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hand cramps/end-stage liver disease

I have end-stage liver disease and I get severe hand cramps and what over the counter pain reliever can i take without it counter acting with prescribed narcotics
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Avatar universal
so what did your dr say to do to prevent/help w/the severe cramps?
i also have hep c but have not been treated for it due to bi-polar disorder.
my cramps are excruiatingly painful. would love advice on how to get rid of them
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Avatar universal
I Have just started having severe charlie horses in every muscle in my body. My feet itch. I checked in to see if this was my hepatitis c...as usual. I have so much pain in my abdomen now. Great news that it is related and not yet something different. Can you get in touch with me on the progress in your case? Any info
would be appreciated.
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Avatar universal
I called Schwepp's a few months ago concerning the Quinine in tonic water and was told  "there is no true quinine in tonic water, only an artificial flavoring to taste the same and the use of real quinine had been discontinued 25 years ago".  The Ph. # is on the bottle.  I like a lime squeez with mine.  Enjoy!

Griz
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446474 tn?1446347682
From MedicineNet.com...

What are muscle cramps?

A muscle cramp is an involuntarily and forcibly contracted muscle that does not relax. When we use the muscles that can be controlled voluntarily, such as those of our arms and legs, they alternately contract and relax as we move our limbs. Muscles that support our head, neck, and trunk contract similarly in a synchronized fashion to maintain our posture. A muscle (or even a few fibers of a muscle) that involuntarily (without consciously willing it) contracts is in a "spasm." If the spasm is forceful and sustained, it becomes a cramp. Muscle cramps cause a visible or palpable hardening of the involved muscle.

Muscle cramps can last anywhere from a few seconds to a quarter of an hour or occasionally longer. It is not uncommon for a cramp to recur multiple times until it finally goes away. The cramp may involve a part of a muscle, the entire muscle, or several muscles that usually act together, such as those that flex adjacent fingers. Some cramps involve the simultaneous contraction of muscles that ordinarily move body parts in opposite directions.

Cramps are extremely common. Almost everyone (one estimate is about 95%) experiences a cramp at some time in their life. Cramps are common in adults and become increasingly frequent with aging. However, children also experience cramps.

Any of the muscles that are under our voluntary control (skeletal muscles) can cramp. Cramps of the extremities, especially the legs and feet, and most particularly the calf (the classic "charley horse"), are very common. Involuntary muscles of the various organs (uterus, blood vessel wall, intestinal tract, bile and urine passages, bronchial tree, etc.) are also subject to cramps. Cramps of the involuntary muscles will not be further considered in this review. This article focuses on cramps of skeletal muscle.

Body fluid shifts: True cramps also may be experienced in other conditions that feature an unusual distribution of body fluids. An example is cirrhosis of the liver, which leads to the accumulation of fluid in the abdominal cavity (ascites).

Low blood calcium, magnesium: Low blood levels of either calcium or magnesium directly increase the excitability of both the nerve endings and the muscles they stimulate.

Low potassium: Low potassium levels occasionally cause muscle cramps, although it is more common for low potassium to be associated with muscle weakness.

Are there medications to prevent muscle cramps?

In recent times, the only medication that has been widely used to prevent, and sometimes also to treat, cramps is quinine. Quinine acts by decreasing the excitability of the muscles. It has also been shown to be effective in many, but not all, scientific studies. However, quinine also causes birth defects and miscarriages. It has also occasionally caused hypersensitivity reactions and a deficiency of platelets, which are the blood components responsible for clotting. Either of these reactions can be fatal. Quinine is also associated with a cluster of symptoms called cinchonism (nausea, vomiting, headaches, and deafness). Additionally, vision and heart irregularities can occur. Consequently, quinine tablets are not available in the United States. Quinine is available in grocery stores in tonic water. Consult your physician before taking quinine for cramps.

Hectorsf
Helpful - 0
446474 tn?1446347682
As others said...talk to your doctor. That is their job. This is a very common symptoms of ESLD. Your doc should be monitoring your potasium level as an inbalance can be commonly caused by diuretics you may be taking.

Pain meds will not help stop the cramping and will further stress your liver.

I have been told to drink Quinine water when I have cramps due to my cirrhosis but can't say it has been totally helpful. Cramps seem to come and go over time. I know it is quite painful so I hope you find a solution. The best source of information is your doc as they know your exact condition.

Best of luck to you.
Hectorsf
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179856 tn?1333547362
Jez it's  a good thing we always say check with your doctor......I wouldn't have thought it could do anything and it really helped me so very much.  Still, I would totally ask. Or maybe even gatorade I'd ask about too in case its electrolyte imbalance. Or pedialyte that babies drink.

But definitely call and ask!

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Avatar universal
Coconut water has lots of potassium and works for me on muscle cramps. It is available in Safeway or Whole foods.
Helpful - 0
87972 tn?1322661239
I’d even be cautious with tonic water when it comes to ESLD. Quinine is sometimes associated with platelet reduction in sensitive individuals; at least in patients with ITP. I’m not sure if it extends to those with ESLD secondary to Hep C:

http://www.medscape.com/viewarticle/409521_6

“…For example, minute amounts of quinine in tonic water and bitter lemon drinks can elicit a severe reaction in patients with quinine-associated thrombo-cytopenia.[66-68] In some patients, however, inadvertent readministration of the drug may not produce a symptomatic response as antibody titers decline over time.”

-Bill
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545538 tn?1295992017
Yeah, tonic water can help due to the content of quinine.
Helpful - 0
179856 tn?1333547362
I was advised that drinking tonic water would help my leg cramps - I do not have end stage but it did help......even though it sounds silly it did help. I would think it probably is something to do with electrolytes too but of course I am no doctor and have no end stage experience except to watch a few friends go through it.

I just wanted to wish you luck. I dont think tonic water could hurt trying so ask your doctor........if it helps at all then that is a good thing.
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545538 tn?1295992017
My ex-husband has end stage Liver Cancer. I'm not really able to give more worthwhile information than Bill, but I'll bump you back to the top and perhaps someone more educated will stop by. My thoughts and prayers are with you...Kathy
Helpful - 0
87972 tn?1322661239
Sorry to hear of your troubles. With ESLD in mind, you really should be consulting with your physician on *all* medications; OTC or otherwise. I don’t know what to say in regards to the cramping; it might be attributable to dehydration/electrolyte imbalance… are you taking diuretics to manage edema? If so, they may need to be adjusted.

Tylenol is often recommended for analgesia, but again, with ESLD, your doctor needs to discuss dosage. Aspirin and NSAIDS like ibuprofen can affect coagulopathy and are often prohibited in ESLD patients.

Are you getting periodic EGD/endoscopy to monitor for esophageal varices (throat bleeds)? Are they also watching for any development of primary liver cancer using imaging and AFP blood testing?

There are others in this group more familiar with cirrhosis than I; hopefully they’ll stop by with more thoughts for you.

Take care, and good luck-

Bill

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