“Can I talk to you, ask you something?” she continued. She needed to get back to the hospital where she worked; her lunch break was almost over, so we spoke as she walked. Shui* told her story and gave me her contact details.
Her nephew had just got engaged and wasn’t sure if he should tell his fiancé’s family about his positive hepatitis B status. She was worried that the family, if they knew, would oppose the relationship.
She was looking for a hepatitis B friendly doctor who spoke their language, a GP her nephew could consult, and his fiancé’s family could talk to.
In communities from regions of higher hepatitis B prevalence, such stories are not unusual. The adverse outcomes of chronic hepatitis B would be familiar, and the fear of transmission – particularly to children – would be real, especially where childhood hepatitis B vaccination is not universal.
For some, a hepatitis B diagnosis must seem like a huge barrier to a normal life. What many don’t realise is that in Australia, with proper management, it is possible to minimise the impact of the virus and live a normal life. The two key tools are:
Although there is currently no cure for hepatitis B, there is treatment to manage the virus. While not everyone with hepatitis B needs treatment, six-monthly liver checks and blood tests will ensure that treatment can be given without delay, if and when it is needed.
The easiest and best way to protect people close to you is a safe and highly effective vaccine available to people of all ages. For most people three doses over six months will provide life-long protection.
If immunity does not develop after three doses, extra doses may be needed. Your family and household could be eligible for free hepatitis B vaccinations. (https://bit.ly/hepbvax-eligibility-sahealth.)
Hepatitis B is transmitted via blood and sexual fluids; babies do not inherit hepatitis B through their parents’ genes.
Mothers with hepatitis B may pass it to baby during the birth, but this can be prevented with a dose of vaccine and Immunoglobulin given to baby in the first four to twelve hours after birth. Immunoglobulin is a blood product with hepatitis B antibodies.
If needed, mothers with hepatitis B may be given treatment during pregnancy to reduce transmission risk to baby. Unless mother’s nipples are bleeding, breastfeeding is perfectly safe even if mother has hepatitis B.
In addition to regular monitoring, a healthy diet and keeping as physically active as possible will help maintain liver health. Also important is limiting fat and alcohol intake as these are damaging to your liver.
If you are not immune to hepatitis A, get a vaccination. Any additional liver infection would put further strain on your liver.
With proper care hepatitis B should not stop you from living a full, healthy life with your family.
And in case you’re wondering, we found a friendly GP who spoke Shui’s language. Despite having closed books, he made an exception and agreed to see them.
]]>The Guide, available for viewing and downloading at liverwell.org.au, promotes steps that Aboriginal people can take to look after the health of their liver and promote healthy activity, food and drink in their family and community.
There are higher rates of liver disease in Aboriginal communities and it is getting worse. Aboriginal and Torres Strait Islander people are 10 times as likely to be diagnosed with viral hepatitis as non-Aboriginal populations.
Melanie Eagle, LiverWELL CEO, was excited to have the guide available in time for NAIDOC week. “LiverWELL is committed to offering specially designed tools to assist the community to take control of their health and counteract the disproportionate impact of liver disease. We hope that the community will find this a useful resource, and we envisage it evolving over time with further contributions and stories from community members.”
Though designed and published in Victoria, the information in the guide is general enough to be useful for Indigenous Australians everywhere, including in South Australia. Designed by Aboriginal graphic designer Sean Miller, it features a number of exciting Indigenous art pieces to add to its appeal. It is endorsed by Creative Director of the ILBIJERRI Theatre Company, Kamarra Bell-Wykes, who is a strong advocate for good liver health in Aboriginal communities, with whom Hepatitis SA has a strong relationship. Her advice? “Love your liver! Love your life! Love yourself!”
]]>In the current COVID situation, until there are effective vaccines or treatments, the only effective safeguard we have is being careful in how we interact with others: how we greet each other, how we behave in groups, how we project expectations of others’ behaviour, and how we react to unexpected situations.
How do you tell others you’re not comfortable in a particular situation. Conversely, how do you tell whether others are uncomfortable? Is it even possible to organise social events such as birthday celebrations, friendly get-togethers and workshops that are enjoyable and positive?
This is of great concern to us here at Hepatitis SA. Our client communities, many of our staff, volunteers and members, or their families are especially vulnerable to the effects of COVID and other infections.
