We all get thirsty from time to time. But it’s not just that feeling that can mean you’re dehydrated – when your body doesn’t have enough fluids. There are lesser known signs you should know to avoid a possibly life-threatening situation, says Awad Alyami, MD, an OSF HealthCare pediatrician.

“You get less perfusion to tissues and organs,” when you’re dehydrated, Dr. Alyami says. “That can cause organ damage.

“Perfusion refers to fluid, nutrients and energy your organs need to function,” he adds.

Unfamiliar signs

Take note of these things to keep an eye on for possible dehydration, especially if you are at high risk. For example, if you work an outdoor job in warm weather or if you look after someone who can’t fully care for themselves.

• You’ve suffered burns. This means there is less skin tissue doing its job of keeping you healthy.
   
• Peeing isn’t normal, such as expelling less urine.

“When you’re hydrated, your urine should look yellow, pale yellow or sometimes almost transparent like water,” Dr. Alyami explains. “When you become dehydrated, your urine will become less in volume, and the color will be darker. It goes into an orange color. It can have a smell, also.”

• Crying without tears
   
• Skin changes, such as eyes appearing sunken in
   
• Fast heart rate
   
• Deep, heavy breaths

“When you’re dehydrated, your blood can be more acidic. You’ll try to get rid of some of that acid in your breaths,” Dr. Alyami says.

• Bad breath
   
• Headaches
   
• Muscle cramps
   
• Food cravings
   
• Sudden weight loss. Dr. Alyami says one kilogram (or around 2.2 pounds) of weight loss means one liter of fluid loss. So if someone has lost two to four pounds quickly and unintentionally (for example, not because of a diet and exercise program), it’s cause for concern.

What to do

Dr. Alyami says while dehydration can be serious, recovering doesn’t have to be. Rest and drink fluids. Water or Pedialyte are go-tos.

“If the dehydration is because of decreased oral intake, the person might just need pain medicine so it’s less painful to swallow while eating and drinking. If they are losing fluids from vomiting, we can give them medicine to stop vomiting,” Dr. Alyami says.

If those steps don’t work, Dr. Alyami says the person would likely get intravenous (IV) fluids in a hospital emergency department.

“You’re probably going to be there for at least a couple hours. [Health care providers] want to make sure you can take fluids and keep them down before you go home,” Dr. Alyami says. “Sometimes the dehydration is severe enough that we need to replace those fluids over one to two days.”

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When watching a basketball game on television, you may hear coaches and announcers say the star player is missing time with a hernia.

A sports hernia is different than a hernia suffered in everyday life, says Raman Kumar, MD, a colorectal surgeon and general surgeon at OSF HealthCare. But each should be taken seriously.

Hernia

Dr. Kumar says a hernia is when an internal organ or piece of fat goes through a hole in the abdominal wall. The most common type – around 80%  – is an inguinal hernia, when a part of the intestine pushes through the abdominal wall in the lower belly (also called the groin). Anyone can get a hernia, even newborns. But Dr. Kumar says they are seen more in older men. Symptoms include a bulge or swelling in the abdominal area and pain when moving.

“A lot of chronic heavy lifting,” can cause hernias, Dr. Kumar says. “Other things weaken the abdominal wall such as diabetes and smoking. Being obese causes a lot of weight hanging down on the abdominal wall. If you’ve had surgery in the past, that’s also a risk factor.”

So be mindful when lifting objects, Dr. Kumar advises. Lift with your knees, not your back, and don’t try to lift heavy items. Get a cart or a partner to help. Eat healthy and exercise to avoid obesity and diabetes. Avoid alcohol and cigarettes.

Dr. Kumar says an exterior wrap known as a hernia belt or abdominal binder can be a short-term solution. But surgery is often the endgame.

“If you have a hole or defect, it needs to be closed,” Dr. Kumar says. “The reason we fix hernias is because we don’t want a loop of intestine or bowel to get into the hernia, twist off and die.”

That would make a person very sick and possibly threaten their life, Dr. Kumar says.

Sports hernia

Dr. Kumar says a sports hernia is a muscle tear in the groin area. They’re seen in athletes due to all the twisting, turning and bending that comes with competition.

