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hep c cirrhosis endstage
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hep c cirrhosis endstage

been in and out of ER this week PLT 74 and high potassium levels, will finally see a Dr on Monday put me back on pain meds,also referral to infectious disease doctor here in tahlequah, spleen extremely enlarged and causing pain and very cirhotic,spoke to OU med hosp Monday they are waiting on my referralso back on the road to getting healthcare straightened out and we are all on the same page now. Liver numbers returned to normal 2 days ago....any in put would be appreciated. Hope all is well with everyone. been very sick.
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Okay, the enlarged spleen is a side effect from your liver's cirrhosis.
When the liver becomes cirrhotic the spleen takes over some of it's job, which is difficult for the spleen. It's also affects the platelets, causing them to drop.
Sorry if I'm not the best at explaining.

Keep hydrated, exercising, don't eat anything with salt or any red meat and get into OU asap.

Good luck.
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I have no great insight but wanted to send you words of support.  Please take care and keep posting.  
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working on OU and thank you for all the support you really have no idea how much it has kept me encouraged. They also did CT scan with IV contrast and that stuff you have to drink. Will post more after Doctor on Monday! have a great weekend. God Bless you all!
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1974758_tn?1330824766
I hope the medicine eases your pain. I've never had an enlarged spleen but can imagine your discomfort. Keep your spirits up!
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Sorry to hear you have been so sick. Hope you get with the right doc soon.
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I am very sorry to hear about your liver condition.

Here are a few comments on the info you provided....

Having a platelet count of 74,000 is typical for patients with cirrhosis. But in and of itself, it doesn't cause any symptoms and you have plenty of platelets to function normally. My platelet count has not been as high as 74,000 in years. Mine are usually in the 50,000s and 60,000s range. Only if they went down below 25,000 would you doctor be concerned.

High potassium (hyperkalemia) is very dangerous. Which I guess is why you are hospitalized? As it can cause serious heart issues (weak pulse, irregular beating) and is needed for the normal functioning of the muscles, and nerves. So your sodium and potassium levels need to be in balance which sounds like they did correct this.

What are the pain meds for? Pain from your enlarged spleen? That is unusual. The vast majority of patients with cirrhosis and enlarged spleens do NOT have any pain until they are very very ill and needing a transplant.

All cirrhotics have enlarged spleens. It is a complication of cirrhosis. How large is yours? My spleen is 16.3 cm. A normal adults is usually about 11 cm. As I said before it is just a typical complication of cirrhosis and there is nothing that can be done about unless you have a spleen disease. The enlarged spleen cause a patient's platelet count to drop.

Are you aware that certain pain drug harm the liver and cause liver disease to progress more quickly? When you get to OU you should let them know what you are taking and if you should be taking it.

" Liver numbers returned to normal 2 days ago" They stabilized you. Which is a very good thing!

Connect up with OU ASAP and have them work you up and get a complete diagnosis.

P.S. If you can formulate some questions about certain aspects of cirrhosis it would be helpful. Advanced Liver Disease is a huge subject and is nothing that can be explained in a few posts.

Good luck with OU!
Let us know what happens.

Hector

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I was UND at two weeks following the prescribed ribo dose.  The incevik gives you that boast you need without ODing on ribo good luck and congrats on und.
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I thought this was a different thread ?????
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As for pain meds: look, as far as I know, opiates (morphine, etc) and opioids (Oxycodone, etc) are fine with liver disease unless they are compounded with acetaminophen (Tylenol, etc) or NSAIDS (Ibuprofen, etc) ---- I would hope that if you are being treated for cirrhosis, then your treating physician would be savvy about the analgesia ---- and can we please stop this knee jerk reaction every time a poster talks about pain meds, e.g., you're abusing, you're addicted, they destroy your liver, you won't get HCV tx if you are taking pain meds, etc?  Grrrrr.
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I have ruptured discs in my back and rhuematoid athritis along with degenerative bone disease. The pain they think is a result of a combination of things like the Hep C along with the cirrhosis and no meds were given to stabilize my liver count. The contrast showed my liver is fibroiding..if thats a word. They cant do surgery on my back because they think bleeding would be an issue. Will be seeing my new primary tommorrow and have already been referred to an infectious disease doctor. Asking for referral for OU when I see the Dr tomorrow. Already have talked to OU and found out what  I need. I have raw spots in my stomach and take Zantac for that. So the pain is a combination of things not just the liver and spleen. Thanks for the encouragement and will keep everyone posted as I find out ...
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yes Im aware of everything when it comes to the pain meds. But They had to give me something in order for me to be abale to just do everyday things. yes have been very sick and starting to get upper respitory infections that are not responding to antibiotics or prednisone. I have alot of med allergies which limit me. So now they are just trying to make me comfortable. Which Im grateful for.
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seen new primary was in need of IV fluids I was so dry and BP had dropped to 93\56 and they allowed me to walk out of there well that was the 21st and Im just now able to get out of bed and do a little. meanwhile complained to Administration and was put with an infectious disease Dr for Apr 21st I really dont know what I have evevr done to deserve such inhumane treatment. Have to go deal with the Indian Hsp for labs and sign paperwork for all my med history from SC that should have been here over a yr ago. Then sit and wait for pharmacy,,,,,,,
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1420486_tn?1384796753

