was told liver was compensated

[Brilorra]

Hello again to all.

i am sorry for sounding so stupid, and i am trying to absorb everything that you all are advising me of and a few doctor reports.

After one of my last posts someone asked how i knew my husband was compensated?  That he must have had a biopsy.  he has not had one and we are trying to get him to get one.  he did however have many ultra sounds done due to having a ruptured appendix for which they wouldnt operate because he was high risk.  high risk due to the hep c and his low platelet count, so they inserted a t-tube that was there for 7 months, (if you can believe that) to drain off the pus.   because he had informed the general surgeon of his hep c she called in a heptologist and i am assuming from the ultra sounds she saw he was compensated,  as she wrote this on one of his reports.  so this is the only reason i know he is compensated.  by having a biospy will this tell us what condition his liver is in.  is this the only thing that doe this or can some of the blood work that has been done tell us this too?

he says his liver is continuly kicking him.  he forever has aches and pains there? is this normal?  

he has already experienced encephalpathy - sorry about the spelling if it is wrong, and was put on lactuous for a bit then taken off.  for why he doesnt know either.

all i don know is that 4 years ago he was taken to hospital for blacken eyes, and the emergency room said to him, if he had waited 6 more hours, he would have arrived in a body bad. platelets were if i remember correctly about 63,000 of coarse at that time he told them he had hep c and again at that time no one ever made any mention of his being compensated cirrhosis, so we believe he wasnt.

i am just trying to understand and again i am sorry if i am being vague and/or sounding silly or not informed but trying hard to learn as i am very concerned.  still doctors are saying no tx -  so yes i am totally dazed and confused and any light that you all can shed for me is wonderful.

you are all more helpful to me than most doctos i have come across. and i thank you all so very much for your patience with me silly postings.

leslie

[Bill1954]

Hi Leslie

I have been reading some of your past posts, and am beginning to get a better picture of your husband’s situation, I believe.

If your husband has already been diagnosed with compensated cirrhosis, it might not be in his best interest to perform a biopsy. This diagnosis can be made (carefully) by an experienced MD taking into account blood test results, physical examination, and signs such as encephalopathy and/or ascites. At this point, there is little advantage to biopsy; the health care professional has already determined that the patient has cirrhosis. I understand now why a doctor might not want to perform biopsy.

As you already know, cirrhosis can cause a reduction in platelets; because biopsy is an invasive surgical procedure, there is little to gain and a lot to lose if something goes wrong during the operation.

If there is any consolation, *compensated* cirrhosis is better news than *decompensated* cirrhosis. When a patient’s liver is compensated, the organ still performs its basic functions, for the most part. When a patient is diagnosed with decompensated liver disease, the organ stops filtering, manufacturing, etc. A patient with compensated cirrhosis can live for many years without transplant (in some cases).

1) I believe you want to ask your husband’s doctor if his liver remains compensated; if so, why is he not receiving treatment?

2) If he is to ill for treatment, then when will referred to a transplant center for evaluation?

As an alternative to opening a new thread for every question, you might try adding additional comments to your original post, by going to the bottom of the page and clicking on “post a comment”. This will help keep all your thoughts and info in one place.

Please continue to ask questions in here; we all had to begin our education at one time or another :o).

Be well,

Bill

[Bill1954]

2) If he is to ill for treatment, then when will he be referred to a transplant center for evaluation?

[HectorSF]

Hi Leslie. Please follow Bill's advice. He is one of the wisest people on this forum.

Just my own 2 cents worth...
What we know - that your husband has Stage 4 advanced liver disease, cirrhosis. It has been confirmed both by a doctor (Hepatologist) and all his symptoms confirm this. How advanced the cirrhosis is can be known by a good doctor (Hepatologist) by evaluating your husbands test results and his symptoms. From a layman point of view (me) his liver appears to be starting to decompensate. (i.e. hepatic encephalopathy).

Basically there are two options available at this point as Bill mentioned.
1. Undergo antiviral treatment to clear the virus that is causing the liver disease to advance.
2. Prepare to get evaluated at a liver transplant center.

Again this is something you the both of you and a good doctor to decide.

I am not sure why he doesn't have a Hepatogolgist at this time that is managing his illness? But I believe you both need someone who will communicate with you about what is going on, and what the future options are.  I would also recommend having his doctor contact a transplant center to make arrangements for the future if he is too ill to undergo antiviral therapy.

Compensated cirrhosis:
At first, you may have no symptoms at all (this is called compensated cirrhosis). In fact, a person may live many years with cirrhosis without being aware that his or her liver is scarred. This is because the pressure in the portal vein is not yet too high and there are still enough healthy liver cells to keep up with the body's needs.

Decompensated cirrhosis:
If you experience any of the serious problems described below, your disease has progressed from compensated cirrhosis to decompensated cirrhosis.
·Bleeding varices (internal bleeding)
·Ascites (fluid in the belly)
·Encephalopathy (confusion)
·Jaundice (yellowing of eyes and skin)

Best of luck to you both.
Hector