How Can I Help?

There are many ways you can support your friend or family member as he or she adjusts to life with hepatitis C. In many ways, just having a shoulder to lean on is a big help. Your friend is most likely nervous and afraid about having hepatitis C and may feel isolated from family members, friends, and coworkers who might react negatively to the news that your friend is infected with the virus. Just knowing that you are still a friend can be a tremendous positive influence during this difficult time in your friend's life.

"Be There" for your friend. The most important thing you can do for your friend is to "be there." To do that, you need to take good care of yourself. To find out more about what you need to do to remain a positive factor in your friend's treatment, go to 10 Tips for Caregivers.

Here are some suggestions that may help your friend as he or she goes through therapy:

How can I help fight hepatitis C's bad rap?

• Remind your friend that he or she didn't contract hepatitis C because he or she is a bad person or needed to be punished.
• Be aware that your friend may be picking up vibes from other people who have the wrong attitudes about hepatitis C. Many people with hepatitis C begin to feel ashamed of their illness if people start treating them as if they are "unclean" and pose a danger to them.
• Help your friend spread the facts about hepatitis C, whenever you have the chance. Explain hepatitis C simply and directly: It's a liver disease-a common condition requiring treatment and affecting millions of Americans. But accept that neither one of you can change or control the way everyone thinks.
• Keep your friend from becoming isolated. Healthy people sometimes avoid sick people, and sometimes patients withdraw from society. Suggest that your friend call his or her Nurse Counselor for help or advice. Support groups can be a great way for your friend to reconnect with people. Encourage your friend to get out and interact with people.

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How can I help with the flu-like symptoms?

• Reassure your friend that he or she probably doesn't have the flu. Instead, it is probably just the most common side effects of therapy. Remind your friend that side effects can mean that the therapy is working.
• Suggest timing the injection a bit before bedtime, which may allow your friend to "sleep through" the flu-like symptoms. Also, have him or her ask the doctor about taking an over-the-counter medicine shortly before the injection to help ease some side effects. If necessary, stronger medicine may be available, but only with a prescription.
• If your friend has a fever, suggest a sponge bath with lukewarm (not cold or hot) water to reduce body temperature. Never use rubbing alcohol; the fumes can be dangerous.
• Recommend a warm bath to relieve any muscle aches.

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How can I help with fighting fatigue?

• Suggest your friend take his or her injection of interferon shortly before bedtime. Fatigue usually occurs within four to six hours of injection, so taking it before bedtime may help the patient "sleep off" fatigue.
• Don't plan a lot of strenuous activities or try activities that will wear out your friend. Also, encourage your friend to get plenty of sleep at night and to take naps.
• Make sure your friend drinks at least 10 to 16 full glasses of water, clear juice (for example, apple or cranberry), or other beverages (caffeine-free and nonalcoholic) every day, especially before and after injections.
• Suggest your friend change his or her work schedule, if possible, by cutting back on the days following an injection.
• Exercise with your friend. It may be hard for a patient to get motivated, but mild aerobic exercise, like walking, can actually boost energy and reduce stress-for both of you.

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How can I help with a loss of appetite?

• Don't concentrate on food all the time. Being overly concerned, especially when your friend is losing weight, may seem like nagging. Limit talks about food to one per day, remembering to respect your friend's right to eat or not eat.
• Don't tempt. Asking your friend to "just try a little" or "have a taste" can irritate someone who just doesn't feel like eating at the moment. Too many food choices at once can turn off an already limited appetite. Always remember, your friend would eat it if he or she could.
• Suggest cooking more than your friend needs for one meal, or do it yourself. Making a large batch of stew or a casserole that can be divided and frozen for another meal is a helpful time-saver.
• Encourage your friend to eat well on days when he or she does feel like eating, to make up for days of poor appetite. Help your friend plan to eat when he or she feels relaxed, or as an opportunity to socialize with friends. Also, suggest nibbling on smaller amounts of food more often, instead of eating three large meals every day.
• Drinking plenty of fluids can help minimize a number of side effects, so be sure your friend drinks at least 10 to 16 full glasses of water or clear juice every day. It's best not to drink only water, because it will fill his or her stomach without giving much nourishment. Try a variety of clear juices.

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How can I help with nausea, vomiting, or diarrhea?

