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REVIEWS

The Patient in the White Coat
Terri Schlichenmeyer

SCHLICHENMEYER: ‘White Coat’ offers honest look into coping with Hepatitis C Open up wide and say “Ahhhhh.”

Scoot down on the table and just relax. This is cold, so let me warm it up. Relax your hand. Relax your arm. This might be uncomfortable. You might feel a little sting here. Squeeze my hand. Take a deep breath. Relax.

Sounds familiar if you’ve been to the doctor’s office; if you’re the doctor, you’ve said these things a thousand times. So have you ever wondered how it looks from the other side of the paper gown? Read the new memoir, “The Patient in the White Coat” by Rosalind Kaplan, MD, and find out.

When, upon being awakened one morning, Rosalind Kaplan’s mother told her husband to “Call 911. I’m dying,” — then did — Kaplan’s father elected to forgo an autopsy. Partly because of the unknown circumstances of her mother’s death and partly for peace of mind, Kaplan, who had just finished her medical residency, ordered a series of routine tests on herself.

She was feeling fine. She was tired, but wasn’t every new, busy doctor? There were brushes with medical mini-crises over the years, but Kaplan fully expected the results to show that everything was well.

She was shocked to learn that it wasn’t.

Abnormal tests indicated that Kaplan had Hepatitis C, a then little-understood cousin to Hep A and B. Kaplan wore herself out trying to figure out where she’d gotten it. Then she looked for a possible cure but because the disease was so “new,”8 treatment was still in the trial stage.

Her first experience in this new frontier began inauspiciously: Kaplan was kept waiting for nearly three hours in a soulless waiting room filled with outdated magazines. She was then accepted for six months’ worth of treatment that didn’t work. She didn’t like her doctor.

A second round of treatment followed the birth of her daughter, then a third some years later. And during it all, Kaplan was given a unique peek on “the wrong side of the curtain.”

A physician living with chronic disease, she admits, has certain advantages. She can order her own tests and interpret her own charts. She can by-pass receptionists by using her title. And she can share what she learns with her patients at bedside.

I enjoyed reading this book, overall. It’s short, to-the-point, and interesting. But what I liked best about “The Patient in the White Coat” was Kaplan’s unabashed openness and complete truthfulness.

She doesn’t always maintain a stiff upper lip here; she tells her readers that it really stinks to have this disease. She is honest about her fears, her needs, and her lack of discussing both with her husband, and she talks about the effect that the disease had on her relationship.

And she’s more-than-willing to scold, via this book, doctors who forget their humanity when caring for sick, frightened patients.

No matter what end of the stethoscope you’re on, this quick-to-read book is worth spending time. Pick up “The Patient in the White Coat,” pull up an exam table, and relax.

The Patient in the White Coat: My Odyssey from Health to Illness and Back, by Rosalind Kaplan, MD, copyright 2010 by Kaplan Publishing, is 245 pages and sells for $25.99.

Contact book reviewer Terri Schlichenmeyer at www.bookwormsez.com.

Source: Rockdale Citizen


Reviewed:  October 2010



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Living with Hepatitis C for Dummies
Lucinda K. Porter, RN, CCRC

There are many fine books about hepatitis C (HCV). Although plentiful, I always thought hepatitis C would make an excellent subject for the “For Dummies” series. Apparently, Wiley Publishing thought so too.

Living with Hepatitis C for Dummies , by Nina L. Paul, PhD, is like others in the “For Dummies” series, complete with its trademark black and yellow cover. The author has a research background and an easy to understand writing style. This book is informative, thorough and upbeat. Dr. Paul covers all aspects of HCV, such as diagnostic tests, treatment and transmission. Her description of the hepatitis C virus and the immune system is well done. Living with Hepatitis C has chapters on liver transplantation, building a medical support team as well as complementary and alternative medicine.

The strongest part of the book is “Living a Good Life with Hep C.” Paul offers concrete suggestions about nutrition, sleep, support, exercise, relationships, the workplace as well as other important aspects of wellness. She uses lists, tips, tables, and diagrams throughout the book. Specific groups of people with hepatitis C, such as children, veterans and those in prison are briefly addressed. The chapter for family and friends is packed with wisdom.

The weakest part of Living with Hepatitis C for Dummies is management of HCV treatment-related side effects. I would have preferred to see a chapter about side effect management rather than “Ten Tips for Vacationing with Hepatitis C.” Also, if there was a good explanation of portal, periportal and bridging fibrosis, I could not find it. A glossary would have been helpful, but these are not typically included in the “For Dummies” books.

