In Our Library

Farewelling Fred

A pillar of the Hepatitis SA community retires

Fred Robertson has been beloved by all at Hepatitis SA for more than 22 years. When he retired at the end of July this year he was my right hand. He was known to the clients of various services as the ‘Chupa Chup Man’ because he handed out Chupa Chups to those who stopped to chat with him about viral hepatitis transmission, testing and treatment over the years. His colleagues know him as an all-round great guy. Whenever anything was asked of him, the word ‘no’ was not in his vocabulary. He was wonderful to work with and his well-earned retirement is a great loss to Hepatitis SA. When asked recently what he liked most about his work, Fred told me that he felt that the people he worked with were like family to him. He commenced as a volunteer at what was then known as the Hepatitis C Council of South Australia in 1998 by working on the phone helpline, and his role evolved to Peer Mentor after about 8 years. He supervised a team of peer educators, working with a number of coordinators, during that time. I remember that I first met Fred when I attended workforce development training about blood-borne viruses 17 years ago. I crossed paths with him many times in a professional capacity, as he attended a variety of my workplaces to provide peer education and information to the clients, and I always found him to be the most affable fellow. When I joined Hepatitis SA as the Coordinator of his team 8 years ago he was the most valuable worker that I have ever had the great pleasure to work with. Speaking about his role, Fred explained that he found his work as Peer Educator very rewarding, enjoying the fact that he got to witness the health of clients improve after being cured of hepatitis C and hearing their gratitude for being informed about the latest treatments from someone with a lived experience of hepatitis C. He said that he did his job for the satisfaction that he felt from being a part of the facilitation of the improvement of people’s health. Fred personally lived with hepatitis C for 20 years, first attempting Interferon treatment in 1996 before finally achieving a cure with a second attempt on the old Interferon and Ribavirin combination therapy in the year 2000. He recalls that, for many, “Interferon treatment had some very nasty side effects such as flu-like symptoms, hair loss, depression and anxiety—to name just a few—and the duration was for either 6 or 12 months depending on which genotype of hepatitis C one was infected with.” He said that he was glad when he was eventually able to promote the Direct-Acting Antiviral (DAA) treatments, saying, “It is so great that the new treatments are just one or two tablets per day for just 8 or 12 weeks,” and how he saw the new DAA treatment for hepatitis C improve even

further since 2016. “This cure is easily prescribed, much more effective than the previous treatment, mostly free from side effects. The all-oral treatment has made it so much easier to promote to our clients.” As part of his role as Peer Educator, he would travel to rural areas with an Educator to provide his lived experience of hepatitis C to thousands of prisoners over the years. A conservative estimate of the kilometres he covered while working for Hepatitis SA is around 48,000 kilometres, which equates to having travelled from Adelaide to Scotland (where he was born) then from Scotland to Adelaide and back again. While it is impossible to list

all of his accomplishments over the years, it should be known that he facilitated the distribution of more than 33,000 printed resources to the thousands of people he engaged. Fred was farewelled at a socially distanced gathering of his colleagues, who attended both in person and via Zoom. Gifts from Hepatitis SA and SA’s viral hepatitis nurses included a deed proclaiming him as a Lord with an established title of a one square foot of land in western Scotland. Therefore, it is with wholehearted pleasure that I am able to announce that he may be addressed as Lord Frederick

Robertson when we happily see him return as a volunteer, part of his retirement plan in the near future! v

Lisa Carter

Coordinator – Hepatitis C

Treatment Peer Education &Support Project

Living with a chronic illness—or with the fear of contracting one— can have serious impacts on mental health. This in turn can further effect how our body copes with existing physical disorders. This is particularly relevant to our current situation: with COVID-19 being a constant presence in our lives. The impact of living with any ongoing health

How chronic stress changes the brain: and what you can do to reverse the damage

The Conversation, Melbourne, Sydney, 2020. 4p. Explains how repeated or prolonged stress can impact on physical and mental health and what changes can be incorporated in our lifestyle to ameliorate the impacts. Provides numerous links to supporting evidence in medical journals.

