stages of cirrhosis

[keyker]

I have been doing alot of reading etc., because my husband has cirrhosis and will not stop drinking, I am wondering what are the 4 stages of Cirrhosis? Anyone ??? Thanks!!!!

[XEMT]

WHAT SYMPTOMS IS HE HAVING NOW AND HOW LONG HAVE YOU KNOWN ABOUT IT?

[keyker]

Thanks for commenting....he is 46 years old, severe alcoholic , will not stop drinking, took him to hospital in March and he walked out after 24 hours, against Dr's advice, he has Hepatitis C, has had for 20 years from drug use, needles I guess, when he was younger. His legs and feet are very bloated, he bruises easy, has lots of scabs on his body that bleed, even without touching them, he lays in bed and drinks beer, his stomach is very tight and bloated and he says it is painful, has low back pain and is mildly jaundiced. He will not call his doctor, when I talk him into making an appointment for him, he just cancels it. He won't listen to ANYONE.....and to be quite frank, I don't see any point in taking him to the doctor because HE WILL NOT do what the doctor tells him to do.....I don't mean to sound like I've "given up" on him but I am very very tired, he hasn't worked in 6 months, and the burden is on me, and when he does work it is very erratic, and no, I do not buy him beer, but he gets it anyway......I don't know what "stage" of this disease he is in, but I would like to know what I am in for......any comments???  Thanks again.

[XEMT]

gosh, i am so sorry.  maybe he is in denial. he sounds depressed.  the dr can give him medicine for that and he will feel better. my father has the same symptoms.  he doesnt drink.  never has.  he has hep. b. he is in stage 4. that is what your husband is in.(i think)  the swelling is called ascites.  they can give him lasix for that.  they can also give him a drug that will cause loose stools. it will get rid of the amonia that is building in his blood.  the high amonia causes the mind not to work right.  do you have any children?  i am  the only child and my parents have been divorced since i was 12. i am 33. this dieases is very hard to deal with even under the best circumstances.  my heart hurts for you. the end of cirrohsis is very emotionally hard. i have seen it in patients i carried on the ambulance.  they get very toxic and confused.  they almost waste away.  i know that is not what you want to hear but that is the facts.  if you need to talk to some one, call me. 870-934-0770.  i need a friend too. or  keep in touch on the computer. my email is ***@****   ps. please be careful.  hep c is highly contagious and at this stage is easy to catch.  there is no vactcine to protect you. bleach everything. it can live in dried blood for months. bye for now.  melissa  xemt

[keyker]

Thank you so much for answering me, My name is Cathy, I am wondering how long he has to live, weeks? days? he will not go to the doctor so unless it's a medical emergency and he is scared, he will just lay in bed. Please be frank with me, I can take it, you've probably seen alot....Will he live through the summer?? The month?? Thanks

[XEMT]

IF I HAD A CRYSTAL BALL ID ANSWER YOUR QUESTION. IT DEPENDS ON HIS WILL TO LIVE. SOUNDS LIKE HE HAS GIVEN UP. THEY TOLD MY DAD HE HAD LESS THAN 2 YEARS UNLESS HE HAS A TRANSPLANT. IF I WERE TO GUESS, ID SAY, 1 YEAR.  HERE ARE SOME THINGS TO MAYBE LOOK FOR.  DARK URINE(THE COLOR OF TEA), CONFUSION(NOT DUE TO BEER),YELLOW OR GREEN SKIN, LIGHT YELLOW STOOL AND FREE BLEEDING. I WISH I COULD TELL YOU EVERY THING IS GONNA BE OK BUT ID BE LYING.  ALOT OF CIRROHSIS PTS EITHER BLEED TO DEATH INTERNALY OR GO INTO CONGESTED HEART FAILER AND THEY ARE VERY TOXIC. THE BRAIN CANNOT FUNCTION WHEN ALL THOSE TOXINS ARE IN THE BLOOD.  THEIR PLATELET COUNT GOES ALMOST TO NOTHING.THE LIVER IS THE KEY TO ALL THINGS.  WRAP YOUR ARMS AROUND YOURSELF AND SQUEEZ.  THAT IS A HUG FROM ME.  HANG IN THERE.  YOU ARE NOT ALONE.  MELISSA

