At a town meeting in July 2009 received the following question and gave the following answer:

Q I’m a licensed acupuncturist and licensed massage therapist in Florissant. And so –

PRESIDENT OBAMA: I could use one right now. (Laughter.) My back is stiff. I’ve been working hard.

Q I’ll be happy to help you. (Laughter.) And this kind of fits into what you were just talking about as far as health care. I’m wondering, as a practitioner of Oriental medicine, knowing that the National Institutes of Health and the World Health Organization has discovered through their studies that alternative medicine often is more cost-effective and very effective, how will alternative medicine fit in your new health care program?

PRESIDENT OBAMA: Well, look, my attitude is that we should — we should do what works. So I think it is pretty well documented through scientific studies that acupuncture, for example, can be very helpful in relieving certain things like migraines and other ailments — or at least as effective as more intrusive interventions.

I will let the science guide me. We just swore in an outstanding new Secretary of Health and Human Service, Kathleen Sebelius, former governor of Kansas. (Applause.) It’s good to see that a Jay Hawk got applause on this side of the border here. (Laughter.) But she’s going to do an outstanding job. And my charge to her is, as we’re going through health care reform let’s find out what works.

I think one basic principle that we know is that the more we do on the prevention side, the more we can obtain serious savings down the road. So giving children early checkups, making sure that they get immunized, making sure that they are diagnosed if they’ve got eyesight problems, making sure that they’re taught proper nutrition to avoid a life of obesity — those are all issues that we have some control over. And if we’re making those investments, we will save huge amounts of money in the long-term…..

From Doc Misha: The following is summary of a report commissioned by Vertex Pharmaceuticals Incorporated from Milliman, an independent actuarial and consulting firm located in many cities worldwide.

Consequences of Hepatitis C Virus (HCV): Costs of a Baby Boomer Epidemic of Liver Disease
by Bruce Pyenson | Kathryn Fitch | Kosuke Iwasaki
May 18, 2009

ABSTRACT
“At least 3 million Americans, many of them Baby Boomers, are infected with chronic hepatitis C virus (HCV). This report examines the projected direct medical cost effects of HCV infection on commercial and government payers as longer-term conditions like cirrhosis, liver cancer, and liver failure emerge in the infected population over the next several decades.”

EXECUTIVE SUMMARY
“Baby boomers account for two out of every three cases of chronic hepatitis C virus (HCV) infection in the United States. As baby boomers infected with hepatitis C virus (HCV) age, their disease may progress from asymptomatic infection to advanced liver disease. This population and disease progression dynamic will result in large financial ramifications throughout our health care system. Receiving treatment for HCV infection prior to the onset of severe complications can reduce long-term, life-threatening consequences.
However, we estimate that only approximately 22% of those infected with HCV are diagnosed. With current treatment side effects, long treatment duration, and limited efficacy associated with current antiviral therapies, even fewer patients receive treatment.

This report presents the projected direct medical cost impact of HCV infection on commercial and government payers over the next 20 years assuming no changes to current HCV infection management. The authors used recent U.S. payer datasets, population survey results, and disease progression information to project chronic HCV infection disease states and associated direct medical costs. Societal burdens other than direct medical costs of HCV disease are not considered in this study, but lost productivity and diminished quality of life associated with chronic HCV infection are likely substantial.

While new HCV infections have declined dramatically over the last two decades, at least 3 million Americans are chronically infected with HCV. Most of these individuals are baby boomers, the generation born between 1946 and 1964, and more than three out of every four (78%) are unaware of their infection. The long-term consequences of HCV infection, including cirrhosis, liver cancer, and liver failure can take decades to emerge, and the population of already infected individuals is entering a period of high cost burden as the sequelae of their infections appear.

Baby boomers account for two out of every three cases of chronic HCV infection in the United States.”

You can get the full report here.

Yours, Doc Misha

Here is a link to a new article in Newsweek featuring a fellow SF Hepatitis C Mayor’s Task Force member, Alan Franciscus………
The Hepatitis C Generation

Thanks to a disease that lays dormant for up to 30 years, Baby Boomers well past their wild years are starting to suffer the consequences.

By Sarah Kliff | Newsweek Web Exclusive

www.newsweek.com/id/230061–

HOT NEWS!
IOM REPORT ON VIRAL HEPATITIS RELEASED TODAY!