The strengths of this book far outnumber its weaknesses. Although a valuable resource for everyone, Living with Hepatitis C for Dummies is a perfect book for people who are new to the subject. I recommend it for anyone needing a general introduction to the world of HCV.

Living with Hepatitis C for Dummies
By Nina L. Paul, PhD
Wiley Publishing, Inc. 2005
292 pages

Reviewed:  October 2005



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My Mom Has Hepatitis C
Alan Franciscus,
Editor-in-Chief, HCV Advocate
 

Part 1

In the United States there are over four million people infected with the hepatitis C virus and each and every one of them in one way or another is involved with a child that feels the impact of their chronic illness.  Children throughout the country have parents, grandparents, aunts, uncles and family friends that are infected with hepatitis C and this book should be proudly and prominently displayed on their bookshelf.  My Mom Has Hepatitis C, an easy to understand story filled with 25 beautiful watercolor drawings, eloquently explains what a virus is, what the liver does in the body, how hepatitis C is transmitted, and why the person that they love that has hepatitis C is sometimes so tired that they are unable to join in family activities. Chronic illness affects the entire family and so often  as adults we dismiss the true impact that the uncertainties of a chronic illness have on the children in our busy and consumed lives.  This book sensitively addresses the child's grief, anger, fears, and questions in such an effective way that it not only gives them a wealth of easily understandable information about hepatitis C but also provides a wonderful platform for which they can ask an adult their unanswered questions.

The story follows a family over about a year. Jake describes his family's experiences when Mom is diagnosed with hepatitis C.   At the beginning of the story, Jake visits Mom's doctor, where he learns factual information about the disease, hepatitis C.  Mom has to have a liver biopsy; the procedure and recovery are covered well. During the story Mom experiences the fluctuations in the symptoms of hepatitis C, sometimes she feels just fine and can do all the family activities, other times she is too tired to do anything, or the drugs make her feel ill. Throughout the book a series of family conversations provide emotional reassurance to both Jake and his sister.  The children are sometimes hurt and upset that Mom cannot do fun family things or on some days even make their lunches. At a support group Christmas party, the family meets Mr. Gomez, who is not doing well on his medications. By the end of the book, “Mom” has cleared the virus and Mr. Gomez has had a liver transplant and is doing much better demonstrating how the authors cover the entire range of treatment options and hepatitis C outcomes in this book.  The book also includes a straightforward and simple glossary of terms along with a list of recommended readings.

Hedy Weinberg is an award-winning writer and essayist. Diagnosed with hepatitis C in 1993, she brings personal understanding of how patients feel and what they want and need to know. Shira Shump, a specialist in early childhood education, works in the psychiatric day treatment program at the Square One Preschool. Gregory T. Everson, MD, a nationally recognized expert on the treatment of hepatitis C, is Professor of Medicine and Director of Hepatology at the University of Colorado School of Medicine and author of the national best seller Living With Hepatitis C: A Survivor's Guide. Joy Chen was born in Taiwan. She is now a freelance artist in New York City.

Part II of this book review will be written by a ten year old child who like so many children has felt the impact of someone close to them having chronic hepatitis C.  The review will include the perceptions that they had of hepatitis C prior to reading the book My Mom Has Hepatitis C as well as after reading the book.

Reviewed September 2002



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Part II

Part II of this book review is written by a ten-year-old child who, like so many children, has felt the impact of someone close to them having chronic hepatitis C. The review includes the perceptions that they had of hepatitis C prior to reading the book My Mom Has Hepatitis C as well as those they had after reading the book.  (Click here to read Part 1.)

The Hepatitis C Support Project asked me to read this book and tell them how it helped me to better understand hepatitis C. Before I read the book I knew quite a lot about the disease as my mommy’s best friend has hepatitis C. Hepatitis C is a virus that hurts the liver and because the liver removes the poisons from our body when our liver is sick the poisons stay in the body and make people with hepatitis C feel very tired, nauseous and sometimes cranky. My mom’s best friend spends a lot of time in bed and can’t do fun things with us often as he does not have the energy. I know my Mom worries a lot about him. I worry mostly that he will die and my mom won’t have a best friend anymore. My mommy is a bit happier at the moment as he is going to go on medicine. I’ve been told that the medicine is injections that will make him even sicker for a while and that he will have to take the injections for a year. Mommy has told me that even if the hepatitis C doesn’t go away the medicine will help his liver be better. I really hope that the medicine works as he can make my mommy laugh and he is so much fun when he isn’t sick and tired.

