question-icon

Suggest treatment for liver cirrhosis

default
Posted on Fri, 26 Sep 2014
Question: I am 63 years old, male, with Type II diabetes, for which I am taking 170 units of insulin daily. I also have non alcohol related cirrhosis, which was diagnosed nearly 3 years ago. I have more and more difficulty carrying heavy objects. They don't even have to be heavy anymore . After a few minutes of carrying some medium sized boxes and loading them into a car, I am bent over like an old man and cannot continue. I have read that cirrhosis can cause a loss of core strength and make it difficult to carry heavier objects, but my liver specialist says he has never heard of this correlation. My liver specialist is retiring soon, so please don't worry about causing a rift between us with a candid honest answer that differs from that of my doctor. What, if anything, can be done to strengthen my core? Is there some medication that will help?

Also, I was diagnosed with cirrhosis by means of a liver biopsy after a scary episode of vomiting six pints of blood and being rushed to the ER. The bleeding turned out to be caused by bleeding varices in my esophagus, which have undergone a series of banding. I suffer from encephalopathy for which I take Xifaxin, and my doctor told me I shouldn't be driving. My chief complaint is that despite my worsening condition, my doctor says my MELD score isn't high enough to qualify being put on the registry for a liver transplant. My last CT scan revealed something that is suspicious for cancer, but my doctor thinks we should wait and see until after my next CT scan in 6 months. Meanwhile I am feeling lousy, weaker every day, getting lost in malls, and wondering why I entered a particular room. I have been having abdominal pain in my right side, which is new, but I only see my doctor every six months. When I call to tell him I am feeling worse, his assistant tells me to be sure to tell the doctor when I see him in 3 months. I fear that while we "wait and see," I may die of liver failure. The liver specialist is the Director of Liver Disease at a prestigious medical facility, who I hoped would be able to get me a new liver. Oh yea, I recently developed a hernia in my groin area, which my regular physician readily diagnosed, but which my liver specialist refused to even look at. I was unbuckling my pants and he just dismissed me, saying he had felt around down there when he examined me, and he doesn't need to look at it. My question is after nearly 3 years of waiting and getting progressively worse, shouldn't I be eligible to get on the registry for a liver transplant?
doctor
Answered by Dr. Noble Zachariah (14 hours later)
Brief Answer:
Please see below.

Detailed Answer:
Hello,

I understand your difficulty. To answer your last question only your hepatologist can decide and help you to be in the transplant registry.
Regarding the other query about the health and memory issues there are two main possibilities. First to consider is the cause of your forgetfulness or getting lost in malls etc. This is probably a result of hypoglycemia unawareness, a condition in which low blood sugars do not produce the classical symptoms of hypoglycemia and the person experiences temporary memory loss or loss of concentration etc. If a blood sugar can be done during these episodes, a low value would confirm this. The weakness is possibility due to a sub clinical encephalopathy. When my patients have such problems I check their plasma ammonia and electrolytes. Correction of the electrolyte abnormalities together with a low protein diet and oral lactulose often solves the problem. You could try these and see if there is an improvement.
I shall be happy to give my opinion if you have further queries.
Best wishes,
Dr. Noble Zachariah
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Noble Zachariah

Internal Medicine Specialist

Practicing since :1974

Answered : 2276 Questions

premium_optimized

The User accepted the expert's answer

Share on
Suggest treatment for liver cirrhosis

Brief Answer: Please see below. Detailed Answer: Hello, I understand your difficulty. To answer your last question only your hepatologist can decide and help you to be in the transplant registry. Regarding the other query about the health and memory issues there are two main possibilities. First to consider is the cause of your forgetfulness or getting lost in malls etc. This is probably a result of hypoglycemia unawareness, a condition in which low blood sugars do not produce the classical symptoms of hypoglycemia and the person experiences temporary memory loss or loss of concentration etc. If a blood sugar can be done during these episodes, a low value would confirm this. The weakness is possibility due to a sub clinical encephalopathy. When my patients have such problems I check their plasma ammonia and electrolytes. Correction of the electrolyte abnormalities together with a low protein diet and oral lactulose often solves the problem. You could try these and see if there is an improvement. I shall be happy to give my opinion if you have further queries. Best wishes, Dr. Noble Zachariah