Re: Different Liver Cirrhosis Stages

August 18, 2009

Dear Gloria , I would like to try to take a

stab at answering your question. In many

cases with hepC, the liver docs have to take a chance

with a transplant first-treatment second.

The drugs you are taking are like chemo, toxic

sommewhere on the same level as alcohol to the liver.

Even a Mcs breakfast can be nearly equal to a few beers or

a few belts of booze in the toxic department, but we must always

weigh the risks with the benefits. The liver is indeed an amazing

gland/organ and it's ability to regenerate and heal is amazing.

With Cirrhosis, to my understanding there is really no way to

tell how far advanced it is, and this is not much use clinically anyway.

Far more important is how it affects all the organ systems and if it is either

well compensated, or decompensated.

Portal hypertension can occur with even a mild case of full blown cirrhosis, on

the other hand

even a severely damaged liver might hold its own, and the portal hypertension

not cause too many problems .

Think of it like this- you may have cirrhosis, but that itself is not as

significant

as this question " how severe is your portal hypertension? Many pediatric liver

transplants

are done each year by living donor because

out of control portal hypertension affects bleeding varicies more than it causes

ascites in some kids. Ascites and lab related decompensation

Will usually cause a meteoric rise in MELD/PELD score, and lead to transplant.

Do you have ascites? How

about portal systemic encephalopathy?

These things will affect far more when you get a liver transplant than just the

condition of your liver

in most cases. But this is not true for cases of fulminant hepatic failure.

Livers can fail dramatically and suddenly

but hopefully this would put you or me at the very top of the list in our

perspective regions.

Stages and grades are good for pathologists and hepatologists, but are not much

use to a cirrhosis patient.

Far far more important is whether you have compensated or decompensate liver

disease.

Remember, decompensation is when ascites, edema, bleeding varicies, hepatorenal

syndrome,severe hepatopulmonary syndrome, significant encephalopathy or

liver failure occur.

I hope this rambling helped. I am not a doctor, and this is all mostly my own

opinion, although much of it is gleaned

from papers by the well known in the hepatology world. Love, Bobby

long life, old age, everything good-Apache prayer

________________________________

To: livercirrhosissupport

Sent: Monday, August 17, 2009 10:52:50 PM

Subject: Different Liver Cirrhosis Stages

Probably because I am just coming out of the after effect of a dose on

interferon, some of the questions or comments lots of you have made have started

to suddenly rattle around in what's left of my brain.

In late January 2009, I was indeed diagnosed with cirrhosis which I believe must

be in early stages as my enzymes had just showed the changes. Thus, I was

accepted to this latest clinical trial. I do know that away back then, it was

suggested to me that they don't like to do transplants unless one can clear the

virus and that I would be going to an MRI near the end.

Ok, my questions, is it possible that these doctors are perhaps prepping me for

a liver transplant if the TX works?? Does anyone know how progressive your

cirrhosis has to be and does cirrhosis ever turn back???

Gloria

August 18, 2009

what symptons are in compensated?

________________________________

To: livercirrhosissupport

Sent: Tuesday, August 18, 2009 4:56:44 AM

Subject: Re: Different Liver Cirrhosis Stages

Dear Gloria , I would like to try to take a

stab at answering your question. In many

cases with hepC, the liver docs have to take a chance

with a transplant first-treatment second.

The drugs you are taking are like chemo, toxic

sommewhere on the same level as alcohol to the liver.

Even a Mcs breakfast can be nearly equal to a few beers or

a few belts of booze in the toxic department, but we must always

weigh the risks with the benefits. The liver is indeed an amazing

gland/organ and it's ability to regenerate and heal is amazing.

With Cirrhosis, to my understanding there is really no way to

tell how far advanced it is, and this is not much use clinically anyway.

Far more important is how it affects all the organ systems and if it is either

well compensated, or decompensated.

Portal hypertension can occur with even a mild case of full blown cirrhosis, on

the other hand

even a severely damaged liver might hold its own, and the portal hypertension

not cause too many problems .

Think of it like this- you may have cirrhosis, but that itself is not as

significant

as this question " how severe is your portal hypertension? Many pediatric liver

transplants

are done each year by living donor because

out of control portal hypertension affects bleeding varicies more than it causes

ascites in some kids. Ascites and lab related decompensation

Will usually cause a meteoric rise in MELD/PELD score, and lead to transplant.

Do you have ascites? How

about portal systemic encephalopathy?

These things will affect far more when you get a liver transplant than just the

condition of your liver

in most cases. But this is not true for cases of fulminant hepatic failure.

Livers can fail dramatically and suddenly

but hopefully this would put you or me at the very top of the list in our

perspective regions.

Stages and grades are good for pathologists and hepatologists, but are not much

use to a cirrhosis patient.