“Stretch before you do any type of activity. Work and develop your core muscles, including your abdominal and hip muscles.” Dr. Kumar says. “If the muscles are strong, they are less likely to tear.”

Athletes who complain of groin pain should immediately leave the competition and get checked out by a trainer or doctor. Resting and icing the groin will help, but a combination of medication, physical therapy or surgery will likely be needed to fully heal.

Be proactive

If you have symptoms of a hernia or sports hernia, see a health care provider right away.

“Nine times out of 10, we can determine you have a hernia just based on a physical exam,” Dr. Kumar says.

But for more complicated cases, your doctor may order an ultrasound or CT scan. Then, the provider will develop a treatment plan.

Interview clips

Previous coverage

Hernias: More common than you think

Pneumonia.

It’s a hard enough word to spell, let alone remember how to prevent and treat it. With respiratory illness season here, it’s time for a reminder about how to avoid this possibly deadly condition.

The basics

Fred Burke, MD, an emergency medicine physician who treats people at OSF HealthCare, says pneumonia is a lung infection caused by a virus or bacteria.

“The most common bacteria that causes it is strep pneumonia [in medical terms, streptococcus pneumoniae or pneumococcus]. The viruses that cause it are things like RSV [respiratory syncytial virus], flu [influenza] and COVID-19 [coronavirus],” Dr. Burke says.

In other words, you could get the flu, and it could progress to pneumonia. The phrase double pneumonia means it’s impacting both lungs. Dr. Burke says people with pneumonia could experience coughing, fever, chills and weakness.

“It can cause a consolidation in the lungs. That interferes with air movement,” Dr. Burke says. “You can also get fluid buildup and scarring in the lungs.” Consolidation refers to inflamed cells that form a mass.

Diagnosis and treatment

Dr. Burke says when someone comes to the emergency department with pneumonia symptoms, a health care provider could do a chest X-ray or CAT scan to confirm the diagnosis.

“If we find it’s from a viral infection, people have to ride it out. There’s no treatment for [the ailment itself]. But we can treat the symptoms. We can give Tylenol for fever or an inhaler for shortness of breath or wheezing,” Dr. Burke explains. “If it’s from a bacterial infection, we give antibiotic medication.”

The person could take antibiotics by mouth for one to two weeks. Or, if they are having trouble breathing, the medicine would be given through intravenous (IV) therapy. Either way, the goal is to stop the bacteria in the lungs from growing.

Another tactic is a bronchoscope, where a pulmonologist inserts a tube down your throat to break up mucus in your airways.

But Dr. Burke cautions: don’t let the guidance of some “ride it out” fool you. Pneumonia is a common cause of hospitalization and death worldwide.

“One complication is sepsis, when the infection spreads to the blood. That can cause organ failure,” Dr. Burke warns. “Pneumonia can also cause respiratory failure [when the lungs aren’t working properly]. Those people might require additional oxygen. Or if it serious enough, they might require intubation [a breathing tube down the throat] or be placed on life support.”



Is it contagious?

Yes, pneumonia can spread from person to person, Dr. Burke says. It’s often transmitted through respiratory droplets (coughing or sneezing on someone), but it can spread on surfaces as well. A child could touch a dirty doorknob then put their hands in their mouth, for example.

That’s why everyday hygiene is important. Wash your hands with soap and warm water thoroughly and often. Cough or sneeze into your elbow or a tissue. Stay home and away from others if you’re sick. These are especially important for people at higher risk for pneumonia: people with a history of strokes or seizures, people suffering from substance abuse, people with a compromised immune system (those with HIV or a transplanted organ, for example), smokers and people with chronic obstructive pulmonary disease (COPD).

The United States Centers for Disease Control and Prevention also outlines the guidelines for the pneumococcal vaccine. Talk to your primary care provider if you have questions about the shot.

“The vaccine comes from evidence-based medicine. Experts have done studies. It’s shown to be very effective in decreasing the severity of pneumonia,” Dr. Burke explains. “I would recommend people take the vaccine.”

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We’re talking about sniffing products like paint, markers or nail polish for a temporary high. You might hear it called huffing, chroming or, in the medical community, inhalant abuse.

