Cirrosis and platelets

Digestive health
1

i was diagnosed with cirrosis in 1997, had all the tests for it. In 2000 I was still drinking on and off re addiction and so had an heamorrhage, violently vomitting blood. I am still on propanol for portal hypertension along with spironolactone, folic acid.

i had/got   ascites,  I still have endoscopes for varices each year.

apart from all the ill health cirrosis has given me over the years, the surgeons will not risk any surgery on me, because of a low platelet count of 28 (I'm a 60 yr female) they say I could bleed to death with surgery. I have, what was a very painful incisional hernia, though it looks unsightly, they will not repair it. So now I have this bulge at stomach site, I've no idea if any acitices is still present.

main reason for this post is that I'm wondering if their platelet count has been severely affected like mine, through liver disease.

2

 In answer to your last line, yes.

I had a bleed on the brain (cerebral haemorrhage) 18 months ago and sometime when I was in hospital for that, I went jaundiced and they then realised they were dealing with two problems, the stroke and liver failure.

I have esophegeal varices (portal hypertension) take spironolactone and I had an endoscopy whilst in hospital. i also had/have ascites and had 10 litres drained at the hospital.

No one ever told me what was happening, which is why after two months I said discharge me or I will discharge myself, but either way, I'm leaving on Thursday. i only found out they had detoxed me in hospital three months later, when the neuro consultant put it in his report, for got to send a copy to my GP, so I sent him a letter to remind him and asked him to send me a copy as well.

So most of what I know, is through my own hard work and a lot of internet research against the nine prescription meds I take. Medical staff tend to let on a bit more now, because I can talk with some authority and they seem to take the view that somebody else has already explained it to me, so they can talk about it.

I haven't yet gone down the research of platelets, but a damaged liver does effect the production of protein, which leads to clotting and coagulation. If i cut a cut, it bleeds profusely and it is very hard to stop it. i can turn a face cloth red in about two minutes using it to stem the blood and plasters are useless.

So yes, I can understand them not wanting to operate, however inconvenient that may be to you. One I first went in for my stroke, they gave me a plasma tranfusion to stablise me, as they wanted to transfer me to a specialist hospital. But they would not risk the 10 mile journey in an ambulance until the plasma had arrived and I'd been given a transfusion under GA.

The ascites they should still be able to check, and if required, drain that. You will have to get your GP (I'm not sure where you're located, so I am referring to the British system) to refer you to the hospital gastroenterologist/hepatologist. Although a quick check to see if you have swollen ankles, feet or legs around the sock line, is an indicator.

 

3

Thanks for sharing your story RHGB.

i am in UK. Originally diagnosed in Kings College Hospital, London.

i still see a liver Professor once a year. I did once ask him about draining fluid (pre hernia) he said no. Apparently one colleague of his said, in a private meeting before seeing me re hernia surgery, 'don't touch it with a barge pole) !

iv spend lot time researching liver disease in order to understand this often complex condition and ask medical staff  informed questions, as they do not discuss our condition with us.

Your bleed on brain you had sounds very serious. I used to get nose bleeds, still get spontaneous gum bleeds in night etc.

your profuse bleeds re soaked face cloth sounds horrific.

i take vitamin K.  I Juice,  kale, spinach watercress & root beetroot as liver tonic. Think milk thistle is a bit to subtle.

when you have a blood test for liver function etc, ask what your platelet number is. I usually as for a copy of results.

Alcohol is such a destructive and dangerous drug, I wish I'd known what I was letting myself open to. I was 100% healthy before I was married with all its problems.

thanks again and best wishes

4

I mentioned the bleed on the brain, because 9/10 strokes are TIA/clots, whereas mine was due to unchecked hypertension (I had been taking BP tablets on an off for many years, but more off than on) and this was partly caused by my drinking and basically an artery gives way and bursts. Again, you can see alcohol played its part.

For my problems I take, lactulose, carvedilol, thiamine, amlolipine, spironolactone, vitamin B compund strong, omeprazole (I would imagine you are on that) folic acid and now Campral to keep me away from alcohol.

I had a basic blood test two weeks ago, I will ask the doctor is they checked platelets.

5

I was aware that bleeds on brain and strokes re blood clots are often connected. I halved my BP pills which doctors said ok. Was on 4 daily which was causing psoriasis.. As I said, I had the burst artery, or vein re varices I had and are still being monitored. I'v never had any meditation to take desire to drink again away, I don't know why, looking back, I could seriously done with it. The desire to drink is still there, but very much less so, it's been a struggle over the years, now it's fairly easy to resist. I do drink red wine and cider 100% alcohol free, for a change of spring water. This alcohol free wine etc does my BS levels no good. The liver caused my insulin problems, hence I'm diabetic now as well.

never heard of some of your medications. Years ago I was taken of lansoprazole, proton pump inhibitor, I should think your omeprazole is much the same. I take various vitamins, especially as I have vegan diet. I thought propanol was THE ongoing treatment for cirrosis.

i always ask for the BT results red blood cell, white cells etc. Though as layperson I usually have to google non obvious medical terminology 

6

Sorry if I misled you, bleed on the brain strokes and clot strokes are almost opposite. One you get a blockage, the other is like a constant rapids going through your artery, until the 'banks, finally burst'.