Date: Jan. 12, 2010
Contacts: Christine Stencel, Senior Media Relations Officer
Luwam Yeibio, Media Relations Assistant
Office of News and Public Information

FOR IMMEDIATE RELEASE

IOM REPORT RECOMMENDS STEPS TO REDUCE THREATS POSED BY HEPATITIS B AND C, WHICH DISPROPORTIONATELY AFFECT MINORITIES

WASHINGTON — Stepped-up vaccination requirements, a boost in resources for prevention and treatment, and a public awareness campaign similar to the effort that dispelled the stigma of HIV/AIDS are needed to curb the health threats posed by hepatitis B and hepatitis C, says a new report from the Institute of Medicine.

Chronic hepatitis B and C cause thousands of cases of liver cancer, liver disease, and death each year — taking the heaviest toll among Asians, Pacific Islanders, and blacks in the U.S. — and these infections account for nearly half of the liver transplantations that must be performed annually. Resources and efforts to contain the viruses that cause hepatitis B and C lag behind those directed at other infectious diseases of similar impact to public health, noted the committee that wrote the report.

“Although hepatitis B and C are preventable, the rates of infection have not declined over the past several years, underscoring the conclusion that we have allowed gaps in screening, prevention, and treatment to go unchecked,” said committee chair R. Palmer Beasley, professor of epidemiology and disease control, University of Texas School of Public Health, Houston. “This report outlines the additional resources and actions needed to reduce the unacceptably high burden of liver disease and cancer associated with these viruses.”

An estimated 800,000 to 1.4 million Americans have chronic hepatitis B and between 2.7 million and 3.9 million have chronic hepatitis C. The majority of infected individuals are not aware of their condition until they develop symptoms of liver cancer or liver disease. Few among the populations most at risk — immigrants from countries where the diseases are endemic, non-Hispanic black men, injection-drug users, and people who had blood transfusions before 1992 — seek testing or information on how to protect themselves from infection. Moreover, health care and social service providers’ knowledge about hepatitis B and C is generally poor, and many fail to follow guidelines for screening patients and providing prevention, treatment, and follow-up services.

The report calls for a public awareness initiative along the lines of the effort that succeeded in increasing recognition, prevention, and treatment of HIV/AIDS, which affects three to five times fewer Americans than viral hepatitis. Educational programs and materials that outline risk factors for viral hepatitis and provide information on immunization, prevention, and proper monitoring of infected individuals should be developed and made available to all health professionals and social service providers.

Steps need to be taken to eliminate the stigma associated with viral hepatitis. Negative attitudes about hepatitis B in some cultures may contribute to immigrants’ reluctance to seek testing. In China, for example, people with chronic hepatitis B face job and social discrimination. In addition, negative perceptions about illicit-drug users, who make up the greatest percentage of those with hepatitis C, can affect the care they receive or their willingness to seek care.

Although the availability of an effective vaccine against hepatitis B has significantly reduced its spread, some 1,000 infants born to infected mothers develop chronic infections each year, a number that has not declined over the past decade. Moreover, three states — Alabama, Montana, and South Dakota — still do not require that children be vaccinated against hepatitis B before entering daycare or school. All full-term newborns whose mothers test positive for hepatitis B should receive the vaccine once they are stable and before leaving the delivery room rather than up to 12 hours after birth as is currently recommended. All states should make hepatitis B vaccination a requirement for school attendance, and health plans need to fully cover the costs associated with the immunization. Particular attention should be given to screening and vaccinating children who were born in countries where hepatitis B circulates widely. Each year, roughly 40,000 to 45,000 people legally emigrate to the United States from countries where hepatitis B is endemic.

Health care and social services related to viral hepatitis are sparse and fragmented among providers and organizations, leading to missed opportunities to prevent the spread of infection and to lessen the impact of chronic infections, the report concludes. The committee recommended several steps to create a more-coordinated approach, including ways to improve identification of infected individuals, social and peer support to reduce the stigma of infection, and medical management of those with chronic hepatitis B or C. These strategies are aimed at not just health professionals in hospitals and doctors’ offices, but also individuals and groups that provide services to at-risk populations, including prisons and jails, HIV and STD clinics, shelter-based programs, and mobile health units.