Ahmet Gurakar, M.D.
Associate Professor of Medicine
Medical Director of Liver Transplantation


Dr. Gurakar joins Johns Hopkins from the Nazih Zuhdi Transplantation Institute at the Integris Baptist Medical Center in Oklahoma City, where he was the chief of Hepatology Research and the program director of the Liver Transplantation Medicine/ Hepatology Fellowship. He has served at various capacities in the Liver Medicine Section, since its first establishment in 1993.

Dr. Gurakar's clinical interests include pre and post-transplant, clinical and endoscopic management of liver diseases and viral hepatitis. His research interests include bioartificial liver dialysis systems and application of total plasma exchange in the treatment of liver disorders. Dr. Gurakar is board-certified in gastroenterology and transplant hepatology.

Medical School: Istanbul University, Turkey
Residencies: New York University (Pediatrics); New York Medical College-Metropolitan Hospital (Internal Medicine)
Fellowships: University of Pittsburgh, Thomas Starzl Transplant Institute (Liver Transplant Medicine/Hepatology); University of Texas Medical Branch, Galveston (Gastroenterology)
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Introducing a New Transplant Team

The state’s newest comprehensive transplant team has just arrived in Oklahoma City. Introducing the Oklahoma Transplant Center, the newest addition to Oklahoma’s only comprehensive academic medical center.

As part of OU Medicine, our new transplant program pairs the state's renowned liver and pancreas transplant team of Anthony Sebastian, MD, Harlan Wright, MD, Rajesh Kanagala, MD and Shi-Feng Li, MD with our respected kidney transplant doctors-andthe state’s only pediatric kidney transplant program. All backed by a full range of adult and pediatric specialists and the region's most advanced medical research programs.

The new team members are nationally recognized for their expertise in liver transplantation and the treatment of all liver disorders, including liver cancers. They have additional expertise in transplant immune suppression and pancreastransplantation for type 1diabetes.
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Oklahoma Transplant Center - 940 NE 13th Street - 405-271-7498, 1-888-777-7081






If you have any questions: please call the Oklahoma Transplant Center at 405-271-7498

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On April 30, Physicians at the Oklahoma Transplant Center Performed Four Pediatric Kidney Transplants in Twelve Hours.

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Comprehensive liver, pancreas and renal transplant for both adults and children

The Oklahoma Transplant Center (OTC) is the comprehensive solid organ transplant service at OU Medical Center and The Children's Hospital.  The team, led by Anthony Sebastian, MD, brings together Oklahoma's most experienced transplant team-a team with more than a half-century of combined experience in liver, pancreas and renal transplantation for adult and pediatric patients.  We believe that the close collaboration with an academic medical center provides a tremendous benefit to patients and has redefined how solid organ transplants are performed throughout the state and the region.  This close collaboration creates a unique combination of progressive patient care and advanced medical research that adds a new dimension to the transplant process.

The transplant program is supported by leading clinics in kidney disease and liver disease, including hepatitis B & C, cirrhosis and liver cancer.

Types of patients accepted for consultation:

Patients with acute liver failure, liver disorders and cirrhosis
Liver cancer patients for liver transplant or surgical resection or ablation
Patients with liver masses or suspected tumors both primary and metastatic
Pediatric patients with liver disease
Type I diabetics with kidney failure on dialysis or with chronic renal failure
Type I diabetics with hypoglycemic unawareness
Patients with end-stage kidney disease for kidney transplants, both adults and children
Some of the advantages of the Oklahoma Transplant Center at OU Medical Center:
Most experienced liver transplant team in Oklahoma with more than a half-century of transplant work
Close collaboration with existing OU Medicine kidney transplant team
Oklahoma's only pediatric kidney transplant program
Access to pediatric specialists and the resources of The Children's Hospital to better support pediatric transplant patients
Our Team of Tranplant Specialists

Anthony Sebastian, MD
Dr. Sebastian is the founding director and chief of the Oklahoma Transplant Center at OU Medical Center. His transplant surgical training was completed at Mt. Sinai Medical Center, New York City, as part of the American Society of Transplant Surgeons accredited fellowship. He is a transplant and general/hepatobiliary surgeon specializing in liver, kidney and pancreas transplant surgery in adults and children. Dr Sebastian is the most experienced liver surgeon in the state of Oklahoma, having performed hundreds of liver transplants and liver surgeries. Dr Sebastian performed the first successful pancreas transplant in Oklahoma in 1995.


