Moral / Legal oblgation to tell a new employer about Hep B

[ColC]

As a newly diagnosed Cronic B candidate. I am interested in hearing other peoples views on the moral/legal obligations to tell a new employer. I ask as I am in this situation and while I passed the company medical for an international posting (Liver panel was normal), I am in 2 minds as to what to do. I already feel like a leper and am worried about losing the job.

[ColC]

All well with family which is good, I start work again tomorrow, I have enough to do to keep me occupied for at least a month working from home which is ok, after that we shall see. As I said my role was supposed to be in the middle east.

I trawl many sites so I guess its time now to get on with things, but at least I have enough information to ask the doc sensible questions.

The ME doc was good but time did not allow me to get a biopsy and without that he would not speculate as to my treatment, but he has given me his personal e-mail should I need questions answered, which is nice.

Enjoy the gardening, I have spent time cycling etc with my son so all is well on that front.

C

[britgirl477]

That sounds great. You seem to really be getting on top of things and making all the right important moves about your health and work. I think Russia would be very interesting place to work lol. Never been there.

The guy I see in my city is very big in livers too apparantly my hospital is notorious for people coming from all over place to get seen!!!! I have to say I have been impressed with him so far and he has been right on the ball so far with my care. But whatever doc you have it's still a bummer to have to have this sodding disease to begin with. I guess going private for an HBV condition is probably quite nice and 'private'. You will be seen in a nicer more comfortable environment etc.

I hope you are managing to do some stuff other than being on this site all day/night. I am having to ban myself from being on this site for a bit. I spend too much time reading thro' posts and getting further worried about my situation.

Did the doctor not go thro any details of your last blood results? As in HBV DNA level - what is that and what did he say about it etc? AST and ALT? anttibodies and antigens etc?

How is your wife and son? They are both clear right and both are getting vaccinated? The thing is that if you have been away from home working then there is prolly less chance that they were able to catch it from you lol. So in fact altho you prolly hate being away from your family like that, it has in fact been a blessing in disguise.

I am on pills (Tenofovir) now for 10 is days. I can't say I notice any terrible side effects apart from some initial joint pain etc and mild upset stomach. But I hope they are doing their job well and booting this out of my body. I am hopeful but who knows? I am tearful at the thought of never having a glass of wine again lol....and I am not even a drinker, but it's just that I don't like to be told what I can  and can't do. However if this is with me for life then I will not ever go near drink ever again.

I have been gardening this afternoon and was watching on youtube that there is such a thing as a hepatic plant. Called that because the leaves are shaped like a liver...so I am going out to buy one and I am going to care for it very well and give it pride of place in my garden!
Brit

[ColC]

Hi BritG

Fridays meeting was a wash out. Open surgery, he looked at my results and then made an appointment for a months time, from what I can gather he also wants to repeat the tests. So plan B for the UK is to go private, yhes you are right, I will see the doc I want but he is also the NHS doc, although his office is in the Private hospital.

All is not lost with me and I am making plans, the company are looking to see if I can fit into a European role but I am not hopeful, after all I was employed for the mid east.

All is not lost as I thing I have an offer to work in one of the old Russian states starting in 2 months. Hence I am keen to jump start the treatment process by whatever means possible.

You are right, I am a fighter and will not let this thing beat me. I am happy with the doc and drugs in mid east, the spec there is an authority on these diseases and regularly lectures in the UK. So going there for 2 weeks to kick start the process if my firm agrees would be nice.

Col

[britgirl477]

Glad to hear that you had your meeting yesterday. Did the doc take blood from you? Your results may take a time if they are checking for whole host of things at one time. I know mine have taken up to 2 weeks.

I can appreciate your anxiety about getting to see certain specialists etc...but I can honestly say that if I am ill and have choice of nhs or private I want the nhs every time. They get bad press but the docs are really fantastic. At any rate your private guy will only be a nhs doc coming to see you in his moonlighting hours lol...so no worries what choice you make I guess. I suppose with private he may take more time to explain in detail etc, altho again I must tell you my doc has spent an hour at a time with me and that is nhs in major scottish city!!!!

Make sure and ask all the qns you need to. Is your work going to let you return back to Middle East?? That's great if they do.

I would imagine that if you are put on tablets in MEast then they will be bale to carry on with same tabs over here. I assume that the tablets are pretty much same ones used in most places. Altho' I did read on one post that in Asian parts ther most up-to-date drugs tend to filter thro to them much slower around 2 years slower..hmmm.