bit.ly/conversation_stress

Mental Health and Chronic Illness: how to deal with stress and anxiety

condition, added to the anxiety of living with the fear of contracting the coronavirus, can seriously influence general wellbeing. Continued underlying stress can manifest as sleep disturbances, anger, tiredness, physical pain and a general lowering of physical strength or the ability to cope. There is much evidence that learning how

Staying strong and healthy during the coronavirus outbreak

Gayaa Dhuwi (Proud Spirit) Australia, 2020. 10 posters, plus webpages. Series of posters containing tips for staying healthy and strong during the coronavirus outbreak. Designed to appeal to wide cross section of Indigenous audiences – remote and urban, and young and old. Each of the numbered tips corresponds to those on the website for more detailed information.

bit.ly/32pYldo

stress affects us and how to manage it can have positive effects on physical health. Below are some resources that provide evidence of the effects of stress along with information about how to build resilience, especially when living with chronic illness or its consequences. v

Joy Sims

Living with advanced liver disease

Hepatitis SA, Adelaide 2013. 22p. Put together after conversations with people who have lived experience. Topics covered include eating difficulties, low/no salt foods, itchy skin, emotional upheaval, confusion and memory loss. bit.ly/hepsa_ald ( read only online: contact admin@hepsa. asn.au for print copies).

Hepatic Encephalopathy (HE) action plan

Flinders Medical Centre, Adelaide, 2017. 1p. HE can be one of the symptoms of prolonged liver disease and can cause changes to mood, sleep, memory and concentration. This chart has brief information about what it is, how to recognize it, what may trigger the symptoms, useful hints for how to manage at home, and warning signs for when to seek medical help.

bit.ly/fmc_he

Chronic physical illness, anxiety and depression

Beyondblue, Melbourne, 2018. 7p. Anxiety and depression are common in people with chronic physical illness. The encouraging news is that there are a range of treatments, health professionals and services available to help with anxiety and depression as well as information on what you can do to help yourself.

bit.ly/beyondblue_illness

Chronic physical illness, anxiety and depression

Living with or experiencing a chronic illness can result in many adjustments and changes, such as loss of independence and not being able to do all the active things you used to do or usually enjoy. Anxiety and depression are common in people with chronic physical illness.

The encouraging news is that there are a range of treatments, health professionals and services available to help with anxiety and depression as well as information on what you can do to help yourself. With careful management, the symptoms of anxiety and depression can be treated along with those of many chronic physical illnesses.

What is a chronic physical illness?

A chronic physical illness is an enduring health problem that will not go away – for example diabetes, asthma, arthritis or cancer. Chronic physical illnesses can be managed, but they cannot be cured. People who live with a chronic illness have a greater risk of developing anxiety and/or depression. There are many different types of chronic physical illness and each presents its own challenges. Here is an overview of some of the more common types.

Heart disease Of the different forms of cardiovascular (heart and blood vessel) disease, coronary heart disease is the heart condition most closely linked with depression. Coronary heart disease is a long-term condition that affects around 685,000 Australians 1 and is a common cause of death and disability. Depression is a significant risk factor for heart disease. 2 Depression is more common among people with heart disease and it affects recovery and increases the risk of further heart-related incidents such as heart attack and sudden death. 2 People who do not have good social support networks (such as someone to confide in and opportunities to participate in social activities) are also at greater risk of developing heart disease. Anxiety can also be a risk factor for heart attack and other heart-related events. 3

Stroke

Stroke is Australia’s second biggest cause of death after coronary heart disease and is a leading cause of disability. 4 In 2012, about 50,000 Australians suffered new and recurrent strokes – that is 1,000 strokes every week or one stroke every 10 minutes. 5 In 2012 there were over 420,000 people living with the effects of stroke and 30 per cent of these people were under the age of 65. 5

