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Low Platelets
Hello,
I was diagnosed with end stage cirrhosis back in March 2010. My last lab test revealed my platelet count is down to 60k. I have concerns since I read I could be heading for real trouble at around 20k. I have splenomegaly (enlarged spleen) which I think is directly responsible for the low platelet count. Any suggestions I would sure appreciate.
Thx
Randy
I was diagnosed with end stage cirrhosis back in March 2010. My last lab test revealed my platelet count is down to 60k. I have concerns since I read I could be heading for real trouble at around 20k. I have splenomegaly (enlarged spleen) which I think is directly responsible for the low platelet count. Any suggestions I would sure appreciate.
Thx
Randy
I have had platelet as low as 18, currently they are 22 thousand..For the last 14 years the highest they have been is38,and I could hardly believe it.Low platelets can be a problem with surgeries.I had my gall bladder removed with low platelets.My fear is a car accident.
COMMUNITY LEADER
Hello and Welcome to MedHelp!
I am very sorry to hear of everything you have been through lately. Unfortunately I don't know enough about your condition to really be able to help but after doing some research I came across a link that I think will help you gain some insight: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2754513/
Also I know some others here that are much more familar than I. One of the main questions we always ask in this community is are you being treated at a transplant facility? Aso what stage of cirrhosis are you diagnosed?
I can also tell you that folic acid is often prescribed for cirrhotic indiviuals, the good side is that it helps accelerate the reproductions of liver cells although with that not all of the cells are healthy and so it increases the risk for Hepacellular carcinoma (liver cancer)
Iron supplements can also be dangerous too for cirrhotic patients so for someone with anemia and taking a supplement it will be critical to have your iron level carefully monitored.
I'll keep researching for you and I hope the article there will help too. I'm glad you found us and I sure hope we can offer some advice to have you feeling better. Take care.
Randy
I am very sorry to hear of everything you have been through lately. Unfortunately I don't know enough about your condition to really be able to help but after doing some research I came across a link that I think will help you gain some insight: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2754513/
Also I know some others here that are much more familar than I. One of the main questions we always ask in this community is are you being treated at a transplant facility? Aso what stage of cirrhosis are you diagnosed?
I can also tell you that folic acid is often prescribed for cirrhotic indiviuals, the good side is that it helps accelerate the reproductions of liver cells although with that not all of the cells are healthy and so it increases the risk for Hepacellular carcinoma (liver cancer)
Iron supplements can also be dangerous too for cirrhotic patients so for someone with anemia and taking a supplement it will be critical to have your iron level carefully monitored.
I'll keep researching for you and I hope the article there will help too. I'm glad you found us and I sure hope we can offer some advice to have you feeling better. Take care.
Randy
what do you know about taking folic acid for hep c/cirrhosis? Ive been in the hospital 8 times since 4/2012, for vomitting blood and bloody diarrhea. I end up getting blood transfusions and discharged with propranalol and vitamins,iron, folic acid. They banded first admission, but said the other admissions that the blood vessels were too small to band. Any ideas on folic acid and 1,000 units of irons daily ?
This is a great thread, thank you so much for all of your input
I did not know that garlic could thin the blood, I have been taking it
Thank you
I did not know that garlic could thin the blood, I have been taking it
Thank you
COMMUNITY LEADER
I am not real familiar with Hepatitis since I have alcoholic cirrhosis. As you may already know there can be many causes for cirrhosis. I can tell you that I think the next step would be to diagnose what stage liver disease she has. This is done one of two ways, Ct Scan or Liver Biopsy, although biopsy seems to be the most common and accurate procedure used.
Here is a link to a video that can assist to educate you about said procedure:
http://youtu.be/ug3n7bvq2Wg
There are many different types of liver biopsies, such as the percutaneous, transjugular, laparoscopic, fine-needle aspiration and open surgery liver biopsy.
You should also know that symptoms of cirrhosis are normally not present until the person has reached decompensated cirrhosis. (End stage cirrhosis)
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What are the symptoms of hepatitis C?
Many people infected with hepatitis C have no symptoms. When symptoms are present, they can range from mild to severe. The most common early symptoms are mild fever, headache, muscle aches, fatigue, loss of appetite, nausea, vomiting and diarrhea. Later symptoms may include dark coffee-colored rather than dark yellow urine, clay-colored stools, abdominal pain, and yellowing of the skin and/or whites of the eyes (jaundice).
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How is hepatitis C treated?
There are no specific treatments for the symptoms of acute hepatitis C. Doctors recommend bed rest, preventing dehydration, a healthy diet and avoidance of alcoholic beverages. Most patients with mild to severe hepatitis C begin to feel better in two to three weeks and recover completely from their symptoms within four to eight weeks.
Synthetic forms of the protein interferon are used to treat some people with chronic hepatitis C. This can improve liver function in some people with hepatitis and diminishes symptoms, although it may cause side effects such as headache, fever and other flu-like symptoms. Sometimes this drug is used in combination with another drug, ribavirin. Treatment is effective in 10 percent to 40 percent of patients.