People at greatest risk for hepatitis B include individuals born in East and Southeast Asia, sub-Saharan Africa, and other areas where the virus circulates widely; infants born to women with the disease; and those who have sexual contact or share injection-drug equipment with an infected person. Asians and Pacific Islanders make up 4.5 percent of the U.S. population but account for more than 50 percent of chronic hepatitis B cases. Those at greatest risk for hepatitis C are individuals who received a blood transfusion before 1992 and past or current injection-drug users. The chances of contracting hepatitis C increase with years of drug use and may be as high as 90 percent among long-term users. Deaths related to hepatitis C have increased, with the highest number occurring among middle-aged men, non-Hispanic blacks, and American Indians.

The report was sponsored by the U.S. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services’ Office of Minority Health, U.S. Department of Veterans Affairs, and the National Viral Hepatitis Roundtable. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies. A committee roster follows.

Copies of HEPATITIS AND LIVER CANCER: A NATIONAL STRATEGY FOR PREVENTION AND CONTROL OF HEPATITIS B AND C are available from the National Academies Press; tel. 202-334-3313 or 1-800-624-6242 or on the Internet at HTTP://WWW.NAP.EDU. Reporters may obtain a copy from the Office of News and Public Information (contacts listed above. Additional information on the study can be found at HTTP://WWW.IOM.EDU/VIRALHEPATITIS.

Just a short note from HelpHepatitisC.com……

For those who have not seen my recent video,

Love,
Doc Misha

I have been asked many questions about hepatitis – one question that comes up often is:

ARE ALL FORMS OF HEPATITIS INFECTIOUS?

The answer is NO.

There are five forms of viral hepatitis that are transmitted in various ways–some quite easily, others only through the exchange of infected blood. But other forms, such as autoimmune hepatitis and hepatitis triggered by drugs or chemicals, cannot be spread to other people.

In this blog today, I will briefly explain these various forms of non-viral hepatitis. (For more in-depth coverage about medications, chemicals and herbs that can cause liver inflammation or severely worsen viral hepatitis, stay tuned for the future e-book Doc Misha’s Special Guide: 7 Things You Must Know Before Going on Interferon Therapy )

Poisons, such as alcohol, some prescription or recreational drugs and environmental pollutants, can cause liver inflammation and may permanently damage the liver. Sometimes toxins can stimulate an autoimmune response, causing the body’s disease defense system to go awry and attack the cells in a healthy liver, destroying its ability to function properly.

The most common form of liver damage that is toxin-produced is alcohol-induced hepatitis. Alcohol is metabolized (that is, burned up and cleared from the bloodstream) by the liver, therefore excess amounts of alcohol–more than two drinks a day–could cause damage. If a person already has hepatitis of any type, drinking any alcohol puts a dangerous strain on the liver and vastly increases the risk of developing serious, even life-threatening, complications.

Prescription drugs and over-the-counter (OTC) medications as well as recreational drugs such as cocaine and barbiturates may also worsen or contribute to hepatitis.

More than 2,000 milligrams a day of acetaminophen (Tylenol)—the standard over-the-counter pill contains 500 milligrams— recreational drugs (such as heroin) and prescription drugs can damage the liver.  

A 2006 study published in the Journal of the American Medical Association reported that healthy adults who took the maximum recommended dose of acetaminophen for two weeks had drastically increased liver enzyme levels that could lead to liver damage. Based on this research, the American Liver Foundation recommends “that people not exceed three grams of acetaminophen a day for any prolonged period of time…. This is the equivalent of six ‘extra-strength’ tablets a day for several weeks. Regular, short-term use of the product is not an issue. Anyone currently suffering from liver disease should check with their physician or hepatologist before taking acetaminophen.”  

General guidelines are that anyone taking any medication or drug should be tested for liver damage regularly. If tests show that bilirubin levels are elevated and your ALT levels are 150 or more, physicians recommend that you stop the medications immediately and seek medical help.

Environmental and industrial toxins such as radiation, solvents, cleaners and polyvinyl chloride may cause cellular changes in the liver resulting in everything from mild inflammation to cirrhosis, liver failure and even cancer.