Harlan Wright, MD
Dr. Wright is the medical director of the liver transplant program at the Oklahoma Transplant Center.  Dr. Wright received his medical degree from Universidad Central de Venezuela, completing his post-graduate gastroenterology training at the University Hospital of Caracas. He spent many years at the University of Pittsburgh Transplant Center and is published in many scientific journals. Dr. Wright treats patients with liver disease and those patients with liver transplants.

*********TO BE CONTINUED
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Puneet Sindhwani, MD
Dr.  Sindhwani is the surgical director of the renal transplant program at the Oklahoma Transplant Center.  He graduated from the Government Medical College in Patiala, India with degrees in Bachelor of Medicine and Bachelor of Surgery and Master of Surgery.  He then earned his Master of Science and Biomedical Science degree from the Medical College of Ohio, as well as completing his residency in urology with one year of residency in transplant.  He came to the University of Oklahoma Health Science Center from Louisiana State University Health Sciences Center in Shreveport, Louisiana where he was an assistant professor and director of andrology infertility.  Dr Sindhwani is an adult and pediatric kidney transplant surgeon.


Ben Cowley, MD
Dr. Cowley is the medical director for the adult kidney and pancreas transplant programs at the Oklahoma Transplant Center.  He received his medical degree from Baylor College of Medicine in Houston, Texas, followed by further training in nephrology at the University of Kansas Medical Center. Following research training at the National Institutes of Health, Bethesda, Maryland, Dr Cowley returned to Kansas University Medical Center as part of the kidney transplant program.  He currently serves as the chief of nephrology and hypertension and the John Gammill Professor in Polycystic Kidney Disease at the University of Oklahoma Health Sciences Center. Dr. Cowley treats patients with kidney disease and those patients with kidney transplants.


Martin Turman, MD, PhD
Dr. Turman is the medical director of the pediatric kidney transplant program at the Oklahoma Transplant Center.  He received his medical degree from the University of Colorado Health Sciences Center, Denver, Colorado.  Following his pediatric internship and residency in Colorado, he completed a pediatric nephrology fellowship at the University of Minnesota.  Dr. Turman was a faculty member at Ohio State University, Columbus, Ohio for seven years and joined the University of Oklahoma Health Sciences Center in 2001, serving as the chief of pediatric Nephrology.  Dually board certified in pediatrics and pediatric nephrology, he is a professor of pediatrics and an associate adjunct professor of cell biology.  Dr Turman treats pediatric patients with kidney disease and those pediatric patients with kidney transplants.


Shi-Feng Li, MD
Dr. Li earned his medical degree and surgery residency from West China University of Medical Sciences.  He also completed a transplant surgical fellowship at Integris. Dr. Li is a member of the American Society of Transplantation and the International Liver Transplantation Society.  He has authored numerous peer review articles, as well as medical textbooks.  Dr. Li joined the Oklahoma Transplant Center in the spring of 2010. Dr. Li serves as a procurement surgeon for the Oklahoma Transplant Center.


Rajesh Kanagala, MD
Dr. Kanagala earned his medical degree from Osmania Medical College in India and was board certified in internal medicine in 2006. Dr. Kanagala was an assistant professor of medicine at the Medical College of Wisconsin, and an internal medicine/hepatology specialist at Integris, prior to joining the Oklahoma Transplant Center in the spring of 2010.  Dr. Kanagala treats patients with liver disease and those patients with liver transplants.


Alan Hawxby, MD
Dr. Hawxby received his medical degree from the University of Oklahoma, Oklahoma City, Oklahoma, followed by a transplant surgery fellowship at Johns Hopkins Hospital, Baltimore, Maryland. Dr Hawxby served as an assistant professor of transplant surgery at the University of Alabama, Birmingham, Alabama, and as an Assistant Professor of Transplant Surgery at the University of Mississippi, Jackson, Mississippi. Dr. Hawxby joined the Oklahoma Transplant Center in January, 2011  Dr. Hawxby is a liver, kidney and pancreas transplant surgeon.  His practice also includes dialysis access surgery.


Judith O'Connor, MD
Dr. O'Connor received her medical degree from the Uniformed Services University of Health Sciences, Bethesda, Maryland, and completed a pediatric and pediatric gastroenterology fellowship at Walter Reed Hospital, Washington, DC.  Prior to joining the Oklahoma Transplant Center, she served as the medical director of pediatric hepatology and liver transplant at the Arkansas Children's Hospital, Little Rock, Arkansas. Dr. O'Connor is currently the director of pediatric hepatology and liver transplant and an associate professor of pediatrics at The Children's Hospital at OU Medical Center.   Dr. O'Connor treats pediatric liver disease patients and those patients with liver transplants.