Far far more important is whether you have compensated or decompensate liver

disease.

Remember, decompensation is when ascites, edema, bleeding varicies, hepatorenal

syndrome,severe hepatopulmonary syndrome, significant encephalopathy or

liver failure occur.

I hope this rambling helped. I am not a doctor, and this is all mostly my own

opinion, although much of it is gleaned

from papers by the well known in the hepatology world. Love, Bobby

long life, old age, everything good-Apache prayer

____________ _________ _________ __

From: Gloria <gadamscanyahoo (DOT) ca>

To: livercirrhosissuppo rtyahoogroups (DOT) com

Sent: Monday, August 17, 2009 10:52:50 PM

Subject: Different Liver Cirrhosis Stages

Probably because I am just coming out of the after effect of a dose on

interferon, some of the questions or comments lots of you have made have started

to suddenly rattle around in what's left of my brain.

In late January 2009, I was indeed diagnosed with cirrhosis which I believe must

be in early stages as my enzymes had just showed the changes. Thus, I was

accepted to this latest clinical trial. I do know that away back then, it was

suggested to me that they don't like to do transplants unless one can clear the

virus and that I would be going to an MRI near the end.

Ok, my questions, is it possible that these doctors are perhaps prepping me for

a liver transplant if the TX works?? Does anyone know how progressive your

cirrhosis has to be and does cirrhosis ever turn back???

Gloria

August 18, 2009

Bobby - since my kidney function is going down, about 30% at present, that

would mean then that I would be considered decompensated since other organs

are getting involved? Jan H

On Tue, Aug 18, 2009 at 5:56 AM, Bob Aragon wrote:

> Dear Gloria , I would like to try to take a

> stab at answering your question. In many

> cases with hepC, the liver docs have to take a chance

> with a transplant first-treatment second.

> The drugs you are taking are like chemo, toxic

> sommewhere on the same level as alcohol to the liver.

> Even a Mcs breakfast can be nearly equal to a few beers or

> a few belts of booze in the toxic department, but we must always

> weigh the risks with the benefits. The liver is indeed an amazing

> gland/organ and it's ability to regenerate and heal is amazing.

>

> With Cirrhosis, to my understanding there is really no way to

> tell how far advanced it is, and this is not much use clinically anyway.

> Far more important is how it affects all the organ systems and if it is

> either well compensated, or decompensated.

> Portal hypertension can occur with even a mild case of full blown

> cirrhosis, on the other hand

> even a severely damaged liver might hold its own, and the portal

> hypertension

> not cause too many problems .

> Think of it like this- you may have cirrhosis, but that itself is not as

> significant

> as this question " how severe is your portal hypertension? Many pediatric

> liver transplants

> are done each year by living donor because

> out of control portal hypertension affects bleeding varicies more than it

> causes

> ascites in some kids. Ascites and lab related decompensation

> Will usually cause a meteoric rise in MELD/PELD score, and lead to

> transplant.

> Do you have ascites? How

> about portal systemic encephalopathy?

> These things will affect far more when you get a liver transplant than just

> the condition of your liver

> in most cases. But this is not true for cases of fulminant hepatic failure.

> Livers can fail dramatically and suddenly

> but hopefully this would put you or me at the very top of the list in our

> perspective regions.

> Stages and grades are good for pathologists and hepatologists, but are not

> much use to a cirrhosis patient.

> Far far more important is whether you have compensated or decompensate

> liver disease.

> Remember, decompensation is when ascites, edema, bleeding varicies,

> hepatorenal syndrome,severe hepatopulmonary syndrome, significant

> encephalopathy or

> liver failure occur.

> I hope this rambling helped. I am not a doctor, and this is all mostly my

> own opinion, although much of it is gleaned

> from papers by the well known in the hepatology world. Love, Bobby

>

> long life, old age, everything good-Apache prayer

>

> ________________________________

>

> To: livercirrhosissupport

> Sent: Monday, August 17, 2009 10:52:50 PM

> Subject: Different Liver Cirrhosis Stages

>

> Probably because I am just coming out of the after effect of a dose on

> interferon, some of the questions or comments lots of you have made have

> started to suddenly rattle around in what's left of my brain.

>

> In late January 2009, I was indeed diagnosed with cirrhosis which I believe

> must be in early stages as my enzymes had just showed the changes. Thus, I

> was accepted to this latest clinical trial. I do know that away back then,

> it was suggested to me that they don't like to do transplants unless one can

> clear the virus and that I would be going to an MRI near the end.

>

> Ok, my questions, is it possible that these doctors are perhaps prepping me

> for a liver transplant if the TX works?? Does anyone know how progressive

> your cirrhosis has to be and does cirrhosis ever turn back???