Also, some herbal remedies may pose a threat. Herbs are potent medicinal remedies, and some may trigger liver inflammation just as a chemical toxin or an over-the-counter or prescription drug may. It is important that you have herbal medicines prescribed by a qualified practitioner that is knowledgeable in drug-herb interactions as well as safety issues.

More on these issues in a future blog entry…..

Yours in health,
Doc Misha

P.S. For those of you who need more detailed information on Hepatitis C, please read my Free Report “The First 3 Things You Must Know to Conquer Hepatitis C” – you can sign up in the box on this page…..

At Chicken Soup Chinese Medicine, Quan Yin Healing Arts Center in San Francisco and many other clinics in the United States, Mexico and Canada, Eastern and Western practitioners are using Doc Misha’s Optimum Interferon Protocol for assisting people with hepatitis C who are undergoing interferon/ribavirin therapy. In this case, Chinese traditional medicine is a complementary therapy that plays a supportive role during Western treatment. Practitioners are having success with alleviating side effects and helping people to maintain the pharmaceutical therapies in order to be able to ultimately clear HCV. Controlled studies are being planned to see if there is efficacy in helping to improve treatment outcomes.

The benefits of Chinese traditional medicine during interferon treatment include:

improved liver function, including enhanced function during treatment;anti-inflammatory effects;

regulating the blood (Xue);

increasing qi;

lessening symptoms;

lessening side effects and their impact;

decreasing the need for additional medication during treatment.

Acupuncture and herbs—by regulating the blood, tonifying qi, and clearing heat—help the liver function better and, therefore, have an anti-inflammatory, anti-fibrotic effect. This in turn may decrease progression of damage and alleviates symptoms of the condition, while also moderating the side effects of treatment. Thus, the need for additional drugs to counteract symptoms and side effects is lessened. The Chinese medicine protocol potentially may also reverse damage already done to the liver.

Keep tuned for more information on how to use Doc Misha’s Optimum Interferon Protocol for Hepatitis C.

November 9, 2009

This article originally appeared on the Body, www.thebody.com, and was contributed by Project Inform

San Francisco Mayor Gavin Newsom has recently established the San Francisco Mayor’s Hepatitis C Task Force. This task force, composed of 32 advocates, medical and social service providers, public health officials, and people living with hepatitis C will create a comprehensive set of policy and funding recommendations on fighting the hepatitis C epidemic in the city.

An estimated four million Americans are living with chronic hepatitis C (HCV), many of whom are not aware of their status. Hepatitis C severely impacts people living with HIV, with 30% co-infected with HCV. Hepatitis C also disproportionately affects African-Americans, Latinos, veterans, parolees returning to the community, injection drug users, immigrants, and low-income residents. Hepatitis C can lead to liver disease, cirrhosis, liver cancer, liver failure and death. However, many people at risk for or infected with HCV are neither tested nor treated due to lack of public awareness about hepatitis and lack of access to care. Thus, many people living with HCV are unable to protect their own health, and efforts to prevent the spread of HCV are severely compromised.

San Francisco has been hit particularly hard by the hepatitis C epidemic, with an estimated 12,000 people infected with HCV. According to the Centers for Disease Control and Prevention (CDC), liver cancer from hepatitis B and C kills more people in the San Francisco Bay Area than anywhere else in the country.
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Among the goals of the Task Force are to: develop better surveillance and reporting for HCV; raise awareness regarding HCV on both community and individual levels; improve access to care and support services and increase quality of life for people with HCV; make HCV screening and testing widely available and accessible; promote partnerships among the public/private health care sector, community organizations, advocates, and individuals affected by HCV; and identify existing assets and gaps in access to HCV education, prevention, screening, testing, and care.

The San Francisco Hepatitis C Task Force is sponsored by the Drug Policy Alliance and cosponsored by Project Inform and the Hepatitis C Support Project. Ryan Clary, Project Inform’s Public Policy Director, is an appointed member of the group. Task Force meetings are held the second Monday evening of each month and are open to the public. For more information, please email action@projectinform.org

I am often asked questions regarding what to eat when you have hepatitis C. Well, the answers are not always so simple. First, let’s talk about some complications of having hepatitis C regarding your blood sugar and related issues – diabetes.

