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Posted 10/13/2013 6:41 PM (GMT 0)
Hi Everyone I haven't been on in a while. My Husband has had a lot of problems lately with fluid in his abdominal cavity and chest cavity. He had is abdominal cavity drain two times in the last 1 1/2 months and just had is chest cavity done on friday. The lung doctor said we need to get him to the transplant center soon. The last time we were at the center was 3yrs ago and they said couldn't do anything for him until his meld score was at least a 15 he is now only a 12. I think his body is going to fall apart before he reaches a 15 meld score. Has anyone had problems with Pleural Effusion. He was drained on friday of a gallon and half of fluid and already has a bad cough again. just very worried and it is very weird his ammonia level has been very low without taking any lactulose. He is only 57 and looks like he is in his 70's this has happened in the last few months. Thanks for always being here for me Dorothy
Posted 10/13/2013 7:20 PM (GMT 0)
Hi, Dorothy. I'm sorry that your husband is having such problems. Due to this, it is possible that they will make an exception and raise his MELD score, so please do follow up at the transplant center. Have the pulmonologst refer him.

I am a victim of pleural effusion myself. The Mayo physicians aren't sure where the fluid is coming from, but agree that my liver is probably involved (from hep C and Grade 3, Stage 3 fibrosis.) However, I don't have ascites (or if I do, it's very, very minimal...not enough to drain.) They think there may be a leak in the pleural space, but not sure just where. I have been drained 6 x since April. They get anywhere from 800 ml to 1200 ml (1 liter + 200 ml.) This is really no fun with a local.

My drainings don't give me relief for long. The last time (on the 8th, I think) the chief of Interventional Radiology did the thoracentesis and did a great job. I had relief for 4 days, which was wonderful. Now I'm short of breath again and coughing/spitting up phlegm.

I have to get drained about every 2 wks., so the plan now is to drain me on Thurs., insert a chest tube and leave it in, coil and tape it to my side, and send me home with a vacuum collection device so that I can drain myself every other day, not giving the fluid a chance to build up. They say the fluid will gradually decrease and the need to drain it will, also. In time (a couple of months at most), the fluid will stop and they can remove the tube. I just hope this works.

They originally considered injecting talc, but it turned out that this is a surgical procedure, requiring an incision and scraping of my lung. They do not like to do this on liver patients, particularly ones who are post-transplant.

Has a TIPS procedure been discussed? Since your hubby has intractable ascites, this might be a good option for him, though it does carry risks.

Look into both of these procedures, as well as returning to the transplant center.

Best of luck and please come back and update us.

Hugs,
Connie
Posted 10/14/2013 2:20 PM (GMT 0)
Hi Dorothy, I have not been here in a long time either, the description of your husbands condition is a mirror of my Mike. Right now he gets tapped about every two weeks, and gets what little relief he can. He had his transplant 13 years ago from Hep C and now his liver is failing because they could not put the Hep C into remission with medication after his transplant. They almost put him on the list again but stopped because his meld score did not stay elevated, now we just deal with what comes along. It is more than scary to watch how he deteriorated in the past several months. My best to you and I will keep you in my prayers.
Arlene
Posted 10/14/2013 9:55 PM (GMT 0)
Arlene, it's good to see you back here, but I'm sorry to hear that your husband is not doing well. Please get him an appt. with a cardiothoracic surgeon to discuss the procedures I mentioned above to stop the pleural effusion, and also discuss with the interventional radiologist the TIPS procedure for his intractable ascites.

Please don't be a stranger here.

Hugs,
Connie
Posted 10/15/2013 2:19 AM (GMT 0)
Hi Arlene,

I hope you'll post more often as we have any number of post transplant members who are anxious to hear how things may go as time goes on for them.

Hugs,

Carol
Posted 10/15/2013 3:43 AM (GMT 0)
I called Transplant Center today . The nurse at the center said since Bill has not been to the center in over a year we need a new referral. so I also change his Doctor appointment from the 21st to this wed to get the referral and as Bill is already coughing again. I'm trying to do all I can for him, and I don't even know if he wants to go though with a transplant. I have tried to get him to talk about it but its really hard for him. I'm just really happy he is finally going to see doctors, if you remember I couldn't even get him to do that a year ago. Thanks again everyone Dorothy

Post Edited By Moderator (hep93) : 10/14/2013 10:26:29 PM (GMT-6)

Posted 10/15/2013 4:29 AM (GMT 0)
Dorothy, this breathing issue needs to be taken care of first. He wouldn't even be a candidate for surgery right now. However, if they can get the pleural effusion under control, then he can go through the pre-transplant evaluation. Remind him that even if he is accepted and is on the TP list, he can change his mind all the way up to the day of TP. I know that made me feel less pressured, having that "out."

Hugs,
Connie
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