A stroke occurs when blood flow to the brain is interrupted. Having a stroke can result in many changes. On a physical level, it can lead to people finding it difficult to move and swallow. Having a stroke can also cause stress, worry and sadness, and affect the way in which people think and feel. There is a strong link between depression, anxiety and stroke.

www.beyondblue.org.au 1300 22 4636 Cancer

Cancer is a leading cause of death in Australia – more than 43,200 people are estimated to have died from cancer in 2011. An estimated 128,000 new cases of cancer will be diagnosed in Australia in 2014, with that number set to rise to 150,000 by 2020. Half of Australian men and one in three Australian women will be diagnosed with cancer by the age of 85. 6

Cancer is a disease of the body’s cells. Normally cells grow and multiply in a controlled way, however, if something causes a mistake to occur in the cells’ genetic blueprints, this control can be lost. Cancer is the term used to describe collections of these cells, growing and potentially spreading within the body. As cancerous cells can arise from almost any type of tissue cell, cancer actually refers to about 100 different diseases. The most common cancers in Australia (excluding nonmelanoma skin cancer) are prostate, bowel, breast, melanoma and lung cancer, accounting for over 60 per cent of all cancers diagnosed in Australia. 7 Men with prostate cancer are nearly twice as likely to develop depression as men in the general community. 8 Research shows that anxiety and depression are common among women with breast cancer, and one study found that up to 50 per cent of women with early breast cancer may experience anxiety and/or depression in the year after diagnosis. 9

11 Grieving the loss of addiction

Psych Central, Newburyport, MA, 2019. 4p. Acknowledges that recovering addicts have a lot to grieve: activity that has been central is now something they can never do again. This grief can manifest as anxiety, loneliness, loss of sleep, anger and depression. Written by a psychiatrist specializing in addiction this article gives advice for how to deal with this specific issue.

bit.ly/psychcentral_grief

Mindfully

Aust Broadcasting Corporation, Sydney 2020. 5 sound files. Sydney Swans legend Brett Kirk teams up with the experts in Mindfulness, Smiling Mind, to show how to use mindfulness in different areas of life - with a special focus on relaxation in the time of COVID-19.

ab.co/3htiw0c

Looking after your mental wellbeing during the COVID-19 pandemic

Australian Red Cross, Canberra 2020. Multiple webpages. Four main sections: Get in the know about how stress can affect you and others during the outbreak; Get together while staying socially distanced; Get a plan to help maintain wellbeing for yourself and others; Get checking on family, friends and people in your community who might need extra care.

bit.ly/redcross_covid

Coronavirus: it’s tempting to drink your worries away but there are healthier ways to manage stress and keep your Stress symptoms: effects on drinking in check

your body and behaviour The Conversation, Melbourne, Mayo Clinic, Rochester USA, Sydney, 2020. 6p. From ‘Little Hep B Hero’ 2019. 2p. Outlines the common effects Describes the negative effects of drinking on the immune of stress on the body, mood system, sleep and mental and behavior - with ideas of health. With advice about how to manage these. Links to managing drinking patterns further detailed information and stress. about stress management bit.ly/conversation_drinking techniques.

mayocl.in/3llFCIH

hepatitissa.asn.au/library

hepsa.asn.au

COVID-19 has had a range of mental health impacts on the community through:

Isolation from loved ones and usual supports

Changes to normal daily routines

Changes to or loss of work

Difficult financial situations

Anxiety about becoming unwell

Our Virtual Support Network is here to help by providing a range of specialist mental health services based in South Australia.

Call 1800 632 753 for mental health support by phone and video. Available 8am to 8pm, every day.

