Losing sleep over my dad's test results

[patientx2011]

Hi : My dad have recently been diagnosed with cirrhosis with blood tests and CT wo contrast. The doctor said liver biopsy is not necessary and said the only option is liver transplant. My dad is 85 y.o. and he have both Hep B and C.

Here is the latest result from a CT done 1 month ago: Is this a death sentence? How long does a patient have to live with this type of diagnosis? His doctor said he can't provide that answer and said no treatment right now, because it's already cirrhosis.

CT results:
"The unenhanced liver shows a micronodular surface and is slightly decrease in size, suggesting cirrhosis. No obvious liver masses seen. No ascites."

He as an ultrasound in 11/2010 and MRI in 3/2010, and they didn't indicate micronodules or cirrhosis. So, it got there within 5 months? Why so fast?

What is micronodules compared to macronodules? How long does it take to advance from micronodules to macronodules?

I love my dad very much and I'm worry for him. Please advise. Thanks.

[patientx2011]

Thanks for the info Hector. My dad is seing a gastro right now. The doctor give him diuretics. His AFP # is very high , well above standard range.  I just want to remind everyone that he also have Hep B.

I read alot about Milk Thistle. Do you think this is something he can try to help out with his Cirrhosis. We gave him 250mg and he stopped after a few days because he have headaches from it. Will this side effect go away eventually? Should we decrease it down to 100mg to start him slow on it? How long should he be on it to see any improvement?

Also, I did my research and there countless companies making Milk Thistle but I read that not all of them are good because they don't have the amount that they claim. Can anyone recommend a reputable Milk Thistle source?

Have anyone tried milk thistle and did it help? Thanks!

[HectorSF]

I am very sorry to hear about you father having cirrhosis. I also have cirrhosis and am on 2 waiting lists for transplant.

Is your father seeing a hepatologist? A liver specialist? He must see one if he is to get the best care possible for his cirrhosis. If so, I would follow their advice as they know the full health status of your father. Many people at 85 have other health issues and they make it more difficult to treat and manage liver disease.

What is your father’s genotype. 1a? 1b?

Besides the symptoms you mentioned does your father have swelling in his ankles and feet. The scan indicated no ascites (fluid in the abdomen) which is good. Fluid buildup and poor concentration/memory (encephalopathy) are usually the first signs of the liver failing. Does he have extreme fatigue? Is he taking any medicines to manage his cirrhosis?
Based on the information provided your father is in the first stage of cirrhosis. He could stay stable (feeling the same as now) for many years before his liver can no longer perform all of its functions. The main thing is for him to avoid anything that can harm his liver. Alcohol for one. Many medicines both over the counter and by prescription stress and can damage his liver further. If he is taking any meds or alternate herbs, supplements, vitamins, his doctor should have reviewed this. They all can potentially toxic to the liver. No one can say how long his liver will continue to function as it is. It is only when he’s liver can no longer function that a liver transplant is needed. If it should ever get to that stage your father will be hospitalized for the many complications of decompensated cirrhosis.

By the way, your father liver didn’t suddenly progress to cirrhosis. It is a slow and gradual process. The reason the sonogram didn’t see the nodule liver is because it is a lower resolution then a CT scan. Having a low platelet count is usually the first sign of cirrhosis. His isn’t too low so there is nothing to be done or worry about it happens to all of us with cirrhosis.

Albumin is low and bilirubin and ALT/AST are high. Again these are all indications of cirrhosis.

What do you mean AFP is off the chart? What is the number? You mean 100 or so? Not over 500 is it?

Micronodules vs macronodules indicated the progression of the disease. It really isn’t important it is just another indication of cirrhosis.

Good luck to you and your father.
Hectorsf

[patientx2011]

Thanks again everyone. We currently put him on western medicine (herbs) but I heard it can be detrimental.

I'm concerned because his other blood test results are abnormal. albumin/birulium ratio is not normal, platelets is at 85,000, AFP is off the chart, and ALT/AST is highly elevated.

Also, does these micronodules will eventually become macronodules. does micronodules means advanced cirrhosis? The doctor said there's no point of doing a biopsy because we're not treating him anyways and we're not considering him for a transplant.