• Remind your friend that health care providers can help him or her manage these unpleasant side effects with prescription medications. Also, your friend can contact a Nurse Counselor for other ways to ease these side effects.
• Don't insist that your friend eat when he or she feels nauseous.
• Besides reminding your friend to drink plenty of water and clear juice, recommend liquids and foods that contain salt and potassium, such as bananas, peach and apricot nectar, and boiled or mashed potatoes. Diarrhea can reduce the amount of salt and potassium in your friend's body.
• If cooking odors trigger nausea, prepare meals somewhere else and bring them to your friend.
• Suggest foods that give the nutrients your friend needs but won't encourage diarrhea, including yogurt, smooth peanut butter, skinless chicken or turkey, lean beef, baked fish (not fried), ripe bananas, and cottage or cream cheese.
• To lessen nausea, encourage light exercise (not after meals), like walking. Also, suggest resting after meals to aid digestion; sitting up-not lying down-for at least an hour.
• Remind your friend that certain foods may be easier to digest, such as toast, crackers, yogurt, sherbet, pretzels, angel food cake, oatmeal, and rice cakes. Also, suggest he or she avoid greasy or fried foods, raw vegetables and fruits, spicy foods, or foods that are high in fiber, such as beans, whole-grain breads and pasta, corn, and broccoli.

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How can I help with thinning hair (alopecia)?

• Remind your friend that in most cases, hair grows back after completing therapy, and that it is important to stay on therapy exactly as the doctor has prescribed.
• Encourage your friend to experiment with different hats, caps, or scarves in the meantime. If he or she thinks the hair loss is excessive, a call to the doctor may be in order.

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How can I help with skin reactions?

• Suggest changing the injection site to help prevent/minimize dryness and itching. Also, tell your friend to avoid long baths with hot water, which can actually rob skin of moisture. Encourage him or her to apply moisturizers to damp skin. If skin irritation persists or is severe, encourage your friend to call the doctor for some special medication. Any swelling, redness, or pain occurring during an injection or up to a few days afterward should be immediately reported to the doctor.

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How can I help deal with family?

• Suggest that your friend not keep the illness a secret from his or her children. Children often sense when something's wrong-especially in their own family. If parents try to protect them too much, children may have fears worse than the real situation. Children can also get upset about a parent's obvious physical discomfort.
• Try to prevent your friend's own worries about treatment from making him or her less available to his or her kids. This can cause children to become rowdy, bring home poor grades, or withdraw and become gloomy. Children can resent lost attention or become afraid to leave the parent's side. Talking with children will improve many of these situations.
• Remind your friend that the Coaching Booklet and the Lifestyle Management section in his or her Therapy Management Binder will help explain hepatitis C to older children and other adults.
• Help your friend accept the fact that different people react differently to hearing that a loved one has hepatitis C. Some may not know how to respond, while others may avoid the infected person in order to avoid facing fears about their own health. Sometimes, people are afraid to say the wrong thing, or don't understand what the patient is going through. When this happens, your friend needs to make the first move by helping others learn more about hepatitis C and its treatment.
• Remind your friend that there's no reason he or she can't lead a normal life. By taking care and staying on therapy, he or she can still live a fulfilling life.
• If you notice that your friend is putting up barriers, recommend a professional counselor to help him or her work through the strong emotions hepatitis C stirs up.

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How can I help manage health insurance issues?

• Sit down with your friend and read a copy of his or her health insurance policy, to understand how he or she is covered. Also check the "Insurance" page of the patient's Therapy Management Binder for further resources. (This page can be found in the Lifestyle Management section of the binder.) This up-front preparation could help your friend save time/effort, and possibly money later!
• Make sure your friend files claims for all covered costs. Many patients don't realize what they're entitled to from their insurance company.
• If a claim is denied, encourage them to file again. If it's denied again, look into the insurance company's appeals process and file an appeal.
• Offer to help keep track of bills, payments to doctors, and insurance payments.
• If your friend has health insurance issues, remind him/her that they can always call Schering's COMMITMENT TO CARE® program for help discussing coverage options.

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How can I help manage work related issues?

• Suggest that your friend talk to his or her employer about possibly adjusting work schedules or taking medical leave, if the side effects of therapy are too draining.
• Make sure your friend knows what his or her legal rights are as an employee. Start by reading the page entitled "Work" in the Lifestyle Management section of the Therapy Management Binder.
• If your friend has temporarily left the job, recommend a gradual return to a full schedule, if possible. Many employers are willing to adjust work hours, shifts, or duties. Also, encourage your friend to keep in touch with coworkers during this time.
• Suggest seeing a financial advisor or counselor to find ways to stretch available funds.

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Effective hepatitis C treatment means a taking a disciplined approach to improving your condition. Receive regular e-mail reminders that will notify you when to perform certain treatment-related activities, such as when it's time to administer medication, meet with your health care provider or refill your prescription.

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To get started, please choose one of the following:   I have been diagnosed with hepatitis C, but haven't started treatment yet I am on treatment for hepatitis C     * Note: If you or someone you know may be at risk for hepatitis C, please visit www.peg-intron.com See Instructions   Select one of the choices above and click "Next"

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