Consider these examples:
In all these cases, there is a genuine risk of COVID spread. Plenty of people have contracted the virus without being aware they were exposed, and gone on to mingle with other people before finding out that they are COVID-positive. Through a mix of good management and good luck, South Australia has so far been relatively unscathed, but there are no guarantees that this will always be the case.
So the big question is: what’s good COVID etiquette? When is it OK to shake hands, hug, and get physically close? Two main approaches suggest themselves. The first is that it is up to individuals to declare their vulnerabilities, such as compromised immune systems, so that others know to follow physical distancing rules with them. The second says that nobody should have to declare their vulnerability because we should automatically act as though everyone is vulnerable, unless special circumstances call for the breaking of that assumption. After all, some people who are at extra risk don’t even know it.
One possible way to manage the first approach is the OrangeAware campaign. For this, people who are unusually vulnerable wear orange—an orange badge or ribbon or wristband—to warn other people. As OrangeAware’s founders put it, “If you are at higher risk of contracting or at most risk to the effects of COVID, if you are a frontline worker, have low immunity, are immuno-compromised, if you are elderly and feel at more risk, if you care for or work with anyone who is at special risk to COVID—please wear orange as a gentle reminder to let everyone around you know to take extra care and keep their distancing.”
This has the advantage of simplicity and also doesn’t require those who are vulnerable to have to go out of their way to verbally identify their issues in every social interaction. But it also has a couple of obvious disadvantages: most people aren’t going to have heard of OrangeAware or know what the colour signifies, and it requires the vulnerable to single themselves out and draw possibly unwanted attention to themselves. As one person interviewed for this article explained, “I take issue with the OrangeAware approach where the vulnerable person has to declare to the world that they’re vulnerable.”
These drawbacks suggest that the second approach is a better idea. If we act as though everybody is vulnerable, and take appropriate precautions, then it makes every situation safer for everybody. Look at the practice of universal precautions in healthcare: nurses and doctors act to protect themselves and others from blood-borne viruses like hepatitis and HIV, as well as other infections, as a matter of course, whether or not the people they are dealing with have told them that they are living with such a condition. Hepatitis SA are great supporters of the concept of universal precaution, as it both helps remove the need for people to subject themselves to stigma through trying to make other people safe, and lowers everybody’s risk of contracting viral hepatitis and other blood-borne diseases.
If we all act as though everyone is vulnerable, nobody needs to volunteer private information about their own lives. Nobody needs to be made to feel uncomfortable or guilty about speaking up in a situation being recklessly managed, whether that’s at work or in their social life. Nobody needs to endanger themselves or their loved ones because of somebody else’s assumptions about what is safe and appropriate. Nobody should be made sick with a life-endangering disease because of peer pressure or embarrassment.
Of course, some people are always going to be too ignorant, macho, bloody-minded or thoughtless to act in this way. But if everybody else is making safe behaviour normal, then the number of risky situations will be dramatically reduced, and the chances of spreading COVID will be minimalised.
So how can those in charge of organisations and activities be encouraged and supported to make this the normal way of doing things? As always, the answer is likely to be a mix of the carrot and the stick. Governments, employer bodies, companies, unions and community groups need to be unequivocal about what is acceptable, and they need to be supported with resources and funding to make it as easy as possible to make interactions COVID-safe. But individuals need to be supported too, with clear ways for them to raise issues or make complaints without being punished for it.
COVID is likely to be a part of life for some time to come. But we are lucky in that it is a disease the dangers of which can, to a great degree, be minimised by forethought and simple precautions. Let’s work together to make caring for one another’s health an automatic part of how we interact.
Do you have a story about a difficult COVID-unsafe situation? Contact us in the comments below or at editor@hepatitissa.asn.au to let us know.
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The current federal government has an unfortunate track record for making impressive funding announcements, and then, months later, making them again as though they were new. Sometimes this is repeated several times–the recent manufacturing funding announcements which garnered wide positive media coverage have now been announced multiple times, without the money yet being spent. Consider this summary from The Monthly‘s Nick Feik:
A plan for manufacturing is a great idea, for sure. It’s so great, in fact, that this is the fifth time in 15 months that he or Industry Minister Karen Andrews has announced one. In May and June this year, and on two occasions last year (May 2019 and Sept 2019), the Morrison government announced almost identical strategies. Last year’s announcement, for example, promised to create “1.25 million new jobs over the next five years” by co-funding investments in new technologies. You’d be right to wonder what happened to that strategy. And the others. The short answer is: very little.
