• Develop good sleep habits (don't read or watch TV in bed).
• Try to go to sleep and wake up at the same time every day.
• Keep afternoon naps short.
• Limit fluids at night to avoid having to go to the bathroom in the middle of the night.
• If ribavirin makes you "jittery," take your pills at 4 PM or 5 PM instead of right before bedtime.
• Close to bedtime, try to avoid large meals, too much exercise, tobacco, alcohol, and caffeine.

• Try relaxation techniques (yoga, meditation, deep breathing).
• Remind yourself: "The doctor told me that the medications would make me feel anxious, so this is not really me... The medication is making me feel this way."
• Avoid stimulants such as caffeine in coffee and tea.
• Tell your provider if your symptoms are getting worse; your doctor may be able to give you medicine for some of your symptoms.

• Try relaxation techniques (yoga, meditation, deep breathing).
• Take deep breaths and count to 10.
• Share your feelings with friends and family.
• Join a support group.
• If you are tired, depressed, or losing sleep, find ways to deal with those side effects too.
• Your job may make your temper worse, so try to arrange ways to make your work less stressful. For example, you might want to talk to your boss about flexible hours, if that would help.

• Do something you enjoy, such as reading a book, going to your favorite restaurant, or visiting a museum.
• Get involved with a support group.
• Spend time with supportive people, such as family members and friends.
• Talk with your doctor about treatments for depression, such as therapy or medicines.
• If you ever feel that you may harm yourself or are contemplating suicide, get help immediately- any hospital should be able to help you, or you can dial 911. Interferon causes these symptoms, and nothing is worth putting yourself in danger.

• Try going to sleep and waking up at the same time every day.
• Take a short nap after work.
• Get regular, moderate exercise.
• Eat healthy meals to maintain your weight.
• If fatigue is worse 1 to 2 days after injecting interferon, take 325 to 1,000 mg of Tylenol before your shot. (Talk with your doctor about this.)

• Drink more fluids.
• Try to get plenty of sleep.
• Take a hot, relaxing bath.
• Lie down and rest in a quiet, dark room.
• Try to reduce your stress level.
• Check with your VA health care provider about taking Tylenol and/or ibuprofen.
• If you have a history of migraine headaches (a certain type of headache, which often comes with vision changes), talk to your health care provider about taking medications (such as Imitrex) for them.

• Check with your VA health care provider about taking Tylenol before your interferon shots. This can lessen the fever that the shots cause. You can also talk with your provider about taking Tylenol after your shots when you have fever.
• Drink plenty of liquids and try eating well to keep yourself hydrated during fever.
• Go to a health care provider if your temperature:
  • is above 101ºF, unless it followed an interferon injection
  • is above 101ºF repeatedly or lasts for more than 24-48 hours

• Check with your VA health care provider about taking Tylenol, aspirin, ibuprofen, Advil, Motrin, or Aleve for your body aches.
• Follow a moderate, low-impact exercise plan.
• Apply a warm, moist washcloth to areas that hurt.
• Take a hot bath.
• Drink a lot of fluids.

• Take a walk or do stretches before a meal. This may increase your appetite.
• Eat 5 or 6 small meals each day, instead of 3 large meals. For example, eat an 8:30 AM breakfast, 10 AM snack, 12:30 PM lunch, 3 PM snack, 5:30 PM dinner, and a 7:30 PM snack.
• Eat your favorite food, even if just a little bit.
• Drink homemade fruit shakes of nutrition supplements (such as Ensure and Carnation Instant Breakfast) instead of skipping a meal. Drink liquid supplements with a straw if you find that their smell makes them less appealing.
• Keep snacks handy, such as hard-boiled eggs, cheese, and peanut butter. Keep snacks that don't require refrigeration near your bed or by the television.
• Pack foods that don't need to be refrigerated for snacking when you are away from home.
• Stock up on frozen meals in single-portion packages. These are quick and easy to prepare.
• Try different food textures (add chopped nuts, seeds, or water chestnuts to dishes) to make eating more interesting.
• Watch cooking shows and keep cookbooks around.
• Make eating enjoyable--eat with others, eat in a pleasant place, light a candle.
• When possible, do not drink fluids with your meals. They can make you feel full sooner.

