chronic liver cirrhosis at 35 confused

hi
last 24.08.10 at mid night i vomited blood about half a bucket and immidiately got hospitalized, there the doctor treated me to stop vomit and given antibiotic and saline to keep the temp and blood pressure well.later in the morning i had to take two bags of blood immidiately as i vomitted a lot of blood.they diagnosed me with andoscopy and ultrasonography. by andoscopy they have done ligation, which means taking of the blood lines inside my stomach to restrict coming of more blood in the intestine.by ultrasonography they were sure of my liver cirrohis. later they did several blood tests by which they confirmed that my cirrhosis wasnt due to hepatic.that is
1.i m not diabetic
2.i m not infected by hepatitis b or c
3.i dnt hv any high blood pleasure
They said cirrhosis is at chronic stage, so they cant do any biopsy which is risky for me.therefore my belly is now swelling with water, which gives a pain inside and a very duisturbing sitution.
the doctor said i need a liver transplantation.

i would like to know people and share their experiances with me those who had the same situation like me. at the moment i m very confused abt myslf tht in bangladesg there is a very few scope for survival. i m willing to get treatment either bangkok or india.I need to know do i realy need a liver transplantation?or i can hv alternative. any help would be most appreciated.
thankx

Hello Rupak and welcome to HealingWell.  I am sorry that you are dealing with this horrible disease.   But you have found a wonderful forum.  We do have lots of members who are or have dealt with it.

First of all we have an educational post in the Hepatitis Resouce folder at the top of our forum.  It has lot's of good information that a number of our dear members have contributed to.   So please read it.  

Have they started you on any meds for the ascites(fluid in the belly).   There are ways to help ease the swelling with  fluid/sodium restriction,medicine and/or procedures.

Take care.....thoughts and prayers.......

Rupok,

Sounds like your doctor is giving you some of the right treatments. What kind of doctor is he?  Hepatologist, Gastroenterologist, or a General practitioner? 

Many transplant patients live long productive lives after transplant.   We have at least 2 who contribute to the forum.  But I don't know what the percentages of survival  lenghth are in India or Bangkok.

If you know the tranplant centers name maybe they have a website.  You may be able to find the information there.   Read up on them to see which will be the better choice for you.  

Here in the states.....the doctor usually refers the patients to a transplant center.  But it's up to the patient to do the leg work and make the appointment or decide to on whether they want to go to it or another one.  We are very fortunate here.......we have lots of choices.  

Just do you homework and follow your doctors orders, don't procrastinate on finding a transplant center and getting the information you need. 

Thoughts and prayers........   

 

Hi Rupok,   The 1st and utmost important thing that you can do is to not drink any alcohol at all.  Not even a drop.   It will damage you liver further. 

Diet,excercise and following your doctors orders as are important also.   Have you read our educational post in the resource folder yet?  It has lot's of good information.    

Some of the following things can cause cirrhosis.

Hepatitus B or C

Alcohol abuse

Some prescription or non prescription drugs. ( Google drugs that can damage the liver )

Obesity can cause Fatty liver disease.

Sometimes it's cause is unknown ........I believe at that point is when they make a diagnosis of AIH  Autoimmune Hepatitis.  It's when your immune system attacks your liver.  (Dany ,  can you clarify if I am correct please?)

There are probably others..........your lifestyle can probably help narrow down the cause of your cirrhosis.

Take care............

 

AIH is it's own disorder.  There are autoimmune markers they can test for but not everyone who is diagnosed has them right away, they sometimes develop later on.  One of the first is the ANA.  Other than that there's the Anti-LKM, SLA, ASMA and others but they aren't specific for the disease...just help in making a diagnosis.  The definitive is a biopsy.  If that can't be performed and the LFT's are elevated (and AIH is suspected) then a response to prednisone is also used to diagnose.

There are some other diseases like PBC and PSC and some others that cause cirrhosis. 

Rupok, is there a way in Bangladesh that you can see a hepatologist and also have an MRI since they are telling you a biopsy is not possible at this time?  You should ask your doctor about a transjugular biopsy.  that's what I had since my liver was damaged enough that I wasn't able to clot at the time.  I needed a biopsy for confirmation of my AIH.  So they went through my jugular with ultrasound guidance.  I was given plasma all day before the procedure to help with clotting.

Please talk to your doctor again.

Dear Pink grandma, connie dginsd and arneeb
thnkz thnkz thnkz alot. I see a lot of people beside me which gives me strength to look for the bright side not to worry about.

I am nonhepatic, nondiabetic, nonalcoholic, nonsmoker and even d'nt have high blood pressure. I am seeing a doctor who had done first liver transplant last 10 june this year. Still the medical adavancement, technology, expertise is not that much here in Bangladesh, thats the reason I am more worried about.

Yes, connie you were right, they said i had esophageal varices and which they ligated once, i have to go through it again this month on 18th. I dont know what kind of an MRI i need to have.

Sandy thx a lot for your kind thoughts and sharings, i know what thoughts my wife is under now. I am only member who took all the decisions before, at this time for myself i have to do the same.

in this case, patients like us is there any determinants, or tests that identifys a patients must undergo a liver transplant? I would clearly like to know if its better to live with cirrhosis under control as long as drugs can arrest further development or delays the progression?or its better to transplant my liverat this age of 35, if i am capable.

