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Archive for February, 2013

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None of us would ever want to be incapacitated to the extent that we could not make decisions affecting our well-being. Unfortunately, for some of us, that day may come.

For most individuals, that time comes later in life, but for others it happens much too early.

What sort of medical situations could cause such a scenario? You could be incapacitated by accident or illness, such a serious head injury, heart attack, stroke, Alzheimer’s disease, meningitis or many other illnesses, diseases, and injuries.

To help in these situations, California has established an Advance Health Care Directive — sometimes referred to as a “living will” — that instructs physicians as to your wishes for medical treatment if you were to be incapacitated and unable to make decisions on your own.

Under California law, this form allows you to name an agent, granting that person power of attorney, to make health care decisions on your behalf should you become incapacitated.

Your agent should be a trusted person, either a family member or a friend, who has your best interests at heart, understands your wishes and will act accordingly. Two alternates may also be named.

The directive must be dated and executed in the presence of, and then signed by, two witnesses or a notary. A witness cannot be your physician, any of his or her employees or any employee of a care facility. At least one of the witnesses cannot be related to you by blood, marriage or adoption and must not be entitled to any part of your estate upon your death.

The most important function of the directive is to permit health care providers to either prolong or not prolong your life and to keep you pain free according to your wishes. You may also state your desire for organ donation, if you so choose.

It is important to make such decisions when you are of healthy mind and body. Don’t put your loved ones in the difficult position of guessing what type of care you would want in an end-of-life event.

All adults need advance directives. Talk to your physician if you have any questions.

You can download a directive form at http://www.sutterhealth.org/health/advance-directive-english.pdf.

 

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Hepatitis C

The national Centers for Disease Control and Prevention is now recommending that all adults born between 1945 and 1965 — the “baby boomer” generation — be tested for hepatitis C, which is the most common blood-borne disease in the U.S.

It’s a serious problem, because the disease attacks the liver and can be life-threatening if not detected early and treated.

About 4,500 people in Santa Cruz County are infected with hepatitis C, as well as more than 2 million Americans, most of them baby boomers. Another 1.5 million Americans have the disease but don’t know it and may unknowingly transmit the virus to others.

Transmission of hepatitis C occurs most frequently through infected blood, whether from working in a laboratory or a dialysis unit, through infected needles used for tattoos or body piercings or by sharing drug needles.

In a few cases, people have been infected with hepatitis C by sharing objects that may have a tiny amount of blood on them, such as a toothbrush, a razor or tools used for manicures.

Hepatitis C can also be spread by sexual intercourse, but only rarely. For steady sexual partners, there are no recommendations about changing sexual practices just because one partner or the other has hepatitis C. But having two or more sex partners does increase one’s chance of getting the virus.

Hepatitis C advances slowly and silently, often taking up to 20 years to show symptoms. The longer the infection goes undetected, the more liver damage it causes.

Hepatitis C is an infection caused by a virus. It attacks the liver, leading to cirrhosis, a condition in which the liver become scarred and functions poorly.

This ultimately leads to liver failure and even liver cancer, and it is one of the most common reasons for liver transplants. More than 200 individuals in Santa Cruz County may need liver transplants because of liver failure resulting from advanced disease.

Baby boomers are more than five times more likely to have hepatitis C than the general population.

This higher incidence is partly due to exposure before implementation of universal precautions and widespread blood screening for hepatitis C.

Many people in this group no longer recall the events that placed them at risk. A significant number of infected individuals contracted the disease decades ago from blood transfusions, medical procedures and tattoos and through intravenous drug use, even if only once.

Other than baby boomers, those with known risk factors should also be screened. The most common risk factors for any age group are intravenous drug abuse, having multiple sex partners and having had a blood transfusion before 1992, the year hepatitis C screening began.

Detecting the virus is very important, because the earlier it is found, the better the chance for a cure. A simple blood test is all that’s necessary. Recently developed treatments have a cure rate of up to 75 percent, which could save 120,000 lives a year.

Those who know they have hepatitis C can protect their livers from further damage by avoiding alcohol and Tylenol (acetaminophen), which can accelerate liver damage.

The bottom line as I see it is that if you are a baby boomer, especially with one or more of the above mentioned risk factors, you really should get the hepatitis C screening test. If you have no known risk factors, you should at least talk with your doctor about this during your next office visit.

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