Health care providers like Justin Rapoff, DO, an emergency medicine physician who sees patients at OSF HealthCare, are again reminding parents about the serious health impacts of this activity and what to do if your child shows symptoms. It’s especially important for kids to steer clear, he says, because their organs are still developing. An interruption to that development could mean trouble. Young people can also be more susceptible to peer pressure, giving in when other kids tell them to try something.

“Inhalant abuse is common because these are things that are easily found in your house," Dr. Rapoff adds. “They’re underneath your kitchen sink and in your garage and bathroom. These are cheap and easy to find for kids.”

The consequences

There are short and long-term effects of inhalant abuse, Dr. Rapoff says. Among the short-term issues is the general haze the activity will put you in. If you have to, for example, drive a vehicle while under the influence, you could crash or face legal consequences. If you’re intoxicated at work or school, your performance will decline.

“You can have cognitive difficulties and even dementia [later in life],” Dr. Rapoff adds of the long-term impacts. “You can have bone marrow suppression and anemia. You can have abnormal coordination.”

Cardiac arrest, when the heart stops beating suddenly, is also possible.

What parents can do

If your child shows signs of intoxication – slurred speech, nausea, confusion and a lack of balance are big ones – call 
9-1-1 and get them to the emergency department.

“Inhalants hit similar receptors to those hit by alcohol. It causes a similar intoxication, which lasts around two to 30 minutes,” Dr. Rapoff says.

That means you should get the child checked out even if they say they feel better. Dr. Rapoff says providers will likely test the person’s blood, urine and heart. There’s no bonafide treatment for inhalant abuse, Dr. Rapoff says. Rather, providers will treat the symptoms. For example, if the child feels nauseous or is vomiting, providers may give an anti-nausea medication.

What about avoiding an unpleasant trip to the hospital in the first place? Dr. Rapoff encourages parents to talk with their kids about the risks of huffing and, generally, any emotional issues they are dealing with. The young ones may be turning to inhalants to cope. In fact, Dr. Rapoff says studies have shown that when young people abuse inhalants, they are more likely to use heroin or even commit suicide later in life.

Parents should also pay attention to kids’ behavior, especially if they make unexplained purchases of things like hairspray or whipped cream canisters. Keep items that could be misused out of reach. Put things like markers and cosmetics out only when it’s time to use them. Keep things like spray paint and gasoline canisters locked up in the garage.

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Author's note: This is part two of a four part story on infant nutrition misconceptions. Read part one here, part three here and part four here.



Bringing a new baby home raises the focus on their and mom’s well-being. Toward the top of the list: what and how the child is being fed.

Whether you choose to breastfeed or use formula, misconceptions about infant nutrition are everywhere. Xandra Anderson, a certified lactation consultant at OSF HealthCare, cuts through the noise.

• Do I need to change what I put in my body while breastfeeding?
  
  This covers a lot of ground, from a mom’s diet to whether she should abstain from alcohol, caffeine, tobacco and medication.

o    Diet: Healthy eating is always good. But Anderson says new moms generally don’t have to change their diet for breastfeeding. If your diet is heavy on certain things (like garlic or dairy) and you notice your baby is extra fussy, you can try changing your meals. A provider may also want to test your baby for allergies.

o    Alcohol and caffeine: Drink these in moderation and with precise timing, Anderson says.

“Babies are very sensitive to caffeine. If you have a cup of coffee and nurse right away, the baby is going to be awake for a lot longer than normal,” Anderson says.

“That doesn’t mean you have to not drink coffee. Just maybe not add three shots of espresso to your morning coffee,” she adds with a smirk.

For alcohol, Anderson says the drink will filter out of your breastmilk like it filters out of your blood. So after having a couple of alcoholic drinks, wait two to three hours before breastfeeding or pumping.

“The breastmilk isn’t ruined. You just need to give it time,” Anderson says.

But here’s a lifehack if mom feels full of breast milk and wants to pump right after having a drink: Go ahead and pump, and use the milk on your baby’s acne or in their bathwater. Just keep it away from their mouth.

