What to do when you are diagnosed with hepatitis B

If you have been diagnosed with hepatitis B, close follow with your specialist (usually a gastroenterologist) is crucial. Your doctor would advice if you should begin medication for your condition (do note medication is usually long term and very expensive) or try to first control via lifestyle changes.

In this article, I would address the lifestyle changes you can take based on observation of those with the condition and caring for my mom with that condition.

Including my mom, there are 3 persons within my close circle who have chronic hepatitis B. Only my mom is on medication (entecavir) while the other two are managing their symptoms without medication. All three have suffer flare up at once or few times of their lives when their hepatitis B turned acute.

Let me share with you my mom’s story

Many people actually find out they got hepatitis B when they developed acute symptoms such as jaundice and ascitis (swelling of the abdomen and ankles). Usually you would be hospitalized when you have acute hepatitis. My mom had to be hospitalized because she had developed jaundice, had refused to eat and insisted to sleep all day without wanting to consume fluid or food. Prior to that, she has been diagnosed with chronic hepatitis B for a few years.

She could have gotten that condition because she had radiotherapy on her throat due to tonsil cancer which wiped out her saliva production, affected her swallowing function and caused her to lose all the teeth. That greatly limit the amount of food she could eat as she had problem swallowing. Hepatitis B, in TCM medicine is often linked to long periods of nutritional deficiency.

In the hospital, they put her on a drip  and give her laxatives to flush out the toxins from her body. Her blood and other vitals were also checked frequently. After a few days, due to her dementia she was acting up in the hospital, refusing to be tested and the doctors agreed to discharge her.

Most people (including me) thought mom was dying

Outwardly, she was all yellow with jaundice, had swelling on her ankles and abdomen. She also was weak and tired all the time. Concerned neighbors and her friends came to visit. Because mom was a nurse, most of her friends are also former nurses and have met patients with such condition. They told me upfront that the situation did not look very good and it seemed she did not have long to live. They wanted to come and see her for ‘the last time’. I was receiving calls and frequent visitors as my mom is well loved by many people.

She looked so bad as if near death’s door that very concerned people sat me down to ask me to ask my mom so that we ensure her last wishes are being respected. Few asked me to consult with my mom about her preference for funeral arrangement while she is still conscious (ie did she prefer to be cremated or buried? Buddhist or Taoist funeral? Any particular clothing she like to wear or photo she liked?)

I am NOT kidding. My grandaunt, who passed away 30 years prior, actually dictated to my mom the arrangements she preferred. Grandaunt (who lived past 90 years old) also had her the set of clothing for her own funeral made  20 years prior to her passing. Hence this was not a taboo for me.

During that period, I was feeling very sad and down. I felt a lot of grief. When mom started telling me about seeing dead relatives, my colleague told me it was a bad bad sign. I made the decision to resign from my job to care for her.

I wanted to share with you this story so that you do not lose hope even if the situation looked bad. It ain’t over till it is over.  It has been 3 years and yes, many are surprised (not in a bad way) that my mom is still alive.

Here are the lifestyle measures I have taken as well as observation of those with controlled hepatitis B

1. Dietary changes

When you are diagnosed with hepatitis B, it is VERY VERY IMPORTANT that you take overhaul your diet.  It is an important key for you to get well. You really need to watch what you eat.

Likely it is bad dietary choices (fatty food, unhealthy food, too much processed food, infrequent meals, high alcohol consumption) that landed you in this mess so if you want to get better, you need to change your diet. You need to heal your digestive system so that your liver is no longer taxed so much.

  • Rice porridge and noodle soup– it is very therapeutic for the digestive system.  If possible, take it for every meal. I had a lady come in to care for my mom and she cook rice porridge and noddle soup for my mom for each meal. Within about a month, I started to see improvement in her condition and energy levels
  • Drink a cup of warm water first thing in the morning
  • STAY AWAY FROM COLD/ ICED DRINKS– it will wreck your digestive system
  • Stay away from oily food, seafood (crabs, prawns, squids, oysters, mussels) and any food that is bad for your liver
  • Stay away of alcohol and caffeine.

Two of my friends who got their condition under control is also because they monitored their diet.

2. Heal your emotions

Hepatitis is issue with the liver. In TCM (Chinese healing system), excessive anger energy is stored in the liver. Do you have a lot of anger within you? A lot of unresolved inner issues?

There is no point mulling over past betrayals, of bitter disappointments as well as self directed anger. The nature of the world is everything changes and people change as well.

Your mental and emotional health plays a vital role in your ability to heal. An illness is often the body’s way of telling us that we are on the wrong course. I have seen far too many cases as well as experience it on my own that I stopped ignoring this.

It is really time to let it go. Be happy. Your survival depends on it.

3. Sufficient sleep and rest

If you used to lead a hectic and stressful lifestyle in the past, it is time to REALLY step on the brakes. You would notice that insufficient sleep and stress would make you feel extremely exhausted. If you continue to ignore your body’s need for rest, very soon you would notice your condition would start to turn acute. If you got that bad, the doctor may have to start you on Entecavir (hepatitis B medication) which is very expensive and may be out of your budget.

No matter how much money you are earning through losing nights of sleep, it would not be worth risking your health and being placed in a lifetime of medication especially if you are from Asia as the medication is very expensive here.

My mom had suffered for years of insomnia prior to developing acute hepatitis B. She said she was not able to sleep and it would be very fortunate if she could get even 4 hours of sleep. I suspected she just had too much of things in her mind to think and ponder that her mind could not relax enough for her to fall asleep. Her childhood trauma caused her to develop an unhealthy coping mechanism towards people and disappointments in life which I strongly suspected had ultimately led her to develop Alzheimer’s.

Nowadays, she does not have insomnia anymore because her brain had forgotten all the bad memory.  Her mind has regressed to a carefree child who wants only food, companionship and sleep. I am doing my best to keep her happy to have unpleasant memories flushed out of her system. In a way, I have learned to accept that this illness has been a merciful one as I have never seen her so genuinely happy and carefree in my life. With her happy emotional state, her hepatitis has been kept in check and the specialist told me her condition is now in remission (but medication still need to continue).

As for my two friends, they also made sure they get enough of rest. No job is worth risking their health for. They learned to say no and have stopped pushing themselves to the limit.

It is not the end

If you have been diagnosed with hepatitis B, it is not the end of it all. Many people live with chronic hepatitis B and is able to lead a normal life with the situation under control. In fact, my two friends have higher energy levels than me. They also go for medical follow-ups and appointments where they would have blood test done for liver function followed by periodical ultrasound scans on their liver.

Just one final note, if your doctor ask you to begin on hepatitis B medication, do consider seeking a second opinion or ask if you could try to control your condition through lifestyle changes first, and then go back for a blood test.

My mom started the medication since 2017 due to the insistence of a specialist from a semi-government hospital in Malaysia. It is very costly (RM530 for 30 days) and usually need to take for a lifetime. When I took my mom to a private hospital in Thailand, the gastrologist and the cardiologist (my mom had no heart problem but she is also on high blood pressure medication that are constantly monitored) said that by right, my mom should not start the Entecavir medication. However they said unfortunately that once my mom start, she had to be on the mediation for life because there is a risk of the virus mutation if she stop the medication. I am sourcing the medication from Malaysia (because in Thailand the medicine cause almost double the price) so the specialist from Thailand had no vested interest and they are offering their honest opinion.


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