The Hepalogue

Micro-Weirdness and the Elasticity of Time

by The Golden Phaeton on 12/05/2016

While I’m waiting to get the nod on the forthcoming ‘How Does One Actually Go About Getting Treated’ post, I thought I might tell you about my fingernails.

About fifteen years ago, I found myself vodka sick in the diner car of the Trans-Siberian Express on the foggy end of a birthday celebration for a Russian man I had only met that night. The air was thick with burnt heroin, the source of which, to my frustration, I never found. Every time I tried to leave, the Russian would force another drink under my nose, and ultimately I made a run for it. I was too fast for the Russian, but he did manage to slam the carriage door on my fingers in disgust.

Now if there’s one thing the Soviets were good at, it was building things heavy, with plenty of steel. It was more like a bunker door than a carriage door and, through the subsequent pain, I feared that I might actually lose the little finger on my right hand.

I didn’t. But the nail never grew right again, developing some distinct lengthways ridges.Here’s a picture. (Warning: I also bite and tear at my nails.)

 

nail-optimised

 

That might have been the end of the story, except that over time, year by year, the same kind of ridges appeared on most of the fingers of both my hands. Not quite so pronounced, but nearly so.

Now, fingernail deformities can sometimes be used as a diagnostic tool – and have been done so since the age of Hippocrates. A thickened nail can mean poor circulation; spoon-shaped nails can point to iron deficiency; overlarge moons may mean an over active thyroid etc. etc.. Fingernail gazing is almost a science, though a very vague one.

My particular issue, the ‘longitudinal’ ridges, can indicate ‘ageing, poor absorption of vitamins and minerals; thyroid disease and kidney failure’. Secretly, I’ve always blamed Hep C, and since I began treatment I’ve been monitoring my nails, waiting for fresh, smooth keratin to emerge from beneath my cuticles.

No such luck.

Even though my ALT count is normal and my viral load reads as undetectable, the ridges keep coming, as inexorably as glaciers. Bummer. It would have been nice to have had – relatively – normal nails.

It would have been nice to have had less of an urge to self-medicate too, but it doesn’t look like that’s going away any time soon either – together with all those other little nigglesome health issues I’ve quietly blamed on Hep C.

Or am I being premature? Possibly. Perhaps the real effects of shrugging off the disease will reveal themselves down the track, at SVR12 or SVR48, assuming I reach those points. (SVR or Sustained Viral Response is measured in weeks after having cleared the virus and is how doctors rate the likelihood of a cure being permanent.)

I do look forward to a time when I can definitely cross Hep C off the list of what’s ailing me, and set about addressing all those second-tier health issues…

As it is, I can’t even begin to do that. There is still, as of my last set of bloods, some Hep C genetic material floating around in my system. Given all my other indicators, my doctor has ventured the idea that it may be dead or so mutated as to not be a threat, but that’s just a guess. There are big holes in our knowledge, not just of the disease, but of how the drugs actually work. Hepatologists have been scratching their heads, for instance, over patients who, weeks after the end of treatment, have suddenly, unaccountably cleared the virus.

So, I struggle through the doldrums, not cured, not not cured – and pretty much over that first flush of excitement and health I experienced during the first few weeks – contemplating my fingernails, worrying about the dubious, long term effects of ribavirin, worrying about the anaemia it causes, frustrated about how difficult even light exercise is when one is anaemic, cursing that my car has chosen this time to throw its clutch …

Contemplating. Worrying. Frustrated. Cursing. Waiting.

These final few weeks of treatment are taking too long and coming on too fast.

The Golden Phaeton

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