After I had read the book My Mom Has Hepatitis C I had so many questions that I wanted to ask. I thought it was rude before to ask how he got hepatitis C but the mom in the book explained it and so now I wanted to know. I used to worry that my mommy would catch hepatitis C and be very sick too but I now understand that mommy or I can only get hepatitis C if our blood touches the blood of someone who has hepatitis C. We will be careful to put a Band-Aid on mommy’s friend’s cuts. I also learned that there is a test that can be done to see how much the hepatitis C virus has hurt the liver. It is called a liver biopsy and what the doctor does is he takes a little bit of the liver and looks at it under a microscope to see how healthy it is and if the virus has caused damage. In the book the mommy gets rid of the virus with the injection medicine that my mommy’s friend is going to take for a year. There was another person in the book whose liver was so sick from hepatitis C that they gave him another person’s liver who died and this helped him get much better. I know this is now called a liver transplant and that the liver is one of the organs in our body that can be transplanted to another person.

I am happy that I got to read this book because I now understand much more about hepatitis C and so I don’t feel so scared.

Reviewed February 2003



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Winning the Hepatitis C Battle
by Dr. Schalla

Alan Franciscus, Editor-in-Chief

The book Winning the Hepatitis C Battle and its companion CD cover every topic related to hepatitis C in an easy to understand format sprinkled with patient anecdotes that help guide the reader though the difficult process of understanding the complexities of hepatitis C—the importance of your liver, maintaining a healthy lifestyle, making treatment decisions, preparing for treatment and getting through treatment. There is a section devoted to helping a patient's loved ones understand hepatitis C, learn to accept and be supportive as well as assist and cope during treatment. The CD is jam-packed with information presented by a variety of speakers, and there are plenty of colorful graphics that make watching it a pleasurable and rewarding learning experience.

It is very apparent that the book and CD are a labor of love by someone who has a passion for hepatitis C and cares deeply for his patients. I highly recommend the book and its companion CD to anyone with hepatitis C. It is also an excellent educational tool for helping hepatitis C affected families, medical providers, health service organizations as well as the general public learn more about hepatitis C.

 

Reviewed March 2004



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The First Year ™ Hepatitis C:  An Essential Guide for the Newly Diagnosed
Alan Franciscus
Editor-in-Chief

This is a very thorough, patient friendly book that is specifically geared towards the newly diagnosed HCV positive person and contains constructive steps to guide the reader to a thorough understanding of HCV.  What is so helpful about this book is that it contains a wealth of information on HCV and offers a step by step practical plan for people to follow that will help them regain a measure of control in their lives and effectively manage the disease which they have been newly diagnosed without feeling totally overwhelmed.

This book is an obvious labor of love by two HCV positive women who share their unique techniques that have helped them move forward after their initial diagnosis and consequently effectively manage their disease.  The book offers a step by step guide broken into daily, weekly and monthly time increments.   Each section consist of two parts:  “Living,” this gives advice on dealing with the practical and emotional consequences of HCV and “Learning,” which gives educational information that one needs to be familiar with in order to become their own health advocate.  For instance the first section is ‘Day One’ --- Living-- So You have Hep C. What Now?  This section focuses on strategies that will help one come to terms with the emotional issues accompanied with their new diagnosis.  The second section for ‘Day One’ is Learning—the companion hepatitis C educational piece.  This section helps the reader understand the very basic facts about hepatitis C.  The entire book is set up in this style and gradually moves the reader through all the issues regarding transmission, prevention, disclosure, lab tests, symptoms, conventional and complementary therapies and much more.  

The design of the book is like attending a workshop where the amount of information given, both written and practical exercises is at a pace that one can assimilate.  Additionally, a very important aspect of this book is that it gives the reader a sense of hope and the skills necessary to begin the process of accepting their diagnosis of HCV. Lastly, the book also gives additional information on specific populations such as children and HIV/HCV coinfection plus a valuable list of resources. 