I saw the bit about haemorrhage but I thought you were referring to the internal varices, not to do with the brain, but your liver and portal hypertension. Yes, my omeprazole would do the same as your lansoprazole, although I'm surprised that they have taken you off of it. Especially as you are seen annually and I am not.

I think my cardevilol is 'my' instead of propandolol as they're both put in the same category by the NHS, as beta blockers.

What they don't tell you, is that most alcohol contains a lot of sugar and that quite often. heavy drinkers/alcoholics will switch to sugar based stuff (e.g. sweets) believing that that is okay, because at least they're keeping off the alcohol.

Six months after I left hospital, I asked about diabetes at my Gp's surgery and was told my tests did even show me in the pre-diabeteic stage. Another six months later, I was told I was one point into the pre-diabetic stage, basically verging on the non/pre. So I had to cut out virtually ll sugar, to bring it back down. I wish I'd been warned about that.

I wouldn't imagine that they would relish the thought of conducting surgery on me (My GP tells me I'm in their top 2% of at risk patients and I started getting offered free flu jabs at the age of 48, I think it is normally 65). When I was in hospital (for nearly two months) I thanked one of the consultants (I saw so many, some were for my liver some were for my stroke), he was a professor, and I saw him the most and he was quite good to me - got my catheter removed and stopped the nurses giving my any more enemas after the first time.

Anyway, after I had thanked him he said, (he was Nigerian, so put your best accent on for this), no, thank you Mr.RHGB. After I shot him a quizzical look, I said what for, I haven't done anything? Mr.RHGB, I am not a betteing man, but if I were and some had offered me good odds on your survival, I would not have taken the bet.

7

Thanks for explaining and please don't be sorry, it's me not being properly informed, as of course one has to get to understand their own illness, so tend to miss all aspects of liver disease (word cirrosis sounds more final).

you have certainly been through it. In 2012, I got an ovarian cyst, I chose to 'wait and see' approach, but it grew with every CT I had, I was forced to agree to surgery. The doctors gave me 2 out of 5 chance of survival, but did it because they thought it was malignant..turned out to be borderline, sorry straying of the page. I am down as high risk to.

yes there are alternatives to the beta blocker I have. I used to have more

prescribed drugs, one of which made me spaced out..glad doctor stopped that. Apart from our respective professors. I think a lot of the text book general doctors are responsible for a huge amount of deaths. Read Dr V Coleman's book, Don't let your doctor kill you..fascinating. Well alcohol is generally known to contain a lot of sugar. Good you avoided Type 2, no fun being I tablets and insulin. Have to inject my pet to, he has D.

though I got BP in the portal vein, my general BP is ok / on low side!

i was never warned either, they say diabetes can course liver disease..so both ways.

makes me smile, your Nigerian professor when I picture the scene.

oh well, my philosophy is you got to die some time, I'm not afraid, but it's what can lead up to it.

could never understand, footballer, George Best, throwing a precious gift of a 2nd chance away.

8

"makes me smile, your Nigerian professor when I picture the scene."

It was surreal, although I was compos mentis, I was still in a bit of post stroke delerium and probably still taking a fair amount of medication.

He meant it in a nice way, it was his way of saying I was lucky and he was glad, in a round a bout way.  I won't forget his name, Chuka Nwokolo, he comes up first hit in Google at Coventry Uni Hospital.

When I was at the rehab (stroke) hospital a year later, I saw the neuro surgeon and I mentioned the story to him, and he said, oh yes, that's Chooky, he would say something like that - a lot of the neuro consultants at the stroke hospital, work at Coventry as well, so they've often seen you at Coventry (as a consultant) before you get to the stroke hospital, for rehab.

As for Vernon Coleman's book, I think I've read snippets of it before and meant to read it. Amazon had some s/h books in, listed as very good condition (not much sign of previously being read) for a penny plus £2.80 postage, so I ordered one. I enjoy reading and devour information.

As for George Best, have you never heard the fable, The scorpion and the frog?

9

Chuka/Chooky sounds lovely and also an accomplished man in his field. In Streatham, Sth London, where I lived till 8yrs ago, is a favourite mp of mine....named Chuka Umunna, he's Nigerian to.

i remember a time when in KCH a certain nurse, not at all friendly or kindly, but one morning when I was feeling very low, she gave me an encouraging 

talk on valuing myself and how to proceed when out of hospital, it was surprising coming from her, but touched me deeply.

yes I got a spare copy of that Vernon Colenan book and another of his Food for thought, more or less free, just the postage. Big fan of Amazon.

you can see all his books listed on his website.

unusual for me, but not heard of the fable you mentioned, mayb it's in my copy of Aesop's Fables or I'll read it via Google