“It’s antimicrobial. It’s antibacterial. It’s moisturizing,” Anderson says, singing the praises of breast milk. “Our babies are in the most perfect environment in the womb. Once they’re born, their world is cold, dark and dry. They can get dry skin, acne or cradle cap [greasy or flaky spots on the scalp]. Breast milk is a great way to prevent or heal those things.”

o    Medication and other health care issues: Anderson says most medication is safe to use while breastfeeding. In fact, it’s important to stay the course – for example, with mental health medication – so you can be the best mom possible. Talk with your health care provider if you have questions.

If you have a medical procedure, also get advice from a professional. For example, Anderson says if you get a hepatobiliary iminodiacetic acid (HIDA) scan for a gallbladder concern, you’ll be radioactive for around 24 hours. Don’t breastfeed during that time. Or if your breasts feel full and you have to pump, dump the milk down the drain.

o    Tobacco: Anderson admits it’s tough to kick the habit. But she reminds moms: infants are very sensitive to nicotine. It can disrupt the child’s sleep and feeding and even interfere with organ development. Secondhand smoke can increase the risk of a respiratory infection and sudden infant death syndrome (SIDS).

If you’re smoking with a new baby at home, do so after breastfeeding, then wait two to three hours before nursing again. Wear one jacket while smoking so you don’t get an odor or residue on a lot of your clothes or the baby.

Learn more

Read more about how to have a successful pregnancy and following years on the OSF HealthCare website.

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He was at a Champaign, Illinois, hospital where his five-year-old daughter Gabby was fighting for her life with what was later confirmed to be Rocky Mountain spotted fever as the result of a tick bite.

Gabby died of sepsis, a condition where your body responds improperly to an infection, three days later. The heartbreak led Tony and his family to become intimately familiar with sepsis. They’re now advocates for sepsis awareness, both ensuring health care providers are following best practices and patients are speaking up.

“I remember slamming every object around me,” in the days following Gabby’s death, Tony Galbo recalls. “I said ‘there’s gotta be a law to protect patients, especially children.’,”

Sepsis and septic shock

Many of the things the Galbo family advocates for to this day are already in place at OSF HealthCare.

Kurt Bloomstrand, MD, is chair of emergency services at OSF HealthCare Heart of Mary Medical Center in Urbana, Illinois. He says aside from following established, rigid protocol, OSF Heart of Mary is going the extra mile for sepsis prevention in a couple of ways. One, the hospital is leading the OSF Ministry in continuing sepsis screening and alerts for people after they are admitted (not just in the emergency department). And two, the facility is among the top 10% of hospitals in the country in following sepsis protocol as measured by the United States Centers for Medicare and Medicaid Services (CMS). Those CMS core measures include giving antibiotics and fluids and rechecking a person’s vital signs in a timely manner.

“We’re trying to identify a set of signs called the systemic inflammatory response syndrome, or SIRS,” Dr. Bloomstrand says. “Those include a fever, a fast heart rate, fast breathing and elevated or low white blood cell count. If someone has any two of those with a source of infection, we consider them possibly septic. We want to establish treatment for them very quickly.”

Treatment includes antibiotic medication or intravenous fluids along with continued testing to pinpoint the problem.

“We take this extremely seriously because we know time is tissue. The sooner we get the treatment, the better the outcome.” Dr. Bloomstrand adds. “Any person who comes into one of our emergency departments, no matter the cause, will be screened for sepsis right from the start. When we get your vital signs, that’s screening for sepsis. If you flag positive, there are alerts that go out to our staff. Then it walks us through a very specific sepsis algorithm for treatment.”

What you can do

Dr. Bloomstrand says young kids, older adults and people with serious health conditions like heart disease and diabetes are at a higher risk for sepsis. Your best bet to prevent sepsis is to practice healthy habits and prevent infection in the first place.

• Wash your hands frequently, especially after touching high-germ areas in public like a doorknob.
   
• Avoid touching your face.
   
• Sneeze and cough into your elbow or a tissue.
   
• Stay home when you’re sick.
   
• Treat wounds and bug bites properly, quickly and under guidance from a health care provider. Dr. Bloomstrand notes that pets can also harbor ticks that can cause serious illness.

Dr. Bloomstrand adds that hospital staff are empowered to speak up if they spot a possible sepsis case. But you can also speak up on behalf of yourself or a loved one about what sepsis surveillance is being done.