See all Virtual Support Network services and other helpful resources at:

sahealth.sa.gov.au/ COVID19MentalHealthSupport

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© Department for Health and Wellbeing, Government of South Australia. All rights reserved. FIS: 20061.5 Printed May 2020.

hep B Take Ac ion We did

Tested Vaccinated Treated

Call Hepatitis SA - 1800 437 222 www.hepsa.asn.au

Useful Services & Contacts

Hepatitis SA Free education sessions, printed information, telephone information and support, referrals, clean needle program and library. (08) 8362 8443 admin@hepatitissa.asn.au www.hepsa.asn.au Hepatitis SA Helpline 1800 437 222 (cost of a local call)

Adelaide Dental Hospital A specially funded clinic provides priority dental care for people with hepatitis C with a Health Care Card. Call Hepatitis SA on 1800 437 222 for a referral.

beyondblue Mental health information line 1300 224 636 www.beyondblue.org.au

Clean Needle Programs in SA For locations visit the Hepatitis SA Hackney office or call the Alcohol and Drug Information Service. 1300 131 340

Community Access & Services SA Alcohol and drug education; clean needle program for the Vietnamese and other communities. (08) 8447 8821

headspace Mental health issues are common. Find information, support and help at your local headspace centre 1800 650 890 www.headspace.org.au Hutt St Centre Showers, laundry facilities, visiting health professionals, recreation activities, education and training, legal aid and assistance services provided to the homeless. 258 Hutt St, Adelaide SA 5000 (08) 8418 2500

Lifeline National, 24-hour telephone counselling service. 13 11 14 (cost of a local call) www.lifeline.org.au

Mental Health Crisis Service 24 hour information and crisis line available to all rural, remote and metropolitan callers. 13 14 65

MOSAIC Counselling Service For anyone whose life is affected by hepatitis and/or HIV. (08) 8223 4566 Nunkuwarrin Yunti An Aboriginal-controlled, citybased health service, which also runs a clean needle program. (08) 8406 1600

PEACE Multicultural Services HIV and hepatitis education and support for people from nonEnglish speaking backgrounds. (08) 8245 8100

Sex Industry Network Promotes the health, rights and wellbeing of sex workers. (08) 8351 7626

SAMESH South Australia Mobilisation + Empowerment for Sexual Health www.samesh.org.au

Youth Health Service Free, confidential health service for youth aged 12 to 25. Youth Helpline: 1300 13 17 19 Parent Helpline: 1300 364 100

Viral Hepatitis Community Nurses Care and assistance, education, streamlined referrals, patient support, work-up for HCV treatment, monitoring and follow-ups. Clients can self-refer. Contact nurses directly for an appointment.

Central: Margery - 0423 782 415 margery.milner@sa.gov.au Debbie - 0401 717 953

North: Bin - 0401 717 971 bin.chen@sa.gov.au Michelle - 0413 285 476

South: Rosalie - 0466 777 876 rosalie.altus@sa.gov.au Jeff - 0466 777 873

Specialist Treatment Clinics Subsidised treatment for hepatitis B and C are provided by specialists at the major hospitals. You will need a referral from your GP. However, you can call the hospitals and speak to the nurses to get information about treatment and what you need for your referral. • Flinders Medical Centre Gastroenterology & Hepatology Unit: call 8204 6324 • Queen Elizabeth Hospital: call 8222 6000 and ask to speak a viral hepatitis nurse • Royal Adelaide Hospital Viral Hepatitis Unit: call Anton on 0401 125 361 or 8222 2081 • Lyell McEwin Hospital: call Michelle on 0413 285 476 or Lucy on 0401 717 971

FreeBlood Safety + Viral Hepatitis

Professional Development via

Book your online education session. All you need is internet access.

Sessions cover: ¤ Blood and bodily fluid safety ¤ An overview of hepatitis A, B and C ¤ Transmission risks/myths (including issues like needle-stick injury) ¤ Testing and treatments ¤ Best practice after blood exposure ¤ Standard precautions ¤ Stigma and discrimination ¤ Disclosure ¤ Available Services

Cost: Free Duration: 1 hour How to book: Contact education@hepsa.asn.au with your preferred date/time (we will then send you instructions, and a link, to access Zoom) 2 HEPATITIS SA COMMUNITY NEWS 87 • September 2020