The only minor criticism I have of this book is that it may be too exhaustive for the average patient.  If followed thoroughly the tasks outline in the book could almost be a full time job in itself.  As I stated above the information is delivered like attending a workshop but the problem though is that for the average newly diagnosed patient they have a working life, a family life etc. and can’t just take on their new diagnosis as if they were at a workshop!  I would advise people to use this book at their own pace and use it as a valuable tool to learn and grow.  With that advice in mind, I am the first to acknowledge that living with a chronic illness such as HCV does require hard work and commitment to fully understand the new life that you are taking on as a person with HCV. This book is an excellent addition to any Hep C library and I would definitely recommend it to anyone affected by HCV.

Reviewed July 2002



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The Hepatitis C Help Book: A Groundbreaking Treatment Program Combining Western and Eastern Medicine for Maximum Wellness and Healing

The Hepatitis C Help Book (Revised Edition) is a collaboration between two of the best known and most knowledgeable practitioners working in the hepatitis field today - Misha Cohen O.M.D.,LAc. and Robert Gish, MD. This is a well-rounded and comprehensive guide that should be in the personal library of anyone dealing with hepatitis C, and can easily be used by both patients and health care providers.

Important information discussed in the book includes:

  • An overview of hepatitis C, the liver and the relationship between the liver and Traditional Chinese Medicine
  • Treatment of hepatitis C including “Western” drug therapies, herbs, nutrition (including recipes), acupuncture, acupressure and moxibustion. 
  • Qi Gong – an exercise and mediation practice
  • Information about managing the symptoms of HCV
  • Side effect management of “Western” drug based therapies

Reviewed November 2008



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The Invisible Enemy: A Natural History of Viruses
Alan Franciscus, Editor-in-Chief

The Invisible Enemy is a very good overview of the world of viruses.  Virologist Dorothy H. Crawford has written a book that is scientific, but it is also interesting, enjoyable, and very readable.  In fact, I became so immersed while reading the book that I felt that I was reading a historical novel and not a book on the science of viruses.  But that is what is so enjoyable about this book – Ms. Crawford weaves together interesting tales, scientific data and her thoughts on viruses in a way that helped me to understand these primitive proteins and their impact on the history and evolution of the human race.  

Throughout the book there is information about the history of a variety of viruses:

 • Yellow fever: how it is spread by mosquitos, the pandemics it has caused throughout history, the spread of yellow fever in the U.S., how the transmission routes were first identified, and more importantly how the spread of yellow fever was stopped in this country.

 • Polio: the impact of this disease on the U.S., how it is spread and the development of a vaccine that has helped to eradicate it from the U.S. and around the world.

 • HIV: a good overview of the history of HIV, how HIV replicates, and the efforts to manage HIV and stop its transmission. 

 • Hepatitis viruses: There is a brief overview of hepatitis A, B, and C.

There is also an overview of the emerging viruses that have the potential to cause future pandemics:

 • Ebola: The emergence of this virus from central Africa and the effects of the virus on the human body.

 • Hanta virus: a virus that caused small but widespread infection in the Western U. S. that by the end of 1995 caused 58 deaths—out of a total of 119 people who became infected.  

 • Bird flu: a brief overview of bird flu and how viruses can jump between species, what is being done to curb a potential pandemic and some realistic data that should help to alleviate some of the fear that has been generated about bird flu in the media.

What is remarkable is that after reading the book I came away with a better understanding of viruses and less fear of potential outbreaks that the media has sensationalized in the last couple of years.

Reviewed:  November 2007



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The Official Patient's Sourcebook on Hepatitis B
Christine Kukka

I had high expectations for this book. There’s the promising title: “Official Patient’s Sourcebook ….,” there’s the book’s hefty girth, and then there’s the undisputed need for a comprehensive, easy-to-understand guidebook to one of the world’s most deadly and complex viral infections
.
Today, 6 percent of the world’s population has chronic hepatitis B. To put this in perspective, 2.8 percent of the world is infected with hepatitis C, and less than 1 percent is infected with HIV. In China, home to 1.3 billion people, 60 percent have been infected with the hepatitis B virus (HBV) and 10 percent are chronically infected with hepatitis B.

Closer to home, one in 20 Americans has been infected with HBV, and 1.2 million (equivalent to the population of Maine) are chronically infected with hepatitis B.

Despite its widespread infection rate, pediatricians and general practitioners have trouble understanding hepatitis B, and even health care providers struggle to interpret hepatitis B viral tests. Most doctors still think of hepatitis B as a sexually-transmitted disease and assume if you don’t sleep around, you won’t get infected.