“It’s appropriate to make sure you are asking these questions just to make sure you’re keeping it at the front of the care provider’s mind,” Dr. Bloomstrand says.

“If we don’t catch sepsis soon enough, it can result in organ dysfunction,” he adds. “There may be long-term complications with their kidneys, such as needing dialysis. If their lungs fail, there may be long-term respiratory issues. There may be brain issues, so they have mental status changes long-term.”

Gabby’s Law

On August 18, 2016, then-Illinois Governor Bruce Rauner came to Presence Covenant Medical Center (now OSF Heart of Mary) to sign Gabby’s Law.

“Senate Bill 2403 requires hospitals to adopt evidence-based protocols for the early recognition and treatment of patients with sepsis, severe sepsis or septic shock that are based on generally accepted standards of care,” the Governor’s office said at the time. “It requires the protocols contain certain components, including those specific to identifying and treating adults and children.”

Tony Galbo recalls many meetings with lawmakers, health care groups and other stakeholders to get the plan the support it needed. And that wasn’t the end. He’s testified before lawmakers in other states and in Washington, D.C., and done countless interviews.

“Sepsis does not discriminate. It does not care about age,” Galbo says.

Interview clips - Tony Galbo

Interview clips - Dr. Kurt Bloomstrand

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There’s renewed optimism for people with fatty liver disease, sometimes called NASH (non-alcoholic steatohepatitis) or MASH (metabolic associated steatohepatitis). The United States Food and Drug Administration recently approved the first medication, Rezdiffra, that can directly address liver damage as the person makes lifestyle changes.

“This is a gamechanger for anyone who has fatty liver disease with moderate to severe liver scarring,” says Marcie Lindstrom, APRN, a gastroenterology provider at OSF HealthCare. “This can reduce the number of complications that can develop with worsening scarring.”

Fatty liver basics

The liver is an important organ. Experts even call it a miniature factory inside us. The liver detoxifies medication; releases glucose to give you energy; aids digestion and makes cholesterol, proteins and amino acids.

Obesity, diabetes, high cholesterol and excessive alcohol use can lead to fatty liver disease, which Lindstrom says impacts around one in four people worldwide. Left untreated, scarring from fatty liver disease can progress to cirrhosis, or severe scarring. Complications from cirrhosis can include enlarged blood vessels in the esophagus which can lead to life-threatening bleeding, fluid overload called ascites, liver cancer and liver failure necessitating a transplant.

How we got here, where we’re going

Lindstrom says before Rezdiffra, people with fatty liver disease could only make those lifestyle changes to try to get better: control your blood sugar, cholesterol and weight.

“Strictly on the shoulders of the individual,” Lindstrom reiterates.

“We know that people who lose 5 to 10% of their body weight are able to make improvement with fatty liver disease. It is considered a reversible condition,” she adds.

Now, Rezdiffra is an option for people with moderate to advanced scarring.

“It works on thyroid-B receptors in the liver. We normally think of thyroid receptors in our thyroid gland [in our throat], but we do have thyroid beta receptors elsewhere. A lot of them are in the liver,” Lindstrom explains. “The medication works to release triglycerides from the liver. It improves and may even resolve fatty liver.”

It’s a once-a-day pill, Lindstrom says, and there’s no “one size fits all” for how long you need to be on it. Side effects include nausea and diarrhea, but Lindstrom says studies have shown those get better after three weeks. She also says women who are pregnant, are about to become pregnant or are breastfeeding should not take Rezdiffra. There hasn’t been enough study of the drug to see how it impacts those groups.

The bottom line: you can talk to your health care provider to see if Rezdiffra is right for you. Be sure to mention what other medicines you are taking so your provider can see how Rezdiffra might interact.

“If somebody is taking a statin for cholesterol levels,” for example, Lindstrom says. “It’s not that we want them to go off their statin. There are certain limitations to the dosage.”

Learn more

Learn more about how to avoid fatty liver disease and other gastroenterology care tips on the OSF HealthCare website.

Interview clips

Quintin Porter is a walking miracle.

He’s battled back from multiple car accidents, cancer, an irregular heartbeat, a torn rotator cuff, carpal tunnel syndrome and more.

