces some trauma to the kidney area, the Australian Family Physician explains: “It rarely damages adjacent organs such as spleen, liver, pancreas and bowel. The short term trauma effect is easily tolerated with minimal harm to the patients and most patients complain only of mild [muscle and skeletal pain] in the abdominal wall and some slight [blood in the urine] for 24 to 48 hours after therapy.” Even children have been treated successfully. This Australian journal concluded: “After 10 years of evaluation ESWL seems to be an extremely safe treatment.”
Indeed, the treatment is so effective that last year’s Conn’s Current Therapy explained: “(ESWL) has allowed symptomatic stones to be removed so easily and with such minimal morbidity that patients and physicians have become less rigorous in the medical management of urinary stone disease.”
Yet, kidney stones are a painful malady that you surely do not want. What can you do to prevent them?
Prevention
Since kidney stones often recur, if you have had one, you will wisely heed the admonition to drink plenty of water. A urinary output of more than two quarts [2 L] per day is recommended, and that means drinking a lot of water!
In addition, it is wise to adjust your diet. Doctors suggest limiting your consumption of red meat, salt, and foods high in oxalate, which are believed to help form stones. These foods include nuts, chocolate, black pepper, and leafy green vegetables, such as spinach. Doctors also once recommended reducing calcium intake, but recent research indicates instead that an increase of dietary calcium tends to decrease the tendency to form stones.
Yet, in spite of your taking all precautions, if you should have another kidney stone, it may be somewhat comforting to know that there are improved methods for treating them.
[Picture on page 21]
Nonsurgical treatment of kidney stones using a machine called a lithotripter
[Credit Line]
S.I.U./Science Source/PR
[Picture Credit Line on page 20]
Leonardo On The Human Body/Dover Publications, Inc.


Kidney Stones—Ancient Affliction Still with Us
KIDNEY stones are one of the most ancient afflictions of humankind. Testifying to that fact are mummies and Indian graves of great antiquity. Not only that, but if you have had a bout with kidney stones you know that it can be one of the most painful of all human afflictions.
Ordinarily the pain is caused as a result of the stone’s having lodged in the ureter. This causes excruciating pain in the back or flank and it spreads across the lower part of the body and down to the groin and inner thigh. According to statistics, one percent of all Europeans, Asiatics and Americans are “stone carriers.” In the United States some 200,000 persons are annually hospitalized because of kidney stones.
If you are among those afflicted, most likely you are under forty years of age. And if you have had an attack, then there are four chances out of five that you will not have another. This is especially so if your attack did not require an operation.
In medical terminology, kidney stones come under the heading of “urinary calculi.” The stones may be almost microscopic in size, so-called “sand,” or large enough to fill a whole kidney, and they may be in any part of the urinary system. They are composed of many substances and assume various shapes. In the main there are three kinds of stones, apparently caused by three differing chemical conditions, the most common being the calcium oxalate stones. What initiates the building up of most types of the stones is not known, but certain elements in the urine collect around a nucleus and in time a stone develops.
Their Causes
Just what causes a person to have kidney stones? A specialist speaking at an international symposium on kidney stones said regarding calcium phosphate and calcium oxalate stones, that their “genesis . . . is poorly understood” and their “management quite unsatisfactory.”
However, at the same symposium another speaker stated that the formation of kidney stones was a process involving many factors. Among these factors, he said, were minerals, anatomical, functional, endocrinological disorders and metabolic disturbances (such as overactivity of the parathyroid glands), and those of a bacteriological nature.
And there is considerable evidence that genetic factors are a contributing cause. Thus patients who have the cystine type of kidney stones have been told by certain specialists that it “is not a disease in the ordinary sense. It is a permanent state of affairs due to your having inherited something from both your mother and your father, through no fault of theirs.”
It is also recognized that living conditions have a bearing on the formation of kidney stones. They are far more prevalent in hot and humid areas than in temperate zones. Thus in the southwestern part of the United States the ratio of kidney-stone carriers to population is almost twice that prevailing in the northern areas of the country. A sedentary occupation also seems to favor the formation of kidney stones.
The same can be said of a “higher” standard of living. Thus, among the white population in South Africa, kidney stones are far more frequent than among the native Bantu Africans. This difference may be largely owing to different eating habits. In fact, it is becoming apparent that diet has an important bearing on the formation of kidney stones. For one thing, there has been shown to be a relationship between kidney stones and eating freely of highly seasoned foods, such as Worcestershire sauce (which contains volatile oils and strong spices). Curry is likewise implicated. Thus Fijians whose diet is bland are practically free of kidney stones, whereas natives from India, living on the same island but eating freely of curry, have a high incidence of kidney stones.
Even consuming much carbohydrate-rich food and beverages, such as those containing a lot of sugar, has been shown to have a bearing on the formation of kidney stones. The same is true of eating many dairy products.
What You Can Do
The very consideration of the causes suggests what you can do and what you cannot do as to preventing recurrence of kidney stones. Obviously you can do nothing about the genetic factor itself, but you can compensate for it.
It appears that people in hot and humid climates who do not drink sufficient water to compensate for their profuse sweating are more likely to have kidney stones than those living in moderate climates. So one of the simplest and most effective preventatives is for you to drink a lot of water. In fact, when suffering from a kidney stone attack, the first thing to do is to drink plenty of water. That, together with rest and the use of pain killers, will often bring relief. But in extreme cases, when a ureter becomes blocked by a stone, surgery may be necessary.
If yours is a sedentary occupation, make it a point to get more exercise. In fact, for this reason even patients confined to their beds are urged to move around in bed and not to lie in just one position.
If you tend to form the calcium type of kidney stones, the course of prudence would be to eat sparingly of dairy products such as milk and cheese. And since overindulgence in highly seasoned foods is known to cause kidney stones, use such condiments sparingly.
Among other things being used by specialists to prevent the formation of calcium oxalate stones—the most common kind—is oral magnesium oxide therapy with or without supplemental Vitamin B6. Reports in medical journals tell of physicians having striking success in preventing the recurrence of stones by one or the other of such methods, over a period of years. Of course, all such treatments should be under the direction of a physician fully familiar with that kind of therapy. The same is true of preventing recurrence of certain kidney stones by the use of phosphate salts and antibiotics.
But the simplest and most widely and most strongly urged remedy is for you to drink plenty of water. Physicians have obtained remarkable results by having their patients drink a pint of water every four hours and even breaking their sleep to do so. In fact, that is particularly important, as it seems that kidney stones form especially during the night. Making use of such remedies can do much to keep you from having a second attack.




all articles are from the watchtower bible and tract society of Jehovahs Witnesses
study with them to learn more!