I don't think there needs to be much in way of ups and down with this condition. You are in particular situ with job that maybe I am not but it doesn't have to run your life. You know the old phrase 'when one door shuts .....' well maybe you are looking now for your next opportunity, for your new experience. Maybe that's gonna be working in Europe?? Maybe it's gonna be doing something new altogether??????? You are an intelligent young man who can kick this thing hard in the ar*e. The virus tries to mess with your mind making you feel shame, fear, etc etc...well you should be standing with your fists up and hitting it hard back. Show it what YOU are made of. You will look back on this soon with a less anxious mind. I have only been 8 months in this game and I am already talking fighting talk. I am not gonna let this thing drag me down. And neither should you. You pick yourself up shake yourself down and move on. And any debris that falls after you shake yourself down, you leave it and don't look back.
Brit

[ColC]

Thanks for the follow up. Basically it was just an intro meeting, no substance and 1 months wait for a proper follow up. I did not see the specialist I wanter to either.

I am fortunate in that I have private medical so on Monday I will make an appointment with the specialist privatly.

Lots of ups and downs on this Hep B thing arnt there. I am also speaking with my employer to see if I can go back to the middle east, there I can walk in to the hospital without an appointment or a referral and see the specialist. He reckons he can do a biopsy with a days notice and then once the results are in  recommend course of treatment.

I am guessing that if I come back to the UK with an approved course of treatment I can carry on here with those drugs, any thoughts.

But this option depends on my employer.

Col

[NashPred]

Exactlly…

Sometimes it even causes ME some stress when I am around people that know about my condition. I find myself wondering if they are thinking that they can catch it from me by just being in the same room.

I’ll admit to being uneducated about HBV before I was diagnosed. If someone had told me they had it, I may have found myself wondering if I could catch it from them too....I like to think that I would understand, but I'm pretty sure I would have had some concerns.

[britgirl477]

Glad to see you agree with me Nash. I was concerned maybe I was being to cynical about the human race. But I really think that seeing as there is no way that neighbours/friends are going to catch HBV from you, then why rock the boat by even mentioning it to them?
Brit

[NashPred]

I agree with britgirl. You have no obligation tell anyone that really doesn’t have the need to know. Most people are afraid of what they don’t understand and even after you explain it to them, most still will not understand. This is a difficult disease to wrap your mind around when you have it and even harder to understand when you don’t have it.

I have lost 1 friend that I told and I I have noticed a change in some other people that I told in the way they act toward me…..sad but true. It’s kind of like when AIDS/HIV was first discovered and people were scared to be around anyone who had it. A lot of THAT attitude has changed because people are more educated about it now, but in the beginning, some people were scared to shake someones hand for fear of contracting HIV. Even though HBV has been around a lot longer than HIV, it seems like the education of the general public (even some doctors) in regards to HBV is light years behind.

If you tell your friends, you may end up finding out who your REAL friends are. Even the friends that stand by you may still have fears somewhere deep in the back of their minds. I can even have an effect on the rest of your family members friends….people may not want their children playing with you children, people may decide not to eat dinner at your house, etc etc. It is just easier to keep it on a need to know basis.

That’s  my take on it anyway.

[britgirl477]

How did you get on today at the specialist?
Brit

[ColC]

will do

tks

[britgirl477]

You just do what the doc says as they are super intelligent. It is also a very complex virus. It's taken me ages to understand the basics. You want to get the HBV DNA down to UND or negative and get the HBe antigen turned to negative with a positive antibody for it. Then you are in stable state. And it just means regular check ups to make sure it stays like that. Good luck tomorrow and tell us what ur doc says.
Brit

[ColC]

Thanks, will do.

The specialist in Mid East said I am chronic without any doubt so that is that. The only symptoms I can remember is tiredness which I put down to hard work and old age!

So tomorrow I find out, wife has checked and the NHS specialist I am seeing is well known with good references so I am hopeful.

C

[britgirl477]

I am not up to scratch on the whole medicine thing. The HBe antigen if detectable I think may mean it's positive but you'd do well to ask maybe bberry. He has been ever so helpful with me. But it might mean that it is low and so may seroconvert on it's own. If it does then you'd be HBe antigen -ve and HBe antibody positive which is good thing to be. My body has done this already without meds and so they are waiting to see if I will clear all of the virus as I am currently still in acute phase. But if you are chronic and have no IgM antibody present then you will be chronic for sure. Have you checked all this stuff with doc coz if you were infected only 6 months ago then you could still clear it? Did they mention IgM antibody or IgG antibody?

