End Stage Liver Disease Cirrhosis

The human liver is one of the most important organs of the body. It is responsible for cleaning our internal organs of the entire gunk and bile that is deposited by a person o 00004000 n a regular basis. But conditions like Gilbert's disease and other forms of liver disease makes our livers weak and prone to breaking down.

To understand better how the liver is affected by different kinds of diseases and the impact of these conditions to our body. Liver disease is a general term used in describing any kind of sickness affecting the liver. Many of theses conditions are accompanied by jaundice caused by the heightened levels of bilirubin in the system. The bilirubin is the product of the breakup of the hemoglobin of dead red blood cells; usually, the liver takes away bilirubin from the blood and excretes it through bile.

The following are some of the known conditions that are considered as liver diseases:

- Hepatitis. This is the inflammation of the liver. This caused mainly by different kinds of viruses, there are also times that it is caused by some poisons, even hereditary conditions.

- Cirrhosis. This is the formation of fibrous tissue in the liver, the fibrous tissue takes the place of dead liver cells.
- Haemochromatosis. This is a hereditary disease caused by too much iron in the body causing liver damage.

- Cancer of the liver. This is usually coming from other parts of the body that is also affected by cancer. Usually, when cancer cells metastasis, it reaches the liver and it starts spreading from there.

- Wilson's disease. This condition is hereditary and copper deposits in the body cause it.

- Budd-Chiari syndrome. This is caused by the obstruction of the person's hepatic vein.

- Gilbert's syndrome. This is a genetic disorder of bilirubin metabolism, found in about 5 percent of the population.

- Glycogen storage disease type II. Here, the build-up of glycogen causes progressive tissue weakness (myopathy) throughout the body and affects various body tissues, particularly in the heart, skeletal muscles, liver and nervous system.

There are also many pediatric liver diseases, including biliary atresia, alpha-1 antitrypsin deficiency, alagille syndrome, and progressive familial intrahepatic cholestasis, to name but a few.

A number of liver function tests are available to test the proper function of the liver. These test for the presence of enzymes in blood that are normally most abundant in liver tissue, metabolites or products.

Symptoms of a diseased liver

There are a few external signs that we could include to determine a diseased liver, some of those external signs are a coated tongue, bad breath, skin rashes, itchy skin, excessive sweating, offensive body odor, dark circles under the eyes, red swollen and itchy eyes, acne rosacea, brownish spots and blemishes on the skin, flushed facial appearance or excessive facial blood vessels.

There are other symptoms to look out for and they include jaundice, dark urine, pale stool, bone loss, easy bleeding, itching, small, spider-like blood vessels visible in the skin, enlarged spleen, fluid in the abdominal cavity, chills, pain from the biliary tract or pancrea, and an enlarged gallbladder.

The improper digestion and absorption of fats may lead to symptoms that include indigestion, reflux, hemorrhoids, gall stones, intolerance to fatty foods, intolerance to alcohol, nausea and vomiting attacks, abdominal bloating, and constipation. Unfortunately, some liver diseases like Gilbert's disease are known to share symptoms with other liver diseases. So it's better to consult a professional.

Frequently Asked Questions

  1. QUESTION:
    My dad has End-stage Liver disease/ liver failure (Cirrhosis) How long does he have?
    My family seems to be keeping a lot of information from me about his illness. I went to the hospital a few days ago and I really didn't find out much. We are working really hard to get him a transplant and I just moved out of state to be with him during this ordeal.

    I may not want to know..but, how long do people normally live when they have Cirrhosis/Liver failure?

    • ANSWER:
      The timing can be tricky. It depends on how bad he is or how bad he is treated in the hospital. I would fight and fight for the transplant before he is no longer allowed one. When they get too sick they normally think the patient can't survive and they don't want to waste a liver on them. Sucks, that happen to my dad after his newer liver started failing. To learn more, I would search it online on Wikipedia.com. When everything was happening to my dad no one would tell us details about his illness and that totally sucked. I only learned once I was in Sonography College in great detail. Good luck it can be a long bumpy ride.

  2. QUESTION:
    what is the life expectancy of a person with end stage liver disease (cirrhosis)?

    • ANSWER:
      from experience in my own family it only took about 8 weeks give or take a few days.

  3. QUESTION:
    Does cirrhosis cause itching BEFORE 'end stage liver disease'?
    My consultant actually started shouting at me that I was foolish and that there was no connection between liver disease inc. cirrhosis and a problem with itching skin (unless I was in 'End Stage' and actually dying (I'm not). Has actually now refused to see me as I am 'difficult' and says my appointments in future will be with a nurse!!! I have read lots of references to itching with liver disease and experience it myself every day - why can they not believe anything other than what they were told in Medical school however many years ago. I think I am actually being barred because I display insufficient gratitude when dealing with her, i.e. I don't necessarily believe everything she says automatically - experience has taught me they don't know everything, or anything like it.