Many chronic carriers remain symptom free or develop only a mild condition, chronic persistent hepatitis. However, approximately 50 percent go on to develop the most serious complications of viral hepatitis: cirrhosis of the liver and liver cancer.
Keep posting as you find out more information, myself and others will do our best to communicate our experiences and knowledge. There is much to learn about the symptoms of cirrhosis and the best way to protect the liver from any increase cirrhotic advancement. Take care and I hope the best for you and your mom.
Randy
Here is a link to a video that can assist to educate you about said procedure:
http://youtu.be/ug3n7bvq2Wg
There are many different types of liver biopsies, such as the percutaneous, transjugular, laparoscopic, fine-needle aspiration and open surgery liver biopsy.
You should also know that symptoms of cirrhosis are normally not present until the person has reached decompensated cirrhosis. (End stage cirrhosis)
---------------------------------------------------------------------------------------------------
What are the symptoms of hepatitis C?
Many people infected with hepatitis C have no symptoms. When symptoms are present, they can range from mild to severe. The most common early symptoms are mild fever, headache, muscle aches, fatigue, loss of appetite, nausea, vomiting and diarrhea. Later symptoms may include dark coffee-colored rather than dark yellow urine, clay-colored stools, abdominal pain, and yellowing of the skin and/or whites of the eyes (jaundice).
----------------------------------------------------------------------------------------------------
How is hepatitis C treated?
There are no specific treatments for the symptoms of acute hepatitis C. Doctors recommend bed rest, preventing dehydration, a healthy diet and avoidance of alcoholic beverages. Most patients with mild to severe hepatitis C begin to feel better in two to three weeks and recover completely from their symptoms within four to eight weeks.
Synthetic forms of the protein interferon are used to treat some people with chronic hepatitis C. This can improve liver function in some people with hepatitis and diminishes symptoms, although it may cause side effects such as headache, fever and other flu-like symptoms. Sometimes this drug is used in combination with another drug, ribavirin. Treatment is effective in 10 percent to 40 percent of patients.
Many chronic carriers remain symptom free or develop only a mild condition, chronic persistent hepatitis. However, approximately 50 percent go on to develop the most serious complications of viral hepatitis: cirrhosis of the liver and liver cancer.
Keep posting as you find out more information, myself and others will do our best to communicate our experiences and knowledge. There is much to learn about the symptoms of cirrhosis and the best way to protect the liver from any increase cirrhotic advancement. Take care and I hope the best for you and your mom.
Randy
Hi,
My mother has just been diagnosed with HEP C & also with Liver cirrhosis.
I got shocked after getting this to know as I was not aware about these disease earlier.
I kept on getting the blood tests done as prescribed by doctors for my Mother.
After checking LFT doctor asked to get the Hepatitis checking done & she got detected with HEP C. After further diagnosis, she detected with Genotype 1 with the HCV viral Load of 220,351 & log value 5.34.
The treatment for Interferon & Ribavirin is so costly & therefore now I have taken her to Government Hospital for treatment. Now they have collected the blood for getting different tests done. I am waiting for the reports.
They have also conducted Liver Fibrosis test the result of which is Stiffness (KPa) 12.2 & some more details given on the report.
As of now she is not vomiting, getting a good sleep at night, due to tiredness she sleeps for sometime at day & again starts working as and when she feels comfortable.
Now I am really worried about her as I do not know at what stage her liver disease is & what is going to happen next.
Can anyone please comment with your expertise knowledge.
Regards,
Kiran
My mother has just been diagnosed with HEP C & also with Liver cirrhosis.
I got shocked after getting this to know as I was not aware about these disease earlier.
I kept on getting the blood tests done as prescribed by doctors for my Mother.
After checking LFT doctor asked to get the Hepatitis checking done & she got detected with HEP C. After further diagnosis, she detected with Genotype 1 with the HCV viral Load of 220,351 & log value 5.34.
The treatment for Interferon & Ribavirin is so costly & therefore now I have taken her to Government Hospital for treatment. Now they have collected the blood for getting different tests done. I am waiting for the reports.
They have also conducted Liver Fibrosis test the result of which is Stiffness (KPa) 12.2 & some more details given on the report.
As of now she is not vomiting, getting a good sleep at night, due to tiredness she sleeps for sometime at day & again starts working as and when she feels comfortable.
Now I am really worried about her as I do not know at what stage her liver disease is & what is going to happen next.
Can anyone please comment with your expertise knowledge.
Regards,
Kiran
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A list of national and international resources and hotlines to help connect you to needed health and medical services.
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STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
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I wanted to mention the standard treatment to prevent variceal bleeding.
All quotes are from the AASLD Practice Guideline for for managing Varices.