But the journey that brings tears to his eyes started with a random text message from an old flame and ended with him ditching his dialysis equipment for a new kidney. And along the way he learned about the technique that made it possible - paired exchange.

“It was kidney or coffin,” says the 56-year-old from Mahomet, Illinois.

Porter’s journey

A former stand-up comedian and radio executive, Porter has no problem recalling what got him to where he is today.

Toward the end of 2019, Porter says his health was “dragging.” His right arm hurt, and he knew something just wasn’t right.

“Your bloodwork is horrible,” Porter recalls his medical team telling him. “You’re at stage three of kidney disease.”

The father of two then went on dialysis, where an artificial filter does what healthy kidneys normally do – remove fluid and waste from your blood.

“You’re tethered to a machine,” Porter describes. “I wouldn’t wish it on my worst enemy.”

Dialysis gave Porter plenty of time to take up new hobbies like bird watching or sketching. Or watching the phone ding with the most important text message he would ever get.

Christy reconnects

The text on March 16, 2022, read, “Can you talk?”

It was from someone Porter hadn’t spoken to in nearly four decades: his high school girlfriend in Glen Ellyn, Illinois, Christy Stott. The 54-year-old retiree from Rockford, Illinois, wanted to catch up. But more importantly, she had seen Porter’s calls for a life-saving kidney.

“I got you. I’ll give you a kidney,” Porter remembers Stott telling him almost nonchalantly.

“I couldn’t believe it,” Porter adds. “It set off a whole bunch of emotions.”

“Sometimes people reach middle age and feel compelled to do something they’ve never done before,” Stott says. “Run a marathon. Write a novel. Something amazing and unexpected.

“I think that’s what this experience has been for me,” she says.

Porter and Stott seemed to be a perfect match if not for one problem: Stott is petite, and Porter is not. A honeybee and a bear, as Porter puts it.

But OSF HealthCare Mission Partners (employees) in Peoria, Illinois, knew another way.

Paired exchange

The nationwide paired exchange program involves a kidney donor and a recipient who aren’t compatible. When you add another incompatible pair, sometimes a match can be made. The donor from one set can donate to the recipient of the other pair, and vice versa. The swap makes a big X. The willingness of everyone to participate allows the process to get a jumpstart and makes optimal use of living donors. It can also significantly reduce wait time, which can stretch into years.

"This one was unusual,” says Dr. Christopher Johnson, a nephrologist with RenalCare Associates and medical director for OSF Kidney Transplant.

“Usually with kidneys, the size isn't the biggest thing. But in this situation, it was such a big difference that we thought we could get a better match for him. Her kidney was perfect for someone her size. It's going to take someone off dialysis and extend their life," Dr. Johnson says. "She's also blood type O. She's a universal donor. But the kidney was smaller than what would be ideal to the recipient. So we knew if we put this into a national exchange, we're going to benefit someone else.

"A lot of times people ask, ‘what's the blood type?’ And they want to know if they're blood type compatible,” Dr. Johnson adds. “I say this every time. I don't care what your blood type is. If you're not compatible, we'll find a trade. What's important about a kidney donor is that they're healthy and able to donate. No diabetes, healthy weight, no cancer or other problems. If there's an incompatibility, we can find a solution."

A research-minded guy, Porter looked into the paired exchange concept thoroughly before taking the leap.

“These nurses work so hard to give you such good, specific instruction that has derived from thousands of hours of treating actual patients,” he says.

So on October 4, 2022, Porter and Stott went to OSF HealthCare Saint Francis Medical Center in Peoria. She to give a kidney, which wound up in the Cleveland, Ohio, area. And he to get one, coming from Eris Diaz, who owns his own cooking business nearly 1,300 miles away in Miami, Florida. But when it comes to saving lives, no distance is too far.

“Of course, there is pain,” with transplant surgery and recovery, Diaz, now 25, says. “But the pain was for a good action and for Quintin’s happiness."

Lessons learned

Porter, Stott and Diaz are doing well in 2023 and are urging others to look into organ donation, either living or pledging to do so after you have passed away.

“I’m so happy for Quintin,” Stott says tearfully. “And I’m fine. I’m better for it. If I could donate again, I would.”