    • ANSWER:
      Very unprofessional. I would not feel comfortable seeing this doctor or his staff again. Please seek another specialist.
      I'm not sure if this can cause itching in stages less than ESLD. Cirrhosis is stage 4 of liver disease, and while you may not be in the decompensation stage, you still have significant scarring. So I would imagine that due to that fibrosis or scarring, your liver is probably not functioning efficiently like it should. It may not be processing the bile correctly, and that build up can cause itching. Doctors often tell us one thing based on research, but in reality, patients often feel otherwise. Another case in point is that people say they feel pain in the area of the liver, but doctors will tell you that there are no nerve endings to feel pain in the liver. However, the sac that surrounds the liver can stretch with inflammation and can cause pain.
      That being said, you're right. They don't know everything. I hope you find a doctor that listens to your symptoms and respects you as a patient. Best wishes.

  4. QUESTION:
    For someone with End Stage Liver Disease, how high does their MELD score have to be to get a transplant?
    Have a friend who is in End Stage Liver Disease, cirrhosis, who refuses hospice care, I need to know how high his MELD score has to be before they will "bump" him up on the donor list.

    • ANSWER:
      Not to discourage you. Not everybody with End stage Liver disease qualifies for a transplant. The doc's have to consider why his liver has cirrhosis. If that is a possibility for the transplant as well, the chances are low.
      If they are already mention hospice care it does not look good.
      Sorry to say this, but my prayers are with him.

  5. QUESTION:
    What are the physical signs of each stage of cirrhosis of the liver and are there 3 stages or more?
    Someone I know has end stage liver disease and is still conscious and able to move around in a wheel chair. I was wondering how long she might have.

    • ANSWER:
      The link below should help. I'm sorry about your friend.

  6. QUESTION:
    Question about end-stage liver disease?
    I ask a similar question a while back, but forgot to add more details. My husband has cirrhosis. His variecs bled all the time. Two years ago in May, he had the TIPS proceedure. He hadn't bled up until 2 months ago, when he did for 1 day, due to an ulcer in stomach. He can't sleep well, eats very little, but seems normal otherwise, except his breath has this wierd smell. Can you enlighten me about this mouth odor? The last person, (very informative), told me it was from bleeding, and probley needed TIPS proceedure. He is on Transplant List and a year ago he was at level 13. Haven't been back except for other tests. Does anybody know what this smell could be, he's had it off and on for about 6 months, it isn't continuous. Thank you

    • ANSWER:
      google around on "Fetor hepaticus"...

      a condition seen in portal hypertension where portosystemic shunting allows mercaptans to pass directly into the lungs. It is a late sign in liver failure. Other possible causes are the presence of ammonia and ketones in the breath. The breath has a sweet, faecal smell to it.
      The compound dimethyl sulfide has been associated with it,[1] raising the possibility of an objective noninvasive measure of liver failure.

      Hope he gets his transplant soon!

      Good Luck and GodSpeed

  7. QUESTION:
    what happens when liver fails (beside jaundice,bleeding,etc.)how long until you're dead?
    diagnosed with end stage liver disease-cirrhosis & hep C. in hospital a week ago, got 4 pints blood to replace what I lost vomiting and with bloody stools (I had no control over bowel functions). Currently experiencing severe abdominal pain on upper right side-front and back. supposed to get evaluated for transplant, but haven't got to St. Louis yet. does this go on for weeks, days?

    • ANSWER:
      When the cells of the liver become damaged,
      the immune system of the body responds to
      this damage and causes inflammation to
      develop inside the liver...which will cause the
      liver to enlarge in size. (Can be seen on an
      ultrasound or Ct scan. No matter what the
      cause may be, it usually follows the same
      course. If the cause cannot be found and stopped
      and the inflammation isn't treated...it can lead
      to the liver cells dying off and forming scar
      tissue inside the liver that will eventually
      block the flow of blood to the other liver
      cells and also through the liver on it's way
      back to the heart. This is then known as
      Cirrhosis of the liver, a progressive disease.

      Because the flow of blood is not accomplished
      now, it can back up in the vein that brings the
      blood to the liver, known as the Portal vein...
      this causes pressure, known as Portal
      Hypertension. It also backs up into smaller
      vessels not used to handling this amount of blood,
      known as varies or varicose veins. These can be
      found in the esophagus, rectal area, and the belly
      button area. (they can be seen when you have
      a endoscopy done in the esophagus.) It is an
      emergency situation if these vein balloon outward
      in weak spots and break open. The doctors usually
      go in there to band them to stop the bleeding.
      A Cirrhosis patient's liver do not make the clotting
      factors like it used to, to help the blood to clot.
      Therefore, easy bruising and bleeding occurs.
      It is very important that any bleeding from these
      areas are treated immediately so the patient does
      bleed internally or bleed out completely. The spleen
      can also enlarge in size because of the blood backing
      up into it. Caution has to be taken that the spleen is
      not injured by blunt force.