>

> Gloria

>

August 18, 2009

I just discovered a site called Answer something or other. Supposed to have

28 doctors on call to answer questions. I decided I would check it out.

First had to register so now I suppose I will get lots of spam. Then I had

to choose the area of specialty. I chose gastro. I asked " What is stage

four cirrhosis " or something like that. Next window introduced me to the

doctor who had received my question. Supposedly my question fell under his

specialty. He was a sports medicine doctor among other things. A pop up

asked how much I would be willing to pay if I was satisfied with his

answer. Three choices were given. The middle one was about $40.00. I

figured I could get and have gotten better answers here for no money, so

tried to back out of the site. It fought me until I told it to close about

4 or more times. Thought I would warn everybody away from it. Jan H

> Bobby - since my kidney function is going down, about 30% at present, that

> would mean then that I would be considered decompensated since other organs

> are getting involved? Jan H

>

> On Tue, Aug 18, 2009 at 5:56 AM, Bob Aragon wrote:

>

>> Dear Gloria , I would like to try to take a

>> stab at answering your question. In many

>> cases with hepC, the liver docs have to take a chance

>> with a transplant first-treatment second.

>> The drugs you are taking are like chemo, toxic

>> sommewhere on the same level as alcohol to the liver.

>> Even a Mcs breakfast can be nearly equal to a few beers or

>> a few belts of booze in the toxic department, but we must always

>> weigh the risks with the benefits. The liver is indeed an amazing

>> gland/organ and it's ability to regenerate and heal is amazing.

>>

>> With Cirrhosis, to my understanding there is really no way to

>> tell how far advanced it is, and this is not much use clinically anyway.

>> Far more important is how it affects all the organ systems and if it is

>> either well compensated, or decompensated.

>> Portal hypertension can occur with even a mild case of full blown

>> cirrhosis, on the other hand

>> even a severely damaged liver might hold its own, and the portal

>> hypertension

>> not cause too many problems .

>> Think of it like this- you may have cirrhosis, but that itself is not as

>> significant

>> as this question " how severe is your portal hypertension? Many pediatric

>> liver transplants

>> are done each year by living donor because

>> out of control portal hypertension affects bleeding varicies more than it

>> causes

>> ascites in some kids. Ascites and lab related decompensation

>> Will usually cause a meteoric rise in MELD/PELD score, and lead to

>> transplant.

>> Do you have ascites? How

>> about portal systemic encephalopathy?

>> These things will affect far more when you get a liver transplant than

>> just the condition of your liver

>> in most cases. But this is not true for cases of fulminant hepatic

>> failure. Livers can fail dramatically and suddenly

>> but hopefully this would put you or me at the very top of the list in our

>> perspective regions.

>> Stages and grades are good for pathologists and hepatologists, but are not

>> much use to a cirrhosis patient.

>> Far far more important is whether you have compensated or decompensate

>> liver disease.

>> Remember, decompensation is when ascites, edema, bleeding varicies,

>> hepatorenal syndrome,severe hepatopulmonary syndrome, significant

>> encephalopathy or

>> liver failure occur.

>> I hope this rambling helped. I am not a doctor, and this is all mostly my

>> own opinion, although much of it is gleaned

>> from papers by the well known in the hepatology world. Love, Bobby

>>

>> long life, old age, everything good-Apache prayer

>>

>> ________________________________

>>

>> To: livercirrhosissupport

>> Sent: Monday, August 17, 2009 10:52:50 PM

>> Subject: Different Liver Cirrhosis Stages

>>

>> Probably because I am just coming out of the after effect of a dose on

>> interferon, some of the questions or comments lots of you have made have

>> started to suddenly rattle around in what's left of my brain.

>>

>> In late January 2009, I was indeed diagnosed with cirrhosis which I

>> believe must be in early stages as my enzymes had just showed the changes.

>> Thus, I was accepted to this latest clinical trial. I do know that away

>> back then, it was suggested to me that they don't like to do transplants

>> unless one can clear the virus and that I would be going to an MRI near the

>> end.

>>

>> Ok, my questions, is it possible that these doctors are perhaps prepping

>> me for a liver transplant if the TX works?? Does anyone know how

>> progressive your cirrhosis has to be and does cirrhosis ever turn back???

>>

>> Gloria

>>

August 18, 2009

Hi everyone..thank you all very much for your replies and encouragement..my

endoscope was good with several small varices that did not need banding..will

know results of MRI in several days..you all hang in there and I will try my

best to do the same..depression comes at me from my mothers side I suppose, but

is worsened by my disease..just got back from the city, and a bit fatigued, so

will post more later on..again I thank you, and I am sorry if I awoke any

sleeping giants. peace, Dave

________________________________

To: livercirrhosissupport

Sent: Tuesday, August 18, 2009 11:44:22 AM