Hepatitis Australia, the national peak body on viral hepatitis, is understandably concerned that the 2019 Health Budget funding for hepatitis commitments is yet to hit the ground, even as 2020’s announcements are made.
“Excellent science, acting with affected communities and solid implementation underpins good public health,” said Carrie Fowlie, Chief Executive Officer (CEO) of Hepatitis Australia. “Hepatitis Australia welcomed the Australian Government’s announcement of an additional $45.4 million over four years, commencing in 2019-20, to increase public health prevention and promotion activities to deliver on the goals of the five National Blood Borne Virus and Sexually Transmissible Infections Strategies.
“We are pleased that this funding from the 2019 Health Budget still stands, however we are concerned that the majority of this funding is yet to be allocated. This is particularly concerning given the falling hepatitis testing rates since the beginning of the COVID-19 pandemic,” said Ms Fowlie. “Pathology testing data shows that there has been a decline in tests for non-COVID conditions, and in the case of hepatitis we understand that the numbers have not yet recovered.
“Recent data from the Viral Hepatitis Mapping Project shows that Australia is no longer on track to meet the nationally agreed targets outlined in the National Hepatitis B and Hepatitis C Strategies 2018-2022.”
“We urge the Australian Government to release the implementation funding under the National Blood Borne Virus and Sexually Transmissible Infections Strategies. This funding is crucial to ensure that Australia meets its 2022 targets and Australia’s commitment to eliminating viral hepatitis is realised,” said Ms Fowlie.
Hepatitis SA is similarly concerned about the reduction in hepatitis testing and treatment (see our cover story here about why now is the best time to act), and we are extremely keen to see all government funding commitments met so that the lives of those living with hepatitis in Australia can be improved.
]]>It’s the time of year when articles about the magical benefits of detoxing flood the media. A fresh start is always appealing, especially when you’ve over-indulged. Unfortunately, detoxing—the idea that you can flush away stored toxins from bad food, alcohol or drugs—is a myth; our bodies simply don’t work this way.
To begin with, these toxins aren’t stored in our bodies. Luckily for us, our liver, kidneys, lungs and skin are breaking down and removing them all of the time. Nothing we do can make this system work better, aside from being healthier. (See medical researcher Nick Fuller’s article: Science or Snake Oil: can a detox actually cleanse your liver? )
… some detox products even contain ingredients that could be harmful for your liver. This is especially worrying for people with … liver disease.
Sadly, quick-fix detox is a big business and this multi-billion dollar industry takes advantage of the fact that their products are unregulated. Manufacturers try to lure us in with promises of renewed energy, glowing skin and healthier livers. The truth is that not only can’t they prove these miraculous results but some detox products even contain ingredients that could be harmful for your liver. This is especially worrying for people with viral hepatitis or liver disease.
Strict diets and juice fasts are also promoted as a way to detox but these won’t affect how quickly your body deals with toxins either. Depending on the diet you may feel better or worse, it’s anybody’s guess.
In contrast, looking after yourself properly has real benefits that can’t be matched by a mythical detox. Here are our top tips for feeling better this year.
Fresh fruit and vegetables, good carbohydrates, good fats, lean sources of protein and low-fat dairy (or substitutes) are all high on the list of foods that are good for you and make you feel good. While the occasional treat is good for your mood, living on a regular diet of junk-food is not. Our Eat Well For Your Liver resource has more information and recipes.
Our liver has a clock and needs a good block of sleep at night to perform some of its most important functions. Aim for 7-8 hours most nights. See our post on sleep for some tips if this is hard for you. See Working with your liver’s clock to learn more about your liver’s cycle.
We all have different capabilities but some form of exercise is beneficial for most people, most of the time. Low intensity, unfocussed exercise such as a stroll or roll around the park can really lift your mood. Regular, moderate exercise can improve fitness, wellbeing and quality of life. Think about what is possible and enjoyable for you and aim to do a bit more than you do now, building up over time.
People with viral hepatitis or liver disease need to be especially careful about the amount of alcohol they drink. If you want to drink it’s best to discuss it with your doctor or specialist so you know what’s right for you. Drinking more than your liver can handle can make you feel bad now and damage your liver in the long term.