      Patients can also develop Ascites; which is the build
      up of fluid in the abdominal area because the liver
      cannot make a protein known to hold fluid inside
      our vessels...called Albumin. This fluid leaks out
      and collects in the abdomen. There is a procedure
      that the doctors do, to remove this fluid...known as
      paracentesis. The fluid can make it difficult to eat
      or breathe, because of the pressure on the stomach,
      other organs, and up against the diaphragm..pushing
      against the lungs. Usually this procedure will give the
      patient immediate relief...however it will have to be
      drained every so often...because of the lack of this
      protein.

      Encephalopathy is when a person becomes easily
      confused, disoriented, have sleep pattern changes,
      flapping or tremors in the hands, etc.
      Our body uses protein all the time. The by product
      from this is ammonia. The liver takes the ammonia
      and try to convert it into urea, so the body can easily
      dispose of it. Since the liver isn't able to do this now,
      the ammonia stay in the blood and goes pass the
      blood brain barrier and into the brain. This
      encephalopathy has to be treated with mediations
      like Lactulose...or it could lead to a patient going
      into a coma.

      All pain, should be checked right away. Any
      bleeding has to be checked immediately.
      The doctors have all the tests results. The very best
      test is the liver biopsy. They can tell from that how
      far advanced in this disease you actually are.
      They are really the only ones who can tell you where
      you are at in this disease and how much longer you
      might have to live.

      When you are placed on the transplant list, there are
      four blood tests that the doctors use to keep track
      of how long you will live without having a transplant.
      They are the Bilirubin, INR, Creatinine, and the Sodium.
      Bilirubin gives them an idea of how well the liver is
      functioning. INR also does this...but also tells them
      how well the blood is clotting. Creatinine is to check
      on how the kidneys are functions. Sodium helps them
      to know if the heart is doing okay.
      To understand this or any other blood testing you might
      have...here is a site you can click on to place the name
      of the tests from your lab work, in, and it will tell you
      more about them:
      http://www.labtestsonline.org or you can type
      in liver functions tests or liver enzymes in your search
      engine.

      Here are some links to learn more about Cirrhosis,
      about Hepatitis C, and about Liver Transplantation.
      CIRRHOSIS:
      http://www.hcvets.com/data/hcv_liver/cirrhosis.htm
      http://www.medicinenet.com/cirrhosis/article.htm
      TRANSPLANTATION:
      http://www.surgery.usc.edu/divisions/hep/patientguide/index.html
      http://www.transplantliving.org/
      HEPATITIS C:
      http://janis7hepc.com/biopsies.htm
      http://www.medicinenet.com/hepatitis_c/article.htm
      http://www.hepctrust.org.uk/The+Liver/How+HCV+affects+the+functions+of+the+liver.htm
      ADVANCED DIRECTIVES:
      http://www.caringinfo.org/stateaddownload
      MELD SCORE
      http://www.unos.org/SharedContentDocuments/MELD_PELD(1).pdf

      (just click on any of the above links to go
      to the sites)

      I hope this information is of some help to you. Best wishes.

  8. QUESTION:
    what happens to the liver at the final stage of cirrhosis of the liver?
    My mother-in-law just passed away due to this disease. She was diagnosed with it 5 years ago. Although she did not drink at all, what could have been the possible reason why she got it? Some people die right away when they are diagnosed, yet others last longer. At the end her kidneys started shutting down too. They did dialysis but did not work. Everywhere she had a cut or sore, blood started coming out. This was happening as we knew she was not making it. Blood came out from her eyes, ears etc. What was happening?

    • ANSWER:
      There are a number of reasons people get cirrhosis which is scarring of the liver which makes it impossible for the liver to do its job. Some reasons are chronic hepatitis B C and D, autoimmune hepatitis (immune system attacks liver), inherited diseases, NASH (fatty liver that progresses to cirrhosis), primary biliary cirrhosis (immune system attacks the bile ducts), and iron overload. Then there are those people who do not have any reason for having the cirrhosis and fall into the category of cyptogenic (reason unknown).

      When the liver slows or stops production of the proteins needed for blood clotting, a person will bruise or bleed easily. This happens in cirrhosis. Cirrhosis can also lead to kidney failure.

      A person will die from cirrhosis when the disease has progressed to its final stage when total failure happens. At that point, only a liver transplant will save a person. The life span of someone with cirrhosis depends on many different things, so that's why some live longer than others. Example: Someone who has cirrhosis from being an alcoholic that stops drinking can slow down their disease very much and maybe even stop it. Someone with cirrhosis that continues to drink will progress to the end stage of the disease much quicker and it will certainly be fatal if drinking continues.