[can-do-man]

Hi there, a death sentence? NO. Just so you know there are many of us LIVING with Cirrhosis. I was diagnosed with cirrhosis over 6 years ago, others here alot longer. I am doing fine and don't plan on leaving anytime soon.
Also before having your dad start taking anything please consult with a good doctor, its not a one size fits all....... Best to you and your pops.

cando

[patientx2011]

Thanks everyone. His doctor (gastroenterologist) doesn't sound hopeful. He had an option of treating 2 years ago but some doctors advised against it because of age. I guess it advanced to cirrhosis since then.

It's very hard to deal with this because I live so far from him and can only see him by being on a plane. He is the hero of my life and I can't imagine losing him. He is someone, a model who I want to be for the rest of my life. Dad, I love you so much....

[copyman]

This is by NO means a death sentence. Start supplements,  diet & exercise program on him right away. This are several supplements he should start taking, if you search "cirrhosis & supplements" within this site you will get an idea of the supplements. I also have included a list below. Eat a low fat & sugar diet. And moderate exercise.
Good luck to your dad




I have added links if additional info wanted.

a multi vitamin/no iron

1000 mg of Salmon Oil (epa=160 mg / dha=240 mg / omega 3 = 400 mg) x1

1000 mg of Flaxseed Oil (ALA/omega 3 450 mg / omega 9 110 mg) x1
Raw flaxseed/ 1 teaspoon daily

Hepatapro PPC (900 mg) x 2
info:  http://www.medhelp.org/posts/show/346752  ;


Resveratrol (500 mg) x1  and x2 (alternate every other day)
info:   http://www.lef.org/resveratrol/
source:   http://megaresveratrol.com/


NAC--(n-acetyl-l-cysteine) A sulfur compound that is a precursor of glutathione and protected sulfur-containing amino acid  (600 mg) x2 with Vit C (500 mg) x2
Info:   http://tinyurl.com/9yopf

TMG (750 mg) x 2
http://www.raysahelian.com/trimethylglycine.html

Taurine (500 mg) x 2
http://en.wikipedia.org/wiki/Taurine

Life Extension Super Curcumin W/Bioperine 800Mg 60 Caps (800 mg) x 2  / Powerful Antioxidant Properties to scavenge free radicals
Anti-Inflammatory Actions
Enhances important detoxification enzymes Curcumin increases the secretion of bile by stimulating the bile duct. It also protects the liver by detoxification, stimulating the gall bladder and scavenging free radicals. With the help of the adrenal glands, it inhibits both platelet aggregation and the enzymes which induce inflammatory prostaglandins. Curcumin may also help break down fats and reduce cholesterol. Large doses not recommended in cases of acute bilious colic, obstructive jaundice, painful gallstones, and extremely toxic liver disorders



Sylmarin (425 mg) x 2 / Milk thistle provides hepatocellular protection by stabilizing hepatic cell membranes.

Green Tea Extract (300 mg) x 2 /
info:  http://tinyurl.com/ypdp9q

Coq10 (200 mg) x 1 / http://tinyurl.com/29em8c


Colon complete complex contains:
Fiber complex (2000 mg) x2
Lactobacillus F19 probiotic (14 mg) x 2
Lactospore prebiotic (20 mg) x2

I use Smartbomb.com as a source except for the Resveratrol.

I will go with Lactulose amd Lactobacillus GG when I use up what I have.

------------------------------------------------------------------------------------
What to take while on tx per HR

The supplements while on tx question is difficult, because the ones having antifibrotic promise are almost all antiinflammatory, somewhat reducing the initiating events at the dendritic cell/lymphocyte interface.I know this sounds technical. Most of them also have, paradoxically an improving effect on some aspects of lymphocyte function, as the spectracell test clearly shows.

Bottom line, NO CLEAR ANSWER possible  regarding  use during tx.

But a moderate use of NAC/VitC, TMG, ALA ( those are quite cheap and possibly  PPC (since it was actually shown to help the SVR rate) is probably a good idea even during tx. Vit D3 is good, but it would be best to know ones serum level.
Also some Inulin is inexpensive (trader joes) and a very good well researched prebiotic. To get any lactulose here in the US  is not trivial.

[buggs1]

cirrhosis is not a contraindication to treatment but is does lower the odds of svr
his age could be a negating factor for treating
nodules indicate cirrhosis and show up better on ct scan
its definately not a death sentence

[Mary4now]

I am so sorry to hear about your dad, I hope there are ways to make him comfortable.  Just be there for him.  thats all any of us can hope for.  
85 is a good old age, could be survive the transplant?
Being born is a death sentence,
I dont understand the test results, but others will help you with that.
Try to relax and take care of your dad.
hugs