'Prevention and Management of Gastroesophageal Varices and Variceal Hemorrhage in Cirrhosis'
http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/Prevention%20and%20Management%20of%20Gastro%20Varices%20and%20Hemorrhage.pdf
Recommendations
8. In patients with medium/large varices that have not bled but have a high risk of hemorrhage (Child B/C or variceal red wale markings on endoscopy),
nonselective -blockers (propranolol or nadolol) or EVL may be recommended for the prevention of first variceal hemorrhage (Class I, Level A).
9. In patients with medium/large varices that have not bled and are not at the highest risk of hemorrhage (Child A patients and no red signs), nonselective -blockers (propranolol, nadolol) are preferred and EVL (banding) should be considered in patients with contraindications or intolerance or non-compliance to -blockers (Class I, Level A).
10. If a patient is placed on a nonselective -blocker, it should be adjusted to the maximal tolerated dose; follow-up surveillance EGD is unnecessary. If a patient is treated with EVL, it should be repeated every 1-2 weeks until obliteration with the first surveillance EGD performed 1-3 months after
obliteration and then every 6-12 months to check for variceal recurrence (Class I, Level C).
11. Nitrates (either alone or in combination with -blockers), shunt therapy, or sclerotherapy should not be used in the primary prophylaxis of variceal
hemorrhage (Class III, Level A).
What this is saying is that all patients with varices should be taking a beta-blocker to prevent the first bleed. It reduces the portal hypertension that we with scared livers have. Why is this important and basic treatment for all cirrhotics? Because once we bleed the chances of future bleeds goes way up. All pretransplant patients that I know use them. I have been taking Nadolol for 3-4 years now and have no bleeds. It is the only proven way to prevent bleeds other than banding which is the next thing to be done before bleeding. Bleeding from varices is a potentially life-threatening complication of cirrhosis. You can actually lose most of the body's blood during a bleed.
'Patients who survive an episode of acute variceal hemorrhage have a very high risk of rebleeding and death. The median rebleeding rate in untreated individuals is around 60% within 1-2 years of the index hemorrhage, with a
mortality of 33%.'
'Nonselective -blockers have no role in the prevention of the development of esophagogastric varices but are the gold standard in the prevention of first variceal hemorrhage in patients with medium/large varices. Endoscopic variceal ligation (banding) has been established as an alternative to nonselective -blockers for the prevention of initial variceal hemorrhage.'
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I am glad you are in Memphis where you will be able to see a hepatologist.
Methodist is where Steve Jobs had his liver transplant.
Maybe you can get a referral from your current doctor to have the transplant center do an evaluation so you know what options are available to you.
Methodist University Hospital Transplant Institute
1265 Union Ave.
Memphis, TN 38104
http://www.methodisthealth.org/healthcare-services/transplant-institute/organ-transplant-outpatient-clinic/
Transplant Outpatient Clinic
Pre-Transplant Evaluation
A good candidate for a transplant is determined by a full medical evaluation and input from several medical professionals. The transplant team performs this evaluation in the Pre-Clinic. This team is composed of the transplant surgeon, hepatologist/nephrologist, pre-coordinator nurse, financial case manager, and social worker.
Evaluation Process
The evaluation process begins with a referral from a potential candidate's primary care physician. The candidate then answers a variety of health and lifestyle questions. This information helps the transplant team decide the eligibility of the transplant candidate.
During an initial visit, a transplant candidate will meet with a financial coordinator and a social worker and receive detailed information about the transplant process. For those who are identified as potential candidates, a complete medical evaluation is performed. The medical evaluation is a series of tests dependent upon the specifics of each case. The surgeon reviews the results of this medical examination to further determine eligibility. If the evaluation indicates the candidate is appropriate for transplantation, staff members work with the patient to finalize financial arrangements.
The candidate will receive written confirmation and be listed with the United Network for Organ Sharing (UNOS), a non-profit scientific and educational organization that administers the only national patient waiting list. Once listed with UNOS, patient evaluations must be performed at regular intervals to determine continual eligibility for transplantation. Should an organ become available, it is offered to a patient on the list based on a defined set of criteria established by UNOS.
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Local Support Group
Get the support you need with Living Kindly, monthly support group sponsored by Methodist Healthcare. The group is open to caregivers, family members, transplant candidates, donors and those who have had a transplant. You will have access to knowledgeable speakers discussing a variety of subjects, such as medication side effects, living donation, financial concerns, blood donation and maintaining a healthy lifestyle.
Methodist University Hospital Transplant Institute staff is on hand at each meeting to offer support, share their knowledge and answer any questions you might have. More importantly, other transplant donors and recipients are available to share their transplant experiences or provide mutual peer support to you and your family.
Not a joiner? That's okay. You are welcome to attend and listen. Living Kindly is designed to give donors and recipients access to as much information as possible to assist with their transplantation journey.
The group currently meets the second Thursday of each month in Stratton Auditorium, which is located at Methodist University Hospital (1265 Union Avenue). The class starts at 3:30 p.m., with a medication education session beginning at 3 p.m.
Food and beverages are served and parking is free.
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I would highly recommend you meet others who are waiting for transplants. It is a good way to learn a lot and you will see that many others are going through what you are going through.
Cheers!
Hector