      I'm sorry that your mother-in-law died from this terrible disease. Try to remember the good times you had with her. It must have been terrible to see her like she was at the end, so try not to focus on that. Focus on the good things.

  9. QUESTION:
    cirrhosis of the liver (end stage) question?
    A family member of mine has cirrhosis of the liver due to no fault of her own (never being an alcohol drinker, I mean). She is in the hospital now and the doctors say she most likely won't last another couple of days. She has been in the hospital this time for almost 2 weeks and for the last 5 days now, the doctors will not give her anything to eat or drink. She is in and out of consciousness and when she wakes up, she mumbles that she is hungry. All the doctors will do is take a swab of water and wipe the inside of her mouth with it. They say that they need to keep her dehydrated so that when she starts to pass away, it will be less painful for her. And she can't eat anything because they're scared she could choke on it or it could end up in her lungs. They say that dying from this disease is a horrible way to die and they are trying to make it a little easier on her. I just don't understand how they can say that starving her for 5 days is making anything any easier on her. The poor woman wakes up from her "sleep" and the first thing she says is that she's hungry and they give her another shot and she goes back to sleep. This just doesn't seem right to me. If anyone knows someone who has gone through this or is a doctor that knows anything on this I would greatly appreciate it.

    • ANSWER:
      End stage cirrhosis IS miserable, and I'm very sorry for your family member. The bottom line, though, is that since her liver isn't functioning properly and is therefore unable to produce the biochemicals necessary for her to digest her food, eating will likely just make her feel worse in the long run.

      Please consider calling a hospice near you. Although the hospital's staff is likely excellent, hospitals are naturally focused on curing disease and are not necessarily the best choice when a cure is not possible. The hospice staff will be better able to help control your family member's pain and other symptoms and to provide much-needed emotional support for you.

  10. QUESTION:
    If a person is in End Stage Renal Disease and needs a kidney, would liver damage exclude her from transplant?
    My girlfriend just found out she cannot take a certain immune suppressor due to cirrhosis of the liver, (Hepatitis C and Lupus damage). Now, if she can't take this drug, are there other drugs she can be prescribed for anti rejection that wouldn't affect her liver? Is she still a transplant candidate for a new kidney? She is currently a home dialysis patient. She also has Sjogren's syndrome, high blood pressure, systemic and subcutaneous Lupus with the Hepatitis C.

    • ANSWER:
      Short answer is that there are no anti-rejection medications that are not processed in the liver. With Hep C she won't be allowed to receive a kidney. I am very sorry to tell you this and wish the best for you both.

  11. QUESTION:
    My husband has stage 4 cirrhosis. Help?
    My husband was diagnosed with Hep C about 8 years ago. He kept drinking way too much for years, and just celebrated 90 days of sobriety.

    He had a liver biopsy last week and the nurse just called to tell me the results and set up an appointment. She said:

    Mild inflammation (I didn't know about grades - not sure of the grade).
    Stage 4 Cirrhosis

    Does anyone know how serious this situation might be? His viral load was around 500,000, and he hasn't really had any symptoms other than his side hurting. Would it be worse if the inflammation was worse than 'mild', or is the stage 4 considered the end stage of liver disease regardless of the inflammation.

    He doesn't go to the doctor for 2 weeks and now is scared to death. Can anyone help us make sense of this? Can he still live a long and healthy life? He's only 50.

    Thanks to anyone that can give me info on what his situation might be.

    • ANSWER:
      I had cirrhosis and a liver transplant, so I do know a little about this. Inflammation (something actively bother the liver such as hep C with your husband) can lead to fibrosis (abnormal fibrous bands in the liver). As time goes by, more and more fibrosis forms. As even more time goes by, liver cells may begin to die and scar tissue begins to form replacing healthy tissue. A doctor can do a biopsy to see how much damage has been done using a staging system of 0-4. Here's how the stages go:

      stage 0- no fibrosis present
      stage 1- small amount of fibrosis present
      stage 2- a little more fibrosis
      stage 3- even more fibrosis present (stage 3 is bridging fibrosis)
      stage 4- cirrhosis present

      So all that stage 4 means in a biopsy is that cirrhosis is present in the liver. It doesn't go into detail as to how much in this staging, so everyone with cirrhosis no matter how mild or how severe would be considered stage 4. So that's why people refer to themselves as end stage if they have any cirrhosis present at all. It's called ESLD (end stage liver disease).

      Now to get a more detailed picture of what is going on, cirrhosis itself also has 3 stages of A, B, and C.