[XEMT]

CATHEY, ON THIS SITE, LOOK DOWN AT QUESTION FROM LIVERLOVER DATED 5-24-02, LOOK AT COMMENT MADE BY PATRIOT.  READ WHAT DR SCHULZE SAID ABOUT THE LIVER IN HIS COMMENT. LET ME KNOW IF YOU FIND IT. MELISSA

[XEMT]

TRY COUNCILING??? WHAT DOES HIS PARENTS SAY?  FAMILY IS A STRONG INFLUENCE. WISH I COULD TALK SOME SENSE IN TO HIM.  MELISSA

[imkindly]

There are THREE stages to cirrhosis: Class A, Class B, and Class C.
Class A cirrhosis is not very ill.....Class C cirrhosis is "end stage".

Class is determined by a CTP score.
There's several medical websites that offer CTP scorecards. We have some listed at  http://forums.delphiforums.com/liverfailure/messages?msg=112.1
(You can scroll through about 10 of them there.)

CTP is what a doctor bases his "prognosis" on. (Life expectancy.)
It's also what is used to see if a person is ill enough to need a liver transplant.
(Only Class B and Class C are eligible for evaluation for the liver transplant waiting list.)
You need to know some simple blood test numbers, in order to calculate the score. (But if your husband won't have a simple blood test done......it's all guesswork.)

There's more information at http://www.expage.com/cirrhosis  if you need it.

As for the comment above referring you to anything "patriot" recommends-----try not to do any "flushes" or anything else unless you know it won't kill your husband.  (*If your husband is Class C.....you could easily kill him.)
The reason I say that is---
Hulda Clark has some "wrongful death" lawsuits against her.

Patriot seems to think very highly of Hulda's methods anyway.


heads up.

[imkindly]

P.S.-

HEPATITIS (inflammation) has four stages.
Stage 1 being not very ill at all.......stage 4 being the begining of actual "cirrhosis".


CIRRHOSIS has three stages. (A, B, and C.)

[XEMT]

THANKS, IMKIDLY.  THAT HELPED ME TOO. I WAS REFERING TO THE FUNCTION OF THE LIVER THAT HE WROTE. NOT THAT DIET STUFF OR ANYTHING ELSE.  JUST THE SECTION ON THE FUNCTION OF THE LIVER. MY FATHER HAS 4 AND 4. 4 ON HEPB AND 4 ON CIRROHSIS. THEY DIDNT GIVE HIM LONG. I KNOW ENOUGH TO KNOW YOU HELP YOURSELF OR KILL YOURSELF WITH PITTY. AT THE RATE HER HUSBAND IS GOING, IT WONT BE LONG.   BUT THEN AGAIN, ONLY GOD KNOWS. HIS WILL BE DONE. THANKS FOR YOUR LETTER TO CATHEY. IT HELPS TO KNOW PEOPLE DO CARE .ANY MORE INFO WOULD BE APPRICIATED. I HAVE LOTS OF QUESTIONS MY SELF./  MELISSA

[keyker]

Thank you so much for answering me, all of you, it's nice to know that there are people out there that know what this is like, I had to work yesterday, (overtime-these bill are piling up!) and when I came home there was a quart bottle of Southern Comfort on his nightstand with maybe an inch left in it, I THREW IT AWAY but the damage had already been done.....he was asleep or passed out, I don't know which.....he says he is having a hard time urinating or having a bowel movement, his stomach is SOOOO BIG and TIGHT....If it was me I'd be in an ambulance PRONTO...I don't understand, maybe he wants to die....thanks for listening ...Cathy

[keyker]