Not only does smoking increase the risk of developing liver cancer for people with viral hepatitis, smoking makes you feel bad, mentally and physically. If you still smoke quitting can make a real difference to your health and how well you feel day to day. The Quitline can help – 13 78 48
Most importantly, if you have viral hepatitis or other liver disease, make sure you are getting the proper medical attention.
You can’t control all aspects of how viral hepatitis makes you feel but if you haven’t been getting the care you need, be sure to visit your doctor or contact the viral hepatitis nurses. People with hepatitis C can now be treated with an over 95% success rate and new hepatitis B treatments are managing the condition better than ever before. If you have hepatitis B or other liver diseases regular monitoring is vital to maintaining your health and helping you feel better.
Call our Helpline on 1800 437 222 for more information. Click here for a list of South Australian liver clinics.
Further reading on the detox myth
https://theconversation.com/do-you-really-need-a-detox-52077
https://www.theguardian.com/lifeandstyle/2014/dec/05/detox-myth-health-diet-science-ignorance
https://www.sbs.com.au/food/article/2018/01/11/no-detoxing-isnt-actually-thing
People with chronic viral hepatitis may face the challenges of:
Unfortunately, there is evidence to show that those living with long-term viral hepatitis are at increased risk of becoming depressed. Although it isn’t known exactly why this is the case it is thought that the most likely causes are a combination of the physical and psychological effects of the disease. Looking at above list this is hardly surprising. They have a lot to deal with emotionally, as well as physically.
Learning better ways to deal with stress and uncertainty can have a real impact on your mental and physical health and lessen the chances of becoming or staying depressed and anxious.
A promising new approach, called self-compassion, could be helpful for people with viral hepatitis.
Self-compassion may:
Practicing self-compassion has been found to improve wellbeing and life satisfaction and reduce levels of depression, anxiety, stress and shame.
Being kind to yourself
Self-compassion is the practice of treating yourself with the same understanding, kindness and forgiveness that you would a cherished friend. Rather than ignoring your suffering or berating yourself for your failings, respond to yourself with gentleness and compassion.
Accepting your shared humanity
Self-compassion recognises that every human being is flawed and that people rarely get exactly what they want in life. Accepting that you are only human too can help you to feel less isolated in your suffering and more a part of the shared human experience of life.
Being mindful
The self-compassion approach encourages you to step back from negative emotions and view them mindfully rather than taking them as literal truth and getting caught up in a negative spiral of self-blame and worthlessness.
Many people mistakenly believe that they need to be tough with themselves to get through difficult situations or to avoid making mistakes in the future. In fact, not only does this approach not work, it can make things worse.
Unchallenged feelings of self-blame, isolation and shame make people more likely to:
Next time something goes wrong or you’re facing painful or challenging feelings, try some self-compassion. Instead of the same old critical or self-blaming responses:
If you need to you can come back to thinking about your problem once you feel better and can think more clearly.
When you think about it, treating ourselves harshly only makes a difficult situation worse. We’re far more likely to cope well with hard times with a little kindness.
And remember, there’s no need to deal with everything by yourself. If you need some support our confidential Helpline is available weekdays (except on public holidays) from 9am – 5pm. Call 1800< >437< >222.
Free counselling is also available for people with hepatitis B, hepatitis C and HIV through MOSAIC Counselling. Call 1300< >364< >277.
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Every Australian will have a My Health Record account set up, unless they choose not to have one. If you choose not to have a record you can opt out between 16 July and 15 October 2018.
If you want a record in My Health Record, you don’t need to do anything. After October 2018, health services will upload the past two years of your Medicare and pharmacy records into the system.
Already, five million people have records in My Health Record. There is now a three-month period for people to opt out by closing their record or stop one being created.
A record in My Health Record will include:
– Medicare records for up to two years
– Prescriptions
– Test or scan results
– Medical conditions and treatment
– Immunisation records
– Specialist referral letters
– Hospital discharge summaries
Once a record is created, you can access it online with a personal access code, where you can add, restrict access or ‘deactivate’ information and apply control features and monitor who has access to your record. However, in an emergency, or where your or another person’s safety is a concern, health workers can ask for any restricted access features to be lifted for five days.
You can also add personal health summaries, allergy information, care plan information, Indigenous status information and other personal information you choose to share.
Health staff can look at your records and information. When you go to a GP, clinic, hospital, pharmacist, dentist or use an ambulance, health care workers can see what’s been happening with your health. My Health Record may improve and support coordination of your care. It may reduce doubling up of tests, prevent drug-drug interactions from prescriptions, and save time in an emergency or where you are unable to communicate.