      Stage A is compensated cirrhosis which is asymptomatic (no symptoms present)
      Stage B is the beginning of decompensation which is when a person will needs medications or treatments of some sort to help control symptoms such as ascites, high ammonia levels, banding varices, etc.
      Stage C is decompensated cirrhosis where medication no longer work very well in controlling the symptoms and total failure is near.

      You might want to ask the doctor what stage of cirrhosis your husband may be in right now or you can probably figure it out for yourself. Mild inflammation is much better than having severe active inflammation. Has your husband checked into getting treatment for his hep C if he hasn't done so already. Drinking on top of having hep C is really bad. It just makes the disease progress much faster. It's so important that he stop drinking all alcohol.

      Once the disease progresses to having severe liver damage, the only option will be to get a transplant to stay alive since it will progress to total failure eventually. How long that takes depends on many factors such as the viral load along with things such as drinking alcohol, taking meds that affect the liver, etc. so it's nearly impossible to put anyone in a time frame. Staying sober will be the absolute best thing your husband can do to treat his cirrhosis. I hope he has a good doctor that specializes in his medical condition such as a gastroenterologist or hepatologist. That is also very important. I hope this helps you some in understanding and wish you the best.

  12. QUESTION:
    Alcoholic Cirrhosis - advice needed - anyone have experience of this?
    My mother has end stage liver disease and now has hepatic encephalopathy (confusion through not being able to process toxins and near coma). It would be good to hear from anyone who has had family members go through this - it is terminal but not getting much out of the doctors. Please no horrid answers - genuinely would like advice.
    She is in hospital already - we know she's dying but we don't know how long she might stay alive for.

    • ANSWER:
      My mother in law has the same thing she has been in hospital a couple of times in comas and near death. with laxatives and drips thay can get the toxins out and rehydrate her. At home she was taking sleeping tablets thats what caused a toxic build up cos her liver couldnt break anything down. She is now in a nursing home as she cant look after herself but at least here she has no access to any chemicals and has a regular routine. Her quality of life isnt 100% but its better than it has been for a number of years. And shes still around.

  13. QUESTION:
    My mother's just been diagnosed with Cirrhosis?
    My mother has abused her body all her life. I'm shocked this hasn't come sooner. I don't know most of the details yet. Just that her ammonia level is at 270-ish, and for the last few weeks she's been acting like she's has a stroke, not remembering things, my name for one. She's lost a severe amount of weight but her stomach is still very large. She bleeding in her bowels, having a hard time sleeping, and won't eat and vomits occasionally. All I was told as of today was that she had active liver disease/cirrhosis, but they are still doing more tests. She is still drinking. Even after she took the medication to help flush the toxins, or was it to help the ammonia level? Does this sound like end stage to anyone? She will continue to drink so I'm really wondering how much longer does she have? Weeks, months, not years though, right? And what does an ammonia level of 270 mean? I know the average is 18-75 something like that. How high would it go before she dies?
    I know she's my mother, but she would abuse a new liver, so I don't believe that is even an option, don't believe she should take it from someone more deserving.

    • ANSWER:
      Hey. I have no information or advice regarding this.... i just wanted to pass on my sympathy. I'm just so sorry that you have to experience this.

  14. QUESTION:
    Who can tell me about Hepatic Encephalopathy in End Stage HCV?
    I have read a bunch of stuff by doing searches and I understand it BUT I need some specific advice.

    My friend has End Stage HCV (hepatitis C virus disease) and he is showing signs of psychological problems - not impaired cognitive function- he is depressed maybe paranoid and at times confused. My friend is able to continue to work full time and is competent at his profession. He drinks heavily and will not stop that or reduce the high dose RX Codeine he is on.
    My friend is under the care of a Dr but has refused further testing since his last Viral Load test was very high and a liver biopsy showed Cirrhosis, six months ago.

    How can I be helpful and supportive to my friend without butting in and interfering with his privacy and personal choices?

    The apparent paranoia and changes in his decision making process are very contrary to his typical past state, this concerns me.
    How can I be helpful and supportive to my friend without butting in?

    • ANSWER:
      Not much will ever be said, I think under hepatitis C. See below. You have to go to insomnia, depression, personality disorders and beyond, likely caused by the Hep C, if not certainly.

      Now, the cirrhosis and fatty liver are more important in determining personality and mood than is said also. It can lead to blood poisoning, hallucinations, anger and disorientation.

      Alcohol solidly makes it worse, causes scarring and hardening in the liver, and smoking does this too, strangely, thus more toxemia and odd behaviour, as the brain is chemically imbalanced.

      It would concern anybody, together with the fact that there is neither a vaccine or a cure, and as you say, the end stages are near the end, or - it is terminal.

