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[Guest guest]

Hi Everyone,

I just finished reading all the messages I missed while I was away this

past week. Looks like it's been a busy week for many of you. There are a

couple of questions that I read that perhaps I can provide some info on.

Superficial veins we develope all over our bodies are called

Telangectsias. They are the result (as are varices) of increased

pressure in our veinous systems. As our liver disease worsens, they

start to become noticable. Most of them resolve after tx. A special form

of these veins are seen on the abdomen, usually the upper abdomen and

around the sides. They can be very striking. They are called Caput

Medusa because they look like the head of Medusa, with all her snakes.

Again, these are a sign of severe liver disease. Petechiae are fine red

spots on the skin (fine bleeding into the skin) and are due to low

platelets which is a whole 'nother thing.

Sexual disfunction in males is well known in advanced liver disease. The

liver is important in the conversion of androgens to testosterone. This

is decreased in severe liver disease. The testes shrink in size and

fertility can become limited. More limiting is the decrease in sexual

desire (due to a combination of low testosterone and limited energy).

This usually resolves after tx. However, some men continue to have

sexual disfunction afterwards for a number of reasons, some emotional,

some physical. There have been a number of successful pregnancies post

tx despite the concern about the effects of immunosuppressants on the

developing fetus. Female liver tx patients have had successful

pregnancies. We must bear in mind though that not all pregnancies have

been normal. Fetal abnormalities have been seen, some very severe.

Insomnia is commonly associated with liver disease with or without

pruritus (itching). It is common to have either problems falling asleep

or remaing asleep. This despite chronic fatigue. Of course this makes

life just that much more difficult for PSC patients/sufferers.

Cholestyramine resin (Questran) is great for itching, if you can

tolerate it's taste and affects. I found taking it with a strong

flavoured fruit juice to be the most tolerable way of " enjoying " it.

Grapefruit juice was my favourite. [it's a good thing I enjoyed the

grapefruit juice then, because now I can't have it because of the Neoral

(Cyclosporine) I'm taking.] As far as I know Questran is not OTC (over

the counter, no need for a prescription).

The two new antiviral agents (Relenza and Tamiflu) have to be started

within 48 hours of developing symptoms to be at effective in reducing

the number of days of having flu symptoms (from 7 to 5.5). They are both

very expensive and of limited effect if you compare not taking them

while taking OTC medications for symptoms (Tylenol, ASA or other pain

relievers, anticongestants). Makers of these products would have you

believe that they are a God send. In truth, studies showed that in North

America, Relenza had no efficacy (2 out of 3 studies showed no

efficacy!), because people also took OTC meds which limit symptoms.

There may be some hope for Tamiflu because it works body wide (it is a

pill), while Relenza mainly works on the lung symptoms (it is an inhaled

product). I'm not sure if they are safe for patients with liver disease.

Most likely, from knowing how they work, I'm sure there are potential

problems. Most antivirals can potentially damage the liver.

Aubrey