I sent this once but it didn't go through-----Thanks for all the comments. It's nice to know that there are other people who have experienced or know what I am going through....I had to work yesterday (overtime---the bills are piling up!! ) and when I cam home there was a quart of Southern Comfort on the nightstand with about an inch left in the bottle, I threw it away, I don't know if he was asleep or passed out. He tells me that he is having a hard time urinating or having a bowel movement, and his stomach is SO BIG and TIGHT....he says it hurts. I told him if it was me I'd be in an ambulance PRONTO.......but he won't listen, maybe he wants to die, I don't know....he's having alot of itching and his eyes are slightly yellow, sometimes worse than others.....What's next? Thanks again for all the comments, I am so glad I found this "forum" It helps just talking about it....Cathy

[imkindly]

Having trouble urinating is a sign of hepatorenal syndrome.
(Kidney failure induced by liver failure.)
Your husband needs help.

As an aside---my husband has been in liver failure since August 2000. The key to keeping someone alive, is handling complications (as best you can), as they come up.
The three "main" complications are : ascites, varices, and encephalopathy.
If you don't try to keep those under control.....his time with you may be short.

[imkindly]

You asked "what's next".

I hate to say what's next (because for anyone else reading this----I don't want them to think anything is hopeless.) Many of the complications of cirrhosis can be controlled.

But if you are wanting to know what to expect---from someone who continues to drink, refuses to try to keep complications under control, and won't see a doctor----
here's some possibilities of what you can expect:

1. He'll begin to vomit large quantities of blood. You'll need to call the lifesquad and hope they can control it before he bleeds to death.

2. He'll act crazy, slur his words, and fall into a coma. You'll need to call the lifesquad before his brain swells and he dies.

3. He'll get an infection in his ascites (swollen stomach). His blood presure will drop and he'll go into shock and sepsis (blood poisoning). You'll need to call the lifesquad and hope that after several days of IV antibiotics that they can save him.

4. He'll go into hepatorenal syndrome. (Can't urinate, kidneys fail). You'll have to call the lifesquad and hope that through dialysis or some other miracle that they can save him.
(Liver transplant is the only real "cure" for hepatorenal syndrome)
Most transplant centers demand 6 months sobriety before transplant.

5. All of the above, (or a combination of some of the above happening together).

Sounds grim, and if you have children, it will be a terrible thing for them to witness.
So what can be done?

For each of the above, there are preventative measures.
FIRST---remove anything that is making matters worse. No alcohol, no medications that may be hepatotoxic (examples: many medications, even OTC meds like acetaminophen or ibuprofen or aspirin)

And for the above:

1. Non selective beta blockers to reduce pressure in the varices.
Endoscopy to locate large varices and band them off.

2. Lactulose to remove ammonia and other toxins from the brain.

3. Watch blood pressure, watch for fevers, watch for pain in the abdomen. Be quick to go to the ER if any of those appear.

4. Go to the ER if he can't urinate. Hope for the best.

Your husband should be taking diuretics and avoiding salt. If you let him continue with the ascites (swollen stomach) without diuretics-----he'll need paracentesis.
If you don't get him diuretics.....and you don't get him paracentesis.....his prognosis is grim.

[XEMT]

THANKS IMKINDLY, I KNOW YOU DONT WANT ANYOHNE BUT CATHEY TO READ YOUR COMMENTS BUT THEY REALLY HELP ME TOO. CATHEY, THIS IS IT IN A NUT SHELL. HE IS GONNA DIE WITHOUT HELP. DO IT NOW. IMKINDLY WAS BLUNT AND TRUTHFUL. SHE OR HE , EXPLAINS IT BETTER THAN I CAN. IMKINDLY, STAY IN TOUCH WITH US PLEASE. WE BOTH NEED YOU. HAHA. THANKS AGAIN.  CATHEY, HANG IN THERE. IM HERE IF YOU NEED TO TALK. MELISSA

[XEMT]