  15. QUESTION:
    Cirrhosis of the liver symptoms.. and Need Help!!?
    I have a family member who has been diagnosed 15+ years ago with cirrhosis of the liver. He is probably the largest alcoholic known to mankind. He drinks at least 30 + beers a day, and is now experiencing constant nosebleeds, for over 3 days now.. It just bleeds and bleeds when he sits up. He has blood in his urine and his stool appears blackish greenish of color and has constant diarrhea, but does not eat very often.. at all!

    I am assuming that hes in the end stages of this disease and want to know if any of you have had these issues with a family member or friend, and what is wrong and how long that this trend will continue and what will happen.

    Thank you so much for your cooperation in advance, we appreciate any answers you may have!

    • ANSWER:
      I have worked with people who had cirrhosis. They get swelling in their abdomen (ascites) & extremities (edema). The stomach can get the size of a honeydew melon.
      Vit K gets reduced & so there is more bleeding. As the toxins build up in the body, the skin begins to itch...the person becomes jaundiced & mental changes occur...sometimes during these various stages antibiotics are given.

      High potency Vit B complex can be helpful as can milk thistle. However, I don't know how long it will prolong his life.

      Google: mayo clinic>>diseases>>cirrhosis

      I'm very sorry to hear of your situation.
      Good luck.

  16. QUESTION:
    Can where I Iive be condemed or declared unihabitable?
    So, my parents are renting the house we live in now. And this place is terrible, theres holes around the lining of the floors, the plumbing sucks, we have leaks everywhere. Theres holes in the ceiling.
    Theres bugs and rodents all over the place.

    Its really gross.

    We would move but don't have the money, because my dads out of work due to a injury on site, and hes in the end stages of Cirrhosis.(a liver disease).
    My mom cant get a job because recently she cut 3 of her fingers and severed the tendons. She cant get them fixed because of the money issue.

    I don't know what to do, I've heard that you get the house inspected and if its unsuitable to live in, that the people who rents you the house has to pay for you to live somewhere else.

    Is that true?

    Please help us

    • ANSWER:
      You are partially correct. The landlord IS required to provide housing that is up to code, and the place CAN be condemned as not suitable for habitation. But depending on where you live, the landlord might just be required to close it down, and you guys could be evicted. Check with your local code enforcement agency (anonymously to see the extent of the landlord's responsibility before you speak up and possibly put yourself in a bind

      Papaw

  17. QUESTION:
    my mother in law was diagnosed with cirrhosis in 2008 when her abdomen was so swollen that we took her to the?
    ER. she was being treated by her own doctor who gave her lactolose and fluid pills. This year she began seeing a Specialist and he said her meld score was 15, so far she does not qualify for a transplant. just this past weekend we went to visit her and she was in the middle of a very vivid hallucination which seemed to be going since the evening before. To her it was real that she had her dead ex-husband and a bunch of indians at her house. Her usually spotless house was a mess because she had been feeding them and made them beds with pillows and covers all over her house.
    We took her to the hospital and they ran many tests with all kinds of specialists until finally a liver doctor said that all of her symptoms where because she was in end stage cirrhosis. she also had tremors in her hands. her hallucinations lasted for 2 days then she was normal. they released her telling us that this is just the progression of her disease, but she needs someone with her all the time. Her cirrhosis is called "nash" not caused by alcohol. she also is a diabetic. I had our family doctor order home health which means that a nurse will come to her to do blood work to keep track of her ammonia level, bilirubin and creatinine levels. How long can someone last after they have been diagnosed with end stage cirrhosis. she sleeps a lot and is tired. sometimes she is confused and walks shuffling her feet, she hallucinates and swells in her feet. but she still can go shopping and clean her house. it's so confusing to us. she is 64 years old. Sometimes she acts pretty normal, others she's a different person. when I take her back to the specialist we're going to check her meld score because with all these new symptoms I fear that it is higher.How long can someone last that has end stage cirrhosis?

    • ANSWER:
      I had cirrhosis and a liver transplant so I think I have some insight into what is going on. Yes, your MIL is experiencing side effects from the cirrhosis which they will try to control, but these problems can pop up at any time. The hallucinations are caused by high ammonia levels since the liver cannot break them down and get rid of the ammonia like it should. The treatment for that is usually taking Lactulose which is also used for constipation. Problem is that it will cause loose bowel movements and diarrhea, but this is the way to get rid of the ammonia which is through bowel movements. Maybe she needs an increase in her dosage or they might want to try other meds that could help. I complained all the the time about the Lactulose side effects and they gave me a drug called Xifaxan which does not have the side effect of loose bowel movements but still helped bring the ammonia level down. I would use it with the Lactulose which worked much better since no one wants to have to live near a bathroom all the time. These high ammonia levels which causes hallucinations do need treated if bad enough. It leads to a condition called encephalopathy and if the ammonia goes too high, it can actually put you in a coma and be a risk to your life. Everyone has a different tolerance to these high ammonia levels. I had high ammonia but never was confused or had hallucinations.

