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#Trispo: Living Well with Hepatitis B

For Edwin Tan, triathlon is a big part of managing chronic disease.

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When Edwin Tan received a notice from the American Red Cross, declaring he had been blacklisted from blood donation, he was puzzled. After all, he was young, healthy, and athletic–on paper, an ideal blood donor. Why wouldn’t they want his blood? His mind immediately assumed his blood tested positive for HIV/AIDS–panicked, he went to the doctor.

The HIV test was negative. Tan breathed a sigh of relief, chalked the blood donation rejection up to a clerical error, and went on his way. It would be three more years before this experience crossed his mind again. At a routine physical, Tan’s doctor discovered an accumulation of fat in the liver; further tests revealed Tan was positive for hepatitis B, a potentially life-threatening liver infection.

“It’s kind of a silent killer,” explains Tan. “A large number of hepatitis B cases are undiagnosed, since it may not show symptoms until it becomes a problem. Many people, like me, get it at birth from an infected mother, who likely doesn’t even know she’s infected.”

Had Tan’s doctor not uncovered the fatty liver–a common symptom of chronic liver infection from hepatitis B–Tan likely would never have known until the infection had progressed to cirrhosis (a scarring of the liver) or liver cancer. Luckily, early detection meant Tan’s infection, though chronic, would likely be manageable.

“My doctor recommended lifestyle changes that more or less revolved around a healthy diet and consistent exercise,” says Tan. “This kicked off my fitness journey.”

Though Tan had always been casually athletic–working out at the gym, going for the occasional run–his diagnosis gave him a push to follow a structured training regimen. A friend recommended Tan join him in training for the Lake Waconia Triathlon, a local sprint race in Minnesota. “By coincidence, I was already swimming, biking, and running in my workout routine,” says Tan. “So a triathlon seemed like the logical thing to do at the time.”

Though Tan claims that first race left him wrecked (“I felt like dying afterwards!”) he also loved the satisfaction he got from race day. Crossing the finish line was more than just an arbitrary marker of covering a set distance–it was the culmination of his healthy-living overhaul. No longer was he a casual athlete–to stay healthy with chronic Hepatitis B, exercise had to become a daily priority.

It was around this time Tan felt compelled to destigmatize hepatitis B. Though experts estimate around 300 million people worldwide, and 2 million people in the United States, live with chronic hepatitis B, the condition is stigmatized, largely due to ignorance about the disease. Though people are not at risk of contracting hepatitis B through casual contact, many with the condition have lost jobs or relationships due to ignorance and fear. Additionally, misinformed people sometimes assume that all people with hepatitis B have used injection drugs (one way hepatitis B can be transmitted), despite statistics showing the majority of people with hepatitis B were infected as a young child.

Tan set out an ambitious plan–more than 336 miles of racing, including a marathon, four triathlons, and an Ironman, all within the span of a year. At each race, he would raise money and awareness for the Hepatitis B Foundation: “I wanted to showcase that having a chronic disease doesn’t have to stand in the way of my dreams.”

One by one, he ticked off his races, starting with Grandma’s Marathon and culminating with a finish at Ironman Wisconsin 2019 with a time of 13:34:25. Today, he’s still following a structured training routine, though his race schedule is on hold due to the COVID-19 pandemic. When races resume, he’s eager to get back on the course to continue representing those living with hepatitis B. 

“In a way, hep B is what led me to triathlon, and it is a disease that personally affects me,” says Tan. “So it made sense to me to use triathlon, as an athlete with the disease, to use my story and journey as a way to raise awareness.”