Julia A. Rygaard, MD
Dr. Rygaard is the Division Chief of Perioperative Transplant Anesthesia Services at the University of Oklahoma Health Sciences Center. She received her medical degree from the University of Missouri--Kansas City. She attended residency at University of Colorado Health Sciences Center, Denver, Colorado, and the University of Utah Medical Center, Salt Lake City, Utah. She was board certified in 1999. She has spent a number of years specializing in cardiac anesthesia and has certification in Perioperative Transesophageal Echocardiography. As an associate professor at OU Health Sciences Center, she leads a team of seven anesthesiologists, both from the adult and pediatric services, who have all received extra training in anesthesia for liver transplantation.


Terry Green, NP
Ms. Green is an advanced registered nurse practitioner (ARNP), receiving an undergraduate degree from the University of Oklahoma and a Masters in Nursing degree from University of Texas. Terry's specialty is managing patients with chronic liver disease working closely with Drs. Wright and Kanagala. Terry was a member of the liver disease management team at Integris, prior to joining the Oklahoma Transplant Center in the spring of 2010 as the clinical director of the liver disease management program.


Mani Vijayan, CNS
Ms. Vijayan earned her master's degree in advanced practice nursing from the University of Oklahoma College of Nursing.  As a clinical nurse specialist, she has served the end stage renal disease community in both kidney transplant and urology.  Ms. Vijayan was a member of the Transplant Services at St. Anthony Hospital and the Veterans' Administration Hospital, Oklahoma City, prior to joining the Oklahoma Transplant Center in 2010 as the clinical director of the kidney and pancreas transplant programs.



Oklahoma Transplant Center at OU Medical Center
(405) 271-7498 | 888-777-7081 | FAX (405) 271-1772 | www.outransplant.com
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Hi Ya lady. Hey I ran across a Kickapoo tribal health suv. the other day. Wow. what a trip as I am near Los Angeles @ the moment. I spoke with the lady. She was here for a medical convention. She was from Mc Cloud..
Back to you. looks like your still getting the run around? You need to be more like Donald Trump (Your Fired) which is what happened to my first GI. You have to be your best advocate/friend :-). I see you got a new PI. Gee what is the problem with them not referring you to the right place. Hey if I can be any help to you. drop a line. A friend said maybe you need to talk to a social worker over @ Indian Affairs.
Im not sure that you have even been diagnosed correctly by the proper type doc.  But you do seem to show symptoms of esld??? I dont know much about ESLD. But I peeked over into trials and found nothing that looked good for de-compensated? liver.
Whats up with OU?  Can you get a social worker to refer you to them?
Sorry you have been thru the ringer lately. Gee your due for a break. Keep us posted on how you are. I looked at your pic's and your son looks similar to my nephew . ****Ginger****
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I plan on going to see the medical director for Cherokee nation tomorrow and have already spoken to OU in OKC and they just need my referral. Guess I have been caught in the crossfire of Cherokee nation buying hastings hospital out which would remove us from government rule...argh and yeah! So much corruption here with our healthcare because they bill medicade and medicare on the patients who have such services. This makes me mad because all services are supposed to be free for tribal members and believe me they dont like seeing me coming when I show up at the hospital. I love firing incompetant medical people who have only their pockets to pad. will keep posting. Still not feeling so great.
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know what you mean about the corruption all over in general in OK. So Im just going to stop right now ;-)
Hey I was wondering if ya had given any thought to LDLT.  oh shoot I might of forgotten the initials already. Ok its where you have a transplant thru a living downer. Like say a son or a daughter. There are many good links for that. if ya like Pm me and Ill refer you.  Again sorry your not feeling well. Stay strong.****Ginger****
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87972_tn?1322664839
Hi Molly,

I saw you wrote recently somewhere that doctors had discovered nodules; in the same paragraph you also mentioned contrast, so presumably you had an MRI or CT scan performed? Have you had time to go over the imaging results with a doctor yet?

Try to avoid jumping the gun regarding the term ’nodules’. When cirrhosis is present, the liver often develops ‘regenerative nodules’; these are a result of the liver attempting to heal itself in its dealing with scar tissue.

These nodules aren’t *necessarily* indicative of anything ominous. Again, try not to freak out over the nomenclature; instead ask your doctor to interpret the imaging, perhaps it’s nothing more than the cirrhosis that you're already aware of, okay?

Good luck with everything,

--Bill
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well feeling pretty good today and just not worrying over this stuff because stress just prevents you from healing and I would rather just take it oneday at a time too much stuff is overwhelming and just gets me confused dont know if this is the liver or old age...LOL! Hopefully the latter! My eyesight is doing weird things have appointment  tomorrow and GI on Tuesday. So cross your fingers...Lord knows I do. Hope all is well for everbody and thanks!
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What is OU.?
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BobBon, OU is referring to Oklahoma University (I'm reasonably sure, after reading these postings) -
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