PLEASE KEEP IN TOUCH WITH ME AND CATHEY. YOU ARE VERY WISE IN THIS DIEASES.  MY FATHER HAS AN APPOINTMENT AT LSU THE 27 AND 28. THEY SHOULD LET HIM KNOW IF HE GOES ON THE LIST FOR A TRANSPLANT.  I READ HIS EKG AND I SAW ALOT OF PROBLEMS WITH HIS HEART. IF HE WERE IN THE AMBULANCE I WOULD HAVE SHOCKED HIM. HEART RATE WAS 45. HE HAS WHAT I CALL ISCHEMIA.  WITH THIS INFO, I DONT THINK HE WILL BE A CANIDATE FOR TRANSPLATE. DO YOU? MELISSA

[keyker]

Thank you for being so straight forward about it....I am going to try to talk to him AGAIN today; but like I said before the last time he was in the hospital he left after 24 hrs, just got up and walked out....but now the symptoms are worse, so maybe he will stay and let them help him.....I never realized what an evil thing alcohol can be.........Thanks again, you sound like wonderful people....God Bless You....and I'll let you know how it goes this evening....Cathy

[XEMT]

you go girl!!!!  if he wont go put his butt on this computer and let me talk to him...  if he does go, tell them he needs something for depression.  maybe that will help to.  GOD BLESS YOU BOTH. i will pray for yall.  melissa

[XEMT]

worried about ya.  let me hear from ya

[imkindly]

Hi Melissa
Each transplant center sets their own criteria for who they will accept. Some centers are stricter than others.
Your father will have to pass LSU's own evaluation, to be accepted there.

Generally, an evaluation is a series of medical tests (cardio included) that show whether the patient will be able to survive transplant surgery.

Some centers list their criteria online (on their website), but I checked LSU's site, and they don't have details listed.
(That's at  http://www.wkhs.com/rtc/liver.html  )

My husband is listed at Baylor Methodist in Houston. They're pretty strict. Along with the physical evaluation, we also had to do a psychosocial evaluation (right attitude).

Good luck to your father :)
If I can be of any help, let me know.

[XEMT]

thank you.  i will probably have many more questions.  how long have yall been on the list or have you already done the transplant thing?  my father never had a drink in his life. we think he got hep.b off the ambulance.  he too was a medic.  but back then you didnt take universal precautions nor did you take any shots for hep.b.  he was tested in 95 and the dr told him he had the antibodies.  he didnt. he had the antigen.  the dr made a mistake in reading the results.  now we are where we are today.  we just found out a month ago.  cirrohsis!!!  caused by hep.b.  wish cathey would let us know something.  i am worried about her.  melissa

[imkindly]

Hi Melissa
My husband went into liver failure very suddenly (August 2000) after a botched kidney stone operation.  At that time, I knew very little about livers, or scar tissue, or liver failure. We were dealing with a local doctor that told us my husband wouldn't live past Christmas 2000. (The local doctor offered NO treatment whatsoever).
That was my incentive to begin learning all that I could. (And also to drop that doctor and find a better one.)


We did find a better doctor, and began seeing him in Nov. 2000.
He explained that my husband's liver and pancreas had been perforated (during the kidney stone operation)...and that my husband's liver had been "insulted" and shut down. (10% function). We also found out that my husband has Hepatitis C. (We had no clue, until then.)
He also explained that there were many things that we could do, to treat complications as they arose.


We went through the evaluation (for the transplant list) in Feb. 2001 and got accepted. We were given a beeper....and we are still waiting. (On the waiting list for 16 months now)

During the past 16 months, we've experienced alot of things.....urosepsis, peritonitis, septic shock, bleeding varices, encephalopathy.
My husband's ascites is large, and has caused two hernias (one hernia is in his navel, and one is above his navel). They can't be repaired until he gets the transplant. (Anesthesia right now could kill him, with his liver not functioning right.)

He takes alot of medication to keep everything under control---Inderal (beta blocker) twice a day.....Lactulose twice a day.....Ferrous Sulfate (iron) twice a day.....mag tab (magnesium) twice a day.....Lasix (diuretic) three times a day.....Spironolactone (diuretic) three times a day.....Noroxin (antibiotic) once a day.....plus two vitamins. (All under doctors orders----everything he takes was prescribed by the hepatologist).