• Tart food can "mask" a metallic taste. Drink orange, cranberry, and pineapple juice, and lemonade. Add vinegar, lemon juice, pickles, or relish to your food.
• Marinate meat, chicken, turkey, fish, or tofu in vinegar, wine, salad dressing, or soy sauce. Add fresh herbs, dried herbs, or condiments to your food (such as onion, garlic, chili powder, rosemary, thyme, basil, oregano, cumin, mustard, catsup, and mint). For example, try sweet and sour pork with pineapple.
• Eat cold food, such as sorbet, sherbet, fruit slushes, ice chips, or frozen yogurt to numb your taste buds. Eat frozen grapes, orange slices, or pieces of cantaloupe and watermelon. Or create frozen popsicles out of sports drinks.
• Chew lemon drops, zinc lozenges, mints, or gum, which can help get rid of bad or "off" tastes that linger after eating. (If you have diarrhea, go easy on your use of sugar-free candies and gum.)
• Eat dark chocolate.
• Rinse your mouth with tea, ginger ale, salted water, or water with baking soda before eating. This will help clear your taste buds.
• Use plastic utensils instead of metal utensils.
• Eat fresh or frozen foods instead of canned foods.

• Use sugar-free candy or sourballs, popsicles, ice cubes, or sugarless chewing gum to moisten your mouth.
• Start and end each day with a glass of water.
• Moisten food with sauce, gravy, yogurt, or salad dressing.
• Dunk bread, crackers, and cookies in soup, milk, juice, or hot chocolate.
• Drink plenty of beverages, such as lemonade or tea with lemon.
• Rinse your mouth with club soda or warm, salted water.
• Keep fluids by your bed so you can drink during the night if you are thirsty.
• Ask your VA doctor about mouth rinses and other products to treat your dry mouth.

• Eat soft or pureed foods. Baby foods or toddler foods may be good substitutes.
• Drink nectars instead of juices.
• Drink instant breakfast formulas or milkshakes instead of eating solid food.
• Use a straw.
• Eat lukewarm or cool foods, not foods at hot temperatures.
• Gargle or rinse your mouth out often with warm, salted water.
• Talk to your doctor about a prescription for lidocaine mouthwash. It can ease discomfort from mouth sores.
• Try to stay away from:
  • foods that are spicy, salty, acidic, or high in citrus content (such as oranges and grapefruits)
  • rough food like dry toast, granola, and pretzels
  • chili powder, cloves, curry, hot sauces, nutmeg, and pepper
  • carbonated beverages (such as colas)

What to try:

• Try the BRATT diet (bananas, rice, applesauce, tea, and toast).
• Eat small, snack-sized meals every 2 to 4 hours, instead of 2 to 3 big meals during the day.
• Take your ribavirin with food.
• Eat foods cold or at room temperature. Fruit or a sandwich with cold cuts or cheese is fine. Hot food can contribute to nausea and vomiting.
• If you've vomited, be sure to "refuel" your body with broth, carbonated drinks, juice, Jell-O, or popsicles.
• Leave dry crackers by your bed, and eat a few before getting up in the morning.
• Foods that may help your nausea and vomiting:
  • Salty foods, such as crackers, pretzels, and unbuttered popcorn
  • Dry foods, such as dry ready-to-eat cereal, crackers, melba toast, and cookies; keep these foods close to your bed or favorite chair so they are within easy reach
  • Peppermint, chamomile, and ginger tea; they can calm the stomach
  • Cold carbonated drinks such as ginger ale, 7-Up, and Sprite
• Talk to your VA health care provider about whether you should take medicine for your nausea.

What to avoid:

• Don't lie flat for at least 1 hour after you eat.
• Avoid smells and foods that trigger nausea (use boiling bags, microwave ovens, or covers for pots). Open the windows to decrease food odors when you are cooking.
• Avoid eating if nausea is extreme.
• Avoid very sweet foods and foods that are hot, spicy, strong-smelling, or greasy.