This attitude prevails despite the fact that about half of those who are chronically infected in the United States were born to HBV-infected mothers and infected at birth because they weren’t immediately immunized, and their mothers weren’t screened for HBV during pregnancy.

And if the viral make-up and natural history of this infection doesn’t confuse you, the available treatments, and when they should be prescribed, will. You need an algorithm and a degree in medicine to understand the unique features of viral load, antigen status and liver enzyme readings that together dictate when treatment is needed.

And did I mention the various hepatitis B viral mutations that are able to replicate without one of the viral antigens, or are able to resist the antiviral punch of lamivudine, the most commonly used antiviral treatment?

Hence, a patient’s source book is exactly what HBV-infected individuals and their family members need to help manage their health care. Unfortunately, the “Patient’s Sourcebook …” doesn’t deliver.

While it touts itself as an authoritative directory for the Internet age, the doctor who edits the book isn’t even a gastro-enterologist or a hepatologist. He edits many of the ICON Health Publications’ “Official Patient Sourcebooks,” that address a variety of maladies from appendicitis and gas to peptic ulcers and Whipple disease.

These books all follow a similar formula; this one offers a brief, simplistic paragraph describing hepatitis B: “Hepatitis B is a liver disease. Hepatitis makes your liver swell and stops it from working right. You need a healthy liver….” After the cursory description of the infection, symptoms and trans-mission modes (all of which gets only two pages), it proceeds to provide more than 200 pages of summaries or abstracts (plus their web addresses) from scientific journals that relate to hepatitis B.

Even when the book lists organizations that focus on hepatitis B support, resources and treatment, it leaves out critically important ones, including the Hepatitis B Foundation and the only available on-line adult support group for adults and families infected with hepatitis B, found at www.hblist.org.

While copying and pasting hepatitis B-related abstracts may make for quick copy production, it does little to truly help adults and families touched by hepatitis B. What is needed is a simple, seamless reference tool that can help patients understand how HBV is transmitted, how it is prevented, how and when it should be treated, and how to interpret viral tests, liver function tests and liver biopsies.

In addition to missing some good resources, any “yellow page” directory to the Internet is going to have a limited shelf life. Abstracts come and go; as time passes and new findings emerge, journal editors take these abstract reports of outdated scientific studies off-line. Many of the abstracts listed in this book date back to the early 1990s, an era that can be considered pre-historic when it comes to hepatitis research.

Nothing moves at a faster clip these days than advances in treatment of hepatitis B and C. A report on lamivudine or conven-tional interferon conducted two years ago has little value today as re-searchers navigate a brave and promising new world of pegylated interferons and new antivirals.

In short, this sourcebook delivers a simplistic primer on hepatitis B, and then plunges the reader into highly-technical abstracts, with nothing to bridge the huge gap between “entry level” patients and medical researchers and practitioners. There is nothing to empower or inform patients so they can become savvy healthcare consumers and partners with their doctors in the management of their health. There is nothing to help them understand privacy and civil rights protections afforded them by federal law, or to understand when and how to disclose their HBV infection to others.

Patients are far better off with William Green’s book, The First Year - Hepatitis B: An Essential Guide for the Newly Diagnosed, if they’re looking for an in-depth, easy-to-understand sourcebook to this devastating infection. The HBV Advocate Web site also features fact sheets on HBV detailed by topic. Anyone who can type “hepatitis B” into Google or any other search engine will harvest far more up-to-date and pertinent information than is offered in this lengthy book.

Reviewed April 2004



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Self-Care for Hepatitis C ~ Applied Meditation for a Healthy Liver
Lucinda Porter, RN

I believe that the body and the mind are connected. For instance, if I told you to close your eyes and imagine that you have just bitten into a huge juicy lemon, you might begin to salivate. You may even have puckered a bit. The mere visualization of biting into a lemon causes a physical response. This is an example of the mind-body connection.

In spite of my strong belief in the mind-body connection, I am a skeptic. When given the opportunity to review the CD Self-Care for Hepatitis C ~ Applied Meditation for Hepatitis C, I accepted the assignment with the intent to find flaws. I just was not feeling open-minded the day I popped it into the CD player. However, within a few minutes, I was unable to resist the encouraging words of Robin Roth or the soothing exhortations of Margo Adair.

