Later stages

[Tiffaney]

What symptoms occur liver failure takes place, please answer my mother is in tremendous pain right now and her abdominal area is more swollen than ever, i'm scared because i do not know which one of these symptoms should require emergency assistance

[imkindly]

P.S.- Check out the message that's just a couple above this one (on the main board).....called "ending stages" by warriorprincess.
I wrote her a reply that describes alot of these same things.

I've also got a homepage over at
http://www.expage.com/cirrhosis

[imkindly]

Liver failure usually makes 3 main threats happen:

1. ASCITES (swollen abdomen)
If you have ascites, you should be on a low sodium diet (stay under 2000 mg. sodium per day)---read food labels, avoid too much sodium. Salt (sodium) makes ascites much worse.
Also---your doctor will probably start you off on diuretics (water pills) to try to shrink the ascites.
It's important to keep track of your weight daily, and if you see a weight gain of 5 pounds during a week---call & tell the doctor. (Because they may need to increase your diuretics dosage).

It's important to keep ascites under control, to keep other "troubles" from getting out of hand.
Ascites fluid can get infected and be life-threatening (peritonitis)
Ascites can also cause hernias....hernias can strangulate....which can also be life-threatening.

************ANY ABDOMINAL PAIN, OR ANY FEVER, COULD BE A SIGN OF PERITONITIS-----MEANS THAT YOU SHOULD GO TO THE EMERGENCY ROOM. (They will give you lots of IV antibiotics there, which could save your life)


2. VARICES (internal swollen varicose veins in the esophagus, stomach, or intestine)
You should have an Endoscopy done to see if you have any large varices.
If they do find large varices (during the endoscopy), they can tie them off with tiny rubber bands. (to prevent them from bursting later).
Also---a doctor can give you a prescription for beta-blockers (like Inderal) to reduce the pressure in the varices. (to prevent them from bursting)

Varices need to be kept under control, Because If varices burst, you could bleed to death.

************ANY COUGHING BLOOD, or VOMITING BLOOD, or VOMITING SOMETHING THAT LOOKS LIKE COFFEE GROUNDS, or PASSING BLOOD, or PASSING BLACK STOOLS----MEANS THAT YOU SHOULD GO TO THE EMERGENCY ROOM.
(They will find the source of the bleeding, and stop the bleeding, which could save your life.)

3. ENCEPHALOPATHY (ammonia build-up which causes mental changes)
Encephalopathy usually begins with drowsiness or sleepiness. It can progress to confusion, tremors, slurred words, etc......and if allowed to get out of hand....coma and death.

If you have any signs of encephalopathy, your doctor should give you a prescription for LACTULOSE.  Lactulose is a liquid laxative that binds with ammonia and removes it from the body.
Once you are taking Lactulose....tell your doctor of any symptoms if they re-occur. (They may want to increase your dosage of Lactulose)

Also----avoid anything containing alcohol (even over-the-counter cough or cold remedies), because alcohol will make encephalopathy worse.
Also----many other drugs have the potential to make encephalopathy worse (painkillers, hypnotics, sedatives)(even mild over-the-counter drugs), so never take any of those without your doctor's approval.

************IF YOUR FAMILY MEMBERS NOTICE THAT YOU ARE ACTING STRANGE (acting drunk, or confused, or way too sleepy, or staggering, or your hands shaking (tremors), or groggy, or slurring your words, etc.) THEY SHOULD TAKE YOU TO THE EMERGENCY ROOM.
(They can save your life there)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Tiffaney, everything that I've mentioned above, happened to my husband. The key to this whole thing is getting help (at the emergency room) quickly if any of those things happen.
If you see any of those things happen, don't sit around and wait to see if they get better.......go to the ER.
Getting help fast, keeps things controllable.

One more thing.
You mentioned kidney failure....
Are you getting blood tests done on a regular basis?
Your doctor should be monitoring your CREATININE and your BUN (Blood Urea Nitrogen)....on blood tests.
If the kidneys begin having problems, those two numbers (Creatinine & BUN) will rise way too high
(This lets the doctor know that something is about to go wrong----and they can step in and do something about it)

The first signs of kidney trouble is rising Creatinine and BUN.
Inability to urinate is a sign of kidney failure.

************ANY TROUBLE URINATING MEANS THAT YOU SHOULD GO TO THE EMERGENCY ROOM.

Are you considering a liver transplant? Has your doctor spoken to you about it? Has your doctor ever told you whether you are Cirrhosis Stage A, Cirrhosis Stage B, or Cirrhosis Stage C ?
(The stage is determined by a "CTP Score" (Child Turcotte Pugh Score)
If I can be of any help, don't hesitate to let me know.
(My husband went through all of this stuff, and if you have any questions about any of it, I'd like to help.)

[Tiffaney]

I already knew myliver was in an acute chronic stage. I was diagnoised with cirrhosis in 1996.  I contracted Hepatitis B in 1979, there was no test for Hepatitis C at that time.  
The doctors stated I contracted the disease in 1979 along with the Hepatitis "B" , due to the severity of my liver biopsy.  I have been turned down for any Hepatitus "C" therapy because it may cause my liver to fail with treatment.  I am currently on maintenance drugs for the syptoms.  I really am concerned about my children.  I've had this disease approximately 23 years, they say after the 20 year period, cancer would set in within the next 10 years.  I guess I'm curious when do I have to go to the hospital for liver failure and or renal failure???????????

[imkindly]

If you're concerned about her liver----the first thing that you should do is to have a blood test done (liver panel).
It's a very simple test!

If the tests show that something is going on.......have an ultrasound done (or even better, a CT Scan)

(It's best to have at least a gastroenterologist handling this---but if there's a liver problem, a hepatologist would be even better.)


If I can be of any help to you----just yell.
(We dealt with my husband's liver failure for two years....and he just received his liver transplant Nov. 7, 2002)

[Concerned lady]

Take your mother to the closest good Emergency Room NOW! Don't delay. Her life may depend on getting some good medical help NOW!

I wish her the best.

Sincerely, Concerned lady