How to take the aches away?

[Meadowbank]

Me again. I wondered if anyone knows how I can stop aching or do something to lessen it. The gastro doc I saw recently said I just have to put up with it and my body will take months to benefit from my improved diet and abstinence.

In the meantime every joint hurts. It hurts to bend my fingers, walk, bend down, carry bags, etc. My feet are really bad as well. I hobble until I get going then it passes a bit but my skin feels hypersensitive. If someone lightly bumps into me, it is really painful.

I have ALD, cirrhosis and take spiro and prescribed vitamin B.

[Meadowbank]

I haven't had chance to try anything yet and I am off on a short holiday now. That will involve light walking and there may be a pool. No bath though. My gastroscopy is shortly after I get back. First one to check for varices.

Fingers crossed.

[Dee1956]

I was trying to think of things you could do.  I wonder if it would be ok to soak in a tub of Epsom Salts?
That helps me quite a bit.  I will have to find out from my doctor if that is ok.

Take Care
D

[Dee1956]

Thank you all for your posts.  The help me to understand what I am dealing with or what I might be if I am not careful.
Dee

[crossroadsec]

I agree with the moderate exercise,stretching, and swimming. I also notice that when I eat a less than best diet, I have more aches.
Example: I actually drink a lot of water if I have some "healthy" pizza. It's low sodium, and fresh toppings, etc. But sometimes I will feel that overall fatigue and achey the next day.
I personally think that moving and drinking water can help flush it out. Also drinking healthy shakes or eating a liver cleansing meal helps.
I hope this helps you. I know it is discouraging... xoxo Karen:)

[rpooo]

Since your liver is damaged it fails to remove all of the toxins from your body so they build up in the muscles (normally the legs) causing them to ache. Increasing blood flow to these muscle groups will flush out the toxins temporarily relieving the pain. To do so you can try (as mentioned above) light cardiovascular exercise, stretching or massaging the muscle. I found this to be very helpful especially at the end of the day before climbing into bed. I hope it helps.

Take care,
Randy

[HectorSF]

I hope you find some relief with those activities. Each of us are different. Try many and see what works the best for you and stick with it.

Be careful not to do too much. Keep it in moderation. We only have so much energy and when we do too much we usually will feel worst the next  few days until we recover from doing to much. Listen to your body if it starts to hurt more during or after back off of what you are doing.

Best of luck to you!
Hector

[Meadowbank]

Thank you both. I will give swimming a try after the long school break is over rivll.

Hector - thank you for your reply. I am very aware of my addictive personality and at the moment I am determined not to take any painkiller at all. My sister also mentioned mild exercise/yoga and relaxation so I think I will investigate those further.

Best wishes.

[rivll]

One thing that helps me is walking and now swimming in a warm pool. The mobility is important and the movement in water is pain free.
I have found it much easier to endure these aches and cramps with the help of the pool at my local 'Y'.
I wish you all the best

[HectorSF]

Assuming I understand the pain you are experiencing it is the all around body aches that us with advance cirrhosis experience to different degrees at different times. Unfortunately there is little that can be done. Many of us have to live with it for many years as we wait for transplants and come to accept it as part of what we have to live with. Since this is relatively new to you it is tougher to deal with and I am sorry for that.

The cause is our underlying liver disease. You have stopped drinking so you have done the best thing you can to not make your liver disease any worse. Your doctor is right, in time your health will improve because you have stopped poisoning your liver so you will probably feel better as the months go by. For most cirrhotics we can't stop the cause of our liver disease or if we do, by the time we are decompensated things only get worse and worse over time. So you are in a lucky position.

In practical terms what can be done? When the aches and pains get bad you can take Acetametaphin for mild pain relief but you are limited in how much you can take (dosage) and how often (how many days you can take it) because any drug that is processed through the liver can damage you liver further. And that is the last thing you want to do as then you will become more ill and have even more pain. That is why most of us with cirrhosis learn to deal with the aches and pains and take nothing for pain relief on a regular basis. Of course you can not take the stronger opiate pain relievers due to your history of addiction and the serious side effects they can cause in decompensated cirrhotics. It is important to keep in mind that patients with a history of alcohol or drug abuse will have to prove that they will never abuse either in the future in order to eligible for a liver transplant. Your life could depend upon abstaining from any addictive substances. So this is very serious.

I would talk to your gastro about using acetaminophen when the pain is too much to bare but as I said you will not be able to take it on a regular bases as you risk further damaging your liver. Some of us also use relaxation practices, imaging, meditation, exercise to less our pain. That is the best way to learn to live with it. Remember that decompensated cirrhosis can lead to end-stage liver disease and transplant or death. Within the big picture aches and pains are little to deal with compared to some of the life-threatening complications of decompensated cirrhosis. Such as vomiting blood because of burst varices. HE stupor and coma and infected ascites. Hopefully you will not experience these nightmare situations and your liver will be able to recover to some degree because you stopped drinking.

I am sorry but we all have a difficult time when we first are diagnosed with a serious illness. It takes time to learn how to live with our illness and it is always an ongoing process. Cirrhosis is no picnic but we all do the best we can with what we have. It is never perfect but you will learn in time that it is good enough. Over time you will learn that aches and pains are something you can deal with a lot more than you can imagine now. And since since you have ALD you do have a good chance of your liver recovering somewhat. So keep that in mind during the tough days.

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Consult with your gastro before taking any drug...

For mild to moderate aches and pains, it is safe to use Tylenol(acetaminophen) at doses of 2,000 mg/day or less (no more than 6 regular strength or no more than 4 extra strength each day AND no more than 20 regular strength or no more than 15 extra strength each week). Some cold medicines and prescription pain medicines contain acetaminophen,so read the labels and make sure you don’t take too much by mistake.

Patients with cirrhosis should avoid pain medications called “non‐steroidal anti‐inflammatories (NSAIDS)”. These include over‐the‐counter medications such as ibuprofen (Motrin, Advil), naprosyn (Aleve), as well as some prescription medications.
NSAIDs can cause mucosal bleeding in patients at increased risk of bleeding as a result of thrombocytopenia and coagulopathy associated with advanced liver disease. This risk is even greater in patients with portal hypertension–related complications, such as esophageal/gastric varices and portal hypertensive gastropathy or gastric antral vacular ectasias. NSAIDs may be tolerated in patients with mild chronic liver disease, but they should be avoided in all patients with cirrhosis because of the increased risk of hepatorenal syndrome and the dire consequences relating to this complication. Preventive medicine, including avoidance of NSAIDs, is exceedingly important in maintaining the clinical stability of patients with well-compensated cirrhosis.

Like anti-inflammatory medications, Opioids can have deleterious effects in patients with cirrhosis besides being habit forming. Although large epidemiological studies are lacking, sedatives and opioids are common precipitants of hepatic encephalopathy and hospitalization, and thus they should be avoided in patients with cirrhosis, especially in those with portal hypertension and encephalopathy. The liver is the main site of metabolism for most opioids.

Good luck.
Hector