Albumin

I was looking at Marks blood work from last Sat night,His Albumin went from a 3.7 down to a 2.7,His feet and ankles have now swelled up to his knees,I looked up Albumin to see what happens if it goes to low and it says swelling,infections ect,my question is,,is his low enough to cause this swelling,or does it have to be lower then that ? It says normal range is 3.8-5. I think I am grasping at straws here,hoping it is caused by something else that can be fixed easier and will go away,the site I went to says once you get edema that its basically down hill from there because of infections,swelling will go to belly ect !
I am getting real scared now !
Robin

did they put you on lasix or anything ? Does it come back the next day ?

I do not know much about the other fixes they have for swelling, but once it becomes ascites in the stomach, if it is hard to control I know they have procedures that they use to help reduce that swelling. I believe David or Ziff said they had it done or knew someone who had it done.

 I took Lasix and Spironlactone for roughly a year due to swelling in feet and legs . It eventually got to a point that large volumes of fluid built up in my abdomen ( Ascites ) , I never responded well to any form of medication to relieve fluid retention . The Lasix caused a reaction that compounded my problems , My testicles swelled up to the point I almost couldn't walk .

 I was at this time going through the initial evaluation process ( Drug , alcohol sobriety verification & screening ) for pre-transplant process . From my abdomen down filled up with ascites so quickly that I eventually was having up to and beyond 11 liters of fluid removed ( Paracentesis ) every 2 days , This went on for 8 months or more . Albumin was only administered after a Paracentesis was done . As I was told the reason for Albumin being given was to replace the good nutrients in my body that had gotten removed with the ascites during the Paracentesis . There is a formula for how they administer Albumin , It's something like 4 oz. per liter of fluid removed if I remember correctly .

A lot of people of course aren't aware of the Albumin loss and some hospitals only keep a minimum supply around , It's very costly and has a short shelf life . I suspect that while being given diuretics you would no doubt eventually run into a albumin loss problem but cant say for sure . One would think peeing as much as that stuff makes you , that you would eventually lose good nutrients also that way . I hope he doesn't get to a point where he needs a Paracentesis , It's not a real comfortable process but the benefit of not feeling like your 10 months pregnant certainly outweighs the aggravation .

 Once I met the requirements of sobriety and counseling it was if new doors swung open and more options were put on the table . TIPS had been repeatedly tossed around by my GI , Radiologist and Hepatologist but only became a option after my requirements were met . I had the TIPS done after a years worth of debilitating fluid issues . TIPS is a shunt placed in the liver that for all practical purposes bypasses liver function and allows fluid to pass through the shunt without restriction , I have no toxin filter ( Liver function ) with the TIPS . My liver exist and does do about a estimated 15% of it's work . TIPS should only be done in extreme cases and is a temporary fix , It has a 4 year lifespan on average before problems start to arise . I am slightly past the four year mark and so far haven't had complications . My MELD score was not high enough averaging 16 so transplantation wasn't a option for me at the time .

 A. Ziffle    

 I stopped drinking & moderate drug use when I was admitted in the hospital with a diagnosis of Hep. C , Cirrhosis and kidney failure in 2008 . The Hep. C was later found to be a misdiagnosis but my liver was shot from Cirrhosis , My kidneys regained function within a few days of being admitted . I haven't touched a drop of alcohol since then but I suffered the consequences of liver disease for a little over a year before I started actually leading a somewhat normal life . My life consisted of sleeping , pain and almost daily hospital trips for that first year , I felt like a guinea pig or a human pin cushion . 

I started gaining muscle tone back and didn't need bi-weekly hospital trips a month after my TIPS surgery . It took 2 years to fully get in my current physical condition , I went from literally on deaths door to my old physical shape in almost 3 years . My normal weight is 210 lbs. @ 6 foot tall . At one point I weighed 150 lbs. and some of that was fluid weight . No muscle mass , eye's sunken and abdomen bulging to the point it caused a hernia from the fluid build up . It was hell , Connie , David and others here have seen pictures of me before and after this disease got hold of me . I was a dead man .

I'm not supposed to be as physically active as I currently am but I found that keeping myself occupied doesn't allow my mind to wonder to bad places . You know it's easy to get to feeling sorry for yourself and sinking into depression . I'd like to think I could go on forever not having to relive this experience over again but the truth is more likely that this is just a reprieve , A reprieve yes and a oh so welcomed one . I've had time to adjust my life and see things differently in this reprieve . Stopping to smell the roses a bit and undoing some wrongs I've done in the past , I'd like to think when the day comes I get a new Liver I will have a absolute clean page to start with in every since of the word .

A. Ziffle     

Hey, Mike! Welcome back. I was actually thinking of you as I read the above posts. Yes, you had a horrible time with edema. Later on, I did, as well. It's certainly no picnic.

Glad to hear you are doing reasonably well now. Are you going to do treatment for your hep C?

Hugs,
Connie

Thanks for sharing guys..am reading it to my hubby, so he doesn't feel like the only one in this boat...regarding the swelling, esp the privates. He hates that.
Angie1953

Hi Robin,

 

My brother had that edema and also had paracentesis, as well as bronchocentesis.  Anytime they took out fluids, usually about 3-4 litres, they would give a couple (once it was 3 units) of albumin to replace the good stuff they sucked out, to be blunt.  He had this done several times before TP and received 3 or 4 IV units total AFTER transplant, even though at that point he didnt have the paracentesis procedure anymore, just the albumin.