Health workers will add to your record after each visit, prescription, or test.
If you change doctors, with your consent, all your test results and medical information can be available to your new doctor without the hassle of transferring your files. It also prevents health information getting lost.
According to the Government, the information in your My Health Record is securely held and cannot be accessed by anyone other than you (or people with your login details) and healthcare workers. Your information is not published online, it is not able to be searched for on the internet, and the Government has stated that your My Health Record data is unlikely to be stolen or hacked.
Unfortunately, people affected by viral hepatitis sometimes report that they experience changes in the attitudes of health care workers and/or the way they are treated, compared to other people, after the health care workers learnt of their hepatitis status. This stigma and discrimination can affect people’s health and safety.
Your health information may be shared with other people or agencies, including researchers, insurance companies, police, immigration or community services
To protect your privacy and safety, you may have been going to one service, such as your usual GP for some things, and going to another health service, such as a sexual health clinic for other matters. My Health Record will share your medical records among all the health services you visit, including GPs, dentists, pharmacists, clinics, and hospitals. If, for example, your record shows you have been tested or treated for hepatitis B or hepatitis C, this information may be seen in your record by all your health care workers.
If you have a record, you can control who views information by going online and changing your privacy settings or ‘deactivating’ data. However, if you ‘deactivate’ data, the information is not deleted, and a copy will be kept in the system. You can choose what is added to your record by clearly telling a healthcare service provider that you do not want your health information uploaded each time you visit them.
The Government says Australians can cancel their record at any time after the end of the opt out period – or create one, if they opted out initially. However, other government departments or other people may be able to legally access your records.
The laws about who can see a person’s health record are very broad. In the future, your health information may be shared with other people or agencies, including researchers, insurance companies, police, immigration or community services.
Currently health information kept in medical files can only be given to these third parties after they get court approval. Once the new system starts, health records may be viewed by third parties if authorities “reasonably believe” the information may prevent or solve a crime, prevent “improper conduct”, protect public spending, or be relevant to a case before a court or tribunal. The laws about this are in the My Health Record Act 2012 (Commonwealth)
Some people may find that their record places them at risk of stigmatisation and discrimination, or may create safety issues for them.
You may wish to consider carefully whether you want your health record held online or shared if you:
– have a criminal record or are affected by the criminal justice system
– use or have used drugs
– live with a lifelong transmissible condition such as HIV or hepatitis B,
– have or had hepatitis C
– are not on treatment after it was recommended
– are sexually active and test regularly for STIs
– are or have been a sex worker
– are transgender or intersex
– are bisexual, lesbian or gay
– have lived with mental health issues
– have been pregnant or terminated a pregnancy
– are a health care worker
You can choose to opt out – but only have from 16 July to 15 October 2018 to do so. If you have any doubt, opt out. You can create a record later if you change your mind.
You can opt out online or by filling out a paper form. Register to opt out here: https://www.myhealthrecord.gov.au/for-you-your-family/howtos/opt-out
If you choose to have a record in My Health Record, you don’t need to do anything. Your records will automatically be uploaded. To view your information in My Health Record, you will need to create a myGov account at https://my.gov.au/ and register with My Health Record.
Read more at the My Health Record website at https://www.myhealthrecord.gov.au/
Our thanks to Hepatitis New South Wales for preparing the paper on which this post is based.
]]>Almost eight out of ten people living with hepatitis C are not current injecting drug users. Although the majority of Australians who acquire hepatitis C did so through unsafe injecting, 67 per cent (124,590) of them are no longer injecting drug users.
Close to 230,000 people were living with hepatitis C at the end of 2015. Of these, 25,000 (11%) were born overseas in regions of high prevalence and almost 16,000 (7%) contracted the virus through transfusion of unscreened blood and blood products, unsterile medical procedures, or mother-to-child transmission.
These numbers, presented in the Reaching Out: Part 1 report from Hepatitis Australia, suggest that a vast majority of those who need to be reached for testing and treatment are not necessarily engaged with the usual services where such information is being disseminated.
The Reaching Out project is funded by the Australian Government Department of Health. Its brief is to “develop and deliver general education and awareness on hepatitis C, available testing and treatment options to individuals with hepatitis C who have either not injected drugs or have done so in the past but no longer identify as a person who injects drugs.”
