It was a late winter day when I returned from the mailbox and absent-mindedly opened the envelope from the local blood bank; I assumed it was just a thank you note for my donation during their Christmas drive. I unfolded the letter and read that my blood had been rejected because they found Hepatitis C (hep c treatment cost) in it. I paused and my cheeks flushed; the letter suggested that I see my doctor for further testing. When I walked through the door, my wife Josie saw the angst on my face. “What’s wrong?” she asked. I handed her the letter and sat down on the sofa to think about what I had just been told. I got depressed immediately. I did not know what to do and who to turn to. When you have hepatitis C and you don’t know how and where, you just go limp. It was one of the most depressing times of my life.
I put off seeing the doctor for months (there was no generic harvoni at the time, sofosbuvir was not invented yet). After all, I felt fine, my weight was down, I had piles of energy and had been described by a co-worker as being ‘healthy as a horse’; I didn’t need a doctor. But Josie’s career as a nurse prevailed and an appointment was made. My doctor ran both the EIA (enzyme immunoassay) and the RIBA (to confirm the positive EIA) blood tests and then, referred me to a specialist. In the mean time, I began to research Hepatitis C through the Internet and our public library, trying to understand the seriousness of my newfound affliction. I soon discovered that it was almost as new to the medical community as it was to me…
With my wife’s prodding, another appointment was scheduled to see a Gastroenterologist, not far from my fiftieth birthday and just two days after my wife’s unexpected death, her heart beating its last while she slept. She was only 48, she wasn’t ill and there were no signs of heart problems. It was just ‘one of those things’. It was later discovered that she had an enlarged heart valve that hadn’t been noticed before. I began to question my own mortality… now, more than ever.
Josie’s death left me devastated, confused and overwhelmed and I entered the waiting room that morning in a state of shock. While trying to anticipate what lie ahead and understand what was behind, my security had departed with my wife and I still had only a limited idea of what Hepatitis C was. I recalled a friend, from years ago, with Hepatitis A. He turned yellow, got sick, was hospitalized for a few days and returned home ‘good as new’, but mine wasn’t the same. I wasn’t yellow, I didn’t feel sick and ‘good as new’ was a cliché I didn’t think I was going to be using anytime soon.
The doctor entered the examining room with a thick folder in his hand. He was a tall, thin and soft-spoken man with compassionate eyes, wearing a Yarmulke. I think he sensed my grief and anxiety, and tempered his words; even then, the news that he gave me was probably better than I perceived it at the time. I listened to him talk with clinical precision of the complications from chronic Hepatitis C, including cirrhosis, cancer and a possibility of the eventual need for a liver transplant. He wanted a liver biopsy, where a small piece of liver is removed and examined, to determine the extent of damage.
My heart sank deep in my chest and my mind swam in a quagmire of unpleasant thoughts as he explained the battery of tests I’d be undergoing; an HCV RNA, PCR Qualitative test to determine the presence of Hepatitis C in the blood and a Quantitative test to detect the amount of virus particles, or viral load, in a specific blood sample. Then, there would be the ‘liver function test’ to measure the ALT and AST enzymes found in the liver that ‘leak’ out and into general circulation when liver cells are injured – high enzyme levels can indicate liver damage. All of these would be used to ascertain the need for treatment and to help him create an aggressive plan. He encouraged me to believe that I could live a normal, productive and long life, but I had my doubts… ‘Normal is already gone,’ I thought.
On my way home that day, the road was blurred through the tears as I considered two funerals; my dear Josie’s and, I reasoned, my own. While I pondered that, I also wondered who would take care of my two teenage sons when I died. I felt weak and helpless, but would soon discover that I was much stronger than I thought and that Hepatitis C treatment, and the treatment of it, was going to test every ounce of that strength…
I was surprised at the fear that welled-up inside me at the idea of a biopsy, especially since, years ago; I had endured 6 months in a hospital and over a dozen surgeries. But, my children once more came to mind and I fretted over the risk of, what I envisioned at the time, as more surgery. I hid my concerns from my sons, though my sister heard the desperation in my e-mails and flew from Guam to be at my side. My brother, a respected local doctor, also came to my rescue with assurances of a ‘simple’ medical procedure. With family beside me, I soon discovered an inner-strength. Through their support I began to believe that I could survive this challenge, get on with my life and, most importantly, that my sons could get on with theirs.