Copyright 2006 St. Louis Post-Dispatch, Inc.
By HARRY JACKSON JR.
St. Louis Post-Dispatch (Missouri)
After 28 years of nursing, Katherine Bryson learned that she had hepatitis C, and that she may have had it for two decades without knowing.
She learned she had it three years ago, when she accidentally pricked her finger on a hypodermic needle left open in a desk drawer.
She thought nothing of it at the time. The needle was clean and unused, but protocols for health care workers require that after a puncture or cut, they be screened.
Normally, that’s just routine. This time, the screening resulted in a call that changed her life. She had the virus, and it had been around a long time. That meant she might have liver damage, and she’d need more tests.
The U.S. Centers for Disease Control and Prevention considers hepatitis C the nation’s most common blood-borne infection — 4 to 5 million Americans have it, more than are infected with HIV, the virus that causes AIDS. The disease scars the liver and can cause cirrhosis. Cirrhosis left untreated can cause liver cancer.
These diseases may not show any symptoms. So if cancer occurs, by the time it’s discovered, it’s too late for most people. Up to 85 percent of liver cancers are linked to hepatitis C.
Bryson had no symptoms of hepatitis C. But after the screening, more tests found a grapefruit-sized cancer on her liver.
It gets worse:
Hepatitis C, even in hospitals, is the fodder of gossip. The stigma is that you get it from the same practices linked to HIV: indiscriminate sex and intravenous drug use.
The truth is, anyone can be infected.
It’s true that the majority of infections can be linked to avoidable behavior. But Bryson is incensed that the stigma overshadows the fact that thousands of people with the disease got it by working as nurses, law-enforcement officers, military personnel, EMTs or in any occupation that requires exposure to blood.
“It’s like the moment people hear hepatitis C, they dismiss it; they say you’ve brought it on yourself,” she said.
“Even I was guilty. The moment the doctor told me, the first thing I said was, ‘I didn’t do anything wrong.’ Well, I didn’t do anything wrong, and I have it.”
Bryson led a conservative life — married 25 years, one child, a religious upbringing. But she worked as a licensed practical nurse for 13 years before researchers identified hepatitis C in 1988.
Treatments:
Surgeons removed the cancerous tumor and roughly half of Bryson’s liver. As for the hepatitis C infection, she can’t be treated for that until she is certified free of cancer. She is undergoing chemotherapy, and the hepatitis C treatment conflicts with her chemotherapy drugs. The CDC says treatment can get rid of the virus in some but not all patients.
Ironically, Bryson feels lucky for that pin prick in October of 2003.
Had the tumor grown for only a few more months, she would have died.
But her life has continued and she’s become a celebrity among liver researchers at St. Louis University School of Medicine. “My tumor is in pieces all over the university,” she said with a laugh.
What next:
Just staying alive wasn’t enough for Bryson. She had always been a caretaker — patients, her parents, her family.
Being a nurse gave her the virus, and being a nurse would be the way she would fight it, not only for herself, but for thousands of other nurses, EMTs and nurse’s aides.
The CDC estimates that thousands of health care workers may have hepatitis C and don’t know it. That doesn’t take into account police, fire and other public safety officers who are exposed to blood.
And Bryson says she still sees health workers who don’t follow safety protocols. “Even now,” she said, “I see nurses, doctors, doing (procedures) ... no gloves. Always rushing.
“One nurse told me (years ago) that she didn’t have to be concerned; she’d been vaccinated. There is no vaccination for hepatitis C.”
Bryson wants routine tests for hepatitis C for health care workers or anyone else. Currently, unless you’re injured at work in a hospital, you have to ask for a test. Health workers are tested in the case of an accident such as Bryson’s, but they’re not required to be tested any other time.
In the meantime, she says, a nurse shares a razor, a toothbrush or has sex regularly with a spouse; or she’s pregnant and passes the virus to her child.
“And she didn’t engage in any questionable behavior,” Bryson said. “And so what if she did? That doesn’t mean you get the death penalty.”
When Bryson was diagnosed with hepatitis C in 2003, a liver specialist told her that by the condition of her liver, she had probably had it for nearly 20 years. Her spouse is not infected, nor is her daughter.
The war:
In her campaign to get testing for health care workers, Bryson found two champions in the Missouri House of Representatives: Jim Lembke and Charles Portwood, both R-St. Louis County. They introduced legislation that would make hepatitis C testing mandatory for people being hired to work at hospitals or as “first responders” — those working in ambulances, police, firefighters.
The measure would require the Missouri Department of Health and Senior Services to design and oversee testing at the expense of the employer. The tests are inexpensive — under $30.
The effort ran into opposition from the health care industry, which feared the legal liability would allow people to blame their employers for their hepatitis C infection.
“I can see the point,” Bryson said, “so we’re trying to draft the legislation so it protects against that.”
But there was one legislative victory: Lawmakers passed a resolution declaring that from now on, May 10 will be Hepatitis C Awareness Day in Missouri. Bryson is already planning for next year’s event, which will include education programs and testing.
Looking for allies:
Bryson has started a campaign — the green ribbon, a symbol of support for liver cancer. And she’s blanketing the state to fire up awareness activities.
On May 10, for example, 275 people were tested for hepatitis C at an awareness rally in Cape Girardeau, Mo. Of the results reported so far, 31 people tested positive for hepatitis C.
It’s both a small step and a major step, she said. “These people volunteered to come out and be tested,” she said. “The word is getting out.
“C. Everett Koop (former U.S. surgeon general) said it, that this is a catastrophe looming, especially among baby boomers. There are about five million people who have hepatitis C, and 75 percent of them don’t know they have it.”
A good nurse helps people who are sick, she said. “And I’m not going to stop as long as I can draw a breath.”
Bryson works with the Julia Spears Foundation, a Tennessee-based effort founded by the wife of a musician who played for Willie Nelson. Its Web site, www.helpwithhepc.com, is undergoing renovation; if you would like more information about Bryson’s awareness campaign, you can e-mail her at spearsfndstl@aol.com.