The project does not suggest that people who inject drugs were any more or less deserving of access to treatment than any other group. Rather, it indicates that if Australia is to eliminate hepatitis C by 2030, there need to be ways of getting the test and treat message out to the diverse group of people who live with hepatitis C.
Part one of the three-stage Reaching Out project looked at estimates and projections of people with hepatitis C in Australia as well as the demographics.
The report identified key non-injecting user communities who may have higher prevalence of hepatitis C. They include:
While the exact number of Australians living with hepatitis C who do not identify as a person who injects drugs is not known, information suggests that the group is extremely diverse. The purpose of the report was to synthesise evidence which can be used to develop tailored communication and engagement strategies for these groups.
Reaching Out Part Two, which looks at strategies for connecting people living with hepatitis C to clinical care, is also available and may be read online here.
The project is currently developing useful, accessible information resources to support the awareness campaign. If you work with any of the communities mentioned above, please feel free to contact us with your suggestions and ideas.
This article first appeared in the Hepatitis SA Community News, issue 75. Read more here.
]]>Part One will cover the No Added Salt diet recommended by GESA and many other medical associations around the world.
Part Two will discuss tracking your daily sodium intake so that you can see whether this is a realistic option for you.
Part Three is for people who don’t cook and rely heavily on takeaway or supermarket meals. We will look which of these foods you are able to continue eating and what types of changes you might need to stay within the recommended daily sodium intake.
Each part will consider the costs and benefits of each style of eating and have links to recipes or further resources.
GESA recommends that people with liver disease limit their daily sodium intake by following a No Added Salt diet. We recommend that you read through the GESA pamphlet in full if you plan to follow this diet (the word diet is used to mean “way of eating” and not “weight loss plan”).
Some of the benefits and costs of following this style of eating are listed in the table below:
Benefits | Costs |
No need to track or count, just stick to “allowed” foods. | Lack of flexibility. Can only eat “allowed” foods. |
A highly nutritious diet that has many health benefits. | Few pre-prepared foods meet the “no added salt” requirement. |
Can be a lot of work to prepare all of your own food. | |
Options for takeaways or eating out are very limited. | |
Loss of favourite foods and flavours. | |
Loss of the social and cultural aspects of eating certain foods, especially for special occasions or with other people. |
It is important to note that the GESA recommended diet includes bread and bread products. Although this may seem contradictory as bread is generally highly salted, bread makes up an important part of a Western diet and if the rest of your diet is low in salt you should be able to eat moderate amounts and still remain within the daily limit without any need for tracking.
An example of a one week meal plan is included below. A variety of meals from a number of sources has been included to show that it is possible to source some flavoursome, low sodium recipes. Examples of suitable snacks and desserts are also included.
Monday
Breakfast – Quinoa Porridge
Lunch – Hummus, veggies & pitta
Snack – Piece of fresh fruit
Dinner – Pasta Primavera
Tuesday
Breakfast – Low sodium cereal with milk and sliced banana (check brands and aim for below 120mg of sodium per 100gm serve)
Lunch – Grilled veggies & mozzarella wrap
Snack – Handful of unsalted nuts
Dinner – Salmon with warm tomato and herb dressing
Wednesday
Breakfast – 2 slices of toast with no added salt peanut or nut butter OR sliced tomato and avocado
Lunch – Low sodium egg salad
Snack – Fruit yoghurt
Dinner – Balsamic Chicken
Dessert – Baked Banana with Honey
Thursday
Breakfast – Apple Bircher Muesli
Lunch – Grilled chicken and avocado sandwich on wholemeal bread such as Burgen or other low salt brand
Snack – Sweet biscuit (check brands and aim for below 120mg of sodium per 100gm serve)
Dinner – Herbed lamb salad (use oats if unable to find low-sodium bread crumbs)
Friday
Breakfast – Porridge, lots of ways
Lunch – Pasta salad
Snack – English or fruit muffin with unsalted butter & jam
Dinner – Roasted red peppers with tuna & herbs
Saturday
Breakfast – Poached eggs (do not use the added salt in the recipe) on toast with reduced salt baked beans
Lunch – Tuna Bean Patties
Snack – Apple and oat muffins
Dinner – Portuguese Style Chicken
Dessert – Strawberry Yoghurt Crunch
Sunday
Breakfast – Buckwheat pancakes with berries
Lunch – Butternut squash soup, stock recipe here
Snack – Unsalted popcorn
Dinner – Spicy beef rendang
Dessert – Ricotta & Almond Stuffed Apples
All of the recipes included in the meal plan above are low sodium, however not all of the recipes at the sites below are so you will need to check the ingredients list for added salt or salty ingredients.