I read all that I can, and post alot of it on my board at Delphi (support group). I've got two homepages ---
http://groups.msn.com/CirrhosisSupportGroup
and
http://www.expage.com/cirrhosis
Both link to the delphi messageboard.

I come to this board (MedHelp) pretty regularly too.

[imkindly]

P.S.-
You mentioned your father's pulse only being 45....

Is he taking any heart medication?

The reason that I ask that is----
Since my husband began taking Inderal (beta blocker), his pulse stays around 55 to 60.  It's actually a good thing (the doctor wanted to reduce his heart rate---in order to reduce the risk of hemmorhage from his varices)

[XEMT]

gosh. yall have been through the ringger.  i am so sorry. my dads ascites is getting worse by the day.  so far they have him on lasix 80 mg. and aldactone 200 mg.  his amonia levels are increasing.  last week they were 40 now its 54.  they may have to put him on laculose(spelling isnt my high point.) i understand how that works.  he is mentally ok so far!!  i live 4 hours from him and i am on the road alot now. i have 2 children. 18 months and 13 years. the 13 year old is my best friend. (both boys)  my husband is very supportive of me. he knows how much dad means to me.  my step mom is blind. i am an only child,so it kinda falls to me. what is varices?  is that internal bleeding? please explaine. i learned alot in medic school but not all this.  your friend, melissa.

[XEMT]

he has never had any heart problems. come to think of it, he has never been sick til now! go figure.  we havent got to see the hepatologist yet.  that will be next week.  melissa

[XEMT]

here is my email address. ***@****  just incase you need it. hint hint

[XEMT]

i have been reading some of the other comments you made to other folks.  you dont take no ****. i think you are well educated and a hell of a person. its an honor for me to be talking to you. even if we loose contact on this forum. you stay in contact with me and cathey. we really need some one who understands all this maddness. you have been there and are still there. and tell your husband how lucky i think he is to have you, searching for answer for him (and  you) on this terrible dieases.   now, i wish cathey would let us know something.  your friend melissa

[keyker]

Hi, I talked to him this morning and he said that if he doesn't feel better by tomorrow (you know, in his head he actually believes this is all going to just go away) he will go to the emergency room. We are in Baltimore and Johns Hopkins is close by. Thank God, maybe there's some hope now....I'm at work and don't have much time now, but I will let you know, everything thats happening, Gosh, it's so good to have someone to talk to about this, you have no idea how helpless I've been feeling, and I read the comment about "Houston" Does that mean you live there, I am from Dallas....Later, Thanks to BOTH of you, you really sound like WONDERFUL people.....It is a pleasure talking to both of you......Cathy  P.S Also,, this morning I looked at his legs and he's got these white spots all over them????? You know what amazes me, my father is an alcoholic, has been all his life, he drinks a fifth of whiskey almost every day, he'll be 81 in August and his liver is fine.....go figure....

[XEMT]

I WAS BEGINNING TO GET WORRIED ABOUT YA. JOHN HOPKINS IS REMARKABLE HOSPITAL. I WISH I COULD WORK THERE. (TOO FAR OF A COMMUTE)HAHA.  I LIVE IN ARKANSAS AND IMKINDLY MUST LIVE IN TEXAS.  SHE HAS REALLY HELPED ME TOO.  THE WHITE SPOTS YOU SEE, MAYBE POOR CIRCULATION???? IMKINDLY, WHAT DO YOU THINK IT IS??  GOTTA GO  BABY IS UP. READY FOR HIS EGGS. HAHA.  HE EATS ME OUT OF HOUSE AND HOME.  GONNA HAVE TO BUY SOME CHICKENS I GUESS. HAHA.  TALK TO YALL LATER. MELISSA

[keyker]

Thanks for answering, I'll let you know what happens with this, it's a start, but he is going to have to realize that he can never drink again......we'll see.......Arkansas huh? When I lived in Dallas we used to drive to Hot Spring to the races, I loved it there....Anyway, thanks again for being there, I feel better about things today.....I'll let you know what happens tomorrow.....Cathy

[imkindly]

Varices (internal varicose veins) are caused by portal hypertension.

