>There's no ability and need to test everyone today, but this is a sign that we should move to more regular screening of higher percentages of the population.
Signs of Hepatitis C, along with most liver diseases, can be caught with the standard liver enzyme tests that's available in pretty much every lab in the developed world.
To be specific, if you see your doctor and it's been more than 6 month since your last visit, then it's standard procedure to take a blood test. Your doctor will take out a pre-printed form that's commonly called "laboratory requisition form" or "assay requisition form", fill out the patient information and tick a few boxes. If they ticked the "ALT" box, then they have ordered the necessary liver enzyme tests. Quoting Wikipedia: "Significantly elevated levels of ALT (SGPT) often suggest the existence of other medical problems such as viral hepatitis, diabetes, congestive heart failure, liver damage, bile duct problems, infectious mononucleosis, or myopathy, so ALT is commonly used as a way of screening for liver problems."[1]
Here's a Kaiser Permanente laboratory requisition form[2] with the ALT checkbox. Here's a Quebec health provider that include ALT in their general profile test #1 through #4 [3].
Testing for Hepatitis C directly is also widely available. Since it's a public health hazard, most state and national governments in the developed world has setup free testing programs. For example, I Googled "california hep c testing" and this page[4] is the third result. They offer _free_ Hepatitis C tests with the results available in 20 minutes.
Forgive a non-bio major, but these tests can generally be segregated into cultured (pcr) / non-cultured, no? And I'm guessing as an enzyme test, this would fall into the later category?
I paid $1300 for a 12 weeks course of generic Harvoni from India. I paid using credit card and it arrived within a week. Normally I'm a law-abiding citizen, but as you said, if it comes down to choosing between violating intellectual property laws and death, it's an easy choice to make.
Considering even a 12 week vacation in India while you undergo treatment is cheaper than the alternative and also legal, the pricing of the US drugs is very... interesting.
There's probably plenty of other countries where you could get treatment for cheap too.
Hardly anyone with a regular job can just decide to take a 12 week vacation. You'd either have to convince your employer to let you take an unpaid medical leave (and you'd need to have enough savings to survive for 3 months), or you'd need to quit your job and hope to find another when you get back (not that easy for those outside the tech industry).
Like many of you, I'm a young and healthy guy. I haven't taken a sick day in years. Since I'm young and healthy, I didn't see the need to take an annual physical exam. Scheduling doctor's appointments is such a hassle. I'm sure many of you feel the same.
So when I was diagnosed with Hepatitis C, it came as a complete shock to me. The shock was due to two reasons:
1. I wasn't involved in any of the "high risk" activities associated with Hepatitis C, which are intravenous drug use and tattoos.
2. I regularly went to the doctor's when I was a child, so there was at least 20 blood tests done back then. None of tests caught the Hepatitis C back then.
Since Hepatitis C is a chronic condition for most people, if I didn't catch mine early, it would have been found much later in life when all of the damaged has been done. I only caught my Hepatitis C because I wanted to an elective cosmetic medical procedure. It was my own vanity, plus pure luck, that caught it.
When I was a child, I was covered under the government's and my parents' health care plans. When I entered college, I was enrolled under the mandatory student health care plan. After I entered the work force, I was covered under my employer's health care plan. All this health care was fully paid for, either through tax dollars, or my parent's contributions, or my own contributions, and I stupidly chose not to utilize it, because I was young and healthy.
If you don't want to end up like me, then please heed my advice: all of you are under-utilizing the medical services that you have already paid for. You should research what kind of screening and preventive care is included in the health care plan that you purchased and then take full advantage of them. It's better for you since you live longer. It's better for your insurance company since screening and preventive care is much cheaper than paying for treatments down the road. It's better for your government since they get to collect more tax dollars over your longer lifespan. And it's better for me since I make a living using the software and services that you guys provide.
I can stick around and do a AMA if you guys have any questions for me.
Did you ever figure out why you got HepC? Did you conclude that you had it from birth, or did you remember that you stepped on a nail while traveling in Vietnam?
Yes, I got it from a blood transfusion when I was a child. The Hepatitis C virus wasn't identified until 1989, and blood bank wasn't wide spread until early 1990s, so anyone who received a blood transfusion before then is at risk.
For those reading, you're not going to believe this but ...
From the 70's to the 80's the medical community thought it was a good idea to mix blood from hundreds of donors and then use in transfusions.
That ended up killing nearly all of the hemophiliacs of that era, plus a good percentage of moms giving birth. Add in Hep C, and hospitals were basically butcher shops.
I followed the AIDS and hemophilia crisis in the press in real-time from the first one-column-inch Kapsoi Sarcoma stories. Boy, it wasn't pretty how the medical community reacted in slow motion.
There's an utterly horrifying Canadian movie about this.
There are quite a few adults today who might not realize or remember receiving blood transfusions as young children. It's worth asking your parents, and when in doubt get tested.
> I only caught my Hepatitis C because I wanted to an elective cosmetic medical procedure. It was my own vanity, plus pure luck, that caught it.
This wording is a little ambiguous because "catch" can mean both diagnoses and the point of infection. So I read that as you were infected by hep c during a cosmetic medical procedure.
Sorry, English isn't my first language. To clarify, I signed up for an elective cosmetic medical procedure. The doctor ordered pretty much every available lab test there is to check for any possible complications. One of the test revealed that I had elevated liver enzymes. A couple of follow-on tests later confirmed Hep C. I never went to through with the original cosmetic procedure because I'm no longer in the mood for it.
