laura

[Guest guest]

Welcome to the group. I'm going to give you

information that may help you understand more about

what your mother is experiencing and why.

When the liver cells becomes damaged, through any number

of different causes, the immune system of the body responds

to this damage and causes inflammation to develop inside

the liver. The inflammation causes the liver to enlarge

in size (this can be seen on an ultrasound or Ct test done)

If the inflammation is not treated and if the cause cannot

be removed, it can progress to where the damaged cells

start to die off. When the cells of the liver die off,

it forms scar tissue inside the liver that blocks the

flow of blood going through the liver on its way back

to the heart and also can block the flow of blood to the

other liver cells, so they may continue to die off.

This is known as Cirrhosis of the liver.

Many people acquire a virus, known as Hepatitis C,

from having a blood transfusion...because in earlier

years, they did not test blood that was given by people

for this virus. A virus, like this, goes into the body

and to the liver cells and uses those cells to replicate

itself. Once it uses one cells, the cell dies off, and

it proceeds to the other cells to use them.

Now that you understand a little about the disease itself,

I'm going to tell you what symptoms can occur with your

mother and what can be done for her.

The liver cells are what does the functions of the liver.

It does over 500 of them. When the cells become damaged,

they cannot do the functions needed efficiently. When

they die off, they cannot do any of them at all.

Your mom may have yellow skin and the whites of her eyes

are yellow. Her urine may appear darker in color from

a darker yellow to almost brownish black. Her stools may

be whitish in color and may float on top of the water.

This is because the liver isn't able to convert a

substance (that is made from our dead red blood cells)

known as Bilirubin, into a soluble form to flow with the

bile (the liver makes) and it stays in the blood.

Bilirubin is a brownish/greenish/yellowish color and it

colors other things. So it goes into the blood and

causes coloring to the skin, eye, etc. The doctor could

start her on a drug known as Ursodiol to help the bile

flow better...but, she will still have this coloring.

You may notice that she develops spider like looking

veins on her chest, neck, shoulder areas..or other parts

of her body. As long as these are not scratched open...

they are just another symptom of the disease.

Patients with Cirrhosis tend to bleed and bruise very

easily because the liver can no longer make certain

clotting factors to help the blood to clot.

Fluid may build up in the legs and feet. This is

because People with cirrhosis tend to hold onto sodium

inside the body and sodium holds onto fluids.

Elevating the legs are good to do, but do not massage

them. The doctor may start her on a lower sodium diet

and give her diuretics to help this. However, the

doctor should tell you how much sodium she is allowed

to have per day and also how much fluids. He needs

to take blood tests on her often during this time to

be sure that the level of sodium is okay..since it

has to do with how the heart beats in rhythm.

Fluid can build up in her abdomen...this is known as

Ascites. This is because the liver can no longer

make a protein efficiently, known as Albumin.

Albumin is what holds fluid inside our vessels and

it now leaks out and collect in the abdominal area.

The doctor can remove this fluid by a procedure known

as paracentesis. It will help give her relief from

the fluid pressing on the stomach and up against the

lung area making it difficult to breathe.

She may start to become easily confused and disoriented.

The times she can sleep may change also and she may

develop tremors of the hand. This is because of

toxins building up in the body that the liver used

to handle and no longer can do. Some of these toxins

can go into the brain and cause this. It is very

important for her to be started on medication to

remove one of the toxins, known as Ammonia, from the

body...without treatment she may go into a coma.

They use Lactulose medications for this.

When the liver cells die off, the liver starts to

shrink in size and take on a hard texture. It is

slowly dying. The blood can no longer flow well

through the liver and eventually will not be able

to do that at all. This blood will back up into

the Portal vein that normally the blood flows

through to go to the liver and cause a build up of

pressure there, known as Portal Hypertension.

It also causes the blood to back up into smaller

blood vessels, known as varies. These varies can

have weak spots and balloon outward and break open

and bleed. This is then an emergency. ( Remember

above where I stated that the blood doesn't clot

and the patient can bruise or bleed very easily.)

A patient may lose blood by bleeding internally or

bleed out completely. Any blood in vomit or from

the rectal area is a definite emergency and they

should be taken to the Emergency room right away.

The doctors can go in and band these varies to stop

the bleeding.

These are some of the main symptoms of this disease.

I hope this has been of some help to you.

Here are a few sites that will help you learn more

about this disease and be able to help your mother.

Your mother should have an advance directive or power

of attorney form signed by her to appoint someone in

your family to have the right to speak for her when

she is not able to do so and also have the right to

talk and make decisions about her care, because

eventually she will not be able to handle anything on

her own. I will give you a link to a site about that

also.

Here are some on Cirrhosis:

http://www.hcvets.com/data/hcv_liver/cirrhosis.htm

http://www.medicinenet.com/cirrhosis/article.htm

http://www.mayoclinic.com/health/cirrhosis/DS00373

http://yourtotalhealth.ivillage.com/cirrhosis.html

Here is a couple on Liver Transplantation:

http://www.surgery.usc.edu/divisions/hep/patientguide/index.html

http://www.transplantliving.org/

Here is one on advanced directive:

http://www.caringinfo.org/stateaddownload

You just have to click on these links to go to them.