I'll try to explain varices in my own words, and then I'll give you a page to look at--

There's a big vein that carries blood to the liver, called the 'portal vein'.
Blood flows through the portal vein, through the spleen....then through the liver (the liver filters the blood),........to get to the heart.

Cirrhosis (scar tissue in the liver) gets in the way of this blood flow. The blood can't flow through the liver freely, so pressure builds up in the portal vein.
That pressure is called 'portal hypertension'

As more and more pressure builds up in the portal vein, the spleen enlarges.
Once the spleen has enlarged all that it can......the blood tries to find an alternate route.  
(The alternate route is little blood vessels in the body---called 'varices'.)

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

Imagine it as a traffic jam-----lots of traffic (blood) is trying to travel through the portal vein, through the spleen, then through the liver......to it's destination (the heart).
There's a traffic jam in the liver (scar tissue in the way).
So traffic slows down in the portal vein....
traffic builds up in the spleen.....
traffic can't get through the liver...
and then the traffic tries to find little "side roads" to travel.

Those little "side roads" are little blood vessels that were not designed to carry all that traffic.  Those little blood vessels enlarge and are under too much pressure.  They are called VARICES (internal varicose veins).  And when the pressure gets too great, they swell up and burst.
Varices are usually in the esophagus, stomach, or intestine.

If varices in the esophagus burst----a person will vomit blood.

If varices in the stomach burst----a person will either vomit blood, or vomit something that looks like coffee grounds, or digest the blood and pass black tarry stools.

If varices in the intestine burst----a person will either pass blood, or pass black tarry stools.

The mortality rate for esophageal variceal bleeding, on the first event, is between 40 and 70 percent.
Anyone experiencing bleeding needs to go to the ER immediately.
They can do several things at the ER----
***usually they use an endoscope and tie off the bleeding varices with small rubber bands (that's called ligation)
***if they can't reach the varices to band them off, they can use sclerotherapy (inject chemicals that can stop bleeding)
***more severe cases can be treated with a shunt (stent)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
PREVENTION:
People with cirrhosis should be screened for varices.  This means that a person with cirrhosis should have an endoscopy done.  The endoscopy is a scope down the throat---looking for swollen varices.  (The goal is to try to find them BEFORE they burst, and have them tied off (banded).....so that they can't burst.)

Another thing that can be done....is to take a prescription of non selective beta blockers (example: propranolol or inderal).  Beta blockers reduce the blood pressure in the portal vein.
(Slow down the "traffic" I described above.)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Here's some pretty good pages

http://www.clevelandclinic.org/florida/research/health/portal_hypertension.htm

http://www.familydoctor.org/handouts/188.html

[XEMT]

are you a teacher??  you should be.  i understand. i thought that is what it was but wasnt sure.  if i am not sure about some thing i ask. even if it does sound dumb...HAHA  thanks so much. i told my step mom about this forum.  she may be joining us.she is really sweet. i love her to death.  yall will like her too.  thanks   melissa

[imkindly]

There's no such thing as a dumb question. :)
I'm pretty compulsive about learning all that I can.

The question above about Houston----no, I don't live in Houston.
I live in a small town 130 miles from Houston. The LOCAL doctors here are a scary bunch.  So we travel to Houston once a month to see a good hepatologist.

[XEMT]

cool.  glad you arent any further.  that is a long drive.

[EMTA]

I HAD TO CHANGE MY NICKNAME.  MY COMPUTER IS MESSED UP.  CATHEY HOW ARE YOU.

[keyker]

Sorry I haven't written in a few days, he went to the hospital, they tapped his stomach yesterday....7 quarts of fluid, they say he will be in hospital at least a week; doctor told him his liver was almost "gone" and so were his pancreas, also told him if he took another drink he would not see Christmas...he guaranteed it...So what now ?????? What am I in for??? Will he ever be able to work again? Tell me what might be ahead if you know???? Thanks Cathy Hope you are doing ok......