What to try:

• Try the BRATT diet (bananas, rice, applesauce, tea, and toast).
• To replace lost fluids, drink plenty of mild, clear liquids throughout the day. These include sports drinks (Gatorade, Powerade, All Sport), chicken or beef broth, herbal tea, or water. Drink liquids at room temperature.
• Eat foods high in soluble fiber. This kind of fiber can slow diarrhea by soaking up liquid. Foods high in soluble fiber include oatmeal, cream of wheat, grits, toast (not whole grain), bananas, rice, and applesauce. A tablespoon of Metamucil mixed with juice may also help.
• Try psyllium husk fiber bars, available in health food stores. Two bars eaten 1 hour before bedtime with a large glass of water can help.
• Eat small, frequent meals and snacks throughout the day.
• Drink and eat high-sodium foods, such as broth, soups, sports drinks, crackers, and pretzels.
• Choose foods and drinks high in potassium, a mineral that you lose with diarrhea. These include bananas, potatoes (without the skin), fish, chicken, and meat, and juices such as orange, apricot, mango and peach, V-8, and Gatorade.
• Drink at least 1 cup of liquid after each loose bowel movement.
• Ask your doctor about antidiarrheal medications such as Lomotil, Kaopectate, Imodium, and Pepto-Bismol.

What to avoid:

• Avoid greasy, fried, spicy, or very sweet foods.
• Limit drinks with caffeine, such as coffee and cola.
• Avoid dairy products (avoid for at least 3 days after symptoms resolve).
• Avoid food and drinks that may cause cramps or bloating, such as beans, cabbage, broccoli, brussels sprouts, onions, green peppers, and carbonated drinks.
• Limit use of sugar-free gums and candies made with sorbitol.

• Wear caps or scarves.
• Use a wide-toothed comb.
• Don't pull on your hair or comb it a lot.
• Don't blow-dry, dye, perm, braid, or cornrow your hair.

• Take cool baths and use moisturizing soaps (such as Dove, Oil of Olay, and Cetaphil).
• Apply skin lotions (such as Aquaphor, Curel, Aveeno, and Absorbase).
• Use hydrocortisone cream as prescribed by your provider.
• If your scalp is dry, use shampoos with selenium.
• Protect your rash from sun exposure, which can make the rash worse.
• Avoid hot showers and baths. They can irritate the skin.
• If these lotions and creams don't work, talk to your doctor about oral medications.

• Apply a cold pack to the area.
• Use hydrocortisone cream for itching (ask your health care provider about this).
• Change the site of injection--from abdomen to thighs, or switch to the other side of the body.

• Go to the emergency room so a doctor can make sure the pain isn't from a heart attack or serious lung problem.

• Take note of when and what activities you are doing when you become short of breath, so you can tell your provider.
• Check with your health care provider to make sure your shortness of breath isn't caused by a heart or lung problem.

• To help describe any vision changes to your doctor, try to remember when the symptoms occur (at night? in bright light? at certain times of the day?) and what they involve (blurry vision? inability to see in a part of one or both eyes? eye pain?).
• For dramatic visual changes (such as sudden poor vision or sudden change in vision in one eye), seek medical care within 24 hours.

• Tell your provider about the side effects that you are noticing from interferon. Discuss whether any of these could be related to changes in how your thyroid gland is functioning. Your provider can then order blood tests, if necessary.

• Your provider will tell you whether your red blood cell count is low and what can be done about this.
• Decreasing the ribavirin dose will help to improve anemia (your provider will advise you about this).
• Sometimes another injectable medication, Epogen (or Procrit), may be used to increase the number of red blood cells and bring them up to more normal levels.

• Your provider will tell you whether your white blood cell count is low and what can be done about this.
• Decreasing the interferon dose can help to improve the white blood cell count (your provider can advise you about this).
• Sometimes another injectable medication, Neupogen (or G-CSF), may be used to increase the number of white blood cells and bring them up to more normal levels.

• Your provider will tell you whether your platelet count is low and what can be done about this.
• If you have a low platelet count, you should pay particular attention to bleeding. Nosebleeds and bruises are more common. If you are concerned that you are bleeding or can't stop bleeding from a cut, seek medical attention.
• Decreasing the interferon dose can help to improve the platelet count (your provider will advise you about this).