Self-Care for Hepatitis C is an opportunity to connect the mind and the body. Although the CD focuses on the liver, it is entirely holistic. Adair takes you through three guided meditations that are relaxing and affirming. The accompanying booklet supports the CD by offering self-care tips.

There is a warning on the CD label telling the listener not to listen to the CD while driving. The first time I listened to the CD, I fell asleep. Fortunately, I was in bed rather than behind the wheel of a car. Each time I felt calmer after listening to it. That alone is worth the price of the CD.

Adair and Roth provide a service to patients with liver disease. Anyone who believes in the mind-body connection is likely to appreciate Self-Care for Hepatitis C. Even skeptics might appreciate it.

Self-Care for Hepatitis C ~ Applied Meditation for a Healthy Liver, by Margo Adair and Robin Roth. CD and 32 page booklet $18.95. Order at: www.hepCmeditations.org

Reviewed:  January 2007



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100 Questions and Answers About Liver Transplantation – A Lahey Clinic Guide
Alan Franciscus

One issue that many of us do not want to think about is liver transplantation.  The obvious reason is that we don’t want to face the idea that we may need a liver transplant.

In the vast majority of cases, people living with hepatitis C will never have to deal with a liver transplant since only a minority of people with HCV will develop serious liver disease progression.  However, as the saying goes – knowledge is power and by learning about the process of liver transplantation should alleviate many of our fears.  Part of the problem is that there is very little information out there that is easy to understand and doesn’t scare the heck out of us that can help us learn about liver transplantation.  To help people understand this issue and many other health related issues, the Lahey Clinic has produce a number of books on topics such as hepatitis C, liver transplantation, and liver cancer that are easy to understand and which answer many of the common questions that we all have about a particular disease or procedure.  One such book is 100 Questions & Answers about Liver Transplantation, by Fredric D. Gordon, MD, which provides detailed information about what you can expect before, during and after undergoing a liver transplant.  Importantly, this guide is helpful because it was written for the lay person in a way that is easy to understand and does not ‘talk down’ to people.  It is also important to note that this guide is about any cause of liver disease including, but not limited to, hepatitis caused by alcohol abuse, and viruses. 

The topics are divided into ten parts including: 

  • The Basics:  The liver and the functions of the liver, causes and complications of cirrhosis and when a person would need to a liver transplant.
  • Before Transplantation:  The criteria for receiving a transplant, reviewing different transplant programs (long term survival, patient care before and after the transplant), questions to ask transplant specialists, description of  types of livers used for a transplant, getting help and support, money concerns, the evaluation process, and a brief discussion of the MELD scoring system.
  • Organ Allocation:  What is UNOS (United Network of Organ Sharing)?  More information on the MELD scoring system including an overview of the waiting list procedure, and the usual wait time before receiving a new liver.
  • Preparing for Transplantation:   The various steps needed to prepare for liver transplantation, including information on diets, drugs and herbs to avoid, and being ready to respond to THE call informing a person of an available liver.
  • Surgery:  The actual transplantation procedure, the hospital stay, and any potential complications of surgery. 
  • Recurrent Liver Disease:  Answers to questions about the liver becoming re-infected with hepatitis C, and, when this happens, what the guidelines are for treatment of  HCV in the newly transplanted liver. 
  • Expectations:  Information about what happens after you leave the hospital and what steps to take to ensure the best possible outcome, plus information about everyday life and the likely improvement in health.    
  • Medications:  Details about the many medications that you will need to take both  short and long term with a focus on immunospressive drugs that are needed so that your body doesn’t ‘reject’ the new organ. 
  • Complications:  Descriptions of the possible complications of a liver transplant  including organ rejection, risks for general infections, and the effects of long term use of immunospressive drugs.
  • Living Donor Liver Transplantation:  An overview of the process of receiving a partial live liver transplant. 

Overall this book is a wonderful overview of the entire process and will hopefully help people understand the complex process of liver transplantation and more importantly reduce some of the fear that people have about this issue.      

Reviewed:  August 2008



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100 Questions and Answers About Liver Cancer – A Lahey Clinic Guide
Alan FranciscusAlan Franciscus

Most people living with hepatitis C won’t have to deal with disease progression that could lead to liver cancer.  However, since we don’t know who will and who won’t develop cancer it is of utmost importance that people with chronic HCV receive regular medical care and monitoring.  Another important component of getting the best possible medical care is that people with HCV should take an active role in their healthcare – one which includes learning as much as possible about all of the aspects of hepatitis C and working closely with medical providers.  