For an introduction to reducing sodium in your diet go to our earlier post ‘Low Salt? But what will I eat?‘. It includes information on converting grams of salt into milligrams of sodium, how to read nutrition labels and links to supermarket shopping guides.
In our next post we’ll look at ways to track your daily sodium intake to allow for a wider range of foods.
*In September 2017, the National Health Medical and Research Council (NHMRC) revised the Suggested Daily Target (SDT) for sodium to 2000mg/day. The Upper Limit (UL) – previously 2300mg/day – was revised to “not determined” to reflect the inability to determine a point below which higher sodium intake was not related to higher blood pressure. For more information visit the Nutrient Reference Values sodium page.
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It seems a bit trite to say that a happier lifestyle will increase the chances of stronger health. How do we actually break this down into achievable steps? If we look at the specific traits or skills that are helpful in developing emotional strength and how to deal with the flip side of corrosive attitudes, then we can start to develop a stepped approach to better health.
Here are some starting points for improving our emotional outlook, with links to specific resources that are free to access online.
These resources are all taken from the mental health and self-help category of the Hepatitis SA online library’s catalogue which has a wealth of easy to access information. Hint: click on the Quick links headings ‘mental health’ or ‘self help’ (under the search box) for comprehensive lists and links to free resources.
…a balanced approach to managing… emotions could strengthen the ability to deal with physical illness and even strengthen our immune system.
Coping with stress, anxiety, depression and grief
Research shows that a balanced approach to managing these emotions could strengthen the ability to deal with physical illness and even strengthen our immune system. Here are some resources to help you start the process:
The Surprising Benefits of Stress (Greater Good Science Centre, Berkeley, 2015): looks at the difference between good stress and bad stress and how to respond to stress in a healthy way
Tips for finding motivation with depression (Medical News Today, Bexhill-on-Sea, 2017): advice and links to source materials about the benefits of physical activity, socialising, avoiding depression triggers, when to see a doctor and when to seek emergency treatment
Get to know anxiety (beyondblue, Melb, 2014): 10 short videos informed by stories and feedback from people who have experienced anxiety. They contain practical information about recognizing and dealing with the various aspects of anxiety
Staying strong through grief and depression (Aboriginal Health Council of SA, Adelaide, various dates): a series of videos about coping with sadness, depression and grief and outlining the importance of connecting with family, friends, music and culture
Drug use, chronic hep C and stress (AIVL, 2013) addresses the unique stresses in the lives of people who inject drugs and gives some lifestyle tips for reducing, or dealing with, stress.
Evaluations of therapies based on meditation and relaxation are overwhelmingly positive…
Relaxing into a stronger life
Evaluations of therapies based on meditation and relaxation are overwhelmingly positive and there are many free reputable meditation sites available – here are some from our catalogue:
Meditation toolkit (ABC Life Matters,Sydney, 2012) includes: explanation of what meditation is and how to do it, how meditation can improve your health, audio practices of different styles of meditation and a diary to keep you motivated
Meditation on the breath (Hepatitis C Trust, London): a 14 minute audio file intended to increase your ability to relax and enjoy more of your life
Relax and dream: (made in conjunction with Royal Alexandra Children’s Hospital, UK): Seven short films of nature locations, with original music. The aim is to reduce the stress of modern living.
First aid for your emotions
And for some extra inspiration: have a look at this video by Psychologist Guy Winch: Why we all need to practice emotional first aid (TED talks & Linnaeus University, New York, 2014): “a compelling case to practice emotional hygiene – taking care of our emotions, our minds, with the same diligence we take care of our bodies”*.
…and there’s more…
Of course these are all just ‘tasters’ – starting points for making changes in your own life in whatever way is practical. We have many other useful, free online resources listed in our catalogue (see box above)…and most G.P.s are now able to give advice and referrals to allied health professionals for more tailored support.
*PS: if you like the idea of the TED talks: there’s a whole playlist of ‘what makes you happy?” at: http://bit.ly/tedplaylist_whatmakesyouhappy .
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