I m newly married and dnt have children yet and i am worried.


for your kind information, i have stated the tests results below or i can send them through email, so if any1 can direct me a U.S. Doctor by consulting, which I amready to pay also.

1. PT(PRTHOMBIN TIME):

a. Patient: 15.9

b. Control: 11.3

c. INR : 1.41


2. Blood Urea: 15 mg/dl

3. S. creatininie : 0.6 mg/dl

4. AFP( Alpha Feto Protein) 5.59 ng/ml

5. Bilirubin under contr

6. Platelet: 87 k/ul

7. Anti-HBc : 1.51

8. Anti-HCV : 0.31

HBsAg : 0.71


I would also like to know if there are any facilities through internet i can consult with a Gastroenterogist and Hepatologist and i can be under treatment through his consultation.

And thanks for all the care and share from the group and you all

Rupok

as was dicussed with another person from the other side of the world... in different parts of the world.. money is the determinant for a transplant... however... still... all of the other things do apply... and it would be a last resort... not a first...your doctor and transplant team would make the determinations...

listen to Connie there Rupak.. and I understand in your culture the wife maybe wouldn't be making the decision... what about male family members... or a friend that you can consult with.. need to calm down though.. and no you are not alone..

connie, i agree with you,liver transplant would be the last resort. I am now only 35,after living with cirrhosis may be 5/10 years could i be able to take such a surgery?cause within this years anything may happen.

Yes, they did ALT:76 U/L, AST : 95 U/L. I dnt have any idea of these tests, can u put some light?
I am willing to go bumrungrad hospital in Bangkok, hope to see for alternate solutions.
Does anyone know, what are tests that identifies the reason of my cirrhosis?do Auto immune patients can take liver transplantation?
Thnks
Rupok

Dany, that was a very informative list!  Thanks for posting it!  So you see, Rupok, there are many causes for cirrhosis.

I am missing most of my liver due to cancer and resection; my LFTs are only slightly lower than yours, and I have cirrhosis in what's left of my liver.  But aside from fatigue, I am doing well.  (My problems are all due to hep C, for which I hope to get treatment next year when new therapy is available.)  If the cirrhosis doesn't advance or the cancer return (it's been over 3 yrs. now), I could live a long time.

So I want you to put transplant out of your head for now.  You first need to get a definitive diagnosis and get proper treatment.  Meanwhile, do as Dany says with low salt intake, nutrition, and no alcohol.

Hugs,

Connie

Rupok, it may be different where you live, but in the USA there is no drug that can specifically halt cirrhosis.  They treat the symptoms (such as diuretics for ascites and fluid retention, or Lactulose for elevated ammonia) and suggest lifestyle changes to include low salt diet and no alcohol, to name two of them, which can halt the progression.

A MELD score of 12 here would not get you a transplant.  Again, I do not know if it's the same in Asia.  Also, a transplant is not a preventative measure as you seem to think.  It is A LAST RESORT.  There are many things that can go wrong during and especially after transplant, including death.  Again, I think it is very premature for you to be considering transplant.

Take the drugs that have been prescribed, keep a low-salt diet, and follow your doctor's directions.  Then, in a couple of months, have the labs repeated to find out if they are the same (stable), have decreased (a good sign) or increased (not good.)

Normally, the cause of the cirrhosis is treated.  In your case, until you know what caused it, you may not be able to stop the progression.  You need further testing at this time to determine the cause of your cirrhosis.

By the way, I am seen at Mayo.

Hugs,

Connie

Rupok,
First, find out how severe your cirrhosis is. Unless your liver is totally failed, don't rush into a transplant. I had one last year, but it had taken 40 years to get to a point where I was about to die. Remember, even at the finest hospitals in the world, 10% of the transplant patients die within the first year. Most transplant centers say that a "new" liver is good for 25 years. That would mean I'm good until 84. In your case, you would be good until you were 60 (my present age). Try to keep the liver you now have healthy, as long as possible. Then, someday, if you really need a transplant, get one. Get a hepatologist now. Then, when you have the right information, it's likely you'll be able to come to a sound decision. I know that one may buy liver transplants in Thailand. But, do you have the resources to buy two, if the first one fails?

Thankyou butterfly.I am just confused that at my age of 35 i can may take the hazards of a surgery like liver transplant, but can i do it after 10-15 years later?in Asia we may not have to wait for a liver transplant, many of the americans and europeans are now turning to Asia just for that reason, there, in 10-15 years anything may happen, shoild i take that risk?i m sorry i m new here so may be i lack a lot of experiences to come in future that i have to endure.

david, pray for me so that i can get a positive result, and doc says good things a lot so that i can agree that without transplntation i can live well,

Best wishes
Rupok

dear all
one crucial question,having a good restricted diet, ow sodium and protein intake with all the medications and by abiding by the restrictions to be maintained by the patient, could he resist the further complicacy of the liver cirrhosis in progression, dnt you guys enduring the stress and pain after abiding by all the rules by the med or doc, if the ans is yes, its better to go for transplantation.

butterfly can you tell me after doing all that a doc told you to do, didnt your loved one fall for encephalopathy?and you knoww there are more to come in near future, can u endure these?

plz i need answeres from all the users here

God be with us
thanks
Rupok