Re: Uncomfortable with treatment

Posted By linda on July 04, 1999 at 14:10:25
My husband had a blood test last August with his white blood count reading 60000.  Our doctor said he didn't have cirrhosis at that time but specialist said he did have it in October.  Ultrasound, x-rays and blood tests were his form of diagnosis. He also was very jaundice.  Dr said if he didn,t stop drinking he would be in trouble before the year was out.  My husband went  away for treatment for his alcoholism February 1,1999 and he has not had anything to drink since.  Our problem is that by the end of Feb. he started to retain fluid in his abdomen.  He was put on diaretics while not reducing the water in his abdomen he did loose 30lbs withing the month of March.  April showed he was anemic even though at this time his eating habits were mostly fruits, vegetables, fish and chicken.  In May they removed
22lbs of fluid from his abdomen and the following day fluid was in his scrotum and penis the size of balloon.  Urologist said nothing could be done do to it being in the soft tissue.  This lasted for about 2 weeks.  June brought us to the hospital with fluid filling his right lung and they removed 2 litres off it on admittance and within the next three weeks of hospitilization they removed an additional 8 litres from this lung and 4 litres from his abdomen.  After much prompting they finally did a CT scan which showed no cancer in his lungs.  Also no cancer cells in the fluid taken out of his lungs.  My husband is so weak and has gone from 204lbs to 164lbs.  His speach is  very weak and he is very slow going.  Blood pressure jumps anywhere from 106/60 to as low as 55/35.  
there is talk of them putting a tube in him to drain him continually but since we are in Canada we are waiting for a bed to  become available.  Therefore they have sent him home with diaretics and told to come in for blood tests again this week.  I feel we are waisting valuable time and I don't know where to turn.  Endoscopy showed some large veins but they have not done any bleeding.  My question to the specialist was why has he not done a biopsey on his liver and he said it wouldn,t change his treatment because if there was a cancer there we would loose him because he wouldn't be up to surgury.  Sorry for being so long winded but my question  is , is there anything you can advise me to do or to look for.  I feel I am sitting back leaving him at this doctors descretion.  Thanks for any help you can provide.
Sincerely Lind.

[cjames]

Posted By cjames on July 16, 1999 at 05:15:20
Linda,
Your Husband's situation sounds very trying.  I have some questions/suggestions that may help you.  First, hopefully he is on a very reduced or no sodium diet, this may help with the ascites, typically stay to less than 2000mg/day of sodium, less than 1000 is better but hard to do unless you prepare all your own foods.  Also, possibly the type of diuretic can help.  I take aldactone and it does ok, it is a non-potassium depleting diuretic so you dont get cramping of muscles much, but I find it less effective than Lasix, which is tons better for me as a diuretic but it caused me lots of muscle cramps by leeching out potassium, I'd cramp my hand just turning the keys in a lock.  The biopsy can help verify cirrhosis and help determine cancer presence, as cirrhosis is often precancerous.  If your husband is anemic, odds are his prothrombin time is way up too, so his blodd isn't clotting well.  This condition becomes very risky for a biopsy then due to the risk of bleed.  Sounds like his BP is low, so not much risk from portal hypertension, but you mention enlarged veins in endoscopy, these are varices and can rupture and bleed, you should monitor that closely, as that is extremely life-threatening.  Ascites is same, as you have higher risk for peritonitis if the fluid gets infected (another risk with the biopsy).  Given the bad probs with ascites (I assume due to portal hypertension) you may have your doctor look into the use of a Tips Shunt, an intravenous stent shunt that is surgically inserted thru the jugular down to the liver and shunts blood flow from the portal vein that is backed up to an alternate route.  This sometimes helps severe ascites cases.  feel free to email me with questions, but i hope this helps.
cjames










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Uncomfortable  with treatment         Wendell 7/17/1999
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