I have had no probs with nhs so far they have been superb and Edinburgh is apparantly well known for its liver unit. You will be fine with UK. Check with bberry about going straight onto meds. I am not sure what the deal is there. I have just been put on meds to see if they will help me kick out the last bits of virus as it seems that my diabetes may be causing probs with immune system. If chronic with HBe antigen +ve then they put you on med soon. I am on Tenofovir. Check with bberry as I say.
Brit

[ColC]

Just re-read my result, think I was wrong my HBe-Ag result says "detectable" Does that mean Positive.

Re the timetable, my suspicion is I contracted between 6 and 18 months ago, I can't be any more specific than that, as to how there are many possibilities.

I hope the NHS is ok as the mid east was excellent, once my first test came back as positive for HepB all the other tests were undertaken within a week.

I will see the NHS specialist tomorrow so we shall see. I have the option to return to the mid east as a "tourist" I can work from home (my appt there) for a month or so and that may give me time to complete the biopsy (recommended by the Mid East specialist) and hopefully commence treatment. At this time I just like to have options. being unemployed in the UK is not one of them.

I am hoping I go straight onto AntiVirals and not the Interferon route - Am I right?

[britgirl477]

HBe negative is good. That's what you want. Do you know how long you have had this for? Because then it will give the doc a timetable to assess your history and see if it's likely that you have had it for long time or not. As StevenNyer always says on this site we at least have the benefit of knowing our status and being able to take care of it. There are loads out there who have no idea that they are walking around with this illness. Therefore they are not able to monitor what they don't know they have.

I think you might be best back at home at the mo until you figure everything out...don't you? The job thing is a bummer. And with the present climate it's difficult. But at the end of the day your health is all that matters. The nhs for all it's many faults is really very good. We are lucky to have it.

I would suggest you make a list of qns to ask the doc on Friday. So you don't forget anything impt.
Brit

[ColC]

Fairly sure I am  HBe Negative, so let the games commence.

Re the booze I used to dring a lot more typically 20 pints a week or so, so dropping to 3 pints last week was my slowdown. I have now stopped. Lucky I am not a smoker so thats one less thing to worry about. Also losing 30/40 pounds would not do me any harm. Who knows this could be a positive thing for my future health.

I do appreciate the advise given, it does help, as I do not plan on going public with my day to day work/social contacts, although they will be surprised when I refuse a beer - I guess I will put that down to getting fitter and losing weight, the things we do to fool ourselves eh.

C

[britgirl477]

Yep been there and done all that reading thing where you look exactly to see what means clearance and then look at your own results to see if they mirror that lol.

My doc told me just last week that if you are a chronic HBV then there are 2 states. One is the HBe antigen +ve and HBe antibody negative. This means that you are replicating fast and are more infectious and more damage is being done to liver. For these sorts of HBV people the aim is to get the VL down to as little as possible. This is done with medication.

The other state is where you have HBe antigen -ve and Hbe antibody +ve. This indicates that you are less infectious and less likely to be damaging liver. I hope I've got that right.

If you are the former, then it is your goal to achieve the second state thro meds. The tabs are really clever these days and my doc is very matter of fact about me getting rid of VL etc.

I do think that you have to strict as anything with yourself about drink and smoking etc at the mo. The liver processes all these things and so if you do them then you are only giving the liver extra work. If it is having to deal with your 2/3 drinks a week even then maybe it isn't doing it's all with your virus. I just swore off the alcohol...not really a drinker that wasn't too hard.

In terms of alternative stuff, I am presently drinking my cherryactive juice which boosts immune system tremendously, if you believe the press! It can be purchased down in England somewhere or even at Holland and Barrat health food stores in UK.
Go try..it cant do any harm. Its just a fruitjuice after all.
Brit

[ColC]

I tend to be very pragmatic and detached when something is wrong. Having known just under 2 weeks I will admit to a few beers. But have not drank in over a week and accept that for the time being (I need something to look forward to) booze is off the menu.

I am reading my *** off at the moment, but there is so much there I guess I am trying to find out if the results are wrong and somehow it will go away. Thats the hope anyway, I guess the best I can hope for is a reduced count. Ultimately unless my HBs-Ag goes below 2.0IU/mL I have no chance in getting a work permit again for the middle east. Anyway less of that.