A series of books called ‘100 Questions & Answers’ offers detailed information about a wide variety of topics including hepatitis C and the possible complications of HCV disease progression.  One book, 100 Questions & Answers about Liver Cancer, has a wealth of information about liver cancer, is well-written and presented in a way that the average layperson can easily read and comprehend.  The book is broken down into the following sections:

  • The Basics – a brief description of the liver and its functions, and a short summary description of different types of liver cancer
  • Risk Factors – an overview of the incidence of liver cancer, who is at risk, the causes and how these factors cause damage to the liver
  • Screening – the who, what and how of screening for liver cancer
  • Diagnosing and Staging – symptoms and how liver cancer is diagnosed
  • Coping with the Diagnosis – dealing with the emotional and practical aspects of a diagnosis of liver cancer
  • Treatment – what therapies are available to treat liver cancer, the decision makers, treatment of liver tumors, liver resection, liver transplantation, various forms of chemotherapy, and which ones are used and why
  • Cancer-Related Practical Issues – the emotional side of all of the issues that come up with liver cancer, practical information about diet, side effects of treatment, and complications
  • Cirrhosis-Related Practical Issues – common questions that patients may have about treatment-related side effects
  • Social and End-of-Life Issues – as the title suggests information about death and dying issues such as a description of a hospice, advance directives, preparing for death – all issues that everyone should think about, but especially those who face liver cancer. 
  • Glossary – a simple glossary of terms

I would highly recommend that anyone with hepatitis C read this book – learning as much as we can about all the aspects of hepatitis C, including liver cancer, will prepare us for the worst case scenario.  If there is one criticism of this book it would be that the section “Social and End-of-Life Issues” was too short and didn’t provide me with enough information to help me really understand end-of-life issues.  But that could be another book in the series because of the complex emotional issues that people who are facing death must deal with.

100 Questions & Answers About Liver Cancer, by Ghassan K. Abou-Alfa, MD & Ronal DeMatteo, MD. Jones and Bartlett Publishers 978-443-5000.

Reviewed:  February 2009


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Healing Hepatitis
Licinda K. Porter, RN

Healing Hepatitis C: A Patient and a Doctor on the Epidemic's Front Lines Tell You How to Recognize When You Are at Risk, Understand Hepatitis C Tests, Talk to Your Doctor About Hepatitis C, and Advocate for Yourself and Others, by Christopher Kennedy Lawford and Diana Sylvestre, Harper Paperbacks, 2009, paperback, 208 pages, $14.99

There are a number of good books about hepatitis C (HCV). I have read most of them. When I ordered Healing Hepatitis C, I expected it to be much like the others. What I didn’t expect is that I would pick it up and not want to put it down until I finished it. Yes, it was that good.

I am acquainted with one of the authors, Diana Sylvestre. A physician, researcher, and faculty member at the University of California, San Francisco, Sylvestre’s passion is working with disenfranchised patients. Her warmth shines through the pages. The other author, Christopher Kennedy Lawford (yes, of the Kennedy-Lawford family) provides good humored insight from the patient’s perspective. His story is inspirational and honest.

Healing Hepatitis C is different from most of theother HCV books. The format is a dialog between the two authors, but it manages to come across as if the authors are speaking to the reader. Although I enjoyed it immensely, this style may not appeal to everyone. My only criticism of the book is sometimes I wasn’t sure which author was narrating.

Lawford expands the dialog concept when he converses between “Sober Chris” and “Junkie Chris.” I don’t know how other readers will find this, but it worked for me. It illustrates some of the turmoil that we experience over this disease, particularly regarding treatment. I assume that patients who have not wrestled with addiction will still be able to relate to the inner struggles that seem to go with living with HCV.

Lawford and Sylvestre address the core issues and fears associated with HCV treatment that many of us have.  This is the magic of this book. It is real yet it reads like a novel. The book is not highly technical yet it succeeds in getting across a lot of information without boring the reader. The Online Resource section provides tools for the reader wanting to know more about various aspects of HCV.

Healing Hepatitis C offers genuine hope for HCV patients. It can be summarized best in the authors’ own words, “…we hope to walk you through the process of facing the diagnosis and treatment head-on, to show you that it is possible to get through this hepatitis C thing—and to be cured—without surrendering your life to it.” That sounds like inspiration to me.

Reviewed:  July 2009



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