Prognosis for stage 4 cirrhosis with Barrett's

Through biopsies I've been diagnosed with stage 4 cirrhosis and advance Barrett's. My liver is compensated. Last check both MELD and CHILD-PUGH were  10 and 8
They also found a suspious mass near my right kidney they are "watching".  Currently taking weekly 50,000 mg doses of vit. D2. Only other meds are Prontonix and Allegra.  Just came off a 5 year cycle of BONIVA. My spine is high fracture risk.
Now told that I need total hip replacements & that I have cycsts in my hips (considered not unusual).  I work 60-70 hours week.  I find I can no longer tolerate that schedule, but need insurance.  There is a possibility that my company may downsize and I would be without both a job and insurance.
My company does offer disability which after 6 months I would be required to purchase COBRA.  The critical thing would be, though costly, it would cover all the pre-existing. Both my doctors and company are agreeable to this if I think it necessary. Although I am exahusted, I do not feel I am "sick".  Considering my condition (sick, but not sick).  Do you think this would be prudent?  Would my combined diaganosis indicate I most likely will begin "failing" within a relatively short time.  I'm just afraid if I do not move swiftly I will be without insurance at a time I will need it the most.
Lastly, I am scared of the hip replacements for fear the meds taken during recovery will cause my liver to decompensate.
Is that a valid concern?
I feel blessed that aside from fatigue and hip/leg pain, I'm fine.  But, afraid I may be lulling myself into complancency about my med problems.  Though not feeling sick, I guess I am sick.

Can you help me figure this out?

[Thomas D Schiano, MD]

i am sorry that you are having these travails.  you are not being complacent and your doctors seem appropriately concerned.  although hip replacement  is something that is better not to undergo, your symptoms will not improve and unfortunately your liver disease may slowly worsen.  Thus, you are probably in better shape now then you would be in the future. As you are stressing, the health insurance is the most important issue for you.  If going on disability would put you at greater risk for being downsized out, you must keep working it seems.  If it wouldn't, then the disability option might be prudent--short-term if you have the hip surgery, longer term for your overall health.  Your MELD score is low so hopefully you will not require transplantation for some time, but the development of HCC is a wild card.

[girl4tide]

God Bless You for sharing your knowledge with those of us who are wandering about afraid and clueless.
My dad was an alcholic my entire life.  Never even had the niggling of cirrhosis. I was always so afraid for him.   How ironic, that his daughter would have it.

Life is strange, but it is all that we have and I am thankfully for the one I have.