Please straight forward answers
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Since last June my sister has been in and out of the hospital due to having a very bad liver still has here lately her legs have been swelling since last June she been in and out at least 10 times her levels keep dropping her ammonia levels sky rocket the syrup she drinks doesn't work sometimes she gets confused she has to have blood transfusion a lot they did test but don't know where the blood is going I'm so scared of losing my sister I've ask doc about her being on the list for a new liver but he says she still to weak to go on table please tell me is this a slow process will she heal from this or does it all go down hill please just be honest with me I scared to death
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Rosie2205 monique_93857
Posted
Due you mean a low albumin level? - this would cause swellling of the legs along with the congested liver damage.. I wish I could help more by answering you honestly, but if she is not fit for a transplant because she is too ill then it sounds pretty bad but don't know the medical diagnosis so difficult to comment further as to her prognosis. I do sincerely hope she gets better soon.
monique_93857 Rosie2205
Posted
monique_93857 Rosie2205
Posted
RHGB monique_93857
Posted
It is called peripheral oedema - the lower leg/ankle/feet.
It can be due to a number of reasons, damaged liver, damaged heart and calcium channel blocker medication, but in this case it is safe to assume it is down to a damaged liver.
The syrup is called lactulose and it is an osmatic laxative, it works completely different to a normal laxative and is used to remove toxic ammonia from the body, which the liver function can no longer do. The dosage either needs to be increased or her diet altered. It comes from protein rich foods (such as meat) are digested, they produce ammonia and nitrogen. If the lactulose cannot perform its job, then the protein in the diet needs to be reduced.
When the ammonia is left in the bloodstream, it travels to the brain and leads to hepatic encephalopathy (Google it, links aren't allowed) and this leads to a state of confusion.
If she has to have a lot of blood transfusions, they will be plasma transfusions, because her platelet count is so low, that she is at high rsik of bleeding, possibly internally and her platelet count needs to be raised to help with clotting in an emergency.
Whether she will survive this for any length of time depends on the stage of liver cirrhosis. The name for the stages of cirhosis are call Child-Pugh, there are three categories, A, B & C and each of them has a number stage as well.
If you are in the States, they sometimes use a different scoring system called MELD. Either way, you need this information before I could even gues the situation, But I am not a doctor, just someone who has been through it and with out all the medical history and all the test results, it is hard for me to offer an accurate prognosis. This should really becoming from the doctor.
Sorry if it is blunt, but that is what you asked.
monique_93857 RHGB
Posted
Thank you I'm unsure of everything main things I know is cirrhosis of the liver stage 2 with kidneys hep c due to her liver failing your right it's not working right so the lactulose she takes it 4x a day to keep the ammonia from poisoning her body but her level climbs high all the time she ends up in the hospital confused bad
Robin2015 RHGB
Posted
RHGB monique_93857
Posted
I have read the four stages liver cirrhosis that is more commonly used in America, I have to say it is not very definitive and doesn't seem to differentiate much between the stages. I can't seem to conflate your sister's symptoms with stage 2.
I have you asked for a recent update on this? Also have you asked for a prognosis, assuming your sister has given them consent to discuss things with you? In my experience, you have to ask and some times be pushy, otherwise doctors are not very forthcoming.
You must ask the doctors for a recommended diet that avoids the proteins that are rich in ammonia if the lactulose is struggling to keep the ammonia intact. It may be. that they would recommend that she gets her protein from vegetable based foods and cuts out meat, but as I don't know her medical history, I cannot really offer advice in this department.
I really would push them for a prognosis, I have put a link here which shows the UK system Child-Pugh if you scroll down a bit (in the article). And you can see the hepatic encephalopathy (confusion - lactulose not working) being poorly controlled is in the final stage, which is why I'm having trouble equating her symptoms to cirrhosis liver stage 2.
https://patient.info/doctor/cirrhosis-pro