Only your hepatologist knows your full heath status. All changes to drugs, diet, vitamins, supplement must be coordinated with your hepatologist first. Taking a drug prescribed by another doctor who doesn’t understand your liver disease can be highly dangerous for someone on a transplant list.
"Pain management in patients with cirrhosis is a difficult clinical challenge for health care professionals, and few prospective studies have offered an evidence-based approach. In patients with end-stage liver disease, adverse events from analgesics are frequent, potentially fatal, and often avoidable. Severe complications from analgesia in these patients include hepatic encephalopathy, hepatorenal syndrome, and gastrointestinal bleeding, which can result in substantial morbidity and even death. In general, acetaminophen at reduced dosing is a safe option. In patients with cirrhosis, nonsteroidal anti-inflammatory drugs should be avoided to avert renal failure, and opiates should be avoided or used sparingly, with low and infrequent dosing, to prevent encephalopathy."
"apparantly this antiinflammatory is a big nono."
You should NEVER take a NSAID if you are on a transplant list. NSAIDs can cause life-threatening complications.
"NSAIDs can cause mucosal bleeding in patients at increased risk of bleeding as a result of thrombocytopenia and coagulopathy associated with advanced liver disease. This risk is even greater in patients with portal hypertension–related complications, such as esophageal/gastric varices and portal hypertensive gastropathy or gastric antral vacular ectasias. NSAIDs may be tolerated in patients with mild chronic liver disease, but they should be avoided in all patients with cirrhosis because of the increased risk of hepatorenal syndrome (progressive kidney failure) and the dire consequences relating to this complication. Preventive medicine, including avoidance of NSAIDs, is exceedingly important in maintaining the clinical stability of patients with well-compensated cirrhosis."
"Why does hepatologist keep looking at palms of hands? They hv looked normal to me up until 3 days ago I noticed they are blotchy on edges of palms goin up pinkies. What is this???"
Did you ask the doctor? Only the doctor knows for sure what they were thinking. We can only speculate.
Maybe the doctor looking for signs of “Palmar erythema”. A crimson coloration of the palms of the hands and the fingertips. It can occur anywhere on the palm and fingers but is most common on the a fleshy pad of the palm of the hand. It could be a sign the treatment is making your liver disease worse.
They did ask to see if your hands were flapping when held out like your are trying to stop traffic?
The transplant center should have educated you on how to live with your liver disease and prevent any future damage to your liver so you can maintain your health as long as possible. Taking various medicines without consulting with your hepatologist is breaking on of the basic tenets of staying healthy. Even over-the-counter meds that are harmless to a healthy persons, can be fatal for a person on a transplant list. It can lead to decompensation or liver failure in some individuals. Ask the center to provide educational materials for living a healthy life style before transplant it is vital to your prognosis.
OH knows she very well as she has had a transplant. If you don't take care of yourself before transplant it is a bad prognosis for success after transplant. After transplant you will have to be compliant every day for the rest of your life. And get labs for the rest of your life. If this is not done it will lead to rejection of the donor liver and possible death. To get a donor liver is a commitment we all make to take care of that liver. People die every day because there are not enough livers available. A donor liver should never to wasted.
Good luck with your visit!
Hector
They look at your palms because reddening is one sign of liver disease.
With the extent of liver disease you have, I'd be concerned about you taking all these meds. They can't be good for your liver.
It is imperative that ALL your doctors know about your liver disease.
What is your meld score ?
i hope your getting blood work (cbcs) maybe twice a week...that hgb is low...i would think that may cause the headache among other stuff...but at the same time its a good sign of the drugs working...my hgb was in the 8s during tx...it was tough....i had one transfusion when in the 7s...be careful and good luck on tx....billy