"Donation is important because you're sharing your life with people who need it, and that is beautiful," Diaz says.

“It’s a big sacrifice. But if you had the ability to save someone’s life, wouldn’t you?” Porter asks.

Learn more

Nearly 100,000 people in the United States are waiting for a kidney transplant. Learn more about how you can make a difference on the OSF HealthCare and Donate Life America websites.

Interview clips - Quintin Porter

Interview clips - Christy Stott

Interview clips - Eris Diaz

Interview clips - Dr. Christopher Johnson

B-roll

Additional B-roll

Quintin Porter demonstrates connecting to dialysis machine - June 4, 2022
Quintin Porter demonstrates disconnecting from dialysis machine - October 3, 2022

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Living organ donation saved my mom's life
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‘They are very special people’

As many as 2 billion people worldwide will be exposed to hepatitis B during their lifetime, says David Rzepczynski, MD, a gastroenterologist at OSF HealthCare in Urbana, Illinois. Around 250 million people have chronic inflammation of the liver from hepatitis B or are carriers of the virus without inflammation. And around 890,000 people will die from hepatitis B. Asia and Africa are hepatitis B hotspots, Dr. Rzepczynski says, while the United States doesn’t have it as bad.

The statistics might make eyeballs widen, but Dr. Rzepczynski says they are not a reason to panic.

“The majority of people who get exposed to hepatitis B in the adult age – after age 10 – it’s typically a condition you recover from without chronic inflammation,” he says.

The reason for the optimism? There’s a vaccine for hepatitis B that’s been around since the 1980s.

“There has been an aggressive program of initiating vaccines with kids, sometimes even as young as infants, to have protection,” Dr. Rzepczynski says. “And when those [vaccines] are administered at a young age, it’s a highly effective vaccination. This vaccination has an efficacy of 95%-plus in the general population.”

The three-shot series is sometimes given soon after birth due to concerns that the mother may pass along hepatitis B to their child. But older children and adults can and should get the vaccine, too.

A hepatitis B immune globulin shot (HBIG for short) may also be appropriate in cases of hepatitis B exposure, either in adults or newborns. The particles in the shot attack the virus.

The next best way to avoid hepatitis B is to avoid risky behaviors.

Don’t share needles, toothbrushes or any other object that can transfer bodily fluids. Practice safe sexual relations. And if you’re bleeding, bandage it up right away.

Treatment

Dr. Rzepczynski says blood tests and watching symptoms can gauge how the virus is behaving. That will determine whether the person just needs monitoring. Or the patient may need medical treatment to suppress the virus and prevent cirrhosis of the liver. These medicines are taken by mouth, and side effects are generally not significant. A vaccine to eliminate hepatitis B hasn’t been discovered yet.

Treatment plans for hepatitis B may be life-long.

“If you stop taking the medicine, it’s like taking the brakes off the system,” Dr. Rzepczynski explains. “The virus will end up reactivating. And in fact, that reactivation might cause liver failure because the virus level skyrockets. And your body’s immune system senses that and starts attacking the liver to get rid of the virus. And that can lead to very serious and acute inflammation of the liver.”

Should I test?

Dr. Rzepczynski says a blood test for hepatitis B isn’t something that constantly needs to be on the mind of the average person. But the following people should consider getting tested:

·       People who come from areas of the world with a high prevalence of hepatitis B

·       Pregnant women

·       If you plan to donate blood or organs

·       People who’ve had an exposure to the virus

·       People getting chemotherapy for cancer treatment

That last one is something medical professionals have looked closely at in the last five years.

“Unfortunately, some of these powerful cancer agents also have the ability to affect the immune system in such a way that a person who’s had hepatitis B and maybe even has gotten over it can have a reactivation of hepatitis B when these particular agents are used,” Dr. Rzepczynski says.

In that case, your cancer doctor would alter the treatment to allow it to proceed without the hepatitis B risk.

Be proactive

If you have questions about hepatitis B, want to get the vaccine or think you may have been exposed to the virus, talk to your primary care provider right away. The OSF HealthCare and U.S. Centers for Disease Control and Prevention websites also have information on hepatitis.

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