[EMTA]

oh cathy, i am so sorry. no, he wont be able to work again.  he needs to get on disability if he can.  what are his amonia levels? his bp and pulse rate?  (imkindly, give her some of your wisdom!!!)i wish i knew what to tell you!! its a long process.  get your tuffs on.  heres a hug!!  melissa

[imkindly]

Cathy, there's a page about how to qualify for social security (for liver disease) at

http://groups.msn.com/CirrhosisSupportGroup/socialsecuritybenefits.msnw?pgmarket=en-us

If you go there, scroll down to "D" and you'll see that
Cirrhosis plus ascites (ascites has to persist for 5 months) qualifies.
The procedure that he had done (tapping his stomach) is called "paracentesis". Social Security mentions that too.

Cathy, if I were you, I'd ask the doctor for these numbers while your husband is in the hospital:
1. What's his ALBUMIN?
2. What's his PT or INR?
3. What's his TOTAL BILIRUBIN?
4. What's his CREATININE?

(Just write those down, hand it to the doctor and say "Can I get these numbers?")

If you get those numbers we can figure out what stage your husband is at.
I know things don't look good right now, but some of this is manageable.

When they let your husband come home, they will probably give him a prescription for diuretics (if his kidneys can handle it) (the creatinine number will tell them if his kidneys are still ok)
Diuretics and a low sodium diet (under 2000 mg. sodium per day) is usually effective in keeping ascites under control.

(If it isn't effective, he'll have to get tapped again later.)


Check out the link for Social Security benefits above and if you have any questions let me know.  
To get the ball rolling....the first thing you have to do is call your local social security office and tell them that your husband has cirrhosis and ascites and is in the hospital and you'd like them to send you the papaerwork.
They'll mail you alot of papers to fill out.

If I can be any help let me know.

[EMTA]

thanks alot for the info.  you help both of us. hang in there cathy!!!

[Cookswife]

Hi, I'm so glad to have found this forum.  I have an alcoholic husband who I belive is starting to go through the diagnosis stage of cirrhosis.  He has his doctors baffled so far, but I have my own personal diagnosis.  Have any of you heard of sores on the arms that bleed easily.  I noticed that no one mentioned this and I was wondering if it was a symptom?
Thanks.

[imkindly]

Hi cookswife
Your husband might have low platelets. (It's very common in cirrhosis)
Platelets are what enables our body to form a scab when we are cut.
People with low platelets bleed easily.
(Even a small scratch will bleed)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
To explain WHY:

If you read that paragraph (above) where I was talking about portal hypertension and varices----
notice the part where the SPLEEN enlarges.

When the spleen enlarges, lots of platelets are trapped in the spleen, and don't get to circulate throughout the body the way they should.

This means that people with cirrhosis usually have a low platelet count (on blood tests).

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

This means that anything your husband has (example---a sore, an insect bite, anything he picks at)-----will bleed easily.
(If he has cirrhosis).

It also means that he'll bruise easily. Sometimes even coughing or sneezing can make blood vessels burst. (Bruises, nosebleeds, etc.)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
BLOOD TESTS:

Platelet Count-  A normal platelet count is 150 to 400
(those are thousands. 150,000 to 400,000)
When platelets are below the normal range, people bleed easily, and bleed longer than normal.
People with cirrhosis have low platelets.

PT (Prothrombin Time)-  Doctors keep track of how bad the situation is, by measuring Prothrombin Time.
Prothrombin Time = How many seconds that it takes blood to clot. (Form a scab)
A normal PT is usually 11 to 12 seconds.
People with cirrhosis have high Prothrombin Time. (Because of low platelets)

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

Anyway, I thought I'd take this a step at a time, so that you could see what to look for.
(If your husband has blood tests done, see if his platelets are low.)
That would explain easy bleeding.

[imkindly]

Cathy--- How does your husband's navel (belly button) look?
Does he have a hernia yet?  

[RuthieTx]

My husband was diagnosed a couple of months ago with cirrhosis caused by years of heavy drinking.  He hasn't had a drop of liquor since the diagnoses and is taking the medications prescribed by the Doctor.  