Research shows that there is a higher prevalence of diabetes among persons infected with HCV. Chronic hepatitis C may contribute to the progression to diabetes. According to the American Dietetic Association, diabetes mellitus is defined as a metabolic disease characterized by hyperglycemia (high blood sugar) and associated with short- and long-term complications.

Diabetes mellitus has been reported to be more prevalent in patients with HCV compared to those with hepatitis B and those with other types of liver diseases. Fatty liver disease is also associated strongly with the development of type 2 diabetes.

Diabetes is a chronic endocrine disorder characterized by the inability to properly utilize sugar, specifically glucose, a simple carbohydrate. This results in excessively high glucose levels in the blood. Diabetes involves either relative or absolute shortage of insulin, a hormone that regulates the body’s breakdown of carbohydrates.

Type 2 diabetes, often called non-insulin dependent diabetes, is the most common form of diabetes. Type 2 diabetes affects 90% – 95% of the millions of people with diabetes.
People with type 2 diabetes produce insulin; however, the insulin their pancreas secretes is either not enough or the body is unable to recognize the insulin and use it properly. This is called insulin resistance. When there isn’t enough insulin or the insulin is not used, as it should be, glucose (sugar) can’t get into the body’s cells.

When glucose builds up in the blood instead of going into cells, the body’s cells are unable to properly function. Other problems associated with excess blood glucose include:

• Dehydration. Build up of blood glucose sugar in the blood can cause an increase in urination. The body is trying to clear the sugar from the body. When the kidneys lose the glucose through the urine, a large amount of water is also lost, which can cause dehydration.
• Diabetic coma. When a person with type 2 diabetes becomes severely dehydrated and is not able to drink enough fluids to make up for the fluid losses, they may develop this life-threatening complication called hyperosmolar nonketotic diabetic coma.
• Other Damage. Over time, the high blood glucose levels may damage the nerves and small blood vessels of the eyes, kidneys, and heart and predispose a person to hardening (atherosclerosis) of the large arteries that can cause heart attack and stroke.

A cross-sectional national survey in the US found that people with HCV were at least three times more likely to have type 2 diabetes than those without HCV. This survey controlled for other factors including age, BMI, economic status and substance use history. Other studies show that among people with hepatitis C with cirrhosis, increased diabetes risk is not correlated with cofactors such as age, gender, BMI, or genotype. This increased risk also is present in people with HCV without cirrhosis. This may be related to fatty liver and iron deposits in the liver (hemochromatosis), which are common in people with HCV infection.

Impaired glucose tolerance (IGT) along with insulin resistance and increased insulin (hyperinsulinemia) is common in people diagnosed with cirrhosis. IGT and hyperinsulinemia usually precedes development of type 2 diabetes mellitus in 10% to 20% of these persons.

Hi, this is Doc Misha again -

Today I am talking to you – the person with Hepatitis C who is about to begin interferon treatment – about how you can have a better outcome in your interferon treatment (clear HCV successfully) through using a combination of Western and Eastern medicine.

One of the mains goals for the use of Chinese traditional medicine and other natural therapies during interferon therapy is to help you continue with close to full-dose therapy of Western medications, and not have to discontinue during therapy due to side-effects. There is sufficient documentation in peer-reviewed clinical trials that if you stay on at least 80 percent of the interferon and ribavirin dose, at least 80 percent of the time, this is crucial to sustained viral response (viral clearance at six months).

Body acupuncture and auriculotherapy are highly effective for treating side-effects associated with interferon and ribavirin. They are also used when a person is trying simultaneously to reduce or eliminate drugs such as heroin, morphine, cocaine, alcohol and nicotine.

Chinese and Western herbal medicines may be used safely in conjunction with interferon/ribavirin therapy, when a qualified licensed acupuncturist and/or herbalist is familiar with both hepatitis C and the contraindications of herbs or herbal formulas in hepatitis C and during drug treatment. Doc Misha’s Optimum Interferon Protocol has been used successfully for many years in helping people to mange their interferon treatment successfully.

More than 300 Chinese medicine practitioners have been certified through the Hepatitis C Professional Certification Program – and many of these practitioners continue to consult with me to help their patients have better outcomes.

More to come on the use of Chinese medicine and natural supplements during interferon treatment.