      NASH (non alcoholic steatohepatitis) is a fatty liver that has progressed to cirrhosis which is when healthy tissue in the liver is replaced with scar tissue. Your MIL most likely needs a transplant. I don't know why they have not accepted her to be listed. Did she go through an evaluation yet at a transplant center? What were their reasons for not accepting her. They will send a letter explaining their decision which is reviewed by a transplant committee. I was put on the list when my meld score was only 12 and received my transplant at 15. I was on the waiting list for 18 months. Everyone in the U.S. has to follow the rules set down by UNOS (United Network for Organ Sharing). At 15, she certainly can at least be listed as long as she passes the evaluation which consists of a lot of medical tests along with psychiatric evaluation. She must also have insurance that will approve the transplant since the surgery does cost about 0,000 these days and that is without complications.

      How long can she last? Everyone is different on that too but most transplant places will give an estimate of how long. They have to know how much damage is present. A biopsy is the best test which shows everything such as the amount of damage and how severe the damage is right then. When I was first diagnosed, I was told my liver had only 10% function left and they gave me an estimate of 5 years before total failure might occur. I had mine done when my meld was 15. The surgeon told me after he saw my liver during the transplant that I had about a year left which was very close to their estimate given me when I was first diagnosed.

      Your MIL really needs to try and get a transplant if she wants to stay alive. She is going to die if she doesn't get one. It's just a matter of when. What is causing her not to qualify? If she can get accepted, she has a chance of getting well again and doing fine. I have talked with a number of people in their 60's that have received transplants and did quite well. I would also suggest her to get an endoscopy done since unwanted veins called varices grow inside when you have cirrhosis due to blood not flowing right to the liver. These veins are not like the ones we are born with. They can be weak, leak, and even burst causing a crisis problem with internal bleeding. If one gets very large and bursts, the person can actually bleed to death in short time. There is a procedure called "banding" which is pretty simple to do which can get rid of these varices and greatly lower the risk of bleeding internally. I used to get an endoscopy done every 3-6 months checking mine and doing banding when needed. They do the procedure when the do the endoscopy. It's done as an outpatient and I was usually in and out within 3 hrs. or so. Nothing much to it, but they do knock you out to do it. If she has cirrhosis, she most likely has varices too.

      I hope your MIL can get the help she needs. You can email me through yahoo if you have any other questions.

  18. QUESTION:
    Job vs. Terminally Ill child?
    Just wanted to get a little advice on a situation that i'm currently going through. First off, im 24, and I have a 4 year old daughter with a life-threatening liver disease called PFIC-2, and she is currently on the transplant list. Im stuck in between a rock and a hard place. I'm currently looking for part time work to help sustain me while I'm going through nursing school at wayne state. The issue that i have is im debating if I should tell my employer about my child's condition BEFORE im hired or after. I had a part time job back at the end of 2010, but I was let go when my daughter's liver went into the early stages of cirrhosis. Basically, her doctors at U of M keep her under a close eye, and when ANYTHING in her blood work elevates, she is usually hospitalized or we are asked to IMMEDIATELY come in for further tests. I got a job back in september 2010, but was fired the week of thanksgiving due to my daughter's condition deteriorating and needing emergency tests and treatments. They basically told me that I was a liability to the company because I was unable to show up for my schedule a lot of the times. I was not eligible for FMLA because i was not a full time employee. Basically all protections under the law i was ineligible for due to me being a part-time worker and not having been there at least 12 months. Now I'm stuck trying to find another job that will not hold my daughter's illness against me. Her father and his family don't help at all(he'd doesnt want anything to do with us because i got him put in jail when he physically abused me while i was pregnant with our son). My mother died from a drug overdose and i was taken away from my dad because of child abuse so I have no family to help either. Anyway, seeing as though my daughter is on the transplant list right now, even if I was to get a job, I would lose it the moment she gets that call, because her full time recovery care would be about 2 months after surgery. She is currently receiving insurance through the state of michigan for terminally ill children that covers all her medical expenses, THANK GOD. For those of you unfamiliar with how the organ donor list works, i can get a call AT ANY TIME to go in for surgery. So what am i supposed to do? welfare is not giving me enough to cover all my expenses, and quite frankly, I want to be off of the cash assistance as soon as possible. Should I apply for a job and just say 'my daughter needs a liver and I could leave any moment as soon as a liver is available, but dont worry about that because i'm a good employee?" Most employers would look at me as a liability to the company......