I have this genetic disorder called G6PD [0]. It's pretty common, with about 5% of human beings having it. Most people who have it go through life without ever finding out they have it, because it has almost no symptoms.
One of the symptoms though is that eating fava beans can kill you. I basically ate a bunch of these beans and soon went into shock. I was rushed to the hospital but the doctors couldn't make an accurate diagnoses. It was kinda like an episode of House, except with just regular doctors. They knew I had acute hemolysis but didn't know what was causing it. Then a nurse suggested that a blood transfusion can fight the hemolysis even without knowing the root cause; that blood transfusion saved my life. It was much later that the doctors found the G6PD; turns out my great-grandmother had it too.
That's another thing: your doctor should be informed of every major medical issue that your genetically-related family members has, since it could potentially help their diagnoses. From genetic conditions, to even common stuff like high blood pressure and diabetes.
"Don't take medical advice from strangers on the Internet." is an important rule, but "Get a yearly physical." is hardly controversial or high-risk advice, eh what?
The annual physical exam as it is currently understood by most patients and performed by many physicians is actually quite controversial. It has become more of a just-in-case tradition with little evidence for its benefits. The best approach is to consult the U.S. Preventive Services Task Force and follow its screening recommendations: https://www.uspreventiveservicestaskforce.org/
I suspect that unless you are a medical doctor or researcher on the cutting edge reading this you have no idea if you are in a high risk group for a disease.
The field of medicine is advancing so quickly that most people’s “common sense intuition” about what is high risk and what isn’t is likely to be very misleading.
They probably didn't realize they were in the high risk group until the diagnosis since the transfusion was so long ago. Even just talking to a doctor about screening tests can still be helpful since they will likely ask "have you ever received a blood transfusion" if you are asking about Hep C.
The original post was about covered preventative measures. They're not "unnecessary medical procedures", otherwise insurances would get rid of their obligation to pay for them. They don't advertise them a lot, which is the only thing OP did.
Therefore: Check what your insurance (and/or local governance) considers essential preventative care and discuss with a professional which of these make sense for you. Then go and do it: it's important enough that some bean counter wasn't able to remove it from your plan as unnecessary medical procedure and it's already budgeted.
It's not the blood draw, it's false positives resulting in unnecessary expensive and frequently invasive procedures done. A quick Google search for too much screening provides many results on the topic.
So what do they conjecture was the means of contracting it?
Excellent write-up, btw, and thanks for it. Totally agree with use-what's-been-paid-for regarding checkups, as it's a win-win all around, for everyone.
I used to do HCV research in British Columbia. Something that might be useful for you if you haven't yet started treatment is to see if you qualify for a settlement. In BC in particular there was a class action lawsuit the compensated people infected from blood products (between 1986 and 1990) [1]
I got it from a blood transfusion when I was a child.
I got diagnosed back in 2016, and the available treatments back then wasn't great. As an alternative, my doctor signed me up for the clinical trials for the drug now known as Harvoni. I figured that it's a moonshot and didn't pay it any mind. (Having read Stephen King's Firestarter didn't help either.) I also moved to a different city for a job. Months later the drug company called and told me I qualified. The drug trial would have been free and would have cured my hep C, but alas I can't afford to quit my job and fly back to the old city for 3 months. (In hindsight I probably should have.)
Around 2018 when generic Harvoni became available from Indian manufacturers, I got serious about curing my hep C once and for all. I found a doctor that's willing to work with foreign-sourced Harvoni and ordered it online for $1300 (all out of pocket). I started the treatment under my doctor's directions and it went smoothly.
I feel you but let’s not forget that there are simultaneously both “fear doctors” and legitimate sources of anxiety and concern which stem from our present way of life.
Signs of Hepatitis C, along with most liver diseases, can be caught with the standard liver enzyme tests that's available in pretty much every lab in the developed world.
To be specific, if you see your doctor and it's been more than 6 month since your last visit, then it's standard procedure to take a blood test. Your doctor will take out a pre-printed form that's commonly called "laboratory requisition form" or "assay requisition form", fill out the patient information and tick a few boxes. If they ticked the "ALT" box, then they have ordered the necessary liver enzyme tests. Quoting Wikipedia: "Significantly elevated levels of ALT (SGPT) often suggest the existence of other medical problems such as viral hepatitis, diabetes, congestive heart failure, liver damage, bile duct problems, infectious mononucleosis, or myopathy, so ALT is commonly used as a way of screening for liver problems."[1]
Here's a Kaiser Permanente laboratory requisition form[2] with the ALT checkbox. Here's a Quebec health provider that include ALT in their general profile test #1 through #4 [3].
Testing for Hepatitis C directly is also widely available. Since it's a public health hazard, most state and national governments in the developed world has setup free testing programs. For example, I Googled "california hep c testing" and this page[4] is the third result. They offer _free_ Hepatitis C tests with the results available in 20 minutes.
[1] https://en.wikipedia.org/wiki/Alanine_transaminase
[2] http://testinfo.kaiserpermanente.org/info_assets/cpp_ga/pdfs...
[3] https://www.dynacare.ca/DYN/media/DYN/Pdf/Print%20a%20Form/G...
[4] https://www.sfaf.org/services/sexual-health-and-testing/hiv-...