 

I am wondering, you guys out there, how long it takes, if ever, for the testicular swelling to subside?

Does it require surgery post-transplant?

 

Thanks

 

Mae

 

 

 Germophobe , Maybe David could answer that question a little better than me considering he has been through transplant . I think it's odd that he would still be suffering from that swelling issue post transplant . My swelling issue seemed to be a reaction to Lasix . They kept switching diuretics around on me to pharmaceutically dissipate the fluid issue . Each time they switched me over to Lasix my testicles would swell , I repeatedly told my GI at the time there was a problem with that medication and he brushed me off . The swelling stopped days after I stopped taking Lasix , That may or not be the case with him . We are all different in how our bodies respond to certain things . On a totally unrelated note I eventually fired his rump and found another GI that actually listened .

Another thing that sounds odd is that he had to have paracentesis done after transplant surgery 3 or 4 times . I know after the TIPS surgery my doctor was adamant for me not to have paracentesis done again unless it got extreme . He explained that my body needed to get used to the shunt taking over and doing what it was designed to do . As I mentioned earlier I was getting paracentesis done 2 times a week for at least 8 months , My body had gotten used to not dealing with the fluid issue due to the frequent procedures . Connie I believe had paracentesis done once after her transplant .

Robin , Yep it's unimaginably painful although I would be willing to bet his situation went to higher level than just painful . I cringe just thinking about that scenario . I know it isn't funny but the frozen pea and corn thing kinda made me chuckle a little , If it hadn't been for the seriousness of the situation that might have provoked me into my " snarky " remark mode   .

A. Ziffle 

 Robin I can't speak for everybody but light hearted PG rated humor is generally accepted , In fact I personally endorse it . There is a time and place for everything but so help me it sometimes takes all the strength I have not to crack a joke sometimes even on serious matters . We do have a few people from time to time that expect the caretakers or patients to be carrying on like their in a mortuary , Some frown on anything that makes you feel human or alive . I found that being active and having a sense of humor has gotten me through some bad times and I have no reason to change . Laugh and rake leaves in the wind is my motto .

 A. Ziffle  

 Syxx , Amen to that !!! A couple of us pass jokes around to each other via personal email to avoid getting axed in the forum . Comedy still the best medicine !!!!  

 Ziff

  

#1 NEH, remind me not to have dinner at your house.
#2 I like my pork unadulterated.
#3 Shortly before my transplant, testicles were unbelievably swollen, my urologist told me they'd be better if I had a a transplant. At that time, a transplant wasn't even in my mind.

In early July of 2009, my legs were so swollen I couldn't bend them and they were bright red. I was taking lasix and spironalactone, plus lots of lactulose. Also was taking quinalone (quinine) for horrible cramps in my feet, legs and hands. I could barely work, but would go set tile for an hour up to 5-6 hours a day depending on my energy. Then, one day I was at the end; called my pcp, went to the local hospital and he put me on IV lasix and a few other diuretics, antibiotics and albumin. MELD was 18. Was only allowed a half liter of fluid per day. In 6 days, I lost 27 pounds of fluid from my legs. Even my doc was amazed it worked so well. Got out of the hospital on a Sunday, saw my pcp on Tuesday, when he mentioned my MELD was 24. Didn't occur I might be close to a transplant. Next day, on the way up to Boston for a check up, got the call and that evening had a transplant. Woke up 3 days later, no swelling in my legs or testes. Mae, I'm pretty sure the fluid will dissipate in a short time.

Thanks for the replies, its good to hear from everyone and know you have been still surfacing every morning. First of all, Connie, my meld score is still low 8 or 9, my sodium level was 134 which has been the best in the last 2 years and my liver doc still says that I cannot take the combo drugs to at least slow down the Hep C virus or get lucky and it working for me and become undetectable. He said something about a combo without the interferon coming out soon, but that was in early December 2012. My next appointment is in May. The damage is done anyway and cannot be undone. I think skipping that step and getting a transplant is what I want because of the fluid and cramping problems. I do not get it! In the last 6 months I had a few episodes of severe cramping. The worst was in August 2012 driving back from a fishing trip. I had to steer with my elbows to the side of the road and stop because my arms, hands and fingers just locked. The pain was overwhelming. I used the steering wheel by pushing my fingers to pry them free. It lasted longer than the usual cramps enough to scare the #..# out of me. Then, right after Thanksgiving dinner at my Mom's house my thighs and lower legs locked up and had to get up and push myself to walk it off. Everyone saw me grimacing in pain, my brothers wives and kids. It was embarassing and it took awhile to go away.

Ziff, you are right about getting away from the website. I believe there is strength in numbers and I like reading your posts mate you make me laugh.

Tiling for 5 to 6 hours in a small bathroom. you got to be a warrior. I cut vegetables for a salad or to just saute some fresh veggies with some olive oil in a pan and my hands start cramping. If I am on my legs for more than a couple of hours they start to ache and then comes the numbness and when I lay down my toes instantly curl up and have to get up and walk it off. David, I also had to do that half a liter a day routine when my sodium level bottomed out. Boy, was I sick. It is not an easy task to do for a week or 2. You can only drink 33 ounces of fluid a day. Tomorrow, when you wake up write down how many ounces of water, soda, juice, etc. you drink until you go to bed and you will be surprised how much you drink. I used a 6 ounce cup and filled it up half way and took little sips and ate a lot of fruit. Remember, you are taking diuretics, so the mouth gets very dry at times.