    • ANSWER:

  19. QUESTION:
    Have Obama's "death boards" of people getting to decide who lives already been created?
    Big Island resident Kimberly Reyes, who was diagnosed with Hepatitis in March 2008, had been told in July that she had less than 30 days to live. Her family claimed the Waimea resident had followed doctor's orders, but her insurance carrier, Hawaii Medical Service Association, denied her coverage for a liver transplant she needed to survive because three toxicology tests showed trace amounts of cannabis in her system.

    According to Reyes' attorney, Ted Herhold, with San Francisco-based Townsend and Townsend, toxicology tests from June 14, July 3 and July 14 were the sole final basis for HMSA's final denial of coverage for the 51-year-old mother of five.

    Reyes' mother, Noni Kuhns, and Kimberly's husband, Robin, acknowledged HMSA's decision was based upon a failure to comply with the insurer's policy forbidding drug use. However, both claimed after the claim denial that neither HMSA nor her doctors notified Kimberly or the family of HMSA's apparent policy on drug use.

    Following at least five separate telephone inquiries from West Hawaii Today made over a one-week period, HMSA public information officer Chuck Marshall replied through an e-mail that HMSA declined to comment. HMSA also declined to provide the insurance carrier's standard policies in regard to drug use or drug use and transplant approval.

    Kimberly Reyes died July 27 at Hilo Hospital, 16 months after being diagnosed. In the months after her diagnosis, she suffered cirrhosis of the liver, chronic Hepatitis infection, end-stage kidney disease and hepatorenal syndrome, which is caused by low blood flow to the kidneys due to liver deterioration.

    "Just because someone takes a hit off of a joint doesn't mean that it should be the end of their life -- this is not a reason to deny life," said Kuhns.

    http://www.honoluluadvertiser.com/article/20090809/BREAKING01/308090006/Marijuana+use+may+have+cost+Big+Island+woman+a+life-saving+liver+transplant

    Something doesn't add up here... Oh wait, it's a NON-government board of people getting to decide gets to live and who gets to die.

    That makes it OK, right?

    • ANSWER:
      This shows a need for tort reform, not a trillion dollar a year "health care reform". I would be all for taking the insurance companies to task for this.

  20. QUESTION:
    Regarding Hepatitis C Anti Viral Treatment (i.e. Interferon combos), is continuing to work fine...............?
    I just found out I am stage 5 (of 6) cirrhosis and am about to clinch a new job, of considerable responsibility and pressure. Have never been treated, but doctor still recommends it, I think as a way of delaying decompensation (end stage liver failure).

    Since there is no way to know, when if I continue on untreated, how much longer I will still feel fine, or start getting into the horrible stuff: My concern is making the decision whether or not to concentrate mostly on treatment, or to attempt both treatment and the new job.

    Obviously it's a decision only I can make (59 yrs old but single), but it sure would help to add as much "reality" as can be learned from those already in treatment, or past treated. It's a catch 22 because I know the disease is going to take me down sooner or later, and probably sooner, because I've had it for I'm guessing 40 yrs.

    Any comments or knowledge, or experiences.......would be very helpful and much appreciated.
    Forgot to mention my Cobra medical coverage expires in November 2010. Without the new job hence, a new "group" medical plan, treatment will be out of my reach financially.

    Also I must work to feed myself, until I become disabled and can apply for whatever is available (i.e. social security disability)
    Baa Baa said was no 1-6 rating system, but there absolutely is. Also there are many other rating systems.
    The 1-6 is called; "Modified HAI Grading: Necroinfammatory Scores". The related 1-6 scale is called: "Modified Staging: architectural changes, fibrosis and cirrhosis". info source is: "Ishak K et al" Hepatol 1995;22:696-699

    • ANSWER:
      As far as I know, there is no stage 5 or 6 when it comes to cirrhosis. There are 4 stages to liver disease itself and then there are 3 stages of cirrhosis. Anyone in stage 3 of cirrhosis would be extremely ill and unable to work any job because that is the decompensated stage in which medications and treatments no longer work on controlling the symptoms of advanced cirrhosis. You would be extremely fatigued all the time and fluid retention would probably be a very big problem. You probably would also have periods of confusion, memory loss, and behavior changes from high ammonia levels. You would also be taking a lot of Lactulose to try to bring those ammonia levels down which means you would be having diarrhea or near diarrhea about 5 or 6 times a day. These are just a few of the fun things that comes with the third stage of cirrhosis which is the final stage where total liver failure is close. As you can see, functioning in a job would be extremely difficult if not impossible.

      I would really question your doctor about this stage 5-6 business since it just does not exist as far as I know. I could list all the stages, but don't want to go into all that right now. It doesn't seem like you are experiencing any symptoms at all from your cirrhosis if you are able to function quite well in life and want to take on a demanding job with lots more stress and responsibility. If that is the case, you most likely are in the very early stage of the disease when there are no symptoms.