My current stats are:
HBs-Ag   >250 IU/mL
Hep Be   Detectable (think that means positive)
HBV-DNA   8,417,419 IU/ml (glad I was insure for that one it was over £600)
My liver panel is good as the ALT is now 37 was 45 2 months ago.

I guess I am dealing ok, luckily wife and son are not affected and have started immunisation 2 jabs to go. As for me I am a bit worried about my finances I am still on the payrole but I was employed to work in the middle east, I think I will be let go end of this month, but I have an offer to work in one of the Stans, but it don't start for 3 months, fortunatly I have already passed the medical, the test I have to watch is the Liver Function, again even now mine is ok. In summary I am not exactly happy but I am dealing with it ok. Being an eternal optimist helps. I will work to beat this somehow - Who knows more about alternative medicine!!!!!!!!

thanks


C

[britgirl477]

I am fairly new to this too as I was diagnosed not that long ago and may still even be acute....hoping! However I do know that the specialist will be fantastic and will know his stuff. My specialist is superb and knows exactly what he is doing. This site is great for finding out what results mean and asking the qns you forget to ask the doctor. They are fab here at calming your fears and making you see that with good monitoring and healthy lifestyle you can live normal life.

I have read a great deal of stuff over last 8 months about HBV, in fact my specialist says I should stay off the internet!!! There's lots of info on the net. I suggest you read as much as possible. It makes me happier to have an understanding of what I am fighting.

What is your HBe antigen? Is it positive or negative?
What about your HBe antibody? Positive or negative?

These 2 things are quite important in deciding what to do next apparantly.

How are you coping with your diagnosis?
Brit

[ColC]

Diagnosed 10 days ago in the middle east, only found out as it is part of the requirements for a residency permit. So I had a week to leave the country - so job probably over now. The firm may have some european opportunities.

As yet no meds, I have had a few tests done the big one being the HBV-DNA which is 8.5 million IU/ml. I see the specialist tomorrow, my ALT score is low so don't now if I will be given interfuron, Anti V's or nothing. I have my first meeting eith the UK specialist tomorrow, (had 5 consults and plenty of tests in the middle east, but not enough time to complete a biopsy).

C

[britgirl477]

sorry ColC I have just read your details in another post. You are chronic right?
Brit

[britgirl477]

Glad to have been helpful, but it's only my opinion. I am sure others may have a different one. However, I really do think that most people are pretty ignorant when it comes to HBV. They don't realise that it's an illness that is easily transmitted and that even some folks are infected at birth. I feel some folks associate it with a 'seedy' lifestyle. That's a real pity. I got very upset when I was first diagnosed because I had no idea where I got it from other than a possible link with a hospital visit that I had made a few months before. I was diagnosed as acute, so that proved I had got it in the last few months and I had split from bf about 14 months prior to this and never used drugs ever!!!! So I chose to tell nobody. It's my body and my health and only very close family members know about it. As far as I see it's nobody's business but mine.

People will only ever let you down and even those that you tell and ask to keep quiet are likely to still blab. Due to their ignorance and at times I feel lack of sensitivity, they think it's summit that they 'need' to tell others about. My advice would be say no more to anyone about your status. The only people that need to know are your doctor and wife.

When were you diagnosed? How are you keeping and whatbtreatments are you on? Are you chronic?
Brit

[ColC]

A good start, thanks for that, it is a dilemma at home (wife started to tell and realized she too is looked on with suspicion) fortunately she is negative and just had first of the vaccinations.

[britgirl477]

I firmly believe that you have no moral obligation to tell anyone that you have HepB other than sexual partners. I recently asked my doc about whether I should tell my dentist that I have HBV and he said no. It is the responsibility of your dentist to always follow excellent cleanliness procedures, not you. So there you go. Don't get me wrong I always make sure that I am very careful about blood and anyone coming into contact with it in my house or anywhere else, but I see it as my business what illnesses I do/don't have. Don't know about the rest of the world, but here in Britain we do not have any legal obligation to discuss our health with any employer or indeed anyone. Even with an illness like HIV you can have HIV pupils in your class and you as a teacher are not told about this. You are simply expected to follow strict guidelines wherever blood is involved. I would not dream of telling my employer anything about my health other than, 'I'm sick and need a few days off'. Hope this is helpful.