He doesn't have medical insurance so we're going through the country health program which is terribly slow.  He still hasn't been referred to a gastro specialist and has to go back to the original doctor for his test results before a referral.  It takes at least a month between appointments.

I guess I'm wondering what to expect - what is the prognosis for someone once they've been diagnosed and follow doctor's orders?  He was to the point that his stomach and legs were completely bloated - he could barely walk.  He fell several times and couldn't get up off the floor.  The doctor told him it was cirrhosis as soon as she set eyes on him.  The swelling has all gone down with the medications and we're watching his diet.  He's lost lots of weight and can walk with the help of a cane.

How long can a person go on like this without a transplant?  And what are the chances of getting a transplant?  

I'm just lost... any help will be appreciated.

Ruth in Texas

[imkindly]

Hi Ruthie

I just got done writing a post to Kush at

http://www.medhelp.org/perl6/Gastro/messages/C34287-5.html

check that out.
It explains what we are watching out for (and what to do), while we wait for my husband's liver transplant.

Ruthie, when your husband sees the gastroenterologist, they are going to do some blood tests to determine your husband's CTP Score. ("Child Turcotte Pugh" Score)
If your husband's CTP score is 7 or above.....they will refer him for an evaluation for the liver transplant waiting list.

The evaluation is a series of medical tests (at the liver transplant center), to see if your husband would be able to undergo a transplant or not.

If he passes the evaluation, he'll be put on the liver transplant waiting list.

Once he is on the list....another scoring system is used. It's called a "MELD Score". (Model for End Stage Liver Disease Score).
Everyone on the waiting list is given a MELD Score.
When a donor liver becomes available....the person (on the waiting list) with the highest MELD Score gets the call to come in for their transplant.
(The sicker a person is...the higher their MELD score is.)

My husband got evaluated and accepted onto the liver transplant waiting list in Feb. 2001. (We are still waiting.)
If I can be of any help to you, feel free to email me.

***@****

[coog]

Well, I am so glad to have found this site while searching for info about cirrosis. My sister has this due to a long addiction to alcohol. My question is.. what are her seizures about?? I know the is due to the cirrosis but what is happening in her body is what I am looking for. Any help with this would be appreciated.
Thanks
Coog

[ritabobcasaja]

I'm Kindly:  I am really impressed with all the information that you provided on the Forum.  I have Primary Biliary Cirrhosis, was diagnosed with it in 1993.  I just had a colonoscopy and an endoscopy, where they say I have varices, stage 2.  Can you tell me just what that means.  I know stage 1, of course, is the beginning and at stage 3 you are at risk for rupture.  I have portal hypertension, an enlarged spleen (found this in 1993), a small liver, platelet count in the 50's, etc.  I am now seeing a new doctor here in town and read all I can about this disease so I have some clue as to what they are talking about when I see them.  Anyway, just now trying to clue in on the stages - and maybe where I am.  Keep up the good work.

[LollyPOP2000]

I have a friend that has a tight swollen tummy and he mentioned he has colon cancer 3 years ago,
but will not tell us what stage.
    I tend to think it is Liver disease....he has been drinking like a fish for 20 some years.    His tummy is tight and swollen in an OVAL shape.  In other words, his tummy is tight and shaped like an egg standing on its end......just an oval shape.
    It is not the typical beer belly, although he uses beer
for water.   He drinks hard liquor by the bottles and has stiff drinks each evening.....could it be liver or his colon causing
his stomach to look tight and oval shaped?   He will not say for sure....so we don't discuss it.    Does Liver failure give the
oval, tight look to the abdomen?     It is not a beer gut like
we see men with beer bellies....his is tight and oval shaped, it
covers his entire tummy area....   I am just concerned about him....he still drinks like a fish each evening...at home or the bars are his "watering hole"  he is 51 years old.
    Lollypop

[grannydi]

A related discussion, Coughing and esophogeal varices was started.

